What Will Happen to India s Demographic Burden as Long as It Can Continue to Reduce Its Birth Rates

Why India Is Making Progress in Slowing Its Population Growth

India is soon projected to become the world's most populous nation, with nearly 1.5 billion people. But behind that statistic lies a more complex reality: Population growth is leveling off in most areas due to rising affluence and advances in women's education and family planning.

India is set to surpass China as the world's most populous country by 2027, according to recent United Nations projections. The country now has 1.37 billion people — second only to China's 1.4 billion — and is expected to add another 230 million by 2050, many of whom will be among the world's poorest.

Prime Minister Narendra Modi may have had those facts in mind earlier this year when he called on Indians to have small families. Yet those alarming statistics hide a more complex reality, and some positive trends, experts say.

As in much of the rest of the world, India's growth rate has been slowing for the past few decades, a decline attributed to increasing alleviation of poverty; rising education levels, especially among women; and growing urbanization. Most Indian states are expected to hit replacement fertility levels of 2.1 children per woman by 2021. Fertility rate has already declined to an average of 2.2 in 2017, according to a government survey of 22 major states, while urban fertility has already fallen below replacement level, to 1.7 children per woman. (The replacement fertility level refers to the number of children born per woman so that one generation exactly replaces the preceding one.)

Still, nine of those states have fertility rates above replacement levels, including five of the poorest. And experts say that India still has a large unmet need for modern contraceptive methods and relies too heavily on sterilizing women. The United Nations estimates that more than 10 million Indian women a year have unintended pregnancies.

According to current estimates, India's population will peak in the early 2060s at 1.7 billion, putting additional pressure on the environment and natural resources and boosting greenhouse gas emissions —though the average Indian generates a fraction of the planet-warming emissions produced by the average American or European. Most of India's population increase by mid-century will be due to demographic momentum, meaning that even as fertility rates fall below replacement levels, the large numbers of young people will continue to boost the country's population, says P. Arokiasamy, head of the Department of Development Studies at the Indian Institute of Population Sciences in Mumbai.

Globally, the trend is clear: The period of high fertility is almost over.

This scenario parallels global trends. With the exception of a few regions, notably sub-Saharan Africa, fertility levels have been falling worldwide in the past two decades, resulting in slowing population growth. The United Nations has even lowered estimates of future population growth, projecting this year that, under a medium growth scenario, global population will hit 10.9 billion in 2100, down from an estimated 11.2 billion a few years ago. Other demographers are even more optimistic, with some mid-range estimates putting global population at 9.5 billion and falling in 2100 due to improved education and better access to family planning services.

Whatever the numbers, the trend is clear. "The period of high fertility is almost over," says Frank Swiaczny, head of the population trends and analysis branch at the United Nations Population Division. The main uncertainties now, he says, concern the pace of fertility decline in some African countries and fertility levels in countries such as France and the Netherlands, which for years experienced sub-replacement fertility levels but now see fertility creeping up again. "For people doing assumptions for models, those are the really open questions," he says.

The overall number of people on the planet still poses a significant challenge, both for the environment and for countries struggling to provide a basic standard of living for everyone. "While it has been argued that technology can help us to accommodate population and economic growth, I think we are seeing with climate change, widespread land degradation, and depletion of freshwater resources …. that already the world's carrying capacity has reached certain limits," says Alex de Sherbinin, an associate director at Columbia University's Center for International Earth Science Information Network. While affluence in developed countries is the most important driver of carbon emissions, he says, "demographics cannot be ignored completely."

Yet demographics can be difficult to talk about, in part due to the unsavory history of population control. In the 1960s and 1970s, alarm over population growth outstripping food supply — fears never realized as agricultural production soared thanks to the Green Revolution — led to coercive policies such as China's one-child rule and India's infamous forced sterilization camps. India's sterilization program, supported by international agencies such as the World Bank, began as an ostensibly voluntary effort (though men and women were paid to be sterilized), but soon turned involuntary. More than 8 million people were forcibly sterilized in 1976 and 1977, most of them men who had to undergo vasectomies.

Activists protest India's sterilization policies in New Delhi in 2014, after more than a dozen women died from botched procedures in the state of Chhattisgarh. AP Photo /Manish Swarup

Apart from the human rights issue, these policies had disturbing long-term consequences. In China, a preference for sons has led to a generation with a predominance of males. In India, the sterilization drive was a setback for family planning, says Poonam Muttreja, head of the Population Foundation of India. "[Then Prime Minister] Indira Gandhi lost the elections, and it became unacceptable for politicians to focus on population again," Muttreja says. That's one reason, she believes, that India's family planning program did not move beyond female sterilization for decades. "For 30 years, we hardly added any new contraceptive methods," she says, noting that injectable forms of contraception have only recently been added to family planning programs.

A backlash against coercive population control policies led to the adoption of an agenda focused on women's reproductive health and rights at the 1994 UN International Conference on Population and Development. However, the legacy of target-driven, sterilization-based family planning persisted. A 2012 Human Rights Watch report found that district health workers in India had to meet informal targets, especially for sterilization, leading them to pressure poorer women to undergo operations without informing them of other family planning options. The Indian Supreme Court finally banned mass sterilization camps in 2016, two years after 15 women died in botched procedures in a camp in the state of Chhattisgarh. Doctors in that camp sterilized 80 women in five hours with the same instrument, according to local media reports; some of the women had been forced to undergo the procedure.

Population control can also be used to target migrants and minorities. In India, Hindu nationalists frequently raise the bogeyman of a "Muslim population bomb." Earlier this year, one Indian minister Giriraj Singh, who has previously criticized Muslim population growth, supported calls for a punitive two-child norm.

In the context of climate change, the issue is complicated by concerns about equity. A recent open letter by 11,000 scientists on the climate emergency was criticized in some quarters for emphasizing population, which was seen as targeting developing countries, where most growth is happening. Historically, carbon emissions in developed countries have been largely responsible for global warming, and per capita emissions in Europe and the U.S. are still 10 times higher than many poorer countries in Asia or Africa. A 2019 study found that one child born in the U.S. would add 9,441 metric tons to the mother's carbon emissions compared with 1,384 tons in China and 56 tons in Bangladesh.

The Indian states with the highest fertility rates also have the lowest socioeconomic indicators.

Also, although the focus in the population debate is almost always on the impact of sheer numbers, research suggests a more complex relationship when composition and distribution of population is taken into account. For instance, urbanization is linked to lower fertility and more energy efficiency. But urbanization also drives up emissions through greater economic activity and increased consumption, which also lead to more land-use conversion and pollution, Swiaczny notes.

Still, Western environmentalists like Robin Maynard, head of the UK-based Population Matters, believe population growth has a place in the climate debate. For one thing, he notes, the UN's world population projections for 2100 range as low as 7.6 billion — slightly less than today's 7.7 billion and 3 billion less than the medium fertility scenario. "Going up or down by half a child in the fertility rate makes a huge difference to the cumulative total" of population and thus carbon emissions, he says.

"We don't support policies that are against human rights or directed at particular communities," says Maynard. Countries that have stabilized their populations such as Bangladesh and Sri Lanka, he adds, "have implemented programs that empowered women and gave them safe family planning choices. They are meeting rights and also meeting planetary needs."

Societies generally experience falling fertility rates as incomes and education improve, child mortality declines, and more women work, a demographic transition captured in the saying, "Development is the best contraceptive." India's experience largely supports this. The states with the highest fertility rates – Bihar, Uttar Pradesh, Jharkhand, Rajasthan, and Madhya Pradesh – also have the lowest socioeconomic indicators, especially with regard to women. Bihar, for instance, which has India's highest fertility rate (3.2), has the largest percentage of illiterate women (26.8 percent). By contrast, low-fertility Kerala has a literacy rate of 99.3 percent, the result of decades-long state focus on basic education and health care. Fertility declines have been especially sharp in India's cities and towns — where women are more likely to marry later, go to school, and work — and in southern states, which include the IT hub of Bangalore, where education levels and age of marriage are generally higher.

The fertility rate for women in India has sharply declined in recent decades, as it has in other countries in Southern Asia. United Nations

Still, modern contraceptive availability has not kept pace with the increasing desire for small families in most Indian states, says Muttreja. As recently as 2016, India spent 85 percent of its family planning funds on female sterilization. Many Indian women have never been given the choice of contraceptive methods such as the birth control pill or injectibles, she says, and the country's high abortion rates are a "proxy" for the unmet need for contraception and birth spacing. Better family planning options — including promoting male contraceptive methods — are not only about population: Unsafe abortions contribute to a third of maternal deaths in India, or an estimated eight women a day, according to one study.

Neighboring countries that have offered wider family planning choices have experienced sharper increases in contraceptive use, says a report by Muttreja. In 2015, when India had five methods available (male and female sterilization, the pill, intrauterine devices, and condoms), contraceptive prevalence in the country was under 50 percent — lower than Bangladesh, Nepal, Sri Lanka, Bhutan, and Indonesia, which had seven or more contraceptive options. Even after injectable contraceptives were introduced in India in 2017, female sterilization continued to make up the bulk of modern birth control use.

India is nevertheless stepping up and diversifying its investment in family planning and says it has added 15.5 million contraceptive users since 2012. And this November, the country reiterated its commitment to a human rights framework in family planning. Both national and UN agencies are concentrating on the handful of high-fertility states, with an emphasis on gender equality in family planning. Speeding up fertility reduction in these states will not be easy, says Arokiasamy of the Indian Institute of Population Sciences.

"This is an issue related to local culture, society, politics," he says. "Changing attitudes takes time."

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Source: https://e360.yale.edu/features/why-india-is-making-progress-in-slowing-its-population-growth

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