Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Reality check on India’s Population policy

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Population prospectus,NFHS report

Mains level : Declining fertility,Population prospectus and development

population

Context

  • Earlier this year, the United Nations published data to show that India would surpass China as the world’s most populous country by 2023.According to the 2018-19Economic Survey, India’s demographic dividend will peak around2041, when the share of the working age population is expected to hit 59%.

What is the Present status of India’s population?

  • Declining Total fertility rate (TFR): The Total fertility rate (TFR) has declined from 2.2 (reported in 2015-16) to 2.0 at the all- India level, according to the latest National Family Health Survey of India OR NFHS- 5 (phase 2) released by Union Health Ministry.1.6 in urban areas2.1 in Rural area and 2.0 all India.
  • Sex ratio: There are 1,020 women per 1,000 men in India according to the recently released Fifth Edition (NFHS-5). Such a sex ratio has not been recorded in any of the previous four editions of the NFHS.

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Need for population control measures

  • At present, India hosts 16% of the world’s population with only 2.45% of the global surface area and 4% of water resources.
  • The ecosystem assessments also pointed out the human population’s role in driving other species into extinction and precipitating a resource crunch.
  • So, the population explosion would irreversibly impact India’s environment and natural resource base and limit the next generation’s entitlement and progress. Therefore, the government should take measures to control the population.

What will be the Impact of declining fertility?

  • Implications on Political economy: It’s not just the economic implications that we need to think about but also the implications of the political economy.
  • Spatial difference: India’s fertility fell below 2.1 births for certain States 10 years ago. In four other States, it’s just declining. So, not only is the fertility falling, the proportion of the population that will be living in various States is also changing.
  • North-south imbalance: The future of India lies in the youth living in U.P., Bihar, M.P. If we don’t support these States in ensuring that their young people are well educated, poised to enter the labour market and have sufficient skills, they will become an economic liability.

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How India can take advantage of its demographic dividend?

  • Investing In literacy: If China hadn’t invested in literacy and good health systems, it would not have been able to lower its fertility rates. In any case, we have much to learn from China about what not to do.
  • Planning for elderly: Especially in the case of the elderly, where the estimates show that12% of India’s total population by 2025 is going to be the elderly. Every fifth Indian by 2050 will be over the age of 65. So, planning for this segment merits equal consideration.
  • Focusing on gendered dimension: India certainly has the capacity to invest in its youth population. But we don’t recognise the gender dimension of some of these challenges. Fertility decline has tremendous gender implications.
  • Lowering the Burdon on women: What it means is that women have lower burden on them. But it also has a flip side. Ageing is also a gender issue as two thirds of the elderly are women, because women tend to live longer than men do. Unless we recognise the gender dimension, it will be very difficult for us to tap into these changes.
  • Educating the young girls: So, what do we need to do? India has done a good job of ensuring educational opportunities to girls. Next, we need to improve employment opportunities for young women and increase the female employment rate. Elderly women need economic and social support networks.

Do we really need the population policy?

  • Existing policy is right: India has a very good population policy, which was designed in 2000. And States also have their population policies. We just need to tweak these and add ageing to our population policy focus. But otherwise, the national population policy is the right policy.
  • Reproductive health is important: What we need is a policy that supports reproductive health for individuals. We also need to start focusing on other challenges that go along with enhancing reproductive health, which is not just the provision of family planning services.
  • Avoiding the stigma: We need to change our discourse around the population policy. Although we use the term population policy, population control still remains a part of our dialogue. We need to maybe call it a policy that enhances the population as resource for India’s development, and change the mindset to focus on ensuring that the population is happy, healthy, productive
  • Thinking beyond two child policy: Our arguments and discussions have not gone beyond the two-child norm. The two-child norm indicates a coercive approach to primarily one community. And there are too many myths and misconceptions around population issues, which lead to this discourse, which takes away attentions of from real issues.

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Way forward

  • Family welfare approach: We need to move from a family planning approach to a family welfare approach. We should be focusing on empowering men and women in being able to make informed choices about their fertility, health and wellbeing.
  • Thinking about automation: As fertility drops and life spans rise globally, the world is ageing at a significant pace. Can increasing automation counteract the negative effects of an ageing population or will an ageing population inevitably end up causing a slowdown in economic growth? We need to look at all of that.
  • Changing the mindset: We are where we are, so let’s plan for the wellbeing of our population instead of hiding behind the excuse that we don’t have good schooling or health because there are too many people. That mindset is counterproductive.
  • Skill development and making population productive: It is not about whether the population is large or small; it is about whether it is healthy, skilled and productive. Thomas Malthus had said as the population grows, productivity will not be able to keep pace with this growth, and we will see famines, higher mortality, wars, etc. Luckily, he proved to be wrong.
  • Adhering to the Cairo consensus: Cairo International Conference on Population and Development in 1994 stressed population. The Cairo Consensus called for the promotion of reproductive rights, empowering women, universal education, maternal and infant health to untangle the knotty issue of poverty and high fertility. The consensus also demands an increase in the rate of modern contraceptive prevalence, male contraception. States instead of releasing population control measures can start to adhere to implementing the Cairo consensus.
  • Adopting Women-Centric Approach: Population stabilisation is not only about controlling population growth, but also entails gender parity. So, states need to incentivize later marriages and childbirth, promoting women’s labor force participation, etc.
  • Seeing Population as a Resource rather than Burden:
    • As the Economic Survey, 2018-19, points out that India is set to witness a sharp slowdown in population growth in the next two decades.
    • Further, population estimates also predict a generational divide between India’s north and south, Fifteen years from now.
    • So instead of population control policies at the state level, India needs a universal policy to utilize population in a better way.

Conclusion

  • We have the capacity to tap into the potential of our youth population. There is a brief window of opportunity, which is only there for the next few decades. We need to invest in adolescent wellbeing right away, if we want to reap the benefits. Otherwise, our demographic dividend could turn easily into a demographic disaster.

Mains Question

Q.Why India’s fertility rate is declining? How India can convert its demography into opportunity by investing in gendered based population policy?

 

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