India
is the second most populous country in the world after China. As per 2011
census, India has a population of about 1.2 billion with an annual growth rate
of 1.64%. Our population density which was 117 persons per square km in 1951
has now increased to 382 persons per square km, much higher than 144 persons
per sq km for China. In the last decade itself (2001-2011) we have added 18.1
crore people to our population. The increase is almost equal to the population
of Brazil (19.07 crores) or Pakistan (18.4 crores) which are 5th and
6th most populous countries of the world. This increase in
population absorbs the results of most of our economic achievements and is a
major hindrance in increasing the per capita availability of resources.
The size of population and high growth rate had been a
cause of concern even during the British period. The Government had set up a
Committee in 1943 to conduct a survey on Indian Health System. The Committee
was called The Health Survey and Development Committee. The Committee submitted
its report in 1946 in which it devoted one chapter to the problem of increase
in population recommending thereafter “the spreading of the knowledge of birth
control as far as the limitations imposed by the peculiar circumstances of the
country will permit”.
After independence, the matter was
taken up in the five year plans wherein family planning was treated as a part
of the health programmes. These emphasized family planning to the extent
necessary for reducing birth rates to “stabilize the population at a level
consistent with the requirement of Indian economy”. National Health policy of
1983 emphasized the need for achieving small family norm through voluntary
participation. National Health Policy of 2002 pointed out that efforts for
improving health standards of the people have been partly neutralized by rapid
growth of population and also that population stabilization measures and
general health initiatives when synchronized, maximize the socio-economic well
being of the people.
However, as a need was felt for a
National Population Policy, an expert group under Dr.M.S.Swaminathan was set up
in 1993 to prepare a draft of the policy. The Committee submitted its report in
1994. The Report basically related
population growth to the basic needs, democratic decentralization, gender
issues and eco-system. These features were incorporated in the 'Statement on
National Population Policy”.
National Population Policy
National Population Policy was
announced in the year 2000. The policy took note of the fact that the growth in
population was due to the large size of the population in the reproductive age,
high fertility due to inadequate availability of contraception, high wanted
fertility due to high infant mortality rates and most of the girls marrying
below the age of 18. Some of the important objectives of the policy were as
under:
- Address
the unmet needs for basic reproductive and child health services, supplies and
infrastructure.
- Make school education up to age 14 free and compulsory, and reduce dropouts at
primary and secondary school levels to below 20 percent for both boys and
girls.
- Reduce
infant mortality rate to below 30 per 1000 live births.
- Reduce
maternal mortality ratio to below 100 per 100,000 live births.
- Achieve
universal immunization of children against all vaccine preventable diseases.
- Promote
delayed marriage for girls, not earlier than age 18 and preferably after 20
years of age.
- Achieve
80 percent institutional deliveries and 100 percent deliveries by trained
persons.
- Achieve
universal access to information/counseling, and services for fertility regulation
and contraception with a wide basket of choices.
- Achieve
100 percent registration of births, deaths, marriage and pregnancy.
- Contain
the spread of Acquired Immunodeficiency Syndrome (AIDS), and promote greater
integration between the management of reproductive tract infections (RTIs) and
sexually transmitted infections (STIs) and the National AIDS Control
Organization.
- Prevent
and control communicable diseases.
- Integrate
Indian Systems of Medicine (ISM) in the provision of reproductive and child
health services, and in reaching out to households.
- Promote
vigorously the small family norm to achieve replacement levels of TFR.
- Bring
about convergence in implementation of related social sector programmes so that
family welfare becomes a people-centered programme.
Targets and achievements
As
per census of 1951, crude birth rate (CBR) was 40.8, Infant Mortality Rate
(IMR) was 146, crude death rate 25 and total fertility rate was 6. As per
Sample Registration Survey for the year 2012 Crude Birth Rate (CBR) is 21.6;
Crude Death Rate (CDR) is 7.0; Infant Mortality Rate (IMR) is 42 and Total
Fertility Rate (TFR) is 2.4. These
figures would indicate that the country has made substantive progress in
population management since 1951. However, when we see it from the perspective
of the targets set by the National Health Policy and National Population Policy
we find that our achievements falls short of the targets under the National Population
Policy. Similarly, with respect to TFR, National Health Policy targeted
replacement levels by 2000 and National Population Policy targeted these levels
by 2010, but the figure for the year 2012 is 2.4, which is again much higher
than the target. At this rate we may take another 10 years or so to achieve this
level of TFR.
National
Population Policy sets the target of achieving a stable population by 2045,
that is, after 35 years of achieving the replacement level. The projections
appear unrealistic considering the example of China which attained replacement
level of total fertility rate in 1990. However, its population is still growing
and is expected to achieve peak level only in 2050 after which it will stabilize
or gradually decline. Thus, in China, peak level is expected to be achieved
after 60 years of achieving replacement level of fertility rates. As India,
does not have such a vigorous population control policy as China time taken by
India is likely to be much higher.
Reasons
for underachievement
The
above said data indicates the many of the targets set by the National
Population Policy have not been achieved. The reasons could be as under:
- 1. Unlike China, we
have resorted to voluntary participation in population control measures;hence
efficacy of these measures would depend on the ability to convince people to
have a smaller family. This makes, literacy level a very important factor. As
per Census, 2011, Kerala, which has the highest literacy rate of 93.91%, has a
very low annual growth rate of .48% while Bihar which has lowest literacy rate
of 63.82% has a high annual growth
rate of 2.26%.
- 2. Poverty is
another important factor. In such families, an additional child is treated as a
potential earning hand and hence birth of a child is not discouraged.
- 3. In a number of areas
particularly in remote areas, adequate health and birth control facilities are
not available without which the people cannot adopt family planning measures.
- 4. Social factors also
play an important role. Traditional Indian society prefers early marriage of
girls which means that a married woman has more years of reproductive period.
This is an important factor in increasing fertility rate and leads to growth in
population.