The World Population Day is time to ponder on a policy that protects our demographic assets while preparing for challenges that lie ahead
Population stabilisation has gone off everyone’s radar as India basks in the security of having the world’s largest, yet youngest populace. Even so, there are robust reasons to announce a new population policy—because unforeseen changes are taking place. While some of them bring unexpected good news, others could be harbingers of potential disaster.
First, the bad news. The National Population Policy (2000) flagged off by the then Prime Minister Atal Bihari Vajpayee has failed to achieve the basic demographic goals set out for 2010. The infant mortality rate (IMR) was to have been reduced to 30 per thousand live births and the maternal mortality ratio (MMR) to less than 100 per 1 lakh live births. Today, in 2015, five years after the goals were to have been realised, India has achieved neither. Were the goals unrealistic? Not so, if one considers how much neighbouring countries have achieved with far fewer resources and minuscule technical strength.
Sri Lanka’s MMR according to international statistics is 35, whereas India’s according to our country statistics is 167.
Sri Lanka’s IMR is 8, while India’s is five times higher. Even Bangladesh and Indonesia have succeeded in lowering the IMR below that of India. Likewise, India’s MMR today is double what the population policy expected the country to have achieved by 2010. The total fertility rate (TFR)—the average number of children a woman produces during her reproductive years—was to have been reduced to 2.1 by 2010; a figure which may not be achieved even until 2020 by present indications.
Despite this dismal result, some good things have happened. Two successful strategies which had not been envisaged by the population policy managed to achieve the unthinkable. One, the erstwhile BIMARU states of Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh, and Odisha together with Chhattisgarh, Jharkhand and Assam, comprising 261 districts and a little less than 50% of the country’s population received focused attention for the first time.
Euphemistically christened the Empowered Action Group (EAG) states, their demographic indicators began to be monitored relentlessly.
The results have been phenomenal. For the first time the decadal growth rate in these states has reduced. The age of marriage went up, so preventing thousands of maternal and new-born deaths and stillbirths. In 2005, with the launching of the National Rural Health Mission (NRHM), prominence was given to hospital-based deliveries which doubled in some EAG states with near-tripling in Madhya Pradesh and Odisha. One of the main causes for maternal deaths is the absence of emergency obstetric hospital-based care—a deficiency which was substantially overcome.
The success of institutional deliveries has been unprecedented but recent data shows a plateauing out. This beckons a renewed policy thrust and reinforced monitoring to prevent sliding back.
Another phenomena which a population policy must address is the skewed female and child sex ratio which is spreading from urban into rural areas. Discriminatory social barriers like the absence of women’s ownership rights over land and property are responsible for the continuing son preference. Couples will continue to try for a male child even after having two or three female children and alternately resort to illegal female foeticide. These developments need to be confronted as part of a new population policy. It is too serious a matter to be left to political persuasion and occasional nabbing of guilty doctors.
The third important area that a new population policy must address relates to migration. The Census 2011 has given the picture of interstate and intrastate migration triggered by employment, business, education, marriage and other variables. While migration is welcomed by the manufacturing, construction, software and service sectors, it can spell trouble when it leads to insider-outsider tension. Unplanned migration to the metros and large cities also puts pressure on the infrastructure, housing and water availability. If this is factored into of the population policy, it would make for more foresight and greater coordination, and avoid the inevitable outcome of mushrooming slums and unplanned habitations. Other countries factor migration into the population policy but unfortunately we have relegated it to the narrow confines of the urban development sector which is driven by different priorities.
Next comes the ageing factor. The growing population of the elderly and the increase in life expectancy accompanied by chronic diseases have the potential to deflect resources from the primary task of providing education, skill development and increasing employability. In the next 10 years, the elderly will account for 12% of the country’s population. Until now policies on the elderly have been buffered with soft talk about old-age homes and protective laws—despite the fact that the elderly are virtually unable to take recourse to such provisions. Dependency ratios are increasing rapidly while the joint family system has disintegrated. The market of caregivers is today unregulated, expensive and undependable. The business opportunity to match the growing needs of this population cohort after factoring in their growing disability needs to be a part of the population policy.
Scores of countries have population policies which cut across sectoral paradigms. India is fortunately the envy of the world because of its youthful population. But several related factors are pulling back great achievements. A population policy that protects our demographic assets while preparing for difficult challenges that lie ahead will protect future generations from catastrophic consequences. The World population Day is time to at least think.
The author is former secretary, GoI; former chief secretary, Delhi; and executive director of the Jansankhya Sthirata Kosh, ministry of health