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Socio-Economic Implications of Demographic Changes

Tarun Das, Economic Adviser, Ministry of Finance, India.

(i) Population Growth in India

India’s population in 1901 was 238.4 million (Table 11.1). There was a virtually zero rate
of growth during 1911-21. The acceleration of the rate of population growth since 1951
(361.1 million in 1951 to 846.3 million in 1991) is attributed to the decline in mortality,
resulting from the various programmes initiated during first two five year plans to control
mortality and disease. The large size of India’s population by 1991 has meant that even
with a relatively moderate rate of growth of about 2 per cent, the absolute annual addition
to its population during the past several years has been nearly 17 million. The density of
persons per sq. Km. also increased from 117 in 1951 to 267 in 1991.

Birth rates were very high and ranged between 45 and 49 in India during 1901-40,
dropping to 40-41 during 1941-70 and 27-31 during the last decade 1988-1997. In 1998,
the Crude Birth Rate (CBR) was 26.4. The death rate which was 42.6 and 47.2 during
1901-1910 and 1911-1920 respectively began to decline after 1921 from 36.31 during
1921-1930 to 27.4-17.8 during 1941-1970. Thereafter death rates reduced substantially to
10.3 during 1971-1990. It fell to 9.0 in 1998. Among the states, death rate in Madhya
Pradesh was highest at 11.2 and lowest 6.4 per thousand in Kerala in 1998. Birth rates in
Kerala and Tamil Nadu in 1998 were 18.2 and 18.9 respectively; in the five states of West
Bengal, Andhra Pradesh, Karnataka, Maharashtra and Punjab were around 21-22 and in
Gujarat, Orissa, Haryana were between 25-28. The four large northern states of Bihar,
Madhya Pradesh, Rajasthan and Uttar Pradesh continued to report birth rates between 31-
32.

Total Fertility Rate (TFR) in1971 was estimated at 5.2. It was 4.7 in 1976, 4.5 in 1981,
4.2 in 1986, 3.6 in 1991, 3.5 each in 1994 and 1995 and 3.3 in 1997. It will be observed
from Table 11.4 that there are significant variations in TFRs among states. It is evident
that population stabilisation strategies will have to keep in view the diversity prevailing
among states in total fertility rate, death rate and infant mortality rate. Efforts are to
provide adequate inputs to improve performance so that the disparities between states
will be narrowed.

The urban population of India has grown faster than the rural, from 79 million in 1961 to
218 million in 1991 or from 18 to 25.7 per cent of the total population of the country.
The decennial rate of population growth has remained stable around 2.1-2.2 per cent
during 1961-1991. The urban population has grown at the average annual rate of 3.82,
4.61 and 3.65 per cent during 1961-71, 1971-81, 1981-91.

One of the features of Indian demographic behaviour, which has been the cause for
considerable concern has been the more or less steady decline in the sex ratio during the
current century from 972 females per thousand males in 1901 to 927 in 1991. The
absolute size of the deficit of women, relative to the number of men, has risen from 4
million in 1901 to 32 million in 1991. The sex ratio for the country of 927 females per

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1000 males is indicative of extensive discrimination against women. Only Kerala has a
sex ratio exceeding unity. The urban population of India has generally shown a higher
deficit of women than the rural population because migration from rural to urban areas is
dominated by males. However, since 1961, the deficit of females in urban India has
steadily declined because of the progressively lower importance of migration as well as
lesser sex-selectivity in migration. A decline in ratio of women was observed between
1981 and 1991 census only in rural India where sex ratio declined from 951 to 939 due to
a higher than “normal” sex ratio at birth and excess female mortality.

(ii) Impact of high population growth on the economy

The rapid population growth and urbanisation pose some serious challenges. Urban
population growth has outpaced the development of basic minimum services;
housing; water supply, sewerage and solid waste disposal are far from adequate,
increasing waste generation at home, offices and industries, coupled with poor
waste disposal facilities result in rapid environmental deterioration. Increasing
automobiles add to air pollution. All these have adverse effect on ecology and
health. Poverty persists in urban and peri-urban areas; awareness about the glaring
inequities in close urban setting may lead to social unrest.

Over 70 per cent of India’s population still live in rural areas. There are substantial
differences between the States in the proportion of rural and urban population
(varying from almost 90 per cent in Assam and Bihar to 61 per cent in
Maharashtra). Agriculture is the largest and one of the most important sectors of the
rural economy, both as a contributor to economic growth and employment. Its
contribution to the GDP has declined over the last five decades but agriculture still
remains the source of livelihood for over 70 per cent of the country’s population. A
large proportion of the rural work force are small and marginal farmers and landless
agricultural labourers. There is substantial under employment among these people;
both wages and productivity are low. These in turn result poverty; it is estimated
that 320 million people still living below the poverty line in rural India.

Though poverty has declined over the last three decades, the number of poor has in
fact increased due to the population growth. Poor tend to have larger families which
puts enormous burden on their meager resources and prevent them from breaking
out of the shackles of poverty. In States like Tamil Nadu where replacement level of
fertility has been attained population growth rates are much lower than in many
other states but the population density is high and so there is a pressure on land. In
States like Rajasthan, Uttar Pradesh, Bihar and Madhya Pradesh, population is
growing rapidly, resulting in increasing pressure on land and resulting land
fragmentation. Low productivity of small land holders leads to poverty, low energy
in-take and under nutrition, and this, in turn, prevents the development of thus
creating a vicious circle. In most of the States, non-farm employment in rural areas
has not grown very much and cannot absorb the growing in labour force due to high
population growth. Those who are getting educated specially beyond the primary
level do not wish to do manual agricultural work. They would like better

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opportunities and more remunerative employment. In this context, it is imperative
that a programme of skill development, vocational training and technical education
is adopted on a large scale in order to generate productive employment in rural
areas for those living there. The entire gamut of existing poverty alleviation and
employment generation programmes may have to be restructured to meet the newly
emerging demand for employment.

Rural poor have inadequate access to basic minimum services, because of poor
connectivity, lack of awareness, inadequate and poorly functional infrastructure.
There are on-going efforts to improve these, but with the growing aspirations of the
younger, educated population, these efforts may prove to be inadequate to meet the
increasing needs both in terms of type and quality of services. Greater education,
awareness and better standard of living would create the required consciousness
among the people that smaller families are desirable; if all the felt needs for health
and family welfare services are fully met, it will be possible to achieve substantial
decline in the family size and enable the families to improve quality of life.

High population growth also pose problems for supply of basic goods and services
such as drinking water, electricity, foodgrains, housing, transport and
communications. Per capita availability of these goods and services in India are
much below the levels in developed countries. Although India ranks fourth after
USA, Japan and China in terms of purchasing power adjusted GDP, India with a per
capita income of only $400 is regarded as one of the poorest countries of the world.
Almost 40 per cent of world poor population live in India.

(iii) Planning, Growth and Demographic Change in India

The overriding objective of India's economic and social development is to improve the
quality of lives that people lead, to enhance their well-being, and to provide them with
opportunities and choices to become productive assets in society. In 1952, India was the
first country in the world to launch a national programme, emphasizing family planning
to the extent necessary for reducing birth rates "to stabilize the population at a level
consistent with the requirement of national economy". After 1952, sharp declines in death
rates were, however, not accompanied by a similar drop in birth rates. The National
Health Policy, 1983 stated that replacement levels of total fertility rate (TFR) should be
achieved by the year 2000.

On 11 May 2000 India is projected to have 1 billion (100 crore) people, i.e. 16 per cent of
the world's population on 2.4 per cent of the globe's land area. If current trends continue,
India may overtake China in 2045, to become the most populous country in the world.
While global population has increased threefold during this century, from 2 billion to 6
billion, the population of India has increased nearly five times from 238 million (23
crores) to 1 billion in the same period. India's current annual increase in population of
15.5 million is large enough to neutralize efforts to conserve the resource endowment and
environment.

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India's demographic achievement during last 50 years of overall planning and the
national family welfare programme is summarised below:

• Reduced crude birth rate (CBR) from 40.8 in 1951 to 26.4 in 1998;
• halved the infant mortality rate (IMR) from 146 per 1000 live births (1951) to 72 per
1000 live births (1998);
• quadrupled the couple protection rate (CPR) from 10.4 per cent (1971) to 44 per cent
(1999)
• reduced crude death rate (CDR) from 25 (1951) to 9.0 (1998);
• added 25 years to life expectancy from 37 years to 62 years;
• reduced total fertility rate from 6.0(1951) to 3.3. (1997,SRS).
• achieved nearly universal awareness of the need for and methods of family planning.

Stabilising population is an essential requirement for promoting sustainable development


with more equitable distribution. It is important to make reproductive health care
accessible and affordable for all and to increase the provision and outreach of primary
and secondary education. It is also equally important to extend basic amenities including
sanitation, safe drinking water and housing to all, to empower women, to enhance their
employment opportunities, and to provide transport and communications to the mass.

(iv) National Population Policy 2000

The National Population Policy 2000 (known as NPP2000) formulated in 2000 affirms
the commitment of government towards voluntary and informed choice and consent of
citizens while availing of reproductive health care services, and continuation of the target
free approach in administering family planning services. The NPP 2000 provides a policy
framework for advancing goals and prioritizing strategies during the next decade, to meet
the reproductive and child health needs of the people of India, and to achieve net
replacement levels (TFR) by 2010. It is based upon the need to simultaneously address
issues of child survival, maternal health, and contraception, while increasing outreach and
coverage of a comprehensive package of reproductive and child health services by
government, industry and the voluntary non-government sector, working in partnership.

The basic objectives of the National Population Policy include the following:

• The immediate objective of the NPP 2000 is to address the unmet needs for
contraception, health care infrastructure, and health personnel, and to provide
integrated service delivery for basic reproductive and child health care.
• The medium-term objective is to bring the TFR to replacement levels by 2010,
through vigorous implementation of inter-sectoral operational strategies.
• The long-term objective is to achieve a stable population by 2045, at a level
consistent with the requirements of sustainable economic growth, social development,
and environmental protection.
• In pursuance of these objectives, the following National Socio-Demographic Goals to
be achieved in each case by 2010 are summarised below:

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(1) Address the unmet needs for basic reproductive and child health services,
supplies and infrastructure.
(2) Make school education up to age 14 free and compulsory, and reduce
dropouts at primary and secondary school levels to below 20 per cent.
(3) Reduce infant mortality rate to below 30 per 1000 live births.
(4) Reduce maternal mortality ratio to below 100 per1000, 000 live births.
(5) Achieve universal immunization of children against all vaccine
preventable diseases.
(6) Promote delayed marriage for girls, not earlier than age 18 and preferably
after 20 tears if age.
(7) Achieve 80 per cent institutional deliveries and 100 per cent deliveries by
trained persons.
(8) Achieve universal access to information/counseling, and services for
fertility regulation and contraception with a wide basket of choices.
(9) Achieve 100 per cent registration of births, deaths, marriage and
pregnancy.
(10) Contain the spread of Acquired Immunodeficiency Syndrome (AIDS), and
promote greater integration between the management of reproductive tract
infections (RTI) and sexually transmitted infections (STI) and the National
AIDS Control Organisation.
(11) Prevent and control communicable diseases.
(12) Integrate Indian Systems of Medicine (ISM) in the provision of
reproductive and child health services, and in reaching out to households.
(13) Promote vigorously the small family norm to achieve replacement levels
of Total Fertility Rate.
(14) Bring about convergence in implementation of related social sector
programs so that family welfare becomes a people centered programme.

The National Population Policy has the following strategic themes:

(i) To enhance public and private funding for health and family planning
(ii) Decentralised Planning and Programme Implementation
(iii) Convergence of Service Delivery at Village Levels
(iv) Empowering Women for Improved Health and Nutrition
(v) Increased Participation of Men in Planned Parenthood
(vi) Improvement of Child Health and Survival
(vii) Meeting the Unmet Needs for Family Welfare Services
(viii) Meeting the special interests of the vulnerable and Under-Served
Population Groups viz.:
(a) Urban Slum,
(b) Tribal Communities,
(c) Hill Area Populations,
(d) Displaced and Migrant Populations
(e) Adolescents

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(ix) To provide encouragement and incentives to diverse health care providers
(x) To provide motivational and promotional measures for small family norms
(xi) Collaboration With and Commitments from Non-Government
Organisations and the Private Sector
(xii) Mainstreaming Indian Systems of Medicine and Homeopathy
(xiii) Strengthening Contraceptive Technology and Research on Reproductive
Health and Child Health
(xiv) Providing better health care services for the Older Population
(xv) Improvement in Information, Education, and Communication Technology
for health care services
(xvi) Strengthening legislation, public support and basic infrastructure
• To establish National Commission on Population
• To establish State/UT Commissions on Population
• To establish Coordination Cell in the Planning Commission
• Technology Mission in the Department of Family Welfare

(v) Outlook

Demographic transition is a global phenomenon; high population growth is inevitable in


the initial phases of the transition. For India the current phase of the demographic
transition is both a challenge and an opportunity. The challenge is to ensure human
development and optimum Utilisation of human resources. The opportunity is to utilise
available human resources to achieve rapid economic development and improvement in
quality of life.

Over the last five decades the country has built up a massive healthcare infrastructure for
delivery of FW services to the population in the Government private and voluntary
sectors. There is universal awareness about the need for these services; in the next two
decades the population growth will be the younger, more literate and aware population
will be able to make optimal use of available facilities. India is currently in the phase of
demographic transition where it will be possible for the country to accelerate the pace of
decline in fertility. If the population now has ready access to good quality services at
affordable cost, it will be possible for them to meet all their needs, achieve the desired
family size and enable the country to achieve population stabilisation rapidly.

Demographic transition does not occur in isolation. Simultaneously, there are ongoing
economic transition, education transition, and health transition and reproductive health
transition. All these affect human development. If there is synergy between these
transitions; the transitions can be completed rapidly; there will be substantial
improvement in human development and economic development. The focus of planners,
programme implementers and people during the next two decades will have to be in
achieving the synergy so that India can achieve rapid population stabilisation,
improvement in economic social and human development.

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