Population perspectives

MAJOR CHANGES ARE taking place on the path of fertility decline in different parts of the country, which if acted on could help realise the medium-term objective of a replacement level total fertility rate (TFR) of 2.1 by the year 2010. Fertility rates are falling everywhere, including in the so-called BIMARU States of Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh though the pace of decline is not very rapid. Moreover, they are declining in spite of limited progress in raising the socio-economic status of women, a slowdown in the reduction of infant mortality rates and a general stagnancy in the availability of important services such as public health, water supply and sanitation. This new situation is a challenge to the National Population Commission, which at its first meeting heard the Prime Minister, Mr. Atal Behari Vajpayee, announce the establishment of a special fund that would focus on the BIMARU States.

Until recently, it was widely believed that fertility would decline only alongside improvement in the health status of women and children as well as female empowerment. The role of good public health services, improved women's education, a higher age at marriage and increased female participation in work in lowering fertility was best illustrated in Kerala where fertility decline began in the Sixties and has now fallen below replacement levels. But more recently, two other States - Tamil Nadu and increasingly Andhra Pradesh - have witnessed dramatic declines in fertility in spite of an indifferent record in female literacy and infant mortality, to name just two important factors that played a role in the demographic transition in Kerala. With a female literacy rate of just 33 per cent, Andhra Pradesh had a TFR of 2.5 in 1997 and the State is expected to reach replacement levels in the next couple of years. Elsewhere, the decline in fertility is nowhere as marked but it is nevertheless taking place even in poor socio-economic conditions. In Uttar Pradesh, where female literacy is just 25 per cent and where the infant mortality rate is 85 (almost five times the level in Kerala), the TFR has declined from 5.8 in 1981 to 4.8 in 1991 - the rate is still very high but a decline is still taking place slowly. Such fertility declines suggest that couples from all groups will use

birth control methods if they are made available. The task of Governments and non-governmental organisations is therefore to make access to these methods easier and more widespread. The anxiety to use birth control methods in even the poorer regions is partly a result of growing aspirations to make the best of the advantages of having a small family. But it is also a reflection of deprivation pushing couples to use measures that can minimise the severity of their poverty.

However, all this does not mean that what have always been understood as the important socio-economic factors underlying fertility decline are no longer important and that population stabilisation can be achieved independently of progress elsewhere. It goes without saying that higher female literacy, lower infant and maternal mortality and greater work participation by women are all extremely important as ends in themselves. But they also have instrumental roles to play in lowering birth rates. For example, if infant mortality rates stay high - worse if they show increases as they did in 1998 - and yet fertility declines, then it is possible that some couples after taking irreversible birth control measures will find that they have to face a future without children. This is clearly an impossible situation. There is therefore no getting away from the need to follow an integrated approach that stresses women's empowerment, faster development of the social sector and better reproductive health care services - which includes access to birth control methods. This indeed is what the National Population Policy 2000 emphasises. The job now is to operationalise these priorities.

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