Only 24 per cent of the married
women between 15 and 49 years want a second child. For men, the corresponding
proportion is 27 per cent, down from 49% a decade ago.
National Family Health Survey-4 (NFHS-4 (2015-16)
Ministry of Health and Family Welfare,
Government of India
Dr. Devendra Kothari[1]
Population and Development Analyst
Forum for Population Action
It was a
wet morning at Red Fort as the country awaited the flag hosting ceremony and
address to the nation by PM Narendra Modi on its 73rd Independence Day. The nation of 1,350 million people was eagerly to know what PM Modi thinks about “New
India”, which he promised during the General Election.
Among many issues PM Modi raised from the
ramparts of Red Fort, the issue of “Population Explosion” was very critical. He
emphasised “small family is good for the society, nation... High time the
nation debates this and brings a law if needed...Else we will soon run out of
resources”. It is because virtually all major problems that
confront India today relate in some critical way to the galloping population.
It leads to a massive 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 like education, health,
sanitation, provision of safe drinking water, etc. That could be the reason why PM Modi brought up the
issue of Population Explosion. In fact, he is the first prime Minister of India
who dwelled at length on this issue from a public platform.
India's
demography is mind-boggling. India’s
population in 1947 was 330 million and in 2018 it was 1350 million. In last
seventy years it has quadrupled. India now contains about 18% of humanity
(i.e. every sixth person in the world is an Indian). China is the only country
with a larger population ‑ in the order of 70 million
more in 2018 as compared to 300 million in 1990. The Indian population grew at an
annual rate of 1.24% during 2010-15. On the other hand, China registered a much
lower annual growth rate of population (0.61%) during the corresponding
period. Based on the analysis of recent
data, it is estimated that India will overtake China in the next 3-5 years that
is before 2025.[2]
The current population growth in India,
however, is mainly caused by unwanted fertility. Around five in ten live
births are unintended/unplanned or simply unwanted by the women who experience
them and these births trigger continued
high population growth. Around 26 million children were born in India in 2018, and out of
this about 13 million births could be classified as unwanted. Further, based on the
National Family Health Surveys (1 to 4), it is estimated that in 2018 around 430
million people out of
1350 million in India were a
result of unwanted pregnancies. With 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 16 - 17 million annually, and while 14 million women, especially in the lower
economic strata including Muslims, seek to postpone childbearing, space births,
or stop having children; they are not using a modern methods of contraception.
This is also known as the ‘unmet need’ for contraception. Often, women with unmet need for family planning
services travel far from their homes 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 or poor
quality of services. When women are thus turned away, they are unable to
protect themselves from unwanted/unplanned pregnancies and sexually transmitted
infections. And this type of incomplete control over the reproductive
process reduces the prospects for an early decline in the rate of population
growth. [3]
Incidents of
unwanted pregnancies can be dramatically reduced, if not eliminated, within a
next five years by simply providing
reproductive services as per the needs of clients, as had been done in Andhra Pradesh during
the nineties. If Andhra, with little outside help, could
manage its population growth under relatively low literacy and high poverty
(Literacy Rate of AP in 2011 was 67.7% compared to 67.1% in Rajasthan, as per
2011 Census), there is no reason why other states especially Four Large North
Indian (FLNI) States of Bihar, MP, Rajasthan and UP, with lesser problems and
with increasingly generous support from the Centre, should fail so
spectacularly in managing unwanted fertility.
The people
of the FLNI states are not against small family norms. While general knowledge
about family planning is almost universal, access to modern methods of
contraception services and products is a big problem in these states.
India must ensure that every child
is a wanted one. So government must provide client-centred reproductive health services with
special reference to poor performing states.
It will help in meeting women’s needs for family planning and that would
help in avoiding numerous reproductive health-related issues. Women who are
able to delay or stop childbearing when they wish to are more likely to meet
their children’s educational goals, earn a living and support their families,
and manage changes in their environment and natural resources. Reducing
incidence of unwanted pregnancies will help in achieving the national goal of
population stabilization at the earliest.[4]
The need of the hour, thus, is to
create confidence among policy makers and programme
managers especially in the poor performing states that a breakthrough is
possible. There is no need to implement
coercive measures like one-child norm or to provide incentives and
disincentives. The real need is to provide services in un-served and
underserved areas by realigning the capacity of health system to deliver
quality care to suit the needs of clients.
A failure to stabilize India’s population will have
significant implications for the future of India’s economy, that was the
concern, one can see on the face of PM Modi while he was talking about this
issue from the rampant of Lal Qila.
[1]
Also see article by author at: https://timesofindia.indiatimes.com/readersblog/population-and-development-in-india/do-indians-want-more-children-5190/
[2] Calculated by the author using data obtained from the
Registrar General and Census Commissioner of India and National Family Health Surveys.
[3] Kothari, Devendra. 2014. “Managing Unwanted Fertility in India:
Way Forward”, -- in Suresh Sharma and
William Joe. (eds.): National Rural Health
Mission: An Unfinished Agenda, Bookwell, New Delhi.
[4] For details,
see: Kothari, Devendra.
2019. Nurturing
Human Development: A Strategy for New India, New Delhi: Paragoan International
Publishers. A copy of the publication could be obtained by contacting author at
dkothari42@gmail.com.
