Bibek Debroy And Sanjeev Sanyal Use This Example Of 'Question On Mosquito Nets' To Show Why NFHS Questionnaire Needs Revamp

India’s data gathering framework has drifted away from real policy issues and needs a rework, say Debroy and Sanyal, Chairman, and Member, Economic Advisory Council to the Prime Minister (EAC-PM) respectively, in an article in the Economic Times published on Monday (24 April).

Using the information published in the National Family Health Survey-5 report on ownership and use of mosquito nets by households, Debroy and Sanyal show that India’s data collection methodology is not always reflective of its development agenda.

The National Family Health Survey (NFHS) is an India-wide survey conducted by the Ministry of Health and Family Welfare in a representative sample of households.

As Debroy and Sanyal point out, some questions asked in the NFHS survey 2019-20 are somewhat ‘odd’ and are not even reflective of ground realities.

The authors take the example of India's fight and policy against mosquito-borne diseases are reflected in the NFHS questionnaire.

They identify two broad problems with the questions.

One, when it comes to mosquitoes, the questionnaire only asks about nets whereas nets are not the only methods used by people to ward off mosquitoes. They also use coils, vaporisers, mats, creams, sprays. However, the survey asks no questions about these.

As Debroy and Sanyal write: "Having acknowledged the importance of the fight against mosquitoes, are people always in bed, or do mosquitoes not bite during the day, or in the evenings?"

In fact, localised surveys show that people use repellants much more than nets. And yet, the NFHS survey asks no questions about these.

And even when it comes to nets, the survey asks questions about long-lasting insecticidal net (LLIN) but reports the usage of insecticide-treated nets (ITN). (LLINs have insecticide in their fibre. ITNs are ordinary nets treated with insecticide).

Two, even when it comes to asking about nets, the questionnaire is oddly interested in the brand of mosquito net being used by people.

The NFHS questionnaire 2019-20 includes questions on brands of mosquito nets (No. 78 in the schedule).

The oddity of this question is highlighted by the fact that even NFHS asks about TV sets owned by households, no question is asked on the brand of TV.

The authors offer an explanation for this oddity.

The World Health Organisation Pesticide Evaluation Scheme (WHOPES) has a list of mosquito net suppliers, which includes Chinese suppliers like Yorkool, which also compete in the Indian market. Yorkool is one of the brands mentioned in the questionnaire.

So, infer the authors, question No. 78 is more reflective of WHO's programme than concerned with India's fight against mosquitoes.

The survey therefore, as Debroy and Sanyal show, says little about actual household behaviour, which ought to be the focus.

The authors, therefore, suggest that the survey be revamped using first principles in consultation with today’s policymakers rather than blindly perpetuate past questions or worse, be hijacked by donor interests.