Some 45 years ago, in the late seventies, India embarked on an ambitious population control program to curb the growing 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 faulty so Indians did not support the program after the demise of Sanjay Gandhi in 1980.
PM Modi has to understand that the situation has changed dramatically in the last four decades or so and there is no need to implement coercive methods or laws to control the population. The number of Indian women including Muslim ones wanting to have another baby is falling fast, as per National Family Health Survey-4 (2015-16). Only 24% of the married women between 15 and 49 years want a second child. For men, the corresponding proportion is 27%, down from 49% a decade ago.
However, India’s demography is mind-boggling. India’s population in 1947 was 33 crore and in 2018 it was 135 crore. 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 7 crore million more in 2018 as compared to 30 crore 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.
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 1.6 – 1.7 crore annually, and while 1.4 crore 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 unavailability 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.
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. The government must provide client-centered 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.
The need of the hour, thus, is to create confidence among policy makers and program 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 rampart of Lal Qila.
After obtaining formal degrees in population sciences from Harvard and Australian National University, Dr. Devendra Kothari has been working on population and development issues. He writes regularly on this at: Kotharionindia.blogspot.com