Hum Do Family Planning

The second phase of data collected by National Family Health Survey-5 (2019—21) was released on November 24, 2021. The survey was conducted in two phases due to the COVID-19 pandemic. The National Family Health Survey — 5 was being conducted in March 2020, but had to be abruptly stopped  due to COVID -19 Lockdown. Therefore, in its first phase, the data of 22 states and union territories collected before the COVID-19 pandemic was released in December 2020. According to the National Family Health Survey —5, for the first time in India, the birth rate has fallen below the replacement ratio of 2.1. According to the survey, the country’s fertility rate has come down to just 2.0 from 2.2 in the National Family Health Survey-4 (2015-2016) and 2.7 in the National Family Health Survey- 3 (2005-2006). The fertility rate is 1.6 in urban areas while it is still 2.1 in rural areas which is equivalent to the replacement rate( Figure 1).

Figure 1

                            Fertility Rate below Replacement Level

fertility rate

Source:National Family Health Survey-5 (2019-2021)

According to the National Family Health Survey—5, only five states of the country, Bihar (3.0), Meghalaya (2.9), Uttar Pradesh (2.7), Jharkhand (2.4), and Manipur (2.2) have recorded relatively high fertility rates and this is also above the replacement rate.

Table 1

   Top Five States  of High Fertility Rates 

Bihar 3.0 3.4
Meghalaya 2.9 3.0
Uttar Pradesh 2.4 2.7
Jharkhand 2.3 2.6
Manipur 2.2 2.6

Source:  National Family Health Survey-4(2015-16) and 5(2019-21)

Although the fertility rate in these five states has been recorded above the replacement rate, the positive side is that it is lower than the National Family Health Survey-4. According to the National Family Health Survey—5, Sikkim recorded a fertility rate of only 1.1 which is lower than all the states and union territories of the country. The fertility rates seem to point to a glimpse of the impact of population control measures.

The World Health Organisation(WHO) describes Total Fertility Rate as the average number of children born to a woman “at the end of her reproductive period”. Replacement level fertility is the level of fertility at which a population exactly replaces itself from generation to the next. One couple replaces two children, if a couple has more than two children then it will lead to rapid population growth. With less than two children, the population will certainly increase, but at a declining rate. In Sikkim, Ladakh, Goa, Andaman & Nicobar, Lakshadweep, Jammu & Kashmir, and Chandigarh, the fertility rate is less than 1.5. Maharashtra and Rajasthan have a fertility rate of 2 which is equivalent to the national average, while in the remaining 22 states and union territories, the fertility rates range between  1.6  and 1.9.

Since the country’s independence in 1947 the problem of population growth in India has always been a matter of concern for governments. The first family planning scheme was planned in 1952. The governments of the time did not take up to  implement it out of fear of their vote bank.The then Prime Minister  Indira Gandhi launched a controversial public sterilization campaign in 1972. It did not result in  controlling  population growth, but it did a great deal of political damage to the Congress Party.

In 1950, the fertility rate in the country was 5.90 which meant that there were an average of 6 children in a household. Since then, the average fertility rate has been declining every decade but at a much slower pace. From 1950 to 2021, the fertility rate has come down from 5.90 to 2.0, which is a relief for the country, but it does not mean that the country’s population will start declining rapidly.In the long run , we will have a potential growth rate of zero, it is not immediate. So far  the country has achieved the goal of stability. According to a study published in the journal Lancet, even if India’s fertility rate continues to decline at the current rate, after 80 years from now (by the end of the century) the country’s population might shrink to 1billion(100 crore), equal to the population of many countries. The study also found that by then, the fertility rate would have dropped from 2.0 to 1.27.

According to the United Nations’ World Population Data Sheet, 2021, India’s population will surpass that of China during 2024-28 and India will become the world’s most populous country. Although the declining fertility rate in India is a very important indicator of population growth, it may delay the time for the country to become the world’s most populous country for a few more years. Much more needs to be done to get rid of it.

According to the current survey, the reason for the decline in fertility is the use of various contraceptives. There has been a 13 per cent increase in the number of people using contraceptives as compared to the National Family Health Survey-4. At present, an average of 67 per cent people in the country are using contraceptives and  institutional births have increased from 79 per cent to 89 per cent. At the same time, 76 per cent of children are being vaccinated over time, which has led to a sharp decline in infant mortality.

The share of women in sterilization is higher than that of men. It has increased from 36 per cent in 2015-2016 to 38 per cent 2019-21. The increase in female sterilization shows that the onus remains with women. It is also important to point out that declining fertility is an important factor in controlling the population, but at the same time infant mortality at birth or at an early age also affects population growth because child mortality  rate then will affect both birth and fertility rates.

Due to lack of nutrients in the diet of children, they are not fully developed as a result of which 36 per cent of children in India are not growing according to their age. At present, 67.1 per cent children in the country are anemic. It is 57 per cent in females and 25 per cent in males. Sadly, this percentage has increased by 8.5 per cent in children, 4 per cent in women and 2 per cent in men as compared to 2015-2016. According to the National Family Health Survey-5, the depressing message from the anemia-affected population is that 67 per cent of children and 57 per cent of women are suffering from anemia due to lack of nutritious food. How can such mothers and children create a golden future for the country!

Although the National Family Health Survey —5 has recorded more women than men in the country, it generally represents more than the census data. The National Family Health Survey-1 (1992-93) had 957 females per 1000 males, compared to 927 females in the 1991 census. Similarly, according to the National Family Health Survey -2( 1998-99), the number of women was 960 per 1000 males whereas according to the 2001 census it was 933 and National Family Health Survey -4 (2015-2016) the number of women was 991 as against  943  in 2011 according to the census. From all these figures, it is clear that the number of women is slowly increasing, but it may take some more  time for them to reach the same level as men.

Figure 2

Number of Females per 1000 Males


Source: National Family Health Survey -5 (2019-2021)

With the declining fertility rate, the percentage of children under the age of 15 in the total population is declining rapidly. According to the National Family Health Survey-1 (1992-93), the population of children under this age group was 38 per cent which has now come down to 26.5 per cent. This shows that India’s population will continue to grow at a declining rate in the near future, which will have a profound effect on the economic and social fabric of the country.

Apart from the government’s family planning programme, one of the reasons for the declining fertility rate is people’s perception of small families. Although in India, ‘the one child policy’ like China, was not imposed on the people, still has a birth rate of 1.1 to 1.9 in 29 states and union territories. This will make it easier for the government to control population growth as people move to a limited family of one child on their own. In states like Bihar, Uttar Pradesh, and Jharkhand, there is an urgent need to implement programmes like ‘Mission Parivar Vikas’ on a large scale and seriously increase the literacy rate of women in these states and make them financially independent. In this direction the government should make serious efforts. Between 40 and 45 per cent of women in these three states are still illiterate. To curb population growth, the government needs to make adequate arrangements for replenishing the nutrients in the diet of women and children. While the declining fertility rate is a good sign, more efforts are needed to bring it down as compared to  the replacement rate across all the states.

Dr. Gurinder Kaur is Former Professor, Department of Geography, Punjabi University, Patiala.

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