How successful have we been in attaining population goals laid down by policies and programs? :India: a historical perspective
Research Scientist, Public Health Foundation of India, New Delhi
Background, Rationale and Objectives
India accounts for only 2.4% land area and more than 17% of the world’s population. With a population of 1.2 billion i.e., equal to that of six countries, it is anticipated to become the most populous country surpassing China in 2030.
Fertility decline continues, contraceptive use has increased but quantitative goals of replacement level fertility is yet to be achieved as a result prospects for country’s future fertility are of considerable interest. This study aims to
Data and Methods
Data for the study has been drawn from various secondary sources – Census, SRS, NFHS, DLHS, AHS & FW statistics. Geographical coverage included EAG states – UP, Bihar, MP, Rajasthan, Odisha, Jharkhand, Chhattisgarh, Uttarakhand & Assam and Non EAG states of TN & AP that have achieved replacement level fertility
Findings: Levels and Trends
India’s population during 1951 was 361.1 million and increased by more than three times in 60 years to 1210 million in 2011. Although it continues to grow in size, pace of net addition is decreasing due to population momentum and fertility decline. Significant fall in growth rates in Empowered Action Group (EAG) states and non EAG states was seen during 2001-2011.
CBRwas 21.4 per 1000 live births in 2013. A decline of about 15 percentage points during the last 40 years period was observed. In EAG states, in 2011 the CBR was as high as 27 per 1000 live births in Uttar Pradesh and Bihar and as low as 18 in Uttarakhand.
ASFRreveals that highest fertility attained in the age group 20-24 accounting for about 31 per cent for India as a whole
TFR during 2012 was 2.4 births per woman. Largest decline was observed during 2001-2011 (23%) followed by 1981-91 (20 %). During 2005-2011 after the launch of the NRHM, TFR declined by 0.5 children, a decline of about 17 per cent. India’s TFR was estimated at 5.2 in 1971 and it declined to 2.4 in 2012 (a decline of about 54 per cent in 40 years). During 2001-11 in UP TFR declined by 24%.
Third and higher order births account for 25 % of total births in India. The percentage share of higher order births in EAG states vary from 26% in Odisha to 43% in Bihar and in low fertility states, it is about 9% in Andhra Pradesh and 10 % in Tamil Nadu.
Proximate Determinants: Marriage, Contraception & unmet Need
Mean age at marriageis 21.2 years for females in India, in all other EAG states it is higher than national average except in Rajasthan (19.8), Jharkhand (20), Bihar (20.1) and Uttar Pradesh (20.2).
The % of women married before legal age of 18, in India, is high (22% ) and varies across states. Percentage of currently married women (20-24 years) married before legal age varies from more than 40% in Bihar, MP, Rajasthan & Jharkhand to around 5% in Tamil Nadu.
Contraceptive use: CPR any modern method has risen from 42.5 in 1998-99 ) to 45.7 in 2002-04 and to 47.1 in 2007-08 an annual increase of about 0.5 per cent in nine years. Recent estimates for EAG states from AHS, 2013-14 reveal that the modern contraceptive use is highest in Rajasthan (62%) followed by Madhya Pradesh (59%). In Bihar and Jharkhand less than 40 per cent of the currently married women use a modern contraceptive method. .
Method Mix: Female sterilization is the prime method and accounts for more than 80% of modern method use. Spacing methods account for 10-15%. Overall in last 20 years a declining trend in male sterilization & IUCD was observed.
Institutional Deliveries a window of opportunity for uptake of Family Planning Services: JSY scheme resulted in drastic increase in institutional deliveries both nationally (from 56% in 2006-07 to 83% in 2012-13) as well as in all the EAG (more than 80% in states of Bihar, MP, Rajasthan, 50% in UP and in non-EAG states. Integration of FP & MCH services would help increase uptake of family planning particularly postpartum contraception
Unmet Need: 13 per cent of currently married women have an unmet need for contraception ; unmet need for limiting (7%) is slightly higher than unmet need for spacing (6%). Unmet need declined from 20% to 13 % in 13 years
Findings: Progress under various policies and Programs
So far goals sets by all policies and programs have not been met
Conclusions and Recommendations