GenderStats 3: Institutional Births

12 November 2021 | Gender, Healthcare, NFHS

Ankur Bhardwaj

Ankur Bhardwaj

Editor, Centre for Economic Data and Analysis

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Institutional birth is when a baby is delivered in a medical institution under the supervision of trained health personnel. According to NFHS-3 (2005-06), only 38.7 percent of all deliveries in the country were institutional deliveries. This figure more than doubled over the next decade to 78.9 percent in NFHS-4 (2015-16). Institutional deliveries highlight the robustness of a country’s healthcare system. It shows the availability of competent medical help to the mother and child.

The increase in institutional births in India from 38.7 in NFHS-3 to 78.9 percent in NFHS-4 shows a remarkable improvement in healthcare facilities for pregnant women in the country. We also have data for some states from NFHS-5 even though pan-India numbers have not been released yet. But how have states performed when it comes to institutional births in the country?

The graphs above show the total percentage of institutional births across states and Union Territories in NFHS-3 and NFHS-4. NFHS-5 data has been released only for some states and Union Territories. To check the percentage of institutional births in a state or UT, hover over the state to find the score.

According to NFHS-4, 99.9 percent of all births in Kerala were institutional births. This was a slight improvement over 99.3 percent institutional births in the state in NFHS-3. This improved to 99.8 percent institutional births in NFHS-5. Other than Kerala, only Puducherry (99.9 percent) and Lakshadweep (99.3 percent) had more than 99 percent institutional births, according to NFHS-4. In NFHS-5, Lakshadweep has improved this to 99.9 percent while data for Puducherry has not been released yet.

Nagaland had the lowest rate of institutional births in the country in NFHS-3 at 11.3 percent. This improved to 32.8 percent in NFHS-4 and to 45.7 percent in NFHS-5. Chhattisgarh recorded only 14.3 percent institutional births in NFHS-3 which improved to 70.2 percent in NFHS-4. NFHS-5 data for the state has not been released yet. Similarly, Jharkhand saw the rate of institutional births improve from 18.3 percent (NFHS-3) to 61.9 percent (NFHS-4), and Bihar saw its rate rise from 19.9 percent (NFHS-3) to 63.8 percent (NFHS-4).

The top five states or UTs with highest percentage of institutional births in the country as per NFHS-4 were Kerala (99.9 percent), Puducherry (99.9), Lakshadweep (99.3), Tamil Nadu (98.9), and Goa (96.9). The bottom five states with the lowest percentage of institutional births in the country were Nagaland (32.8 percent), Meghalaya (51.4), Arunachal Pradesh (52.3), Jharkhand (61.9), and Bihar (63.8 percent).

For the 22 states and UTs for which data has been released in NFHS-5, only Manipur (79.9 percent), Bihar (76.2 percent), Meghalaya (58.1 percent), and Nagaland (45.7 percent) have an institutional birth rate of less than 80 percent. Out of the 22 states and UTs, 14 saw more than 90 percent institutional births, according to NFHS-5.

“GenderStats by CEDA” is a new series by the Centre for Economic Data and Analysis on the Picture This page. With the help of graphs, we will highlight the socio-economic and health status of Indian women and help understand their position vis-à-vis Indian men and other women in the rest of the world. If you have a suggestion for us or if there is an indicator that you would like us to focus on, please write to us at


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