What the fertility rate decline means for India

Is India's population declining?

In a milestone of sorts, India’s National Family Health Survey 2019-21 (NFHS-5) has recorded a decline in the total fertility rate (the average children a woman has) from 2.2 in the previous survey ( 2015-16) to 2.0 in the latest one. And here too, it was 1.6 in an urban population and 2.1 in a rural setting. Public health experts are taking a moment to let this sink in, as it indicates the population is stabilising – some states are inching up, others largely trending downwards, the direction is towards an equilibrium.

What has made this demographic transition possible?

The dip in fertility is attributed to a combination of factors, including better contraception initiatives and government health and family welfare schemes. But a key factor is the education of the girl child and efforts to improve overall health and nutrition.

Is it a positive development?

With about 25 million babies born every year, health administrators have often pointed out that no Government anywhere in the world would be capable of creating schools and other facilities at such a pace. A stabilisation was what the health administration has been working towards all these years, and indeed, that moment has arrived, it seems.

Does this mean that India will not overtake China to become the most populous nation globally?

There are too many variables to make that prediction, including how China handles its declining population. Across geographies, there is a declining trend, but experts believe that India may still be on the path to becoming the most populous nation. A critical step, however, has been achieved in stabilising growth. India has achieved replacement level fertility (pegged at 2.1), defined as the level at which the decline on a sustained basis would result in a generation replacing itself.

Are all States uniform in this development?

The short answer is no. The latest NFHS is the fifth in the series and was done in two phases because of pandemic-induced restrictions and lockdowns. It

provides information on population, health, and nutrition across India, down to the state and union territories. But different regions reflect different stages of development.

The second phase of the NFHS (covering 14 States and UTs) saw a TFR range from 1.4 in Chandigarh to 2.4 in Uttar Pradesh. All Phase-II States have achieved replacement level of fertility (2.1) except Madhya Pradesh, Rajasthan, Jharkhand and Uttar Pradesh. According to reports, five states with TFR above 2 were Bihar, Meghalaya, Uttar Pradesh, Jharkhand and Manipur. Just shy of TFR 2 were Haryana, Assam, Gujarat Uttarakhand and Mizoram at 1.9. Six states - Kerala, Tamil Nadu, Telangana, Arunachal Pradesh, Chhattisgarh, and Odisha were at 1.8. Further at 1.7 were Maharashtra, Karnataka, Andhra Pradesh, Himachal Pradesh, Nagaland, and Tripura. And TFR was the lowest in this survey in West Bengal, at 1.6.

What policy changes should the government make to adjust to this reality?

Public health voices and doctors say the government should focus on more of the same – educating the girl child across the board. It’s one of the single most critical factors, as with education, the family’s overall well-being improves, say specialists in women and child health.

Alongside, family planning and reproductive health awareness need to be imparted to adults, and they need to be encouraged to adopt these measures. Coercive policies should be kept out. Education gives young people, especially girls, a greater sense of awareness and well-being that prevents early marriages and pregnancies. This is critical in keeping the population in check, even as health administrators would now brainstorm on calibrating this growth from now on, to prevent the demographic profile from losing its balance between young and older populations.