Tamil Nadu has cemented its position as one of India's top-performing states in maternal and child healthcare, with 99.7 per cent of births now taking place in medical institutions — far above the national average of 90.6 per cent. Yet the state's next public health crisis is already taking shape, as obesity, diabetes, and other non-communicable diseases rise sharply, according to the National Family Health Survey (NFHS-6, 2023-24).

Maternal Healthcare: A Near-Universal Achievement

Institutional delivery rates in Tamil Nadu have reached near-universal coverage, with rural areas recording 99.6 per cent and urban areas 99.8 per cent — a parity that underscores the strength and reach of the state's public health infrastructure. These figures represent a sustained, decades-long investment in primary and secondary healthcare delivery.

However, the same survey flags a troubling decline in antenatal care quality. First-trimester pregnancy registrations have slipped from 77.4 per cent to 71.2 per cent, while the proportion of women completing at least four antenatal visits has dropped from 90.6 per cent to 87.6 per cent. Health specialists caution that while women are ultimately reaching hospitals for childbirth, delayed prenatal care could compromise long-term maternal and child health outcomes.

Obesity and Diabetes: The Emerging Crisis

Tamil Nadu now ranks among the most obese states in the country. According to NFHS-6 data, 44.2 per cent of women aged 15–49 are overweight or obese — up from 40.5 per cent in the previous survey and well above the national average of 30.7 per cent. In urban areas, nearly one in every two women falls into this category. Among men, the figure stands at 38.8 per cent, compared with the national average of 27.3 per cent.

The metabolic consequences are already visible. Approximately 25.2 per cent of women and 26.7 per cent of men in the state have high or very high blood sugar levels — both exceeding national averages. Public health experts warn that unchecked, these trends will drive higher hospitalisation rates, escalating healthcare costs, and a rising burden of premature deaths in the years ahead.

C-Section Rates and Gestational Complications

The survey also points to a steep rise in caesarean deliveries. Nearly 46.9 per cent of births in Tamil Nadu are now delivered via caesarean section, compared to the national average of 27.2 per cent. Healthcare professionals attribute part of this increase to timely surgical interventions that have helped reduce maternal and infant mortality. However, rising rates of gestational diabetes and pregnancy-induced hypertension — both linked to the broader obesity trend — are also contributing factors.

What Experts Are Saying

Former World Health Organisation Chief Scientist Dr Soumya Swaminathan has emphasised the urgency of strengthening primary healthcare systems, with a focus on prevention, early diagnosis, and timely intervention. While investments in advanced tertiary care remain important, she has said that preventing disease before it progresses into a serious condition must be the priority. This comes amid a broader national pattern in which urbanisation and dietary shifts are driving non-communicable disease burdens in states that have already resolved first-generation public health challenges.

What Tamil Nadu Must Address Next

The NFHS-6 findings suggest the state's public health agenda is shifting from access to quality and prevention. The challenge ahead is no longer getting women to hospitals — it is ensuring they arrive healthier, earlier, and with better prenatal support. Simultaneously, a population-level response to obesity and diabetes, including community screening programmes and dietary interventions, will be critical to containing costs and mortality over the next decade.