The National Family Health Survey (NFHS–6) findings for Rajasthan have revealed an increase in the adolescent pregnancy rate, and a decline in institutional births, vaccination and health of children, prompting over 50 groups and activists to urge the state government to intervene.As per data from NFHS-6, conducted between 2023 and 2024, which was released last week, adolescent pregnancy rate among girls aged 15 to 19 has increased to 4.7 per cent from 3.7 per cent in NFHS–5, which was conducted between 2019 and 2021.The use of modern contraceptive methods has also declined from 62.1 per cent to 57.1 per cent. Although there was a slight overall improvement in using any contraceptive method from 72.3 to 74.4 per cent, this was due to an increase in traditional methods, which registered a jump from 10.2 per cent to 17.3 per cent.Read | Missing from National Family Health Survey: Key indicators linked to sex ratio, cancer screening, access to basic facilitiesInstitutional births have also registered a slight decline, from 94.9 per cent to 94.1 per cent, with deliveries in public health facilities falling from 77 per cent to 70.5 per cent. Additionally, deliveries attended by skilled health personnel have decreased from 95.6 per cent to 94.9 per cent. At the same time, the Caesarean section rate has increased from 10.4 per cent to 15.6 per cent.The situation in child health and nutrition has also indicated a worrying trend. Exclusive breastfeeding among infants below six months has declined from 70.4 per cent to 54.3 per cent. Here, Rajasthan reflects a national trend where the figure dropped from 63.7 per cent to 55.8 per cent.Read | Sharp rise in obesity, diabetes in five years since 2019, shows latest health surveyAmong children under five years of age, wasting (low weight for height) has increased from 16.8 per cent to 19.8 per cent, while the proportion of underweight children (low weight for age) has risen from 27.6 per cent to 33.3 per cent.Immunisation coverage has also witnessed a significant decline. Full immunisation coverage among children between 12 and 23 months has dropped from 85.3 per cent to 75.0 per cent.Story continues below this adWhile BCG coverage has fallen from 95.6 per cent to 92.9 per cent, coverage of all three doses of Pentavalent vaccine has declined from 89.4 per cent to 87.2 per cent, and measles vaccination coverage (first dose) has reduced from 91.1 per cent to 90.3 per cent.Read | Nearly 1 in 3 Indian children still underweight: What NFHS-6 says about childhood nutritionGroups raise concernsJan Swasthya Abhiyan (JSA), Rajasthan, a key signatory in the letter to state Health Minister Gajendra Singh Khimsar, said that this decline is concerning as it points to serious gaps in the reach and effectiveness of routine immunisation services. If not addressed urgently, it could increase the risk of vaccine-preventable diseases and outbreaks among children, JSA said.On maternal health, JSA said, “These trends raise serious concerns regarding access to and quality of maternal and reproductive health services, as well as the effectiveness of family planning programmes. They underscore the urgent need for measures to ensure equitable access to safe and quality maternal healthcare across the state.”Story continues below this adOn child health and nutrition, it said, “The long-term consequences could adversely affect children’s health, development and life opportunities.” On the immunisation process, it said that “this decline is concerning as it points to serious gaps in the reach and effectiveness of routine immunisation services. If not addressed urgently, it could increase the risk of vaccine-preventable diseases and outbreaks among children.”Also Read | For India, obesity complicates the nutrition challengeThe JSA has emphasised that many of the indicators showing deterioration “are key indicators under the National Health Mission, Poshan Abhiyaan and the Sustainable Development Goals (SDGs). Failure to take timely corrective measures could adversely impact maternal and child mortality, malnutrition levels and the burden of preventable diseases in the state”.The signatories in the letter to the Health Minister include the People’s Union for Civil Liberties (PUCL), Mazdoor Kisan Shakti Sangathan (MKSS), Indian Health Development Society, Basic Health Services (Udaipur), Jeevandhara, Jan Sambal Sansthan, and Jan Adhikar Manch, among others.In their letter to Khimsar on Tuesday, they asked the state government for a special state-level action plan for indicators that have worsened in NFHS-6 and to undertake regular district-wise reviews; revitalise adolescent health programmes and strengthen efforts to prevent child marriage and adolescent pregnancies; improve the quality and credibility of maternity services in public health facilities; fill vacant positions, and ensure the availability of essential human resources, medicines and equipment; focused campaigns on breastfeeding, newborn care and child nutrition; and increase in budget allocations for maternal and child health services.