Dr. Devendra
Kothari
Population
and Development Analyst,
Forum for
Population Action
What
the future holds for every Indian is more queues and troublesome time ahead
unless India concentrates on basic issues.
Anniversaries like
Independence Day are a time for celebration, but they are also a time for
introspection. India has just celebrated
its 66th birthday on 15th August, a healthy age among the nations
that emerged after World War II. However, sixty years of a planned economy has
not been able to resolve some basic issues. We have the largest number of hungry, malnourished and
illiterate people in the world, terrible infant and maternal mortality. These
are facts the Indian elite does not want to look at, as noted by Jayati Ghosh, one of the world's leading development economists.[1] “We just want to prove we have arrived at the
world stage”.
In comparison of with other developing
countries, India has fallen badly in major development indicators. One of the
strong indicators of a nation’s progress is the state of life expectancy at birth. It measures overall quality of life or welfare
in a country. Life expectancy, not surprising, is low in India,
as compared to other countries. Table 1
indicates that an Indian born today is projected to live to the age of 64, which
is one of the lowest among major developing countries. The table indicates that around fifty years ago, there were no great variations in the life expectancy
between India and other populated Asian countries like China and Indonesia, but
since then gap has increased sharply. A variation in life expectancy is mostly
caused by differences in public heath, medical care, living conditions, nutrition,
etc.
Poverty, easy to
spot but hard to define, is another indicator of
development. The United States of America sets its
poverty line at just
over $30 a day per person. Any income below that amount is judged inadequate
for the provision of fundamental wants. The threshold for dire poverty in
developing countries is set much lower by the World Bank, at $1.25 a day of
consumption (rather than income). This is an international yardstick by which
poverty reduction in developing countries is measured. Table 1 indicates that one-third of India's population is living below
International Poverty Line (IPL).[2] A comparison of other
Asian countries reveals that the poverty rate in China and Indonesia was much less
than India during the reference period - 2009-2011, but that was not the case
around twenty years ago. The hype about India’s post-liberalization
success has been busted by none other than the World Bank. The data available
shows that the rate of poverty decline in India was faster between 1981 and
1990 than between 1990 and 2005. The poverty rate - those below IPL - for India
declined from 59.8% in 1981 to 51.3% by 1990, or 8.5 percentage points over nine
years. Between 1990 and 2005 it declined to 41.6% - a drop of 9.7 percentage
points over 15 years; however the number of people below the IPL increased
to 455 million in 2005 from 420 million people in 1981. On the other
hand, East Asia’s progress has been dramatic since 1981, when it was the
poorest region in the world. For example, in China, the number of people living
on less than $ 1.25 a day in 2005 has dropped from 835 million in 1981 to 207
million in 2005.[3] It is observed that more and more people in
India could fall into extreme poverty due to soaring food and energy prices in
coming years.
Table 1: Trends in development indictors, selected countries
| ||||
Selected Countries
|
Life expectancy at birth
(in years)*
|
% of Population living under $1.25 per day ( IPL)**
| ||
1960
|
2010
|
1993-95
|
2009-11
| |
1
|
2
|
3
|
4
|
5
|
India
|
40
|
64
|
49.4
|
32.7
|
Brazil
|
58
|
72
|
13.6
|
6.4
|
china
|
45
|
74
|
54.1
|
13.1
|
Indonesia
|
43
|
71
|
54.4
|
18.1
|
Iran
|
43
|
73
|
1.4
|
1.4
|
Source: *World Population Prospects: The 2012 Revision; **World Bank Development Research Group.
| ||||
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. Growth of the Indian economy, measured in terms of GDP, has already touched a decade low of less than 5% in 2012-13. Further, the country has recorded the all-time low in exchange rate of Rs 68.80 to a US dollar. These developments could be seen as a manifestation of poor development planning. It appears that efforts made over the years for improving socio-economic standards have partially been neutralized by the rapid growth of population. Fast growing population 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 social services.
In the last 66 years, the population
of India has increased more than three and half times from 350 million in 1947
to 1250 million in 2013; and is projected to reach 1640 million by the year 2060. Population is increasing
mainly because more than two in five pregnancies are unintended/unplanned
or simply unwanted by
the women who experience them and more than half of these pregnancies result in
births that spur continued population growth. Around 26.5 million children are
born in India every year and out of them about 6 million have been classified
as unwanted. Further, based on the National
Family Health Surveys, it is estimated that there were
around 450 million people out of 1210 million in India in 2011 who were product of unwanted pregnancies, and most of them were from the
lower economic strata.[4] The consequences
of unwanted 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. And this is reflected in widespread hunger,
poverty, poor governance, 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. On the other
hand, most of the developing countries, during their initial stage of
development, gave importance
or urgency to the issue of population stabilization.[5]
On an average, a woman
in India produces 2.6 children during her lifetime. The replacement level fertility of 2.1 children per woman, required
to initiate the process of population stabilization, has already been achieved
by Thailand (1.5), China (1.6), Brazil (1.7) and even Islamic country Iran
(1.9), as shown in Table 2. Indonesia,
another Muslim dominating country is going to attain it within couple of years;
However, India will not achieve this level before 2035, as per the UN
Population Division.
Table 2: Trends
in total fertility, infant mortality and literacy rates , selected countries
|
|||||
Country
|
Number of children per woman (TFR)*
|
Infant deaths per 1000 births (IMR)*
|
% literates (age 15 and over who can read and write)**
|
||
1970
|
2010
|
1970
|
2010
|
2012
|
|
India
|
5.7
|
2.6
|
132
|
51
|
61
|
Brazil
|
5.4
|
1.7
|
100
|
24
|
89
|
china
|
6.0
|
1.6
|
63
|
18
|
92
|
Indonesia
|
5.6
|
2.2
|
118
|
29
|
90
|
Iran
|
6.7
|
1.9
|
154
|
21
|
77
|
Mexico
|
6.8
|
2.3
|
80
|
17
|
86
|
Thailand
|
6.0
|
1.5
|
76
|
12
|
93
|
Source: *World Population
Prospects: The 2012 Revision and **CIA World Fact book.
|
|||||
Poverty and
fertility are two important and closely related aspects of welfare. It is evident from Tables 1 and 2
that slow population growth leads to rapid decline in poverty. Why our politicians find that unbelievable?
The present ‘development’ strategy is failing. It is s not delivering welfare.
The ongoing debate on the views of Amartya Sen and Jagdish Bhagwati/Arvind
Panagariya has generated more heat than light. This is presented as
distribution versus growth argument.
That is wrong, as argued by Jayati Ghosh. India needs a balanced ‘development’
strategy. Mere focus on boosting growth through large investment and opening up
the economy without emphasizing on human development is not a panacea for
India’s long-term economic challenges. On the other hand, an excessive focus on
subsidy and dole-driven policies could slam the brakes on the economy and drag
people below the poverty line, rather than push up per capita income and
welfare. The Food Security Bill, for example, is a bad policy measure and does
no service to the poor. It fails the country on the two critical counts: on economic
implications and winning the war against malnutrition. Real prosperity can only be brought about by focusing
on basic structural changes aiming to improve human resources, as has been done
by many developing countries including China, Indonesia, Sri Lanka, Thailand and
Brazil (Table 2).
Now
question arises as how to forge ahead. I
believe that a stable population is most important ingredient in the sustainable
development agenda. 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 economies in the world. The
economic reforms completed 20 years in 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 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.[6] An
experiment, carried out in a selected group
of villages in Comilla district of Bangladesh, finds that equitable,
even-handed development may be a good 'contraceptive', but is not a realistic
alternative to family planning effort.[7] Also, there are some examples from
India. Andhra Pradesh is one such
example. During the early nineties, the State Government decided to revamp its family
planning program to reduce population growth. It was a political decision that
increased the use of contraceptives significantly. As per the NFHS-3, more than
two-third of
married women in Andhra Pradesh were using modern contraception in 2005-06, the
highest in the country. It had dramatic impact on fertility by reducing
unwanted pregnancies. Andhra Pradesh
exhibits one of the lowest fertility among major states of India –
1.8 children per woman in 2011, and its decadal population growth declined from
24.4% in 1991 to 11.1% in 2011. It is interesting to note that married women
in Andhra with no education or less than 5 years of education are more likely
to use contraception than women with more education, since quality reproductive
health services are easily available looking to the needs of clients.[8]
The persistence of
high levels of fertility in India especially in Four Large North Indian States
of Bihar, Madhya
Pradesh, Rajasthan and Uttar Pradesh is mainly driven
by poor access to family planning;[9]
education and reproductive health provision are crucial elements in reducing
fertility. Universal access to quality contraceptives is not yet a reality
in India — especially among the poorest. The country wide, 15 million women
would like to delay or prevent pregnancy, but are not using effective contraception.
Simply meeting this ‘unmet need’ for contraception[10]
would go a long way towards lowering fertility. Further, the demand for family
planning is expected to soar in coming years as millions of young people become
sexually active and smaller families become the norm especially in poor
performing States. So letting women have the means to manage their childbearing
will help to make India a more stable place. Hence, a decisive action is needed
now and it is the need of the hour. Key
to this new approach should be to provide quality reproductive health services
with contraceptive choices. [11] When women have
access to contraception appropriate to their needs, desires, and budgets,the potential benefits are many, including reduced maternal and
child mortality as well as lesser number of abortions and unwanted pregnancies.
In addition to its health benefits, family planning allows families and
communities to invest more in education and health care and helps reduce poverty,
as argued by the President of Population Council, Peter J. Donaldson.[12]
In other words, children by choice not by chance are the only way poor can
aspire a better life.
Another issue which
needs equal attention is quality of education, especially female 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.[13]
As such, investment in education has to be increased to improve the quality of
education especially at the government schools and colleges/universities where
most of the students are from poor and rural families. Hence, instead of
wasting money and time on enacting legislations like RTE that might turn out to
be road blokes for the implementation of a sound education policy, the
government would do well to open more educational institutions with good
infrastructure and well-trained teachers and free them from political
interference.
Living conditions
are equally important in producing an enabling environment for development. Findings of the Census of
India 2011 – Tables on Houses, Household Amenities and Assets indicate
that sub-human living conditions still
haunt people. Only 47% of households have a source of water
within the premises while 53% of households travel more than half a kilometre in rural
areas and more than 100 meters in urban areas to fetch their supplies. This problem is further compounded
by lack of access to sanitation. About 53% of Indian households do not have a
toilet within their premises. Only 28% of the households use LPG (Liquefied Petroleum
Gas) as a cooing fuel. Around two-thirds of the total households have electricity as the main source of lighting
in the country in 2011 while 31% still depend on kerosene. Any improvement in access to toilet
facilities, water, electricity and LPG is likely to result in a considerable
reduction in domestic drudgery especially for girls/women, freeing up their
time for other activities including schooling. [14]
I believe that the above measures
that can turn around dejected scenario are not Solomon’s secrets. We have been discussing
them since the launching of First Five Year Plan in 1951. However,
successive governments have failed to satisfactorily cater to the reproductive
and educational needs of the country. Maximum
investment in human resources will bring highest dividends in terms of all
round development. 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 development scenario.
There is no excuse for not trying.
[1] Jayati Ghosh,
“Marie Antoinette economists have lost their basic grounding”, Times of India,
August 5, 2013.
[2] As per the Planning Commission, Government of India, at the all
India level share of the population below poverty line (BPL) was 21.9% in 2011-12,
almost 270 million. This means that every fifth Indian lives below the poverty
line. The government has set the bar
abysmally low,
defining as BPL anyone earning Rs. 27.20
or less in rural areas and up to Rs 33.30 in urban areas. This is totally
erroneous.
[3] For details, see: http://www.reuters.com/article/2008/08/26/us-worldbank-poverty-idUSN2635022720080826.
[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] For example, in the late seventies, it was quickly realized
by the policy makers of China that with half of the population under the age of
21, further growth was inevitable even if each family was quite small. Some
drastic measures are needed. The “One Child Policy” backed by quality Family
planning services was the answer to that
concern and the Chinese leader Deng Xiaoping announced it in 1979 to limit
China’s population growth. Such interventions were also adopted in India during
seventies. Sanjay Gandhi, a member of the Nehru-Gandhi dynasty,
publicly initiated a widespread compulsory
sterilization programme to limit population growth. Journalist Vinod Mehta in his
1978 book - The
Sanjay Story
- states that the sterilization programmes were initiated
at the behest of the IMF and
the World Bank. But India could not continue
with the program.
[6]
Kothari, Devendra and S. Krishnaswamy.
2003. “Poverty, Family Planning and Fertility vis-a vis Management of Family
Planning Services in India: A Case Study”. In Maria Eugenia COSIO-ZAVALA (Ed.).
Poverty, Fertility and Family Planning, Paris: CICRED, 335-58.
[7] Barkat-e-khuda, Harbison SF, Robinson WC. 1990. “Is development really the best
contraceptive? A 20-year trial in Comilla district, Bangladesh”. Asia Pac Popul J.:5(4):3-16.
[8] Kothari, Devendra. 2013. “Managing unwanted fertility in India: Way
forward”, a paper
is prepared for the National Conference on National Rural Health Mission: A
Review of Past Performance and Future Directions, organized by the Institute of
Economic Growth, New Delhi , August 6-8, 2013.
[9] There is a wide
diversity of fertility levels among States of India. The replacement level fertility of 2.1 children per
woman, required to initiate the process of population stabilization, has
already been attained by Tamil Nadu (1.7), (Andhra Pradesh (1.8), Kerala (1.8)
and Karnataka (1.9). On the other hand,
Four Large North Indian States of Bihar (3.6), Uttar Pradesh (3.4), Madhya
Pradesh (TFR 3.1) and Rajasthan (3.0) have a long way to go before they achieve
this level.
[10]
The standard
definition of unmet need depends upon the apparent inconsistency between a
woman’s contraceptive behavior and her stated reproductive preferences. The
concept of unmet need was highlighted first time in India in a study conducted
by the author in Rajasthan in 1988 on behalf of Ministry of Health and Family
Welfare, Government of India. Based on the field data, the study revealed that
there was sizable number of eligible couples that were not using contraceptive
methods but did not want another child or want to wait two or more years before
having another child. According to the study, 15% of currently married women in
Rajasthan had unmet need for family planning services. For details, see
Devendra Kothari, Family Planning Programme in Rajasthan: Beyond the
Existing Approach, Indian Institute of Health Management Research, Jaipur,
1989.
[11] Kothari,
Devendra. 2012. “Empowering Women in India through better Reproductive
Healthcare”, in Sheel Sharma and Angella Atwaru Ateri (eds.) Empowering Women through
Better HealthCare and Nutrition in Developing Countries, New Delhi: Regency
Publications, 2012, pp 68-86.
[12] “New Vision for
Contraceptive Research and Development”, Blog Entries by Peter J. Donaldson,
posted March 6, 2013.
Also see: “Controversy over Injectable contraceptives in India” Blog Entries by
Devendra K Kothari at kotharionindia.blogspot.com, posted October 4, 2011.
[13] “How India is managing its ‘Demographic
Dividend”,
Blog Entries by Devendra K Kothari at kotharionindia.blogspot.com, posted June
26, 2011.
[14]
“Quality of life and living environment in India”,
Blog Entries by Devendra K Kothari at kotharionindia.blogspot.com, posted
September 9, 2012.
