Evolution of the Women\'s Questionnaire in India\'s National Family Health Survey (1992–2024): Expanding Dimensions of Women\'s Health and Autonomy

Background: The National Family Health Survey (NFHS) is India's largest nationally representative health survey and a major source of evidence for population health, reproductive health, nutrition, and gender-related policy formulation.Since its inception in 1992-1993, the Women's Questionnaire has evolved substantially in response to changing public health priorities, demographic transitions, technological transformations, and emerging gender concerns.Objective: This paper critically examines the evolution of the NFHS Women's Questionnaire from NFHS-1 (1992-1993) to NFHS-6 (2023-2024), with particular attention to changes in thematic scope, respondent inclusion, and policy orientation.Methodology: A narrative comparative review was conducted using official NFHS questionnaires and reports published by the International Institute for Population Sciences (IIPS), Ministry of Health and Family Welfare (MoHFW), and the Demographic and Health Surveys (DHS) Program.Thematic domains, respondent eligibility, survey innovations, and methodological shifts were systematically extracted and compared across six NFHS rounds and against DHS-8 model questionnaires.Results: The analysis demonstrates a progressive transition in the NFHS Women's Questionnaire from a predominantly fertility-and family planning-oriented instrument to a multidimensional framework encompassing maternal health, nutrition, domestic violence, financial inclusion, menstrual health, non-communicable diseases (NCDs), and digital access.Since NFHS-3, the inclusion of all women aged 15-49 years broadened the representativeness of the survey.Recent rounds introduced modules on menstrual hygiene, digital access, reproductive health services, and women's autonomy.National Family Health Survey-6 further reflects India's post-pandemic and digital governance landscape through expanded questions on digital and financial inclusion, tele-health, and reproductive healthcare access.Conclusion: The evolution of the NFHS Women's Questionnaire reflects broader transformations in India's public health priorities and gender policy discourse.While the increasing breadth of the survey strengthens its policy relevance, it also raises important methodological considerations regarding questionnaire burden, comparability across rounds, and ethical management of sensitive data.Future NFHS rounds may benefit from integrating climate-health vulnerability, adolescent mental health, unpaid care work, and digital misinformation exposure within a robust methodological framework.