World Population Day: Family planning, migration and India’s changing demographics

Falling fertility and ageing populations in developed states will create huge employment gaps that will be filled by migrants from underdeveloped north
As fertility and populations get smaller in regions where education, employment and living standards are higher, people from less developed states will migrate there looking for employment and opportunity.(Getty Images)
As fertility and populations get smaller in regions where education, employment and living standards are higher, people from less developed states will migrate there looking for employment and opportunity.(Getty Images)
Updated on Jul 11, 2018 09:20 AM IST
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Hindustan Times, New Delhi | By

All discussions on population growth revolve around the accompanying demographic dividend when the productive population (15 to 64 years old) is larger than the non-working population (under 14 years, 65 years and older) and boost economic growth potential. India is at that crossroad. More than a fourth (27%) of India’s population is below 14 years and 64.7% of the population in the ages of 15-59 years, according to the National Health Profile 2018.

The focus on the young demographic and slowing population growth by lowering the total fertility rate (TFR), which is the average number of children a woman has in her lifetime, has taken the attention away from older people, who already constitute more than 10% of the population in Kerala (13.2%), Himachal Pradesh (11.1%), Tamil Nadu (10.5) and Punjab (10.4%). The percentage of older persons 60 years and above is projected to go up from 8.3% in 2016 to 19% in 2050, increasing three-fold from around 100 million to 300 million by 2050, according to UN Population Fund’s India Ageing Report 2017.

“We haven’t even started thinking of ageing and loneliness, which do not get adequate money or thought from governments that spend few several thousand crores on the defence budget,” said Dr Dileep Mavlankar, director, Indian Institute of Public Health, Gandhinagar.


Declining TFR, which fell from 2.7 in 2006 to 2.2 in 2016, has slowed growth but also fuelled a major demographic divide between states.

A little more than half the country’s population in 24 states have already achieved “replacement” TFR of 2.1 children per women, which is the desired family size when the population stops growing, shows countrywide data from the National Family Health Survey-4. Some states have showed stellar results. Kerala, Punjab and Chandigarh have a TFR of 1.6, which is comparable with western Europe.

But total fertility rate remains above replacement levels of 2.1 in the seven high-focus states, which together make up 44% of India’s population. Bihar’s average family size is 3.4, which is more than double that of Kerala and Punjab.

Uttar Pradesh (2.7), Jharkhand (2.6), Rajasthan (2.4), Madhya Pradesh (2.3), Chhattisgarh (2.2) and Assam (2.2) are the other large and populous states pushing up the nation’s average.

This means that even as India achieves replacement TFR of 2.1, its large youth bulge — 47.5% of India’s population is 24 years old or less — mostly in the overpopulated Hindi-speaking belt, will continue to increase population that is projected to overtake China’s by 2024.

“Around 26 million births annually will continue for some time because of the youth bulge in the high-focus states. These young people will have children and keep population momentum high for some decades before it tapers off,” said Shailaja Chandra, former executive director at National Population Stabilisation Fund and former chief secretary, Delhi. “This is worrying because if women in these states continue to be anaemic, malnourished and not in good health, they will give birth to malnourished children and the cycle of poverty will continue,” said Chandra.


States that have delivered results and slowed population growth have expressed concern about losing a young workforce, with southern states protesting the Fifteenth Finance Commission, which lays out the roadmap for revenue sharing between the Centre and states beginning 2020, using 2011 Census of India as the terms of reference, instead of the 1971 census used earlier. This, they argued, will result in states with smaller populations getting a smaller share of national revenue.

“I used to advocate family planning. But now I am asking people to have more kids,” Andhra Pradesh chief minister Chandrababu Naidu has said publically more than once. Recognising the validity of the argument, @PMOIndia tweeted on April 12: “The Union Government has suggested to the Finance Commission to consider incentivising states who have worked on population control. Thus, a state like Tamil Nadu, which has devoted a lot of effort, energy and resources towards population control would certainly benefit: PM”.

Incentives, however, are not enough to make up the shortfall.

“As long as we take basic population as the term of reference, states that have slowed population growth and improved health, education and other social indices will be penalised,” said Keshav Desiraju, former secretary, ministry of health and family welfare.

The real gains happen over a generation, not overnight. Tamil Nadu introduced the mid-day meal scheme in 1982 and the results are showing now. “We need investment not just in population stabilisation programmes but also creating an environment where girls and women are healthy and empowered to choose,” said Desiraju. “Data gives us broad trends in family size and fertility, but we need to go beyond simple data to address the attitudes and imbalances that are the likely cause,” said Desiraju.


As fertility and populations get smaller in regions where education, employment and living standards are higher, people from less developed states will migrate there looking for employment and opportunity. “Already, migrants are moving beyond Mumbai, Delhi, Kolkata, Bangalore and Chennai to small towns and villages in Punjab, Tamil Nadu, Kerala and Andhra to look for unskilled work in sectors like construction. While the educated, skilled and semi-skilled local population will not perform these jobs even when it doesn’t have the earning power, they will resent the so-called ‘outsiders’, leading to conflict,” said Chandra.

The changes in the demographic composition will also change the political texture. “India will turn into a city of migrants like Delhi and Mumbai. Three decades ago, Punjabi and Baniyas voted in governments, now Purvanchalis (people from eastern India) make up nearly a third of the city’s votebank,” she said.


Then there are issues of ageing and loneliness. “Increasingly, more women will survive their husbands, on average by a decade, and there will be single people, couples without children, people with children who have migrated etc. We need a plan to look after these millions, we haven’t even started thinking,” said Dr Mavlankar.

“The dependency ratio in states with negative population growth will go up tremendously as the ageing population will need people to look after them. Old age care will become a big business as noncommunicable diseases like heart disease and cancers rise and longevity increases,” said Chandra.

Last fortnight, Prime Minister Narendra Modi laid the foundation stone for a 200-bed National Centre for Ageing at a cost of 330 crore to focus on clinical care, research in geriatric medicine and related specialties, and train undergraduate and postgraduate courses. The centre will be ready in February, 2020.

“One centre is not enough, all medical colleges must have a department of ageing and geriatric care. The ministry of social justice doesn’t do enough, older persons must come together as political muscle to be heard, they are anyway more likely to vote than younger people.,” said Dr Mavlankar.


    Sanchita is the health & science editor of the Hindustan Times. She has been reporting and writing on public health policy, health and nutrition for close to two decades. She is an International Reporting Project fellow from Paul H. Nitze School of Advanced International Studies at the Bloomberg School of Public Health and was part of the expert group that drafted the Press Council of India’s media guidelines on health reporting, including reporting on people living with HIV.

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