The latest national health survey reveals a region of sharp contrasts — Sikkim leads India in vaccination, while Meghalaya’s children go hungry, and a caesarean section crisis quietly spreads across the hills – Dr. Tiken Das
India released the report of its sixth National Family Health Survey (NFHS-6) on 29th May 2026, offering the most detailed snapshot yet of health outcomes across the country. For the eight northeastern states that could be surveyed — Manipur, locked in ethnic violence, was left out — the data tell a story of real progress shadowed by stubborn problems that have resisted both central government schemes and state-level intervention.
The broad picture is encouraging. Every state in the region reduced childhood stunting between NFHS-5 (2019-21) and NFHS-6 (2023-24). Vaccination coverage improved almost everywhere. More mothers than ever are delivering in hospitals. But look closer, and the data reveal a region where Sikkim’s healthcare achievements sit alongside Meghalaya’s nutritional crisis and where a surgical epidemic in maternity wards is quietly undoing some of the progress made elsewhere.
The Good News: Vaccines and Hospital Births
The Northeast’s clearest success story is vaccination. Assam has made a remarkable leap — full immunisation coverage among children aged 12-23 months rose from 66.7 per cent in NFHS-5 to 81.7 per cent in NFHS-6, nearly matching the national average of 82.6 per cent and outperforming Bihar (77.3 per cent). The turnaround is largely credited to Mission Indradhanush, the government’s targeted immunisation drive, which focused intensively on high-burden districts such as Dhubri and Barpeta.
Sikkim goes further still. Its 92.9 per cent vaccination rate is the best in the Northeast and beats Kerala – long considered India’s gold standard for healthcare. Institutional births in Sikkim have reached 97.7 per cent, approaching the near-universal coverage that only the southernmost states have previously achieved. These numbers matter: vaccinated children are less likely to die from preventable disease, and hospital deliveries reduce the risk of maternal and newborn death significantly.
The Bad News: Hunger That Schemes Cannot Fix
Meghalaya’s nutrition crisis is the most sobering finding in the Northeast data. Despite a near 10-percentage-point improvement in stunting since NFHS-5, the state still records 36.8 per cent of children under five as stunted — meaning they are too short for their age due to chronic undernutrition. That figure is higher than Bihar (35.6 per cent) and comes close to the worst-performing states in the country.
The problem goes beyond food supply. Government data show that fewer than one in six young children in Assam receive a diet that is diverse and frequent enough to meet their nutritional needs, despite the presence of thousands of anganwadi centres. Experts say the failure lies in turning food schemes into behavioural change — teaching families what to feed children, not just providing supplementary rations. Nationally, Kerala benchmarks the achievable: stunting at 20.1 per cent and wasting at just 10.9 per cent.
The Warning: Too Many Unnecessary C-Sections
Perhaps the most alarming trend in the NFHS-6 northeast data is one that looks, on the surface, like progress. Sikkim now delivers 51.1 per cent of all babies by caesarean section — more than three times the 10-15 per cent ceiling that the World Health Organization considers medically justifiable. In private hospitals across the region, the figure routinely exceeds 80 per cent. Assam’s overall C-section rate has risen from 18.1 per cent to 22.9 per cent in a single survey cycle.
A rising C-section rate is not a sign of better healthcare. In the absence of strict clinical oversight, it is a sign that financial incentives in private hospitals are driving surgical decisions that should be based on medical need. Governments in the northeast possess the legal authority to act, as the Clinical Establishments Act empowers states to regulate private facilities; however, enforcement has been consistently weak.
What Needs to Happen
The NFHS-6 data make three things clear for India’s northeast. First, vaccination programmes work when they are consistently funded and community-focused. The Mission Indradhanush model should be deepened, not diluted, especially in Nagaland, where coverage at 64.3 per cent still lags nearly 20 points behind the national average. Second, nutrition requires a different kind of intervention altogether: one that changes what families eat, not just what governments distribute. Third, the caesarean section surge demands regulatory teeth – clinical audits, transparent reporting, and real consequences for facilities that exceed safe thresholds.
Manipur’s absence from this survey is a reminder that health data, however valuable, only counts what it can see. The state’s children and mothers remain uncounted in NFHS-6 – a gap that must be closed the moment conditions allow.
(The author, Dr Tiken Das, is a health economist and assistant professor of economics at Nagaon University, Assam. He can be reached at tikenhyd@gmail.com).