WHEN the Union Ministry of Health released the National Family Health Survey (NFHS)-6 fact sheets only in May 2026, based on data collected during 2023-24, the godi media headlines celebrated gains in child nutrition and maternal care. But public health experts soon asked: where had the data gone? Compared to NFHS-5 (2019-21), which had 131 key indicators, the latest fact sheet contains only 101. Omitted are some of India's most sensitive progress measures: anaemia prevalence, infant and under‑five mortality, neonatal mortality, fertility and population indicators, sex ratio at birth, access to clean cooking fuel, sanitation coverage, HIV awareness and cancer screening. The survey has been stripped down, omitting those indicators where the government’s performance was weakest.  Critics argue that it is not a technical adjustment. It is a concerted effort to shield high-profile schemes from scrutiny and emphasise gains while downplaying persistent poverty, child malnutrition and women's health failures. After public criticism, the government claimed the fact sheet is "not final" - an admission acknowledging omissions. What does this survey mean, as distinct from what earlier surveys meant? Does it seek to hide what we as a nation have failed to deliver from the policies carried out as market reforms: health for our people, particularly the most vulnerable - who form the majority of our population - women, children and the poor? And for those who are socially discriminated, the handicaps are even bigger. A question that arises is: who has gained from these policies? The answer is the private hospitals and the healthcare industry.

MISSING DATA AND SELECTIVE DISCLOSURES

The official defence for the missing indicators is that they are tracked elsewhere: mortality by the Sample Registration System and anaemia by a specialised diet survey. On the surface, this sounds reasonable. Yet NFHS's unique value has always been its linkage of numbers to socio‑economic, geographic and demographic characteristics across multiple rounds, allowing trend analysis. Fragmenting indicators across databases breaks the time series researchers rely on and makes independent cross‑validation nearly impossible. A health survey is an accountability instrument; removing metrics that expose policy failure turns it into a publicity tool. The pattern of omissions tells its own story. Consider the Pradhan Mantri Ujjwala Yojana (PMUY), launched in 2016 to provide LPG connections to poor women. NFHS-5 showed that more than 40 per cent of households in rural areas still lacked access to a clean cooking fuel, and over half relied on firewood and dung. Now the clean cooking fuel indicator has vanished from NFHS-6. Or Swachh Bharat Mission. The government declared India "open defecation free" in 2019 after building over 100 million toilets. Yet NFHS-5 found that 19 per cent of households had no access to any toilet facility. The new survey dropped the sanitation indicator!

Most dramatically, all seven anaemia indicators have disappeared. This follows NFHS-5, revealing a worsening crisis: anaemia among children under five rose from 58.6 per cent to 67.1 per cent, and among women aged 15--49 to 57 per cent, casting doubt on the Anaemia Mukt Bharat programme. Today, the survey tracks inputs (iron-folic acid tablets) but no longer tracks outcomes. Also missing is the sex ratio at birth -- a long-standing reflection of gender discrimination. The latest SRS report puts it at 918 girls per 1,000 boys, far from parity. These omissions did not occur in a vacuum. In 2023, while NFHS‑6 fieldwork was underway, the government suspended K.S. James, director of the International Institute for Population Sciences (IIPS), which conducts the NFHS. The official reason cited "irregularities in recruitment". But the reality was that James had been asked to resign because the government was unhappy with certain IIPS data -- including anaemia, sanitation and clean fuel figures that contradicted official claims. James refused, and the suspension followed. After public criticism, the government revoked the suspension -- but accepted James's resignation the same day. When the man in charge of India's most important health survey is forced out for inconvenient findings, the message to researchers is clear.

DISTORTED HEALTH PRIORITIES, RISE OF PRIVATE HEALTHCARE

NFHS-6 has not simply removed indicators; it has added 13 new ones, including on ageing, financial inclusion and antenatal care. It reveals troubling trends in non‑communicable diseases (NCDs). Obesity has risen sharply: nearly 31 per cent of women and 27.3 per cent of men are now obese -- increases of 6.7 and 4.4 percentage points. High blood sugar is found in 17.8 per cent of women and 20.9 per cent of men, and hypertension in 19.4 per cent and 22.1 per cent respectively. This focus on lifestyle diseases is important -- India accounts for over half of all NCD deaths in Southeast Asia. But shifting the policy lens towards obesity comes at the cost of diminishing attention to undernutrition, which has not disappeared. Among children under five, stunting stands at 29.3 per cent, underweight at 31.8 per cent (essentially unchanged), wasting at 19.0 per cent, and severe wasting at 5.2 per cent. Only 15.3 per cent of children aged 6--23 months receive an adequate diet. Exclusive breastfeeding has fallen from 63.7 per cent to 55.8 per cent. Roughly one in five Indian men and women remains underweight. Experts call this "epidemiological polarisation", where health outcomes in a population become increasingly divided between groups. It widens the gap in disease, life expectancy, and access to healthcare. Removing anaemia data while adding obesity figures gives only a partial health narrative, sidelining basic nutrition failures.

Another driver of the Modi government's health strategy is funnelling people through insurance into private care. Health insurance coverage has jumped from 41 per cent to 60.2 per cent, driven largely by Ayushman Bharat PM-JAY - yet about 40 per cent of households still have no coverage. One visible consequence is the steady rise of Caesarean sections: nationally, C-sections have jumped to 27.2 per cent of all births. That is 27.2 per cent - more than one in four births - well above the WHO benchmark of 10 – 15 per cent. Let me repeat: 27.2 per cent C‑sections, more than double the global medical norm. And in the private sector alone, it is 54.1 per cent - five times the WHO floor. The private sector is the main driver: 54.1 per cent of births in private facilities are by C-section, compared to 16.9 per cent in public facilities - over‑medicalisation for profit. Meanwhile, total institutional births rose to 90.6 per cent, but the share in public facilities fell from 61.9 per cent to 58.6 per cent - growth captured by the private sector. The survey has removed data on out-of-pocket expenditure for individual deliveries, obscuring the true financial burden on families.

The gendered burden remains. Female sterilisation stands at 36.5 per cent while male sterilisation is only 0.5 per cent - a 70 to 1 gap unchanged for decades. Modern contraceptive use has declined from 56.4 per cent to 52.7 per cent, while traditional methods have risen - a possible sign of weakening public family‑planning supply. Child marriage remains stuck: 20.1 per cent of women aged 20–24 were married before 18. Spousal violence still affects about one in four ever‑married women. Urban‑rural and equity divides persist. Internet use among women is 77.3 per cent in urban areas versus 58.6 per cent in rural areas. Hygienic menstrual protection is 90.7 per cent in the urban population, and only 75.0 per cent in the rural population.

DATA AS POLITICAL PROPAGANDA

The NFHS-6 fact sheets were reportedly ready for nearly a year before release, despite being done on a digital platform designed for real‑time error detection. Questions in Parliament about the delay went unanswered. The timing of the eventual release - after the 2024 general elections and important state elections in April 2026 - raises further questions about political sensitivity. Such delays, together with the omission of key indicators, suggest an attempt to avoid public scrutiny before the elections. Public health problems do not disappear when the data disappears -- only the ability to hold systems accountable does. Without NFHS data, how will policymakers know whether anaemia is falling? Whether Ujjwala has finally reached the poorest? Has India truly become open defecation-free?

For decades, NFHS has answered these questions. Its strength has been continuity -- allowing India to track progress, identify failures and adjust course. By breaking that continuity -- delaying release, omitting politically sensitive indicators, fragmenting data across surveys and sidelining the survey's own director -- the government has removed the very tools by which citizens and researchers can independently assess whether policies deliver results. That is not data harmonisation. That is data as propaganda -- making the inconvenient simply invisible. And it is how authoritarianism operates: by controlling the data so that only the official narrative survives.

(I acknowledge Prabir Purkayastha for his help in writing this article)