Sunday, 31 October 2021

Managing the Infant Mortality in India

Dr. Devendra Kothari

Population and Development Analyst

Forum for Population Action


Higher incomes often translate into improvements on many counts. In IMR, however, there’s no evidence of a tight link between the two. For instance, Nepal with just over half of India’s per capita GDP, has a lower IMR. Sri Lanka’s IMR is close to that of EU at a fraction of the per capita income. If it’s not income, neither is state capacity a watertight indicator. Iraq, Syria and Libya, three countries where state capacity has been undermined by civil war, do better than India. The answer may lie in the starkly uneven performances of India’s states.

Wednesday, 29 September 2021

Are seniors in India struggling with loneliness?

 

 Dr. Devendra Kothari

Population and Development Analyst

Forum for Population Action

 

 

“Indian society needs to understand and accept the need for emotional and even physical support especially at the old age. The stigma of late life companionship has been running in society for so long but it should   hopefully be changed.”

News18 [1]

 

The relationship between age and loneliness is intriguing. While loneliness has been widely perceived as a problem of old age, there is evidence suggesting that adolescence is the peak age for experiencing loneliness and there are demonstrable variations between nations in reported rates of loneliness.[2]  This Post (#132) focuses on people of an advanced age or seniors (70+) with special reference to India. 

The Indian Census 2011 was conducted in two phases, house listing and population enumeration. The population enumeration phase was conducted between 9 and 28 February 2011. According to the reports, the Indian population increased to 1210.8 million (623.7 million males and 587.1 million females) as on March 1, 2011 with a decadal growth of 17.70 per cent. 

 

The data on sex and marital status by age unveils the characteristics of population composition and provides disaggregated data for target oriented projects. In the age-group 0-14, male population was about one per cent more than female, whereas in the age-group 60+, the proportion of females was one per cent more than Males. 

At the national level, the percentage of the aged (60+) population is 8.0 per cent (96 million). Distribution of the population by marital status shows that in 2011, 47.8 per cent of the population at the national level is reported as never married. Married population constitutes 47.0 per cent of the total population whereas widowed/divorced/separated constitutes 5.2 percent (63 million). The proportion of the W/D/S female population is much higher than males at the national level.

 

There is no shortage of lonely older 70+ single Indians. According to the 2011 Census data, almost 15 million elderly Indians live alone and three-quarters of them are women. There are signs that some are interested in remarriage or looking for partnership or companionship. But social pressures are creating obstacles, as per News18.

 It is completely understandable as to why one might feel lonely as he/she gets older. Children or family members might have moved out of the house and are far away. Even worse, your spouse could have passed away. Further, in the Covid-19 pandemic period where loneliness, aloofness, depression, and mental breakdown has engulfed strong and young individuals  and compelled  them to take    disastrous decisions to end  their lives, it is now time  for every such individual  to pull up their socks  and take  effective measures  and exercise  one’s right  to treat  oneself for better wellbeing and live a quality life.

 I had an active social and working life but, after the death of my wife around six years ago, the 78-year-old widower whose children have settled down in North America  has felt a need for someone at home. Evening is my favorite time of the day. I spend it sipping tea sitting alone on the balcony. Also, as evening fell I’d get worried about my health and being alone at home and my safety.  Due to Covid-19, I cannot go out.  I need a partner, but in India late-life relationships are generally frowned upon by a society that places a high value on marriage and disapproves of living outside wedlock. This is a story of lonely people like me who are living alone. Here the conception of partnership or companionship is very important.

 

In traditional Indian society, older people have always occupied a position of reverence. They, in turn, are expected to lead a life that's centered on spirituality and family -- often helping to care for grandchildren, for example. Dating or finding a partner in later life, after a spouse has passed away, isn't the cultural norm. 

And while seniors dating agencies are making matches, some say it's still difficult to sign people up, especially women -- even when they're offered financial incentives. Silver Talkies is one of such platforms for 55+.[3]   The platform runs two social clubs for seniors in Bengaluru. The following discussion is based on such experiences.[4]

 

Adult children in urban India or outside no longer automatically invite their parents to live with them, leaving many without a support network they may have expected when they were younger. In 2012, Madhav Damle, an-ex publisher in the Indian city of Pune, Maharashtra, conducted a survey of 400 senior citizens in that city about their attitudes towards finding a companion. More than 70 per cent of respondents thought live-in relationships were an ideal solution for lonely senior citizens looking for companionship.

 

Saroj Ghatani, a 60-year-old widow from Pune, has been seeking a partner to live with for the last year. Her children don't like the idea, but she's prepared to go against their wishes. "They feel at 60 I have lived my life and shouldn't really think of finding a partner," she said, adding that her children worry she may not be available to help raise her grandchildren if she finds a new partner. "All my life I have worked to raise them and support them and the family. Now I want to think only about myself and live the life I want to," she says. But it is not easy.

 

Men and women typically want different things from live-in relationships, according to Natubhai Patel, 71. He started his non-profit dating service, Anubandh Foundation, after the 2001 earthquake in Gujarat. Around 25,000 people were killed in the quake and many survivors were left without a spouse. Patel says while many older Indian women want companionship, many potential male partners are looking for someone to manage the kitchen. But it is not easy.

 

"Companionship is much needed, but I'm afraid many older men are so used to being taken care of by their now-deceased wives that they are looking for someone to run their house and take care of them in old age. That's not my idea of having a companion. I don't want additional responsibility," said a former schoolteacher.

 

Parekh and Deepa, another live-in-relation couple initially faced opposition from his sons, who live in the same city. "Gradually, they realized I needed someone to take care of me and came around, as did hers," he said. My children live in North America and she said life with Parekh is comfortable and easy. "You need a support structure in your old age and I have it now. I don't mind taking care of him in return," she said.

 

Those aren't their real names.

 

Relationship counsellor Hema Yadav-Kadam thinks that many senior citizens and their children are confused about what constitutes a live-in relationship. "Fear of losing out on their inheritance, having a new contender in their parent's will and the inability to deal with the social disapproval -- that is inevitable and common -- is what makes most children oppose (a new relationship)," said Hema.

 

It is widely believed that a live-in arrangement is ideal for older couples as it gives them a sense of independence within the relationship and avoids the paperwork and legal complexities of marriage. But its legal implications are not clear.

 

While there is no particular law regarding the status of live-in relationships in India, in 2015 India's Supreme Court ruled that living together out of wedlock was an acceptable custom in Indian society. But the social stigma remains and, in some cases, is perpetuated by adult children who fear their parents will be ostracized by their communities, and worry over complicating inheritance issues.

 

As such, live-in relationships have always been the focus of debates as it possesses threats to our basic societal framework. As of now, there is no legislation or statute that specifically governs matters related to succession, maintenance, guardianship in regards to live-in relationships. However, the Protection of Women from Domestic Violence Act, 2005 legislature has acknowledged the right of partners living in a live-in relationship to get protection; but it is not so easy.

 

There can’t be anything more important than protecting the life and liberty of an individual, when weighed against social norms that may threaten these basic constitutional rights. And yet, our judges often refuse to protect couples in live-in relationships when they approach courts against threats from their families and others. Many judges believe they are duty-bound to uphold social values and customs and leave the couples to fend for themselves, often in the face of grave danger, as noted by Robin David of the Times of India in an article: ‘The Right To Live-In Relationships: High courts are placing so-called social norms above individual choices despite a key SC ruling”. [5]

 

The Supreme Court  in an order when it told the Police Officers in Punjab’s Taran Taran district to protect a live-in-relation couple whose plea for protection was turned down by the Punjab and Haryana High Court. The HC has rejected the plea because it found live-in-relationships “morally and socially not acceptable”. Sc disagreed and ordered: “Needless to state that since it concerns life and liberty, the SSP (Senior Superintendent of Police) is required to act expeditiously in accordance with law including the grant of any protection to the petitioners in view of apprehensions/treats.” [6]

 

The message was clear and loud: you may frown upon live-in relationships, but you can’t refuse such couples protection. The right to life and liberty takes precedence over social norms in such cases, as noted by experts.

 

The concept of live-in relationship is not something that has been accepted with open arms in Indian society. However, live-in relationships are not illegal in India. The Supreme Court in its judgments has made it clear that live-in relations are not illegal and do not constitute an offense. The Apex Court has held that two consenting adults can live together without marriage. Live-in relationships are included under the ambit of the Domestic Violence Act 2005.

 

In conclusion, the foregoing discussion reveals that loneliness increases with age, and it is greater in men than in women. It is argued that  there must be a separate statute dealing with this current issue so that the rights of living partners, children born out of such relationships and all those people who are likely to get affected by such relationships should be protected. At the same time, there should also be awareness among live-in partners regarding the legal consequences arising out of such living arrangements.

 

I would like to conclude in the words of an organization- Silver Talkies - which is working with seniors to find companionship in the silver years in India:   “In an era of hyper-connectedness, India’s ageing population is struggling with loneliness and becoming increasingly disconnected from its environment.”  [7]



[1] An article by News18: ‘A Dating Agency for Seniors is Helping Elderly Indian Couples Find Love Again’. Read more at: https://www.news18.com/news/buzz/a-dating-agency-for-seniors-is-helping-elderly-indian-couples-find-love-again-2703349.html

[2] Yang Keming and Christina Victor. ‘Age and loneliness in 25 European nations’, Aging & Society 31 (8), pp. 1368-1388, Cambridge University Press   (09 February 2011). Read more  at: https://www.cambridge.org/core/journals/ageing-and-society/article/abs/age-and-loneliness-in-25-european-nations/CB2D91D8793AA3522286EAD7203FA492

 [3] To get in touch with Silver Talkies, contact at: mail@silvertalkies.com.

 [4] Chakraborty, Reshmi. (2019): ‘Are Live-In Relationships For Older Couples A Solution To Loneliness? (on May 2)’ Silver Talkies. Read more at: https://silvertalkies.com/live-relationships-older-couples-solution-loneliness/  Also, refer News18 article at: at: https://www.news18.com/news/buzz/a-dating-agency-for-seniors-is-helping-elderly-indian-couples-find-love-again-2703349.html    

 [6] Landmark Judgments- Live-In Relationship: SC’s Judgments Concerning The Legal Standing Of Live-In Relationships, 10 June 2021. Read more at: https://www.lawyersclubindia.com/articles/landmark-judgments-live-in-relationship-sc-s-judgments-concerning-the-legal-standing-of-live-in-relationships-14068.asp

 [7] https://silvertalkies.com/a-companion-for-the-silver-years/

 

Tuesday, 31 August 2021

Are seniors in India struggling with loneliness?

 

Dr. Devendra Kothari

Population and Development Analyst

Forum for Population Action

 

“In an era of hyper-connectedness, India’s ageing population is struggling with loneliness and becoming increasingly disconnected from its environment. But, there are ways of coping and help is Nishi available.”


To be concluded.....

Saturday, 31 July 2021

UP Population Control Bill 2021: Is it part of a hidden agenda?

 

Devendra Kothari PhD

Population and Development Analyst

Forum for Population Action

The issue of population control has become a topic of hot debate after the most populous state of Uttar Pradesh (UP) announced a draft Population Control Bill 2021 on the World Population Day 2021. BJP ruled Assam has already passed a resolution in the State Assembly regarding the same, and have introduced measures discouraging people to have more than two children. Thus, the Governments of Uttar Pradesh and Assam are pushing for the two-child norm (TCN) population policy despite scant evidence that it works. Is there any hidden agenda?  The paper stresses that   India has to stop looking at the issue of population   from a religious angle. The issue is more about availability of quality services; gender equity and human development since an overwhelming majority of Indians do not want more children.

 

Some 45 years ago, in the late seventies, India embarked on an ambitious population control programme to curb the increasing population pressure on the nation. It was the brainchild of the then PM Indira Gandhi, and her son, Sanjay Gandhi, who oversaw the execution. But its implementation was flawed, so Indians did not support the most pertinent, sensible, and timely population control programme.  Since then population control in India has always been a political rather than a social-economical issue. Our political leaders rig out the population issue whenever they see some political advantages, especially in terms of electoral gains or vote bank politics, and then keep mum. The latest example is the ‘Uttar Pradesh Population (Control, Stabilisation and Welfare) Bill, 2021, which was unveiled by Chief Minister Yogi Adityanath just ahead of the Assembly elections to be held in early 2022. 

Salient points of the Bill:

Uttar Pradesh (UP), the most populous state of India, is currently home to 17.1 per cent of the country’s population. The state also holds the top position in high population growth rate in India. It is witnessing an annual growth of around two per cent in its population which is very high as compared to the national average of around one per cent. The total population of the state was 8.8 crores in 1971. It increased to 11.1 crores in 1981 and then reported to be 19.9 crores in 2011. The estimated population of the state in 2021 was 24.1 crore, as per Office of the Registrar General and Census Commissioner, India. 

The Bill target is to bring the total fertility rate to 2.1 per woman   by 2026 and to 1.9 by 2030. To achieve the target, the policy proposes that people having more than two children in the state should not be granted any special benefits and should be barred from using official concessions. [1]   It means any couple who follows the policy would receive perks from the State. These incentives are linked to the government schemes, government jobs, promotions and welfare measures etc. which would be a driving force for those who wish to avail the benefits from the government.   “We have proposed that any couple that follows the two-child policy will be given all government benefits,” said State’s Law Commission Chairman Aditya Nath Mittal.   “If somebody doesn’t follow this policy, they won’t be eligible for such schemes. Their ration card will be restricted to four units. They will not be able to apply for Government jobs and if they are already Government employees, then they won’t get a promotion,” Mittal added.  Meanwhile listing out benefits for public servants who adopt the two-child policy, the draft Bill said, “Public servants who adopt the two-child norm will get two additional increments during the entire service, maternity or as the case may be, paternity leave of 12 months, with full salary and allowances and three per cent increase in the employer’s contribution fund under national pension scheme.” There are also provisions to provide exemptions in water, electricity, house tax, home loan, and other such facilities to couples with two children who are not in Government jobs. 

In short, the draft Bill proposes a bunch of monetary incentives to be conferred to the people of the state in lieu of the two-child norm. It is stressed  that the adherence to the policy will be a voluntary exercise and it will not make distinctions based on caste, creed and economic class. In that sense, the proposed policy is sensible one. It has, however, racked up a political debate regarding demography not in the state but also in the country too. It is a well planned strategy by the BJP government at the Centre to use it to draft a national policy on population control. 

In past, some states have adopted the concept of Two-child Norm to control the surging population. In general, however, they have failed in bringing down the fertility or population growth rates as desired. However, there is evidence that such measures could lead to negative consequences such as increases in sex selective practices and unsafe abortions, especially given the strong son-preference in the country. [2] 

Based on an extensive analysis, the author came to the conclusion that any policy based on the incentives and disincentives could not have any positive effective impact on fertility unless they are backed by quality family planning services.[3] For example, Madhya Pradesh aimed at achieving the replacement level fertility of 2.1 children per woman by 2011 but it was far from the targeted goal – it recorded TFR of 3.1 in 2011.  Same can be said about other states except Andhra Pradesh (Table 1, Col. 6). 

Table 1 Trends in decadal population growth (%) and number of children/woman (in parentheses), some selected states of India 

State/Year

1981

1991

2001

2011

2017

1

2

3

4

5

6

Bihar

24.16

(5.7)

23.38

(4.4)

28.62

(4.3)

25.07

(3.6)

NA

(3.2)

Madhya Pradesh

27.16

(5.20

27.27

(4.6)

24.34

(4.0)

20.23

(3.1)

NA

(2.7)

Rajasthan

32.97

(5.2)

28.44

(4.6)

28.33

(4.1)

21.40

(3.0)

NA

(2.7)

Uttar Pradesh

25.39

(5.8)

25.55

(5.1)

25.86

(4.7)

20.10

(3.4)

NA

(3)

India

24.66

(4.5)

23.86

(3.6)

21.54

(3.2)

17.64

(2.4)

NA

(2.2)

Andhra Pradesh

23.10

(4.0)

24.20

(3.0)

13.86

(2.3)

11.10

(1.8)

NA

(1.7)

Karnataka

23.79

(3.6)

21.12

(3.1)

17.25

(2.4)

15.70

(1.9)

NA

(1.7)

Kerala

19.24

(2.8)

14.32

(1.8)

09.42

(1.8)

04.90

(1.8)

NA

(1.8)

Tamil Nadu

17.50

(3.4)

15.39

(2.2)

11.19

(2.0)

15.50

(1.7)

NA

(1.6)

Source: Office of the Registrar General and Census Commissioner, Ministry of Home Affairs, Government of India.

https://rbidocs.rbi.org.in/rdocs/Publications/PDFs/4TABLE21E801E5C71B464B9BDA2543C8D7F207.PDF

 

 

Way forward:

Do Indians want more children? The current population growth in India is mainly fueled by unwanted/unplanned fertility. The National Family Health Surveys (NFHSs) [4] provide estimates of the total or actual fertility and wanted fertility rates.  Based on these and other data, it is estimated that around five in ten live births are unintended or simply unwanted by the women who experienced them, and such births    trigger continued high population growth. [5]  Around 24 million children were born in India in 2020, and out of this about 13 million births could be classified as unwanted.  It is estimated that around 480 million people out of the total population of 1,400 million in 2021 were the result of unplanned pregnancies. 

With such a large number of people resulting from unwanted pregnancies, how can one think about using them for nation building?   The consequences of unwanted pregnancy are being reflected in widespread malnutrition, poor health, low quality of education, and increasing scarcity of basic resources like food, water and space.

While India’s population continues to grow by 15-16 million people annually, around five  million women in the reproductive ages, especially those in the lower economic strata including Muslims wish to postpone childbearing, space births or stop having children; however, they are not using modern contraceptives. This is also known as the ‘unmet need’ for contraception.  Often, these women travel far from their communities to reach a health facility, only to return home ‘empty handed’ due to shortages, stock outs, lack of desired contraception and/or non availability of doctors and paramedical staff. When women are thus turned away, they are unable to protect themselves from unwanted pregnancies and sexually transmitted infections. This type of incomplete control over the reproductive process leads to relatively high levels of unwanted childbearing and reduces the prospects for an early onset of the population stabilisation process, and that is really happening in the Hindi speaking states, including Bihar, Madhya Pradrsh, Rajasthan and Uttar Pradesh. 

The biggest obstacle to population control is the non-fulfilment of the demand for family planning services. Despite poverty and illiteracy, modern family planning services are in demand among Muslims as well, but they are as inadequate as other communities. Measures need to be taken to fulfill it and not talk of animosity. Instead of stopping the growth of population by enacting laws, only easy availability of the quality family planning services can give better success. Further, the problem of population explosion should not be seen as a 'Hindu vs Muslim' problem, but as a problem common to both the communities and should be taken seriously. The policy makers have to understand that the situation has changed dramatically in the last three decades, and there is no need to implement coercive methods or laws to control the population. The number of Indian women, including Muslims, wanting to have another baby is falling fast, as per the NFHS-4 (2015-16). Only 24 per cent of married women aged between 15 and 49 years wanted a second child. 

Incidents of unplanned pregnancies can be dramatically reduced, if not eliminated, within the next five years by simply providing reproductive services as per the needs of clients, as had been done in Andhra Pradesh during the nineties by using strategies like Vikalp. [6]   If Andhra—with little outside help—could manage its population growth under relatively low literacy (Literacy Rate of Andhra in 2011 was 67.7 per cent compared to 69.7 per cent in UP), there is no reason why other states, especially, Four Large North Indian (FLNI) States of Bihar, MP, Rajasthan and UP—with lesser problems and increasingly generous support from the Centre—should fail so spectacularly in managing unwanted fertility. [7]

 

A user friendly service delivery system can help address the causes that lie at the root of unwanted fertility. At the same time, investment in human development has to be increased to push the process of human capital formation. [8] Encouraging women’ paid employment could be a miracle step as has been seen in Bangladesh.[9] 

In conclusion, India has to make the issue of population stabilization a non-political one. The country has to find a way of talking about religious demography that is judicious and logical so that the debate on the subject can take place without any fuss, outrage and annoyance. If the economy is to be allowed to grow uninterrupted, the issue of Hindu-Muslim population must be thoroughly but seriously discussed while fighting the rumour and hate-mongers. This is necessary because apparently Indian Muslims want to be part of the mainstream of the Indian culture, as noted in the Foreword written by the author for the book: The Population Myth by S.Y. Quraishi .[10]  

In sum, not only Uttar Pradesh and Assam but other states with high fertility need an effective people centric population control policy. For this, the draft Uttar Pradesh population control bills must be redrafted in the light of above discussion. The revised draft must emphasise on the provision of quality family planning services looking to the needs of clients. Here the concept of ‘Vikalp’ could be handy. Also, the revised bill   must discuss the measures to be adopted in order to create job opportunities for women. Such a population control strategy/bill could be a role model for the country as a whole. India has to recognise that population growth is a choice, not an inexorable force of nature.



[1] Refer newspaper article: UP law panel proposes 'two-child' population policy. All you need to know. Read more at: https://www.hindustantimes.com/india-news/up-law-panel-proposes-two-child-population-policy-all-you-need-to-know-101625905036415.html

 [2] Visaria Leela, Akash Acharya, Francis Raj (2006): ‘Two-Child Norm Victimising the Vulnerable?’, Economic and Political Weekly, Vol 42, (24), January 7, pp 41-48. 

[3] Kothari, Devendra (2013):

[4] The National Family Health Survey is a survey carried out on a massive scale across the country to collect information on many parameters with special reference to reproductive health which helps MOHFW, GOI to frame policies and programmes. The first round of the NFHS was conducted in 1992-92. Subsequently, four other rounds have taken place, the latest being NFHS 5 that started in 2018-19, however, is stalled currently amid the COVID-19. 

[5] Kothari, Devendra (2014): “Managing Unwanted Fertility in India: Way Forward” in Suresh Sharma and William Joe.   (eds.)   National Rural Health Mission: An Unfinished Agenda, pp 25-36, Bookwell, New Delhi.

[6] Vikalp’ is an alternative, client-based decentralized strategy developed by the author which provides a comprehensive framework to implement the Family Planning Programme looking to the needs of women/clients.  The strategic focus is on segmentation of the clients based on the current unmet need, followed by fulfillment of the identified needs through improved service delivery. The strategy aimed at convergence and optimum use of resources as targeting and providing services in response to the identified needs of clients rather than targeting the entire pool of clients in the reproductive ages. For details, see: Kothari, Devendra et al. (1997): ‘Vikalp: Managing Family Planning Programme in the Post-ICPD Era’, Occasional Paper No. 2, Indian Institute of Health Management Research.  

[7] Kothari, Devendra, Sudha Tewari (2009): “Slowing Population Growth in India: Challenges, Opportunities and the Way Forward”. MIPD Policy Brief No. 2, Management Institute of Population and Development, Parivar Seva Sanstha, New Delhi. 

[8] Kothari, Devendra (2019): Nurturing Human Development: A Strategy for New India, New Delhi: Paragoan International Publishers.

 

[9] Kothari, Devendra (2020): ‘Empowering Women in India: A Viewpoint’, Productivity (National Productivity Council), Vol 61(2), pp 115-24.

 

[10] Quraishi Y.S. (2021): The Population Myth, HarperCollins, New Delhi.