From Population Control to Stabilization – The New Indian Express

Recently released data from the fifth round of the National Family Health Survey (NFHS-5) reveals that India’s total fertility rate (TSF) has declined to 2.0 from 2.2 in the previous round. The TFR is the number of children born to a heterosexual couple during their reproductive life. Given that 2.1 is the figure at which the population is held steady, given the likelihood of some child deaths, the latest figure suggests that the specter of population explosion need not haunt India any longer. . However, five states still have a high TFR: Bihar (2.98); Meghalaya (2.91); Uttar Pradesh (2.35); Jharkhand (2.26) and Manipur (2.17). They too must achieve a FRR of 2.1 or less.

The nomenclature of population size limitation programs has changed over the years, from population control to population stabilization and from family planning to family welfare. These changes denote the realization that “development is the best contraceptive.” Population stabilization signals a non-coercive approach to population control, while family welfare indicates that the goal is to improve the health, well-being, and social stability of small, well-planned families. .

Economic growth and equitable social development encourage the adoption of a reduced family norm. In particular, women’s education and employment in the labor force have a profound impact on couples who choose to have a small number of children. This has been confirmed worldwide and is now also validated in India. The benefits of economic growth must not only be reflected in aggregate national indicators, but must also be well distributed among all sections of the population.

Along with economic growth, improved health and social services also reduce TFR. Poor families wish to have more children who will become laborers to bolster the family income, so that they can survive at a subsistence level. As the country’s economic growth increases opportunities for gainful employment, couples emerging from poverty will limit the number of children to preserve earnings. When greater access to better health care and good nutrition improves child survival, there is no obligation to produce many children to compensate for possible child deaths and to seek security for support in old age.

Access to reproductive services is important. These include not only sterilization procedures, which have been aggressively implemented by past family planning campaigns, but also modern methods of contraception that can be used to space births. It is essential that women have easy access to these methods and autonomy to decide on their use. Female sterilization still remains the most frequently used method of contraception, indicating that men continue to place the responsibility for surgical sterilization on their female partners.

While 99% of married men and women aged 15-49 knew at least one contraceptive method, use of modern contraceptive methods for family planning was reported by only 56.4%. There was a socioeconomic gradient in access to family planning methods. NFHS-5 shows that “unmet need for family planning methods” was reported by 11.4% in the lowest wealth quintile versus 8.6% in the highest wealth quintile.

Modern contraceptive methods were used by 58.7% of women in the highest wealth quintile and 50.7% in the lowest quintile. Use of these methods was 66.3% among employed women, compared to 53.4% ​​among unemployed women. Women’s level of education is important, not only for obtaining a job, but also for awareness, autonomy and the ability to negotiate choices with a partner.

While a young population provides a demographic dividend for economic growth, healthy and well-nourished children are also essential. Loving parental attention and intellectually nurturing stimulation are essential for early childhood development. Birth spacing and a small family norm allow this. This makes knowledge of and access to family planning methods essential. Even if the objective of population stabilization is achieved, it is imperative that we invest in promoting the health and well-being of all our citizens, throughout their lives. Declining fertility frees up funds to invest in the development of our human resources.

Population stabilization is also necessary to protect the environment. A rapidly growing world population will rapidly consume the planet’s resources, increasing water and food insecurity. This will lead to more energy use, more deforestation, and even worse pollution than is currently plaguing the planet. It will also deplete biodiversity and endanger other life forms with which we share an interdependent existence. Even if science and technology have enabled humanity to escape the Malthusian trap, crossing planetary boundaries will be at our peril.

In his recent book The Journey of Humanity, economist Oded Galor argues that climate policy should not be limited to reducing carbon, but should also involve “pushing for gender equality, access to education and the availability of contraceptives, to advance the decline in fertility”. India would do well to heed this advice.

Cardiologist, Epidemiologist and Chairman, Public Health Foundation of India (PHFI)