Sexual and reproductive health and rights (SRHR) are fundamental to well-being, yet access to these services remains deeply unequal in India. This analytical paper provides a comprehensive equity-based analysis of SRHR indicators, leveraging data from NFHS-4 (2015–16) and NFHS-5 (2019–21).

The report identifies significant disparities across population subgroups based on age, wealth quintile, education level, caste, place of residence, and geographic region. Through a “Leave No One Behind” lens, the paper focuses on five key SRHR indicators: antenatal care (4+ visits), institutional delivery, unintended births, use of modern contraceptives, and unmet need for family planning. It employs both disaggregated data and Classification and Regression Tree (CART) analysis to pinpoint groups that are furthest behind.

Findings reveal that women who are less educated, poorer, and residing in rural or marginalized communities face greater barriers in accessing essential SRHR services. The paper also tracks progress between the two NFHS rounds, identifying states that have succeeded in improving coverage and reducing inequalities, as well as those where gaps have widened.

This paper is a valuable resource for policymakers, programme planners, and development partners working toward equitable SRHR outcomes and the achievement of Sustainable Development Goals (SDGs).