The recently released National Family Health Survey 2019-21 has much to be happy about. India’s population growth, which hogged so much of the headlines and policy debates in the 1970s and early 1980s, seems to be on the path of stabilisation.
First, the good news. The total fertility rate (the average number of children born to a woman) — both rural and urban combined — has come down to 2.0 from 2.2 in the last survey conducted in 2015-16.
This means India’s population officially is on a downward trend. In population and demographic studies, fertility rate of 2.1 is known as the replacement rate of the population. This means that women having a family size of 2.1 are replacing the population. Or in other words, the number of people dying are being replaced at the same rate by new births. A fertility rate of 2.1 is an indication of the population size of the country stabilising.
A rate below 2.1 indicates that the country’s population is actually falling, which seems to be happening in the case of India. The urban and rural fertility rates are also revealing. In urban India the fertility rate is just 1.6 while in rural India the rate is 2.1. This means even in rural India the family sizes are getting smaller.
Women choosing to have smaller families is a huge positive, both in social and economic terms. On the economic front, smaller families mean that households can allocate greater resources for education and healthcare for their children. On the social front, it means greater empowerment of women as they have greater say in their reproductive choices.
Population trends
On the overall population front, it means that India’s population, currently at close to 1.4 billion, is expected to peak to 1.5 to 1.6 billion between 2040 and 2050. After which, going by current trends, there is likely to be a rapid drop in population. Some estimates say that by the time this century ends there will only be a billion Indians, which is a good 40 million less than today.
But as journalist Rohit Saran, in a recent column, says, this is a mixed blessing. Apart from the positive news on the resource allocation and welfare front, India by at least the middle of this century, will have to grapple with an ageing population, much like how Japan and some Western European countries are dealing with now.
Saran says that the peak of our demographic dividend is already behind us. So, the most obvious fallout of this shrinking population is a contraction of the labour force. Also if the number of elderly rise that will automatically raise the costs of taking care of them — pensions, healthcare, and so on. This could in future also lead to retirement ages being pushed beyond 60. Already in some European nations the retirement age is 67.
The other way to deal with an imminent fall in labour force is to encourage immigration into the country. But this issue is a political hot potato as we have seen in the case of the US as well as EU nations.
The other positive news is that neo-natal, infant and under-five mortality rates have fallen in 2019-21 from the 2015-16 survey at the all-India level — though there are likely to State-wide disparities. This is an indication of improving status of general healthcare and maternal healthcare.
Pain points
Now the bad news. The sex ratio at birth has declined in seven States in the last five years to below 950. Sex ratio is calculated as the number of female children born of every 1,000 male children born. This is a crucial indicator of economic and social development of the country and is also a vital indicator of the status of women in society.
The most alarming news on this front is that even Kerala — a State that has consistently topped the social and human development charts — has seen drop in sex ratio at birth from 1,047 to 951. Tamil Nadu, another State that is high on the social and human development charts, has seen its sex ratio at birth plummeting to 838 from 954 in the 2015-16 survey.
Tamil Nadu Health Secretary J Radhakrishnan was quick to say that the State will work on the 17 districts where the sex ratio is below the national average.
The survey has a wealth of data on health and nutritional status of children and women in India which needs to be analysed further. For now, the country can rest easy that the dire predictions of the past of population explosion and starvation deaths were overblown.
Also more importantly the data from the recent survey also punches a hole in the population policies that many States, led by Uttar Pradesh, in the last one year, were eagerly trying to implement.