The alarm around “population explosion” is not substantiated by national or global data and there is no evidence of it, says Poonam Muttreja, executive director of Population Foundation of India. In an interview with Outlook, Muttreja says that the country is on course to achieving population stabilization and it should be committed to the importance of rights and dignity, rather than coercive policies.
Uttar Pradesh State Law Commission has released a draft of the Population Control Bill, promoting a two-child policy to achieve population stabilization by adopting strict measures. Do past experiences show that coercive policies have the desired effect of reducing births?
There are two parallel processes taking place in Uttar Pradesh. On the one hand, the Chief Minister, on 11 July, announced the UP Population Policy, which is focused on women’s empowerment and health and development in the state. On the other hand, the Uttar Pradesh State Law Commission has released the first draft of a bill that proposes stringent measures for population control in the state. The bill has called for incentives for those who have two children or less and disincentives for non-adherence.
There is no evidence to show that proposing incentives or disincentives for adherence to the two-child norm will be effective. The concern and alarm around “population explosion” are not substantiated by national or global data and there is no evidence that there is a population explosion in either India or Uttar Pradesh. There is no question that both the Uttar Pradesh government and the people of the state want population stabilization. In reality, data from the National Family Health Survey (NFHS-4), 2015-16, states that the country is on course to achieving population stabilization.
The state’s unmet need for family planning is high, at 18 per cent which is much higher than the national average of 13 per cent which makes it all the more important to ensure the provision of Family Planning and Sexual and Reproductive Health services. According to NFHS-4, Uttar Pradesh has a Total Fertility Rate (TFR), or births per woman, of 2.7, which is well above the national average and the replacement level of TFR. However, due to the efforts of subsequent state governments, health outcomes have improved since 2015 and are expected to continue to improve. This will eventually have a positive impact on TFR. The Technical Group on Population Projections for the Period of 2011-2036, constituted by the National Commission on Population (NCP) under the Ministry of Health and Family Welfare in July 2020, has projected that Uttar Pradesh will achieve the replacement level of TFR by 2025, without coercive policies.
Further, India is a signatory to the International Conference on Population and Development (ICPD), 1994. At the landmark event, we committed to a global consensus on the importance of rights and dignity, rather than numerical population targets or coercive policies, as the best way to realize fertility goals. These commitments are critical to securing the reproductive health and rights of women and we should not turn away from them when we are so close to reaching population stabilization. Instead, the focus must be on securing the reproductive health of women and girls, ensuring access and availability of modern contraceptives, and empowering and educating young people.
Q: In Assam, a similar law is already in place since 2019. Recently, CM Himanta Biswa Sarma asked Muslims in Assam to adopt “population control measures” underlining the notion that the Muslim Community lags behind in the use of modern contraceptive methods. Your comments
The statement by the Assam Chief Minister Himanta Biswa Sarma is not based on facts. In Assam, the use of any modern contraceptive methods (female and male sterilizations, IUD/PPIUD, pills, and condoms) is the highest amongst currently married Muslim women, at 49 percent, compared to 45.7 percent for Christian women and 42.8 percent of Hindu women, according to the National Family Health Survey (NFHS-5), 2019-20. This means that Muslim women are already using family planning methods more than women from other religious groups.
If we look at the unmet need amongst different religious groups in Assam, the unmet need for Muslim women is 12.2 percent, compared to Hindu women (10.3 percent) and Christian women (10.2 percent) according to NFHS-5 data. This indicates that Muslim women want to use contraceptive methods but are not able to do so due to the lack of access to family planning methods or lack of agency.
Seventy-seven percent currently married women and 63 percent of men, aged 15-49, in Assam want no more children, are already sterilized, or have a spouse who is already sterilized. More than 82 percent of women and 79 percent of men consider the ideal family size to be 2 or fewer children. (NFHS-5)
This means that men and women in the state want smaller families. However, their need for family planning is not met. The state needs to expand the basket of contraceptive choices, especially spacing methods, especially for the young population, and also make them available up to the last mile.
Q: Apart from these two states, many other states have enforced the two-child policy. Have they been able to achieve the target?
There are currently eight states with active two-child norm policies. These are Andhra Pradesh, Assam, Bihar, Gujarat, Maharashtra, Odisha, Rajasthan, and Uttarakhand.
The policy on the two-child norm has not been independently evaluated in any state and its efficacy has never been demonstrated. The five-state study by former senior IAS officer Nirmala Buch found that instead in the states that adopted a two-child policy, there was a rise in sex-selective and unsafe abortions; men divorced their wives to run for local body elections and families gave up children for adoption to avoid disqualification.
Q: While India does not have a national two-child policy, is it desirable that states implementing their own versions?
India does not have a national two-child policy, and rightly so. The country adopted the National Population Policy in 2000. The policy takes its basic philosophy from the ICPD Programme of Action and calls for a comprehensive approach to population stabilization and recommends for addressing the social determinants of health, promoting women's empowerment and education, adopting a target-free approach, encouraging community participation, and ensuring convergence of service delivery at the community level. Socio-cultural factors such as age at marriage, age at first birth and education of girls for maternal and child health find a prominent place in the policy along with promoting a basket of contraceptive choices.
The states have a comprehensive framework and inspiring document in the form of National Population Policy, 2000 to follow. Recently, in an affidavit filed in the Supreme Court on the petition in December 2020, the Union Ministry for Health and Family Welfare said, “the international experience shows that any coercion to have a certain number of children is counter-productive and leads to demographic distortions. India’s TFR is already down “substantially” to 2.2 as per the 2018 Sample Registration System, which is part of the Census exercise, from 3.2 in 2000, when the National Population Policy was adopted. The Family Welfare Programme is voluntary in nature, which enables couples to decide the size of their family and adopt the family planning methods best suited to them, according to their choice, without any compulsion,”
There is an outcry for introducing a population control policy. What is the data saying? Do we need to worry about population explosion?
There is no evidence that there is a population explosion in the country. India has already started experiencing a slowing down in population growth and a decline in fertility rate, The Indian Census data on Population confirms that the decadal growth rate during 2001-2011 had reduced to 17.7 percent from 21.5 percent over 1991-2001. Similarly, the Total Fertility Rate (TFR) is decreasing in India, going down from 3.4 in 1992-93 to 2.2 in 2015-16 (NFHS).
China revised its two-child policy recently. What should we learn from China’s experience?
On May 31, 2021, the Chinese government revised its policy and allowed couples to have up to three children – reversing the coercive population policy and admitting that the consequences of its one-child and two-child measures were counterproductive. The announcement came after the publication of Census data which reported dramatic declines in births and a sharp slowing down of the population. Particularly disconcerting to China has been the sharp decline in the proportion of the population in the age group of 15-59 from 22.9 percent in 2000 to 9.8 percent in 2020. In other words, China’s population continues to age. The proportion of people aged 60 years and above is 18.70 percent of the total population in 2020 as against 13.26 percent in 2010.
China introduced the one-child policy in the late 1970s in an attempt to boost economic progress by slowing down the rapid population growth. The policy was reversed in 2016 to allow families to have two children. The impact of these strict birth limits has been to create a rapidly aging population and shrinking workforce that is straining the country’s economy.
India and its states must learn from China’s failed experience with enforcing coercive population policies. Stringent population control measures have created a population crisis for China. Today Sikkim and Lakshadweep also face the challenges of an aging population, a shrinking labor workforce, and an increase in sex-selective practices, given that the total fertility rate (TFR) well below the replacement level.
As you pointed out, India’s population growth is on a decline. However, a UN report says that India will exceed China as the most populous country by 2027. Does that mean norms like these are necessary?
With a current population size of 1.37 billion, India is the second-most populous country in the world. By 2027, India is expected to overtake China to become the country with the largest population globally (UN World Population Prospects 2019). The overall size of our population will continue to increase for some more time, as two-thirds of India’s population is under 35 years of age. Even if this young cohort produces only one or two children per couple, it will still result in a quantum increase in population size before stabilizing, which as per current projections will take place around 2050.
The IHME study indicated that India was expected to reach its peak population of 1.6 billion by 2048. Following this, India is also projected to have a continued steep decline in total fertility rate, which will reach 1.3 along with a total population of 1.1 billion in 2100. Due to naturally declining growth rates fuelled by higher levels of women’s empowerment, education, and economic opportunities, India’s population is stabilizing.
The issues that should concern us include continuing widespread deprivation, inequality, and social and gender discrimination in access to health, education, and employment. These cannot be addressed through coercive population policies, but rather through dedicated programs to improve health and education. We need to stop considering family planning as a 'women's issue, as reflected in the abysmally low male engagement in Family Planning programs. According to data from NFHS-4, less than 6 percent of men use condoms and male sterilizations are less than one percent!
Activists and experts have also sounded alert on the decline in the female sex ratio and female feticide as a major concern. Many also point out that population control will impact the marginalized sections especially the reproductive rights of women. What is your view on this?
Two-child norm policies are known to disproportionately impact the most deprived and vulnerable, particularly women, who already have little to no access to health and education services. This further impacts their ability to make decisions regarding their health and wellbeing. The Covid-19 pandemic and subsequent lockdowns and restrictions have compounded inequities and vulnerabilities of the most marginalized. Actions such as those proposed in this draft bill will further increase inequalities and impact the poorest. Incentives such as maternity leave, increments etc, will have little to no meaning for 80% of the female workforce who are employed in the informal sector.
According to a recent study by Institute for Health Metrics and Evaluation (IHME), published in The Lancet (July 14, 2020), improvements in women and girl’s education and access to contraceptives are key drivers of fertility decline. By focusing on policy measures that improve access to and quality of health and education in the state and implementing social and behavior change campaigns to challenge regressive gender norms, programs that keep girls in school and prevent child marriages, we will be able to ensure a decline in fertility and also improved quality of life.
A five-state study by Nirmala Buch, a former senior IAS officer found that states that adopted a two-child policy witnessed a rise in sex-selective and unsafe abortions; men divorced their wives to run for local body elections and families gave up children for adoption to avoid disqualification.
Population control measures can lead to an increase in sex-selective practices and unsafe abortions given the strong son preference in India, as has been witnessed in a few states in the past. China is a prime example of what we must not do. The reversal of the two-child policy in China earlier this year is proof of the inefficiency of coercive policies. The country, which enforced a one-child and a two-child policy had to eventually abandon both after finding itself in the midst of a demographic disaster and an abnormally high male-to-female sex ratio and ageing population. Today, it faces a workforce crisis that will have a deep impact on its economy.
As per NFHS-4, while UP’s sex ratio for the overall population is 995, the sex ratio at birth for children born in the last five years has been 903 girls for every 1000 boys. The data clearly indicates an alarming trend in sex-selective practices in the state. Stringent population control measures can potentially lead to an increase in these practices and unsafe abortions given the strong son- preference in India, as has been witnessed in a few states in the past. NFHS-4 also reports that while UP’s sex ratio for the overall population is 995, the sex ratio at birth for children born in the last five years is 903 for every 1000 boys. The data clearly indicates an alarming trend in sex-selective practices in the state.