https://www.indiaspend.com/indiaspend-interviews/india-will-have-largest-population-but-data-show-the-growth-is-slowing-826826




India Will Have Largest Population But Data Show The Growth Is Slowing The
United Nations projects that India's total population will surpass China's
much sooner than expected, but even so, data show that India's population
is actually declining, says Poonam Muttreja of the Population Foundation of
India

ByGovindraj Ethiraj <https://www.indiaspend.com/author/govindraj-ethiraj>|19
July, 2022

ยท

*Mumbai**: "What could women do if they wanted fewer children? They were
opting for, amongst other things, abortion," says Poonam
Muttreja, executive director of the **Population Foundation of India*
<https://populationfoundation.in/pfi-team/#Team6>*. "Abortion rates as a *
*proxy*
<https://www.indiaspend.com/why-10-million-indian-women-secretly-undergo-abortions-every-year-92682>*
for
contraception are unacceptably high in India."*

*Muttreja is talking of Indian women who do not have access to
contraception, and are instead forced to abort unwanted pregnancies as a
way of family planning, which is important in light of the United Nations'
World Population Report 2022 that has **forecast*
<https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/wpp2022_summary_of_results.pdf#page=10>*
that
India will surpass China in terms of total population in 2023, four years
ahead of the previous UN **forecast*
<https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Jan/wpp2019_highlights.pdf#page=18>*
of
2027.*

*India will thus become the most populous country next year and is expected
to **reach* <https://population.un.org/wpp/Graphs/Probabilistic/POP/TOT/356>* a
total population of 1.5 billion by 2030 and 1.66 billion by 2050, the UN
said. To discuss the social implications, we spoke with Muttreja, who has a
Master's in Public Administration from Harvard University, USA and has
spent over 40 years in various roles in India's development sector.*

*Even if all these millions of young people have just one child, India's
population is going to grow, says Muttreja. But India did not need a UN
report for this, as its own data, from the National Family Health Survey,
and the Census, already show what direction the country was headed, she
explained. "Why express shock as a nation that we are overtaking China, or
our population is increasing in terms of numbers?"*

*Muttreja talks about what India must do to avoid demographic disaster, why
women need easier access to contraception, and why men need to be involved
in family planning.*

*Edited excerpts:*

*Let's look at India's population growth numbers in terms of our own
resources and our ability to provide good social and economic prospects,
including job opportunities, to our young population. Where do we stand
right now in terms of our capability of providing these resources to manage
a growing population?*

I give India literally three or four out of 10, and I'll explain why. We in
India knew where we stood in terms of demographics and numbers, and in
which direction we were going, but we have done very little to invest in
either health or education or skill development. We talk a lot about skill
development
<https://www.indiaspend.com/how-govt-skills-training-programmes-aimed-for-wrong-targets-wasted-public-funds-13387/>
and
India's demographic dividend
<https://www.indiaspend.com/indias-demographic-dividend-64-4-youth-27-3-children-in-2015-2015/>,
as though it's an automatic thing that will happen. Though there is a
window of opportunity we still have [to reap the demographic dividend],
it's limited. It won't last forever.

About 15 years ago, we got a study done which showed that only 2% of
Indians had the skills and capabilities of entering the job market, where
the good job opportunities exist. That hasn't improved very much, if you
look at the numbers
<https://www.worldbank.org/en/news/feature/2017/06/23/skilling-india>. It
could be 3% by now, but it is still dismally low.

Second, where is our investment in health? We invest 1.4%
<https://m.rbi.org.in/Scripts/PublicationsView.aspx?id=20877> [instead of]
3%
<https://populationfoundation.in/wp-content/uploads/2020/10/Government-Spending-on-Health-2.pdf>
of
our gross domestic product in health. The previous and current government
have talked about increasing investments in health. But within the health
sector, [family planning accounts for] a meagre 6%
<https://m.rbi.org.in/Scripts/PublicationsView.aspx?id=20877> of the meagre
health budget. We don't even invest much in temporary [family planning]
methods, which is what young people who want to postpone having children or
to space [apart] childbirth, need. Why do we invest 85% of our [family
planning] expenditure in permanent methods
<https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Jan/un_2019_contraceptiveusebymethod_databooklet.pdf#page=12>,
which is sterilisation? Around 77% of Indian women who undergo
sterilisation have never had prior experience with temporary methods of
family planning.

In education, I think India has made some progress, though we need to do a
lot more. I'm not going to talk about learning achievements, but just in
terms of the fact that if a woman is educated up to class 12, she'll have
fewer children, i.e. two or less, and if she has lesser education, she will
have three or more children. So there, we've made some progress.

*You also spoke about population growth slowing down, globally as well as
in India. Can you put that in context for us? Why do you say we shouldn't
worry too much about this?*

Thirty one states and Union territories in India have reached
<http://rchiips.org/nfhs/NFHS-5Reports/NFHS-5_INDIA_REPORT.pdf> the
[population] replacement level
<https://nhm.gov.in/New_Updates_2018/Report_Population_Projection_2019.pdf#page=22>
of
2.1. When I say replacement level, I'm referring to two children born to
replace two parents. There are five states in India which have rapid
population growth, of which two, Bihar and Uttar Pradesh, need investments
in population stabilisation, not coercion and incentives and disincentives.
I can tell you that the latest NFHS data show that they are also making
progress. Fertility rates are coming down in both Uttar Pradesh
<http://rchiips.org/nfhs/NFHS-5_FCTS/Uttar_Pradesh.pdf#page=3> and Bihar
<http://rchiips.org/nfhs/NFHS-5_FCTS/Bihar.pdf#page=3>.

In the short term, it is a good thing. But in the long run, it means our
population will stabilise by 2050, which is what both the Indian government
projects and international data show. In that case, we will begin to have
an adverse [dependency] ratio
<https://ourworldindata.org/grapher/age-dependency-ratio-projected-to-2100?country=~IND>
between
older generations and young people. This means we will have fewer young
people and more older people, thus we will not have enough young people to
look after older people. Plus, we don't have social security in India at
all, in any form, especially for the aged. That is going to be a problem.
Also, in about 20 years, if we don't skill our young people and create
jobs, there's going to be a demographic disaster.

*Why is it that population growth is **slowing down*
<https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/wpp2022_press_release.pdf>*,
whether in India or elsewhere?*

Let me talk about India first. In India, population growth is slowing
because people want fewer children. Frankly, women across the world want
fewer children. In India, the 'wanted fertility rate
<https://ourworldindata.org/grapher/fertility-and-wanted-fertility>' is 1.8
<https://data.worldbank.org/indicator/SP.DYN.WFRT?locations=IN>. Data in
2015 showed 16 million abortions
<https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30453-9/fulltext>,
but this would have increased, and as we don't have a subsequent
assessment, I would imagine that we are close to 20 million per year now. I
think it's a big shame and I feel very upset about the fact that women
should have to use abortion as a proxy for contraception. It shows you the
desperation.

Then, if you look at the most recent NFHS data, the unmet need for family
planning in India--i.e. people who desire to have fewer children and are
not able to because they don't have access to or the agency to opt for
family planning--is still 10%
<http://rchiips.org/nfhs/NFHS-5_FCTS/India.pdf#page=3>. No child should be
an unwanted child. In fact, an unwanted, unexpected, or unplanned child has
a 50% higher chance of being malnourished. [India also had] high under-five
mortality rates <http://rchiips.org/nfhs/NFHS-5_FCTS/India.pdf#page=3>.

Further, women or families wish to have fewer children [because] they can't
afford to feed children anymore, leave alone educate them. Look at the food
inflation rates in India.

Finally, the marginalised and poor people in terms of education and
incomes, now know how the better-off half lives, thanks to the media. They
recognise that the better-off have one or two children, and invest in them.
So they too wish to have more education and better lives for fewer children.

Another reason is that fertility has declined because the age at marriage
is increasing
<https://www.indiaspend.com/indiaspend-interviews/law-not-sufficient-to-bring-social-change-that-will-end-child-marriage-803628>.
Not sufficiently, as one in five girls still gets married below the legal
age, but we have made some progress.

*How should we be broadly preparing to become the most populous nation in
the world? To what extent will this be an opportunity, and to what extent
will it be a challenge? How do we manage our resources as a country going
forward?*

I would like to see this as an opportunity for us to invest more in family
planning and more methods [of family planning]. Every time you add a new
method
<https://populationfoundation.in/wp-content/uploads/2020/04/Fileattached-1513326457-Infographic.pdf>,
the use of contraceptives increases by 6% to 12%, and fertility declines.
In our whole region
<https://populationfoundation.in/wp-content/uploads/2020/04/Fileattached-1513326457-Infographic.pdf>,
I would say, India has the fewest number of contraceptive methods. India
needs to bring in the technology which the world is using. We are yet to
introduce implants
<https://www.nhs.uk/conditions/contraception/contraceptive-implant/>, which
is a very suitable method for people who are planning families or who want
to space their children. There is also this hormonal method
<https://www.nhs.uk/conditions/contraception/ius-intrauterine-system/> with
which pregnancy can be prevented from three to five years. There's one
method for [delaying for] three years and one for five years. It is
something for which women don't need permission from or consensus within
the family, unlike for sterilisation.

I can name any number of countries in our neighbourhood where fertility
decline has taken place on the basis of introducing new modern methods.
India needs to do that. India needs to spend more money on temporary
methods of family planning. India needs to, without coercion, involve and
engage its men in family planning. Men do not take responsibility for
family planning or for having children. I always say for men, it's about
sex, and for women, it's about getting pregnant and having families. So we
need more male methods. But of the male family planning methods that exist,
which are condoms and sterilisation, just 0.3%
<http://rchiips.org/nfhs/NFHS-5_FCTS/India.pdf#page=3> of Indian men opt
for sterilisation while among women, it's about 50%.

*You're saying that reaching this landmark of the world's largest country
by population is an opportunity to really step up the efforts on population
management, but we've tried this before as well. So are you advocating a
more stringent focus on this?*

Coercion will not work in India. Even if we succeed in coercing some
people, we are going to have adverse sex ratios because of male preference
and daughter aversion in India. China has male preference but they don't
have daughter aversion, as we do. As it is, our sex ratios are adverse and
they will decline much further [with coercive methods of population
control].

Two other points I want to add: first, we need sex education. We need to
make our young people not just aware of contraceptives, but about issues
around planning for their lives, for their education, and how early
marriage and early childbirth impacts this. We need to do comprehensive sex
education and create awareness in schools.

Second, we need young people to have more access to contraceptives. Even
today, an ANM
<https://nhm.gov.in/images/pdf/communitisation/task-group-reports/guidelines-on-asha.pdf#page=5>
[auxiliary
nurse midwife] or ASHA
<https://nhm.gov.in/images/pdf/communitisation/task-group-reports/guidelines-on-asha.pdf>
[accredited
social health activist] worker, who belongs to the same community and
shares the same social norms, doesn't encourage family planning or give
young people access to contraception. Not even newly married couples; I'm
not talking about single people. Young, newly married couples are always
told that they don't need contraception, they need to prove their fertility.

Also, as we discussed earlier, we need to invest in both education and
skill development of young people more seriously in a mission mode. This
government has shown that what it is determined to do, it does do. There
has to be determination.

Finally, we have to stop diverting the issue by saying there's a population
bomb and we need coercion. We can't just stop there. We need to do all
these other things. Just coercion is going to get us nowhere.

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