Infant mortality

Population Stabilisation – Issues and Concerns

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India’s population growth rate has been declining over the years but the overall population will continue to grow as more than half the people are in the reproductive age group and more will join this group each year

IND1A S 2001 census puts the country’s population at over I billion, In the next twenty years India will be the most populous nation in the world overtaking even China. The population of India’s a states is comparable to large countries.

India has grappled with the issue of population stabilisation* for over 60 years. Although stabilisation was projected to take place by 2045, the performance of several states indicates that this will shoot past this forecast with serious implications for sustainable development. On the positive side India has the benefit of a young population and it can expect high levels of productivity and lower levels of dependency. even as the developed world is confronted by the prospect of aging and low fertility. While India’s youth could be a huge asset it could also be a dangerous liability, because unless the population is healthy it will pull hack development.

In the next 16 years, the bulk of the population growth will take place in Uttar Pradesh, Utrarakhand. Bihar. Jharkhand, Madhya Pradesh, Chhattisgarh and Rajasthan-accounting for more than 50% of the growth. In contrast the Southern states will add only 13% to the total population growth.

Fertility Pattern among Different States -The Challenge Ahead:

The Total Fertility Rate (TFR) signifies the average number of children a woman will produce in her childbearing years. Alok Ranjan Chaurasia and S. Gulati in “India the State of Population 2007” have divided the country into three groups.

1. In the first group there are the Hindi belt States and some north-eastern states like Manipur and Meghalaya. Together they will account for more than half the population growth in the country by 2026. In these States. lowering fertility will be very difficult as the majority of couples use no contraception.

2. In the second group, stand States like Maharastra, West Bengal, Gujarat, Haryana and Orissa, which have achieve the two child goal.

3. The third group of States comprises Andhra Pradesh, Goa, Hirnachal Pradesh, Karnataka, Kerala. Punjab and Tarmil Nadu. These States will account for hardly 15 per cent of the population growth by 2026 and have already achieved replacement levels of fertility with two children per woman.

Enforcement of the legal age of marriage — The Challenge ahead:

Marriage take place very early particularly in rural India. Later marriages will do more to stabilise India’s population momentum than any other measure. In rural areas 60 to 70% of the women are married by 18 particularly in states like Bihar, Jharkhand. Rajasthan. Uttar Pradesh and Madhya Pradesh. The percentages are as low as 20% among rural girls of Kerala and Himachal Pradesh where girls continue to study and get married at a later age. This shows that over time, change is possible but the challenge lies in focusing on the age of marriage which has a direct relationship with the mother’s and child’s health.

Very early child bearing and an absence of spacing increase risks to mother and child. Teenage pregnancies are the cause of a high number of maternal deaths. Repeated pregnancies increase the risk of death and disability to both mother and child.

Apart from the Hindi belt states., Andhra Pradesh and West Bengal also stand out as examples of states where the marriages before the legal age are unusually high. The Jansankhya Sthirata Kosh, (JSK) also called the National Population Stabilisation Fund has started implementing a strategy in districts where the prevaicnce of the practice of early marriages is exceptionally high by giving awards and financial rewards for girls to marry after 19, where the first birth this when the girl’s 21 years old and the second after she is 24 years old. These are all responsible parenting practices. Role models from the community have been showcased at public functions emphasizing why it is necessary for the girl to be in good health at the time of pregnancy and childbirth.

To give a positive example, Himachal Pradesh placed strong emphasis on the enforcement of the legal age of marriage and simultaneously encouraged girls to stay in school. It has the lowcst percentage of boys and girls married before the legal age. School retention is also far higher than the rest of the country with (be exception of Kerala. That is the model that would work in the northern states but ii requires a new focus which is completely absent at present.

  • Need of Registration of Marriage –
  • Legal and Social aspect: The only way that this can he enforced is by making the registration of marriages compulsory and at that time documentary proof of to be shown about the age of the girl and boy.

    The Supreme Court order: On 25th October 2007 the Apex Court directed that all marriages should be registered. It was reiterated by the Supreme Court that marriage should be compulsorily registered ‘sin respect of persons who are citizens of India even if they belong to various religions.’

    The Rajya Sabha Committee on Petitions recently in its Hundred and Thirty-Fifth Report 2009 on Introduction of Sex Education in Schools included the following recommendation:

    “Students should be made aware qf the marriageable age which is 21 years in the case of boys and 18 in the case of girls…. . Students should also be made aware that child marriage is illegal and is injurious i’o the health of the girl child”

    Major factors that impact on population stabilisation:

    Three factors impact upon population growth and are intrinsically linked, The first is maternal mortality which refers to a woman’s death linked to pregnancy having a direct impact upon population stabilisation because that determines how far a newborn child will receive care during infancy. If mothers die, children are bound to be neglected. Therefore institutional deliveries are being given a lot of emphasis. The good news is that there has been a huge response to the Governments Janani Suraksha Yojana (JSY) and the number of women who have availed of hospital delivery facilities has increased from 29 lakhs to 73 lakhs during 2007-08. Unless maternal mortality reduces it would be difficult to ensure child survival. This leads to a vicious cycle of having several children to compensate for the ones that die.

    Maternal Mortality (MMR) – The Challenges Ahead: Within the country there are huge disparities in maternal mortality. The latest figures show a huge improvement over the past. All- India MMR having fallen from 301 in 200 l-0.3 to 254 in 2004-05.

    Although the southern states of Tamil Nadu and Kerala have fared comparatively well, still, their maternal mortality levels are far higher than those of neighboring Sri Lanka and China.

    The positive development is that hospital deliveries have increased by more than 40% in the Hindi belt states which are now poised to register lower MMR. That in turn wifl impact very positively on population siabilisation as both mother and children will receive institutional care, also essential to deal with obstetric complications.

    Infant Mortality – The Challenges Ahead:

    High Infant Mortality Rate (JMR) is the second significant factor that impacts on population stabilization, as parents continue to have several children because they know that some will die. Infant deaths refer to children who die before reaching their first birthday. Among infant deaths, IMR is higher in rural areas and excessively so when the mother’s age is less than 20. If the birth interval is less than two years the IMR escalates hugely. The challenge lies in reducing infant mortality and for that two critical factors are the mother’s indifferent health and lack of spacing between children.

    Family planning – challenges in meeting the unmet demand for contraception :

    The third aspect is improving access to contraceptive products and services. More than half India’s population is in the reproductive age group and only half are using contraceptives. In this we are far behind neighbouring countries like Indonesia. Sri Lanka and Thailand. Sterilisation is the most common method of limiting families but nearly 96% of all sterilisations were until recently carried out only on women with hardly 1% on men.

    In the last two years numerous steps have been taken to offer a range of contraceptives and to upgrade the skills of the medical and paramedical workers responsible for providing family planning services. Fixed day services are being widely publicised and there is a revival of interest in male sterilisation. Compensation money for undergoing sterilisation operations has also been increased and private providers have been encouraged to join in family planning activities with a tee for procedures carried out.

    As a result of these initiatives, vasectomies (male sterilization) have registered a huge increase which had been declining up to 2007. The increase was 84% increase last year and this year it has crossed 24% increase in the first six months of the year.

    Overall the total sterilization figures (male and female) have gone up significantly. In the entire 1-Hindi belt States except Madhya Pradesh and Chhattisgarh the performance has increased appreciably over the last three years. This is a reversal of past trends and the emphasis on family planning given by these states is a very positive sign.


    India’s population growth rate has been declining over the years but the overall population will continue to grow as more than half the people are in the reproductive age group and more will join this group each year. With only half of them using contraceptives, it may take several decades more to achieve the goal of achieving planned families which is a necessary requirement for sustainability.

    India’s maternal and infant mortality levels are very high and repeated childbirths are seen as an insurance against multiple infant and child deaths. Vast numbers of people cannot avail of services even when they are available, due to problems of knowledge and access.

    The progress in the last two years has been remarkable, which gives the hope that the importance of population stabilization has been recognized by people themselves. This has now to be sustained and accelerated particularly in the Hindi belt states where fertility Levels are very high. Many of the factors that impact upon population momentum are cultural in nature. Attitudes to early marriages, expectations about early childbearing, and disregard for the need for spacing between children need to be altered. Low female literacy impacts adversely on safe motherhood and the maternal care that their children receive. Additionally a strong son preference leads to negative feelings towards girls and results in pre-natal sex determination and elimination of the female foetus.

    All these issues require that civil society fully understands the importance of driving change. Within civil society, political representatives, the media and religious leaders can play the most influential role.