Tuesday, 31 January 2012

Beat the gloom, India needs to focus on real issues


Devendra Kothari
Professor, Population Program Management

Wishing you a New Year filled with New Hope and New Beginnings!

Often, in the hype over economic growth, we forget to recognize the harsh reality of India – extreme poverty, hunger, low status of women and deteriorating quality of education. These stewing issues cannot be allowed to fester since they will deepen an environment of pessimism that will ultimately risk India’s growth story. The post argues as to how to beat emerging gloominess.
 
Latest data indicate that things are not improving in India at all. In fact, things are going from bad to worse. India’s rank in the latest UN’s Human Development Report has fallen from 119 in 2010 to 134 out of 187 countries and territories in 2011. In addition, the 2011 Global Hunger Index (GHI) report places India amongst the three countries where the GHI between 1996 and 2011 went up from 22.9 to 23.7, while 78 out of the 81 developing countries studied succeeded in improving hunger condition[1]The HUNGaMA (Hunger and Malnutrition) survey carried in 2011 and released by the Prime Minister of India on January 10, 2012 reconfirms that malnutrition among children in India has taken ominous proportions, and the situation in many districts of the country has worsened when compared to what it was about a decade back. The report reveals that over 40% of children are underweight and almost 60% are stunted[2]. Similarly, per capita availability of food grains and pulses has declined significantly in the last few years.

India is simply not doing enough for its women either. The country has fallen from 112 out of 134 countries in 2010 to 113 out of 135 countries in 2011 according to the Gender Gap Index 2011 released by the World Economic Forum. In addition, three recent studies paint a grim picture of school education in India -  OECD’s Programme for International Students Assessment (PISA) study ranked Indian higher secondary students only better than those from Kyrgyzstan, which ranked last  among 74 participating countries; NGO Pratham`s  Annual Status of Education Report (ASER), 2011, assessing schools in rural India, found sharp declining reading and mathematical abilities of children in the six to 14 years age category; and lastly  Wipro’s EL Quality Education  Study 2011 of India’s elite schools, shows that learning levels are not on par with international standards.  http://articles.timesofindia.indiatimes.com/images/pixel.gifTaken together, these three reports make it amply clear that despite a welcome high enrolment rate - around 97% - at the primary and upper primary levels, the quality of school learning is simply not up to the mark. Though India’s children are attending schools, but a large number are not learning even basics, since teaching standards are poor, with high teacher absenteeism. It is little wonder then that only 48% of class V students surveyed under ASER were able to read class II-level texts, among other depressing statistics.

All this is a rather   shameful reflection of the prevailing conditions in a country that is said to be on a growth song, and indicate that India is heading towards an unstable situation of extreme danger or difficulty that could lead to despair, social instability, political strife, policymaking paralysis and capital flight as well as a rapid collapse in growth rates. It appears that efforts made over the years for improving socio-economic standards have partially been neutralized by the rapid growth of population. One has to recognize that population is an important factor in development, especially when it is growing seemingly out of control since it leads to a significant diversion of national investable resources to consumption which could otherwise be used for increasing investment and productivity and for improving the quality of public services. India’s population has grown from 361 million in 1951 to 1210 million in 2011,  and is still growing by around 17 to 18 million every year. India’s population is projected to peak at 1.7 billion in 2060.

By all accounts, population growth in India has been rapid; however, relatively high population growth mainly due to unwanted fertility makes it more difficult to lift large numbers of people out of poverty. More than 75% of India’s population lives in poverty on less than the equivalent of US$2 per day, according to the World Bank. Around 26 million children are born in India every year and out of this about 5.5 million births have been classified as unplanned/unintended. Further, based on the National Family Health Survey[3], it is estimated that   about 30 per cent or around 224 million people in the age group 0-35 years in India was the product of unwanted childbearing. The level of unwanted fertility in this age group has increased from 23 per cent in 1992-93 to 30 percent in 2005-06.

Based on findings of the National Family Health Surveys 1, 2 and 3, it is estimated that currently there are around 450 million people out of 1200 million in India who are product of unintended/unplanned pregnancies, and most of them are from the lower economic strata. The consequences of unintended pregnancy are serious, slowing down the process of socio-economic development. It is because unwanted childbearing results in poor physical growth, reduced school performance, diminished   concentration in daily tasks thus impacting work capacity and work output resulting in diminished earning capacity. The impact of unwanted childbearing is reflected in widespread hunger, poverty, unemployment as well as increasing scarcity of basic resources like food, water and space in several parts of India despite concerted developmental efforts since 1991. India’s large unwanted fertility, a threat to sustainable development, demands immediate attention.

A popularly held belief is that as a country becomes economically more prosperous, its fertility declines significantly and leads to a stable population. However, this is a simplistic view of a complex phenomenon.  Since the introduction of market-based economic reforms in 1991, India has become one of the fastest growing major ecinomies in the world. The economic reforms completed 20 years in the last  July (2011), however, during this period, India’s population increased by 365 million, much more than the population of USA - the third most populous country in the world.  This raises the question: Is Development the Best Contraceptive or Are Contraceptives?  It is argued that there is a need to go beyond the prevailing notion that socio-economic development is an essential precondition for fertility transition, since it provided only a partial explanation for the monumental changes taking place in fertility behavior, especially in low-income economies (Kothari 2011)[4].

Some experts predict population growth could turn out to be a bloom to the economy since more than half of the population of India is younger than 25 years, it gives the country a potential edge over China, where an aging population could slow its economy by 3030.  However underneath, this rosy outlook for India epitomizing the country’s ability to surpass China on the back of a younger population lies some difficulties, especially deteriorating level of education. “Whether India can benefit from its young population will depend on economic development and equitable social development”, argued by AR Nanda, Former Executive Director of Population Foundation of India.

Now question arises as how to forge ahead. For this, India needs to focus on some real issues. The most important and positive steps are still largely unrecognized by policymakers as well as by the bilateral and philanthropic organizations. More than four in ten pregnancies are unintended by the women who experience them, and half or more of these pregnancies result in births that spur continued population growth[5]. This means population growth would slow and then end through something women want and need: the capacity to decide for themselves when to become pregnant, as noted by Robert Engelman, who authored the highly acclaimed book: More: Population, Nature, and What Women Want.  If all women had this capacity, available  data affirm, level of unplanned fertility would fall significantly and consequently average Indian childbearing would immediately fall below the replacement fertility value of slightly more than two children per woman required initiating the process of population stabilization. And population would immediately move onto a path leading to a peak followed by a gradual decline, possibly well before 2045, as targeted by the National Population Policy 2000.

The central issues before of the 12th Five Yea Plan should be reinvigorating interest and repositioning Family Planning in India.  The population of India is expected to increase from 1210 million in 2011 to 1380 million in 2021, as per Population Reference Bureau. As a consequence, the population density will increase from 382 to 418 persons per sq. kilometre in 2021, creating more demand for additional resources like water, food, education, health, housing, etc.  Of the net addition of 170 million people during 2011-21, around 46 million will be the result of unwanted/unplanned childbearing. This sort of population and development pattern has already created and will create several internal conflicts in India.  Addressing this issue of population is the antidote to the various concerns plaguing the nation, as noted earlier. As such, the population issue should not be allowed to become a “stumbling block” to socio-economic progress as well as the unity of the country.  It is argued that towards faster and more “inclusive growth”, the Indian economic road map especially during the 12th Five Year Plan must give due importance in reducing the incidence of unwanted fertility. The Planning Commission in collaboration with Ministry of Health and Family Welfare, GoI have to put together a position paper outlining its “Road Map” to repositioning Family Planning and come up with strategies that outline concrete actions to be carried out successfully.

Another issue which needs equal attention is quality of education. Unless education is rescued from quagmire of mediocrity, all talk about developing a skilled human resource pool and realizing the country`s demographic dividend will be without substance; and the country would be inching closer to demographic disaster. As such, investment in education has to be increased to improve the quality of education especially at the government schools and colleges where most of the students are from poor and rural families.

The writing is on the wall. The question is not whether we act or not, but whether we act now or later and deal with much more dire and expensive consequences. What we do in the next few years especially during the period of Twelve Five Year Plan (2012-17) will determine India’s future. If we do not take required steps however, there will be lack of decision-making, inefficiency and a stalling of progress and growth. Hope policy makers are listening!

The findings of the Census of India 2011 clearly reinforce that two contrasting demographic "nations" are emerging in the country. The next post aims in this direction.    


[3]India: National Family Health Survey (NFHS-3), 2005-06, IIPS, Mumbai, 2007.
[4] Devendra Kothari, “Implications of Emerging Demographic Scenario: Based on the Provisional Results of Census of India 2011”,  A Brief,  a publication of Management Institute of Population and Development – A Unit of Parivar Seva Sanstha, New Delhi, 2011.   
[5] Around half of these pregnancies are being aborted. According to the World Health Organization and Guttmacher Institute, New York, India recorded 6.5 million abortions in 2008 of which 66% were deemed unsafe.  

Tuesday, 20 December 2011

Rotary: Population and Sustainable Development


Rtn. (Dr.) Devendra Kothari
Prof. Population Program Management

Global population has reached 7 billion on October 31, 2011, just 12 years after reaching 6 billion in 1999. “The eighth billion may also take about 12 years, but only if birth rates in all developing countries follow projections that assume a smooth decline to two children or fewer," says Carl Haub, PRB's senior demographer. While declines in birth rates have been virtually universal across countries, the pattern of decline has been very variable. In most  countries, birth rates have fallen below two children or are in process of achieve that level; birth rates in other countries, mainly located in Africa and Asia, have decreased to medium levels or have barely begun to decrease. It is therefore entirely possible that the 8th billion may reach in the next 10 to 11 years, placing us squarely in the middle of history's most rapid population expansion. And high levels of fertility and population growth make it far more difficult for families and societies to overcome poverty. Here, Rotary can play a catalytic role in motivating the policy makers to focus their attention to resolve the issue of growing population, as it did in case of Polio Eradication[1].  This is why the world is looking towards Rotary to take the challenge[2].

Today, most population growth is concentrated in the world's poorest countries and within the poorest regions of those countries. And it is mainly because more than “two in five pregnancies worldwide are unintended or unwanted by the women who experience them, and half or more of these pregnancies result in births that spur continued population growth”, as noted by Robert Engelman, who authored the highly acclaimed book: More: Population, Nature, and What Women Want.  

Are people in poor countries against small family norm? While world’s population continues to grow by around 85-90 million annually, more than 200 million women, mainly from the poor countries lack access to basic contraception. Often, these women must travel far from their communities to reach a health facility, only to return home “empty handed” due to shortages and stock-outs as well as non availability of staff. When women seeking family planning services are turned away, they are unable to protect themselves from unintended pregnancies and sexually-transmitted infections, including HIV/AIDS, as argued by the Population Action International, Washington DC.

The main reason could be that the international community has allowed attention to drift away from the reproductive health. “Over the past ten years population issues have lost priority”, as noted by the report: Return of the Population Growth Factor: Its Impact on the Millennium Development Goals. The report further notes that “funding has stagnated or decreased at a time when unmet need for family planning information and services is increasing”[3].

There is an urgent need to focus on population growth, since global population is projected to grow from seven billion in 2011 to over 9.3 billion by 2050. Of this growth, around 90% of this will be concentrated in the poor performing countries. Here, the Indian case needs special attention. With around 1.2 billion people, India is currently the second most populous nation in the world. The UN Population Division projects that it will surpass China as the most populous within 15 to 20 years. India's population is projected to peak at 1.7 billion in 2060. China at its peak in 2025 will have 1.4 billion people. In fact, when China peaks, India will have already surpassed it in population. Other countries which will contribute significantly in the near future are: Nigeria, Pakistan, Ethiopia, Philippines, etc. (see, Blog:  kotharioninida.blogspot.com, dated 29.11.2011).   

Now question arises as how to forge ahead? The most important and positive steps are still largely unrecognized by policymakers. Here the women centred approach could be a positive option that has been largely unrecognized by policymakers as well as by many bilateral and philanthropic organizations. In the changed situation, most women even in the poorest countries do not want more children, but that they have them is mainly due to non-availability and inaccessibility of quality reproductive healthcare services. They have been trapped in a vicious circle[4]. The women need help to have children by choice and not by chance. This requires steady political as well as administrative will, which sadly has, so far, been inconsistent. The need of the hour, thus, is to create confidence among policy makers and programme managers as well as among the donor agencies that a breakthrough is possible by adopting a feminist agenda for population stabilization. We need creative policies to strengthen this foundation.

As such, Rotary International and its sub-divisions like Rotarian Action Group for Population Growth and Sustainable Development (RFPD) [5] must re-emphasize its commitment to population stabilization and provide essential leadership to promote reproductive health services and increase awareness of the social, economic, and environmental consequences of rapid population growth.  Also one should work actively to educate policymakers, program managers, the media and the general public about population issues.  We hope that the Rotary will take leadership role in organizing discussions on this important issue by involving major partners, as it did in the late nineties by organizing a number of international population submit.  

We are sure that the Rotary International will take the position that every child should be a wanted one. Achieving this goal would prevent the suffering of women and their families and the social problems that often follow the birth of unwanted children under the motto “Service Above Self”.

The next post discusses what should be the New Year resolution for India.

Wishing you a New Year filled with New Hope and New Beginnings!!!


[1] The most notable global project, Polio Plus, was initiated by the Rotary International to eradicate the polio in 1985. Inspired by Rotary's commitment, many organizations joined the eradication effort. In 1988, the World Health Organization (WHO) passed a resolution to eradicate polio by 2000.
[2] The Rotary International is a worldwide net work of inspired individuals who translate their passions into relevant social cause to change lives in communities. With Rotary’s rich, religious, ethnic, and cultural background and with membership in over 160 countries, many believe that Rotary is the ideal organization to address this challenge like polio eradication.

[3] The Report is based on discussion with the All Party Parliamentary Group on Population, Development and Reproductive Health. For details, see report: Return of the Population Growth Factor: Its Impact on the Millennium Development Goals, 2007 (http://www.appg-popdevrh.org.uk/).  

[4] For details, see: Kothari Devendra, “Empowering Women in India through Better Reproductive Healthcare”, FPA Working Paper No 5, Jaipur: Forum for Population Action, 2010.

[5] Founded in 1996, the 23,000+ members of the Rotarian Action Group for Population Growth and Sustainable Development (RFPD), Inc. work to address the population crisis around the world. RFPD is dedicated to educating and motivating the 1.2 million Rotarians around the world about developing and implementing projects that directly address the population issue.  


Tuesday, 29 November 2011

Seven Billionth Baby and its Implications



Devendra Kothari

Prof. Population Program Management

Baby Nargis Yadav, born on October 31, 2011 at the Mall Community Health Centre on the outskirts of the capital city of Uttar Pradesh – Lucknow, was officially declared, in India at least, to be the seven billionth citizen of the world. The status accorded to her is of course symbolic. For, coinciding with Nargis's arrival on earth, many more births were recorded in diverse parts of the World[1] including India. Should we celebrate or fret about the seven billion mark? This post discusses the implications of the milestone and suggests the way forward.

With seven billion people and still growing, the world is getting dangerously overcrowded. At the time of the Lord Buddha, the global population was under 100 million; when Christ was born it was 170 million; when Isaac Newton (1643-1727) discovered the ‘Law of Gravitation’ it was 550 million. The world population reached one billion in 1800.  It took newly 130 years to add the second billion. However, “the world added the sixth billion and the seventh billion in a record 12 years for each,” says Carl Haub, PRB's senior demographer. "The eighth billion may also take about 12 years, but only if birth rates in all developing countries follow projections that assume a smooth decline to two children or fewer."
                   
It appears that the World is in the midst of its most rapid population growth in the history. Today, the world is adding the largest numbers to its population than in any time in history. Despite the fact that the annual population growth rate has declined from 2.1% in the late sixties to 1.2% per year in 2011, world population is currently growing by about 85-90 million annually.  According to the UN's World Population Prospects (2010), future population of the world will mainly be fuelled by some large African and Asian countries.

Most of the countries of the world have already achieved or are in the process of achieving replacement level fertility of 2.1 children per woman required to achieve stable population. For example, in some large countries such as Germany (1.4), Italy (1.4), Japan (1.4), China (1.5), Russia (1.6), Thailand (1.6), and Brazil (1.9), total fertility rates have fallen far below two children.  In some other large developing countries such as Indonesia (2.3), Mexico (2.3), Indonesia (2.3) and Bangladesh (2.4), total fertility is fast approaching to the replacement level. On the other hand, in some large countries of Africa and Asia total fertility rates of more than 2.5 children per woman continue to be the norm. For example, lots of efforts have to be made to achieve replacement level fertility in countries like India (2.6), Egypt (2.9), Philippines (3.2), Pakistan (3.6), Nigeria (5.7), Ethiopia (5.3), Congo (6.1), Niger (7.0), etc.

The emerging population scenario in India is of interest to anyone interested in India’s development, as well as concerned with the global demographic situation. With around 1.2 billion people, India is currently the second most populous nation in the world. The UN Population Division projects that it will surpass China as the most populous within 15 to 20 years. India's population is projected to peak at 1.7 billion in 2060. China at its peak in 2025 will have 1.4 billion people. In fact, when China peaks, India will have already surpassed it in population. Other countries which will contribute significantly in the near future are: Nigeria, Pakistan, Ethiopia, Philippines, etc.   The estimated population of the ten most populous counties in 2010 and 2050 are given in Table 1.

Table 1 Ten most populous countries of the world in 2010 and 2050

Ten most populous countries in2010

Ten most populous countries in 2050

Rank

Countries

Population

 (in million)

Rank

Countries

Population 

 (in million)

I

China

1,346

I

India

1,692

II

India

1,241

II

China

1,313

III

United States

312

III

Nigeria

423

IV

Indonesia

238

IV

United States

423

V

Brazil

197

V

Pakistan

314

VI

Pakistan

177

VI

Indonesia

309

VII

Nigeria

162

VII

Bangladesh

226

VIII

Bangladesh

151

VIII

Brazil

223

IX

Russia

143

IX

Ethiopia

174

X

Japan

128

X

Philippines

150

Source:  United Nations Population Division.

 

Are people in poor countries against small family norm? While world’s population continues to grow by around 85-90 million annually, more than 200 million women, mainly from the poor countries lack access to basic contraception. Often, these women must travel far from their communities to reach a health facility, only to return home “empty handed” due to shortages and stock-outs as well as non availability of staff. When women seeking family planning services are turned away, they are unable to protect themselves from unintended/unwanted pregnancies and sexually-transmitted infections, including HIV/AIDS[2].

Relatively high population growth mainly due to unwanted fertility makes it more difficult to lift large numbers of people out of poverty (see my earlier Blog entitled: What the poverty debate in India misses?). Nearly half the world (48 percent) lives in poverty on less than the equivalent of US$2 per day, including 80 percent of people in the Democratic Republic of Congo, 76 percent in India, 65 percent in Uganda, and 61 percent in Pakistan, as per the World Development Indicators (2011), World Bank.


Now question arises as how to forge ahead? The most important and positive steps are still largely unrecognized by policymakers as well as by the bilateral and philanthropic organizations. “More than two in five pregnancies worldwide are unintended by the women who experience them, and half or more of these pregnancies result in births that spur continued population growth”, noted by Robert Engelman, who authored the highly acclaimed book: More: Population, Nature, and What Women Want.  This means population growth would slow and then end through something women want and need: the capacity to decide for themselves when to become pregnant. If all women had this capacity, survey data affirm, average global childbearing would immediately fall below the replacement fertility value of slightly more than two children per woman. And population would immediately move onto a path leading to a peak followed by a gradual decline, possibly well before 2050[3].

The women centred approach is also advocated by politicians like Richard Ottaway MP, Chairman of the House of Commons Select Committee on Foreign Affairs. He noted[4]: “most of women in developing would want fewer children than they are having now, but the international community has allowed attention to drift away from the family planning. Letting women have the means to manage their childbearing will help to make the world a more stable place. Hence a decisive action is needed now” and it is the need of the hour.  Key to this new approach is empowering women and providing them with more choices through expanded access to education and health services and promoting skill development and employment[5].

What we do in the next few years will determine our future.  Here bilateral agencies like UNFPA and philanthropic organizations like Rotary international cannot afford business as usual.

The next post discusses: what should be next in Rotary International service agenda after Polio Eradication?





[1]A baby girl named Danoca May Camacho was chosen by the United Nations to be one of several children around the world who will symbolically represent the global population milestone. She was delivered just before midnight on Sunday amid an explosion of press camera flashes in a packed government-run hospital in the Philippines at Manila's Jose Fabella Memorial Hospital. In Bangladesh, authorities named another baby girl the world's seven billionth child. Weighing 2.75 kilos and named Oishee, she arrived a minute after midnight at a hospital in the capital Dhaka. In Cambodia, the honor fell to a baby girl who has yet to be named.



[2] “Empty Handed: Responding to the Demand for Contraceptives”, a documentary by Population Action International, Washington DC    tells the story of women’s lack of access to reproductive health supplies in sub-Saharan Africa, and its impact on their lives.

[3] See article: Seven Billion Problem: What Women Want   by Robert Engelman, Tomes of India, October 31, 2011. Also see: Kothari, Devendra. 2010.  “Empowering Women in India through better Reproductive Healthcare”, FPA Working Paper No 5, Jaipur: Forum for Population Action.
[4] See letter to the Editor: The Economist (June 4th-10th, 2011) by Richard Ottaway, p.18.
[5] For details, see: Kothari Devendra, “Empowering Women in India through Better Reproductive Healthcare”, FPA Working Paper No 5, Jaipur: Forum for Population Action, 2010.