New Delhi: We have all heard the doomsday predictions about the implications of unchecked growth in India’s population, and demands for a population-control law from politicians make the headlines every now and then.
But the fifth edition of the Union government’s National Family Health Survey (NFHS-5), released on 12 December, suggests the fears may be unfounded. According to data on fertility rates presented in the survey, India’s population is stabilising.
A population is said to stabilise once it achieves what is known as replacement-level fertility — that is the total fertility rate at which a population exactly replaces itself from one generation to the next.
Replacement-level fertility is roughly 2.1 children per woman, although it may vary slightly with mortality rates. This means that if two adults have two children, it translates to the new generation effectively replacing the old one, without adding additional members.
Data in the NFHS-5 currently accounts for 17 states and five Union Territories (UT) as the survey was delayed in the remaining areas on account of the Covid-19 pandemic.
While data from some larger states such as Uttar Pradesh — India’s most populated — and Madhya Pradesh — among the top states by population — is still awaited, the areas surveyed throw up promising results.
Apart from three states — Bihar, Manipur and Meghalaya — all the states and UTs surveyed so far have reported a total fertility rate of 2. Even for Bihar, Manipur and Meghalaya, the rate has declined since the last survey in 2015-16.
“We do not need a two-child norm and we do not need to have a fear of a population boom. India’s population is stabilising,” said Poonam Muttreja, executive director of the Population Foundation of India (PFI), an NGO.
“It is important to note that population is stabilising across states, this trend is not limited to some regions,” she added.
Anand Lakshman, a Bengaluru-based public health expert and founder-CEO of AddressHealth, a paediatric primary healthcare service, said even the 2011 Census had confirmed that India’s population is stabilising.
Many factors affect fertility rate
Experts say there are many factors that affect fertility rates, including the use of contraceptives.
Data from the NFHS, a multi-round survey conducted in a representative sample of households throughout India, shows that the decline in fertility rate has been accompanied by an increase in the use of contraceptives.
In Assam, the fertility rate went down to 1.9 from 2.2 as the use of family planning methods went up to 60.8 per cent from 52.4 per cent.
In Bihar, the total fertility rate has declined to 3.0 in 2019-20 from 3.4 in 2015-16, with 55 per cent of families now using different methods of family planning, as opposed to 24 per cent in the last survey.
“The data shows that use of contraceptives has significantly improved in the last four years,” said Lakshman.
Dr Rajib Acharya, a researcher at Population Council, an NGO, said other factors that affect fertility rate include abortions, proportion of women who are married, and education.
Talking of abortion, Acharya added that there is no data on the practice, and that there is no reason to believe it may have increased significantly.
About the second factor, he said, “Proportion of women who are married in the age group between 15-49 — that is the reproductive age group — has been 97 to 98 per cent in the last few years.”
The age of marriage is consistently increasing in India. Except for West Bengal, all states have registered a decline in the proportion of women who are married, according to NFHS-5. “That would be another factor that led to the decline in fertility,” he said.
Research, he added, has shown that women’s education has the highest impact on decline in fertility rates.
“When girls are in school, they get married later. They have better agency and their negotiation skills also improve,” he said.
Kerala sees rise in fertility rate
The only state in the survey that marks a rise in fertility rate as compared to NFHS-4 is Kerala, going to 1.8 from 1.6.
According to Lakshman, it is not possible to draw conclusions on why this may have happened in a relatively developed state like Kerala. However, he added that it would be interesting to analyse whether the higher fertility rate is due to the migrant population working in Kerala.
Workers from Bihar and Bengal — which have lower education levels — travel to Kerala for work and this may explain the increase in fertility rate, he said.
“However, this is purely speculative at this point. We need micro-level data to understand this better,” he added.
Among other notable findings of the survey, female sterilisation continues to be the most popular modern method of contraception in a number of states, such as Andhra Pradesh (98 per cent), Telangana (93 per cent), Kerala (88 per cent), Karnataka (84 per cent), Bihar (78 per cent) and Maharashtra (77 per cent).
According to PFI’s Muttreja, family planning should not be the burden for women alone. “It is not just a women’s issue, it is as much a men’s issue… The easiest contraception methods are condoms and vasectomies. So, men have to step up going forward. These are the safest methods of contraception,” she said.
Muttreja said the NFHS-5 is good news, but cautioned that “we still have a long way to go”.
“We should still make further efforts in the states and districts where there is a high fertility rate and unwanted pregnancy,” Muttreja added.
Among other things, she advised against complacency about the survey finding that suggests most families have access to family planning.
“India should not get complacent because the number of people who need family planning services and access to contraception is still very high,” she added.
Given the fact that the population is stabilising, Muttreja also pointed out that India has to prepare for an ageing population. “Given the demographics, we have to start really planning for the social security of the aged.”
Public health expert Lakshman agreed, but said the demographic shift will take a long time since India is a large country. “Our older population is still very small. But some of the more developed states are definitely heading in that direction,” he added.
Lakshman said data from large states like Uttar Pradesh and Madhya Pradesh is eagerly awaited because they have a higher impact on the overall numbers for India.