Demographic Change And Population Policy In India

Socio-Economic Implications of Demographic Changes Tarun Das, Economic Adviser, Ministry of Finance, India. (i)

Population Growth in India

India’s population in 1901 was 238.4 million (Table 11.1). There was a virtually zero rate of growth during 1911-21. The acceleration of the rate of population growth since 1951 (361.1 million in 1951 to 846.3 million in 1991) is attributed to the decline in mortality, resulting from the various programmes initiated during first two five year plans to control mortality and disease. The large size of India’s population by 1991 has meant that even with a relatively moderate rate of growth of about 2 per cent, the absolute annual addition to its population during the past several years has been nearly 17 million. The density of persons per sq. Km. also increased from 117 in 1951 to 267 in 1991. Birth rates were very high and ranged between 45 and 49 in India during 1901-40, dropping to 40-41 during 1941-70 and 27-31 during the last decade 1988-1997. In 1998, the Crude Birth Rate (CBR) was 26.4. The death rate which was 42.6 and 47.2 during 1901-1910 and 1911-1920 respectively began to decline after 1921 from 36.31 during 1921-1930 to 27.4-17.8 during 1941-1970. Thereafter death rates reduced substantially to 10.3 during 1971-1990. It fell to 9.0 in 1998. Among the states, death rate in Madhya Pradesh was highest at 11.2 and lowest 6.4 per thousand in Kerala in 1998. Birth rates in Kerala and Tamil Nadu in 1998 were 18.2 and 18.9 respectively; in the five states of West Bengal, Andhra Pradesh, Karnataka, Maharashtra and Punjab were around 21-22 and in Gujarat, Orissa, Haryana were between 25-28. The four large northern states of Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh continued to report birth rates between 3132. Total Fertility Rate (TFR) in1971 was estimated at 5.2. It was 4.7 in 1976, 4.5 in 1981, 4.2 in 1986, 3.6 in 1991, 3.5 each in 1994 and 1995 and 3.3 in 1997. It will be observed from Table 11.4 that there are significant variations in TFRs among states. It is evident that population stabilisation strategies will have to keep in view the diversity prevailing among states in total fertility rate, death rate and infant mortality rate. Efforts are to provide adequate inputs to improve performance so that the disparities between states will be narrowed. The urban population of India has grown faster than the rural, from 79 million in 1961 to 218 million in 1991 or from 18 to 25.7 per cent of the total population of the country. The decennial rate of population growth has remained stable around 2.1-2.2 per cent during 1961-1991. The urban population has grown at the average annual rate of 3.82, 4.61 and 3.65 per cent during 1961-71, 1971-81, 1981-91. One of the features of Indian demographic behaviour, which has been the cause for considerable concern has been the more or less steady decline in the sex ratio during the current century from 972 females per thousand males in 1901 to 927 in 1991. The absolute size of the deficit of women, relative to the number of men, has risen from 4 million in 1901 to 32 million in 1991. The sex ratio for the country of 927 females per

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1000 males is indicative of extensive discrimination against women. Only Kerala has a sex ratio exceeding unity. The urban population of India has generally shown a higher deficit of women than the rural population because migration from rural to urban areas is dominated by males. However, since 1961, the deficit of females in urban India has steadily declined because of the progressively lower importance of migration as well as lesser sex-selectivity in migration. A decline in ratio of women was observed between 1981 and 1991 census only in rural India where sex ratio declined from 951 to 939 due to a higher than “normal” sex ratio at birth and excess female mortality. (ii)

Impact of high population growth on the economy

The rapid population growth and urbanisation pose some serious challenges. Urban population growth has outpaced the development of basic minimum services; housing; water supply, sewerage and solid waste disposal are far from adequate, increasing waste generation at home, offices and industries, coupled with poor waste disposal facilities result in rapid environmental deterioration. Increasing automobiles add to air pollution. All these have adverse effect on ecology and health. Poverty persists in urban and peri-urban areas; awareness about the glaring inequities in close urban setting may lead to social unrest. Over 70 per cent of India’s population still live in rural areas. There are substantial differences between the States in the proportion of rural and urban population (varying from almost 90 per cent in Assam and Bihar to 61 per cent in Maharashtra). Agriculture is the largest and one of the most important sectors of the rural economy, both as a contributor to economic growth and employment. Its contribution to the GDP has declined over the last five decades but agriculture still remains the source of livelihood for over 70 per cent of the country’s population. A large proportion of the rural work force are small and marginal farmers and landless agricultural labourers. There is substantial under employment among these people; both wages and productivity are low. These in turn result poverty; it is estimated that 320 million people still living below the poverty line in rural India. Though poverty has declined over the last three decades, the number of poor has in fact increased due to the population growth. Poor tend to have larger families which puts enormous burden on their meager resources and prevent them from breaking out of the shackles of poverty. In States like Tamil Nadu where replacement level of fertility has been attained population growth rates are much lower than in many other states but the population density is high and so there is a pressure on land. In States like Rajasthan, Uttar Pradesh, Bihar and Madhya Pradesh, population is growing rapidly, resulting in increasing pressure on land and resulting land fragmentation. Low productivity of small land holders leads to poverty, low energy in-take and under nutrition, and this, in turn, prevents the development of thus creating a vicious circle. In most of the States, non-farm employment in rural areas has not grown very much and cannot absorb the growing in labour force due to high population growth. Those who are getting educated specially beyond the primary level do not wish to do manual agricultural work. They would like better

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opportunities and more remunerative employment. In this context, it is imperative that a programme of skill development, vocational training and technical education is adopted on a large scale in order to generate productive employment in rural areas for those living there. The entire gamut of existing poverty alleviation and employment generation programmes may have to be restructured to meet the newly emerging demand for employment. Rural poor have inadequate access to basic minimum services, because of poor connectivity, lack of awareness, inadequate and poorly functional infrastructure. There are on-going efforts to improve these, but with the growing aspirations of the younger, educated population, these efforts may prove to be inadequate to meet the increasing needs both in terms of type and quality of services. Greater education, awareness and better standard of living would create the required consciousness among the people that smaller families are desirable; if all the felt needs for health and family welfare services are fully met, it will be possible to achieve substantial decline in the family size and enable the families to improve quality of life. High population growth also pose problems for supply of basic goods and services such as drinking water, electricity, foodgrains, housing, transport and communications. Per capita availability of these goods and services in India are much below the levels in developed countries. Although India ranks fourth after USA, Japan and China in terms of purchasing power adjusted GDP, India with a per capita income of only $400 is regarded as one of the poorest countries of the world. Almost 40 per cent of world poor population live in India. (iii)

Planning, Growth and Demographic Change in India

The overriding objective of India's economic and social development is to improve the quality of lives that people lead, to enhance their well-being, and to provide them with opportunities and choices to become productive assets in society. In 1952, India was the first country in the world to launch a national programme, emphasizing family planning to the extent necessary for reducing birth rates "to stabilize the population at a level consistent with the requirement of national economy". After 1952, sharp declines in death rates were, however, not accompanied by a similar drop in birth rates. The National Health Policy, 1983 stated that replacement levels of total fertility rate (TFR) should be achieved by the year 2000. On 11 May 2000 India is projected to have 1 billion (100 crore) people, i.e. 16 per cent of the world's population on 2.4 per cent of the globe's land area. If current trends continue, India may overtake China in 2045, to become the most populous country in the world. While global population has increased threefold during this century, from 2 billion to 6 billion, the population of India has increased nearly five times from 238 million (23 crores) to 1 billion in the same period. India's current annual increase in population of 15.5 million is large enough to neutralize efforts to conserve the resource endowment and environment.

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India's demographic achievement during last 50 years of overall planning and the national family welfare programme is summarised below: • • • • • • •

Reduced crude birth rate (CBR) from 40.8 in 1951 to 26.4 in 1998; halved the infant mortality rate (IMR) from 146 per 1000 live births (1951) to 72 per 1000 live births (1998); quadrupled the couple protection rate (CPR) from 10.4 per cent (1971) to 44 per cent (1999) reduced crude death rate (CDR) from 25 (1951) to 9.0 (1998); added 25 years to life expectancy from 37 years to 62 years; reduced total fertility rate from 6.0(1951) to 3.3. (1997,SRS). achieved nearly universal awareness of the need for and methods of family planning.

Stabilising population is an essential requirement for promoting sustainable development with more equitable distribution. It is important to make reproductive health care accessible and affordable for all and to increase the provision and outreach of primary and secondary education. It is also equally important to extend basic amenities including sanitation, safe drinking water and housing to all, to empower women, to enhance their employment opportunities, and to provide transport and communications to the mass. (iv)

National Population Policy 2000

The National Population Policy 2000 (known as NPP2000) formulated in 2000 affirms the commitment of government towards voluntary and informed choice and consent of citizens while availing of reproductive health care services, and continuation of the target free approach in administering family planning services. The NPP 2000 provides a policy framework for advancing goals and prioritizing strategies during the next decade, to meet the reproductive and child health needs of the people of India, and to achieve net replacement levels (TFR) by 2010. It is based upon the need to simultaneously address issues of child survival, maternal health, and contraception, while increasing outreach and coverage of a comprehensive package of reproductive and child health services by government, industry and the voluntary non-government sector, working in partnership. The basic objectives of the National Population Policy include the following: • • • •

The immediate objective of the NPP 2000 is to address the unmet needs for contraception, health care infrastructure, and health personnel, and to provide integrated service delivery for basic reproductive and child health care. The medium-term objective is to bring the TFR to replacement levels by 2010, through vigorous implementation of inter-sectoral operational strategies. The long-term objective is to achieve a stable population by 2045, at a level consistent with the requirements of sustainable economic growth, social development, and environmental protection. In pursuance of these objectives, the following National Socio-Demographic Goals to be achieved in each case by 2010 are summarised below:

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(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

(11) (12) (13) (14)

Address the unmet needs for basic reproductive and child health services, supplies and infrastructure. Make school education up to age 14 free and compulsory, and reduce dropouts at primary and secondary school levels to below 20 per cent. Reduce infant mortality rate to below 30 per 1000 live births. Reduce maternal mortality ratio to below 100 per1000, 000 live births. Achieve universal immunization of children against all vaccine preventable diseases. Promote delayed marriage for girls, not earlier than age 18 and preferably after 20 tears if age. Achieve 80 per cent institutional deliveries and 100 per cent deliveries by trained persons. Achieve universal access to information/counseling, and services for fertility regulation and contraception with a wide basket of choices. Achieve 100 per cent registration of births, deaths, marriage and pregnancy. Contain the spread of Acquired Immunodeficiency Syndrome (AIDS), and promote greater integration between the management of reproductive tract infections (RTI) and sexually transmitted infections (STI) and the National AIDS Control Organisation. Prevent and control communicable diseases. Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services, and in reaching out to households. Promote vigorously the small family norm to achieve replacement levels of Total Fertility Rate. Bring about convergence in implementation of related social sector programs so that family welfare becomes a people centered programme.

The National Population Policy has the following strategic themes: (i) (ii) (iii) (iv) (v) (vi) (vii) (viii)

To enhance public and private funding for health and family planning Decentralised Planning and Programme Implementation Convergence of Service Delivery at Village Levels Empowering Women for Improved Health and Nutrition Increased Participation of Men in Planned Parenthood Improvement of Child Health and Survival Meeting the Unmet Needs for Family Welfare Services Meeting the special interests of the vulnerable and Under-Served Population Groups viz.: (a) Urban Slum, (b) Tribal Communities, (c) Hill Area Populations, (d) Displaced and Migrant Populations (e) Adolescents

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(ix) (x) (xi)

To provide encouragement and incentives to diverse health care providers To provide motivational and promotional measures for small family norms Collaboration With and Commitments from Non-Government Organisations and the Private Sector (xii) Mainstreaming Indian Systems of Medicine and Homeopathy (xiii) Strengthening Contraceptive Technology and Research on Reproductive Health and Child Health (xiv) Providing better health care services for the Older Population (xv) Improvement in Information, Education, and Communication Technology for health care services (xvi) Strengthening legislation, public support and basic infrastructure • To establish National Commission on Population • To establish State/UT Commissions on Population • To establish Coordination Cell in the Planning Commission • Technology Mission in the Department of Family Welfare (v)

Outlook

Demographic transition is a global phenomenon; high population growth is inevitable in the initial phases of the transition. For India the current phase of the demographic transition is both a challenge and an opportunity. The challenge is to ensure human development and optimum Utilisation of human resources. The opportunity is to utilise available human resources to achieve rapid economic development and improvement in quality of life. Over the last five decades the country has built up a massive healthcare infrastructure for delivery of FW services to the population in the Government private and voluntary sectors. There is universal awareness about the need for these services; in the next two decades the population growth will be the younger, more literate and aware population will be able to make optimal use of available facilities. India is currently in the phase of demographic transition where it will be possible for the country to accelerate the pace of decline in fertility. If the population now has ready access to good quality services at affordable cost, it will be possible for them to meet all their needs, achieve the desired family size and enable the country to achieve population stabilisation rapidly. Demographic transition does not occur in isolation. Simultaneously, there are ongoing economic transition, education transition, and health transition and reproductive health transition. All these affect human development. If there is synergy between these transitions; the transitions can be completed rapidly; there will be substantial improvement in human development and economic development. The focus of planners, programme implementers and people during the next two decades will have to be in achieving the synergy so that India can achieve rapid population stabilisation, improvement in economic social and human development.

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