Continue to invest in health and education to get the best from this stabilising demographic profile

On December 01, 2021, the government released factsheets of key indicators on population, reproductive and child health, family welfare, nutrition and others for India as well as 14 states and UTs, clubbed under phase two, of the 2019-21 NFHS-5.

This is a major demographic milestone for India as in the last two years, its total fertility rate slipped below the replacement level for the first time. The replacement mark— which is a woman giving birth to 2.1 kids in her lifetime -- is a benchmark and will help keep the fertility rate that keeps a population stable over time by balancing births with deaths. If it is below 2.1, it means that the population is heading for a decline.

In my view, the findings are a clear sign that that fertility rates in India have finally stuck a population peak. It is interesting to note that despite an unprecedented and a challenging environment, in a span of just five years, from NFHS 4 (2015-16) to NHFS 5 (2019-20), the use of modern contraceptives for family planning has jumped by 8.7 percentage points – from 47.8 per cent to 56.5 percent.

All this clearly signals that the decrease in fertility is the function of indicators such as the use of contraception, increase in the age of marriage, more awareness and advances in career progression opportunities available, changing lifestyles and life choices as well as government health schemes are reasons for this shift. Infact the current generations strongly believe that they cannot afford to have two children. Education of girls plays a key role in these changes.

Fertility rates will decrease further and even states like Bihar, Meghalaya, Uttar Pradesh, Jharkhand and Manipur which currently have the highest fertility levels -- even higher than the national average will have lower fertility rates which are beyond the replacement rates once we focus on education of the girls and the availability of modern contraception methods for population control. We will soon see a time when we will have a model of countries like Japan where we will end up with a very elderly population with a very small young population that will not be be able to provide the income to put into social security.

Education and prosperity indicators

In my view, over and above everything, women education matters the most and these trends indicate that India’s religious composition does not matter as long as girls in every religion are educated for 10-12 years at least. In India and elsewhere, education is a primary factor in how many children women tend to have. Other prosperity indicators – such as life expectancy and average levels of wealth – also frequently correlate with fertility measures: Women who have better access to schooling, jobs and health care tend to have fewer children.

Hence, India’s population will start to shrink sooner than expected. For this to happen there is no necessity to bring in laws that enforce population control. A country’s population, along with how fast it grows and its composition, has a significant impact on its economic growth. India’s population is among the youngest in the world and the country is said to be on the cusp of enjoying a demographic dividend if we continue to invest in education and our health systems. This young population should not be subject to population control laws that have no scientific basis. Our focus should only be to educate them (including on reproductive health) and provide them with jobs that are commiserate with their level of education.

(The writer is Director (Medical Services) Cloudnine Group of Hospitals, Bengaluru. Views are personal.)

(eom)

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