Interview | Andhra Health Minister: 'We Shifted Our Approach From Population Control to Care'

The chief minister’s vision has always been rooted in long-term demographic resilience. As we analysed our trajectory, we realised that Andhra Pradesh, like many advanced economies, is facing the challenges of an ageing population and a declining total fertility rate. The realisation was that we must shift our philosophical approach from population control to population care. This is not about dictating family sizes, but about creating a supportive ecosystem where families feel empowered to have the children they desire.

The government’s broader analysis, including extensive public consultation, indicates that while financial support is appreciated, the decision to have a child is driven by much deeper socio-economic factors—primarily the cost of education, health care and child care. Therefore, the chief minister’s vision does not rely solely on direct cash transfers. The focus is on creating a robust support system. The government is exploring a holistic framework that addresses the root causes of hesitation, ensuring that any support provided is part of a larger, sustainable ecosystem rather than an isolated financial nudge.

The government fully acknowledges that raising a child requires a lifetime of commitment, far exceeding any one-time financial assistance. Therefore, the broader vision focuses on systemic, life-cycle support rather than isolated monetary incentives. Families will receive support through a comprehensive framework: ensuring safe motherhood and reproductive care, continuous health tracking and preventive care, enabling infrastructure like workplace creches and safe transport for women, dignified ageing support for grandparents and future-ready skilling for youth. The state is looking at making child-rearing a shared societal responsibility, not just a household expense.

The government’s focus is on providing continuing support through anganwadi centres for nutrition, ensuring comprehensive health insurance for the household and facilitating quality education. Sanjeevni, our digital backbone, is desi­gned to ensure proactive health tracking from birth through childhood, adolescence and old age. The support does not end at birth; it evolves with the individual’s life stages, ensuring that every child has the environment to thrive.

Under the Shakti scheme, the vision is to aggressively expand childcare infrastructure. We are exploring the strict enforcement of the Maternity Benefit Act’s provision for creches in establishments with 50+ employees and developing anganwadi-cum-creches to maximise existing infrastructure. While specific implementation details are being worked out, the long-term goal is universal access to quality child care. For working women hostels, the focus is on upgrading existing facilities and setting up new ones in urban and industrial hubs to ensure safe and affordable accommodation.

The government is adopting a phased approach, starting with pilot interventions and building fiscal sustainability through net present value-based budgeting, convergence of existing schemes and public-private-people partnerships. The intent is to signal that child care is a shared responsibility but the implementation will be calibrated to ensure fiscal prudence.

This is the core focus of our Shakti scheme. We are shifting the burden from women to society through three key int­e­rventions: infrastructure [creches, working women’s hostels, safe transport], policy [exploring 12-month collective par­ental leave with non-transferable paternity leave] and social norms. By making men equal partners and the state a facilitator, we ensure women’s economic and physical autonomy is protected.

The vision is to guide the state towards a balanced demographic future by addressing all three dimensions simultaneously. While we aim to support families and move towards replacement-level fertility over the long term, the immediate focus is on enhancing the productivity of our existing population and preparing for an ageing society. The framework aims to increase female labour force participation and stabilise the elderly dependency ratio by 2040, ensuring that our demographic transition does not become a demographic debt.

The policy acknowledges the fiscal and political implications of demographic shifts. In India’s federal structure, population numbers influence political representation and finance commission allocations. States that successfully stabilised their populations early risk being penalised. While protecting Andhra Pradesh’s political voice is a legitimate concern, our primary driver is the socio-economic well-being of our citizens and ensuring the state’s economic future. The policy is about demographic resilience, not just political arithmetic. It is about equity and federalism. Encouraging families to have more children is a sovereign demographic choice based on our own socio-economic realities. We are not asking people to have more children just for political seats; we are asking them to have the children they want to have, supported by the state.

We acknowledge the historical context. That is precisely why we have shifted from population control to population care. The government is not asking couples to bear the cost. Instead, the vision is for the state to take on the responsibility through a robust ecosystem—covering education, health and nutrition. The government is correcting the course by investing in human capital and creating a supportive environment for families.

We reject this binary. Our strategy foc­u­ses on both: enhancing per-capita prod­u­ctivity and ensuring a stable demographic base. The Shakti scheme aims to significantly raise female labour force participation, which directly boosts GSDP [gross state domestic product]. The Naipunyam scheme ensures our workforce is highly skilled and future-ready.