Health

‘India’s growing and aging populations require investments across all sectors’

Down To Earth speaks to demography expert Poonam Muttreja about the findings of the latest National Family Health Survey

 
By Shagun
Published: Saturday 27 November 2021

Photo: Vikas Choudhary / CSEThe recently released Fifth Edition of the National Family Health Survey (NFHS-5) has ignited debate across India with its findings. India’s Total Fertility Rate (TFR) has reached replacement level according to NFHS-5. Also, there are 1,020 women per 1,000 men in India now.

Down To Earth spoke to Poonam Muttreja, executive director of Delhi-based non-profit Population Foundation of India, about the road ahead for the Indian economy and people in the light of the findings of the NFHS-5. Edited excerpts:

Shagun Kapil: The TFR now stands at 2.0. Is this on expected lines and what does it mean for India?

 

Poonam Muttreja: India’s Total Fertility rate (TFR) has reached a replacement level of 2.0, which is below the replacement level of 2.1. The NFHS-5 (2019-21) has also reported that the TFR in urban areas is 1.6 and 2.1 in the rural areas.

India’s efforts to improve health, education and development indicators over the years have started yielding results. The decline in TFR, along with improvements in other indicators, will ensure that the population has better access to health services.

India has a huge population size and profound demographic diversity. Hence, a differential planning approach is needed to reap the benefits of the demographic dividend.

The country has a large young population and we need to adequately invest in their well-being and development, especially education, health and skill development in order to capitalise on the window of opportunity that we currently have for the next thirty years.

Also, the country must invest in girls’ education, particularly secondary school education. Women’s empowerment and a more gender-equitable environment will accelerate development in the long-run, contributing to substantial growth of the Indian economy.

SK: Once a country reaches TFR, how much time does it take for the population to start declining?

PM: When a country reaches replacement level fertility, there are other conditions to be met to attain zero population growth.

Replacement level fertility will lead to zero population growth only if mortality rates remain constant and migration has no effect. The momentum of past and current demographic trends determines the decline in population.

A change to replacement level fertility therefore leads to zero population growth only in the long run. A study by Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, published in The Lancet indicates that India is expected to reach its peak population of 1.6 billion by 2048.

India is also projected to have a continued steep decline in total fertility rate which will reach to 1.3 along with a total population of 1.1 billion in 2100.

SK: Is population explosion a closed chapter for India?

PM: There is no evidence of 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 reduced to 17.7 per cent from 21.5 per cent over 1991-2001. India is currently in the third stage of its demographic transition where the birth rates are falling but the population continues to grow due to its large young population.

India has a high proportion (about 30 per cent) of young persons – adolescents (10-19 years) and youth (15-24 years), who are in the reproductive age group or will soon be.

Even if this group produces fewer children per couple there will still be a quantum increase in numbers because the number of reproductive couples is high.

The overall growth in numbers will still appear to be high because of the population momentum, which is very much a result of the demographic transition underway. Thus, India with its large proportion of young persons will take some time to reduce its population growth rate. 

SK: According to the current trend, India’s population is likely to peak by 2047 and then decline by 2100. Are we peaking before the time that was estimated earlier?

PM: A Lancet study in 2020 projected that TFR in India would reduce to 1.29 by 2100 and its population would decline by 300 million (30 crore) by the end of the century.

India was expected to become the most populous country globally between 2024 and 2028. Going by the current trends in TFR and especially with a much-reduced urban TFR, India will take a little longer to become the most populous country in the world.

However, India’s population will peak by 2047 with variations across states as the Indian states are at different stages of demographic transition.

For instance, states in the south have already achieved replacement level TFR. On the other hand, states such as Uttar Pradesh, Bihar, Jharkhand and others are yet to achieve it.

SK: What are the likely impacts on India’s demographic dividend? India has one of the youngest populations in the world while most developed countries are growing older. By when do you see India facing a situation like Japan and the US?

PM: The ‘demographic dividend’, which translates to a large working age population, has led to a fall in dependency ratio to 65 per cent in 2011, from 75 per cent in 2001.

The projected dependency ratio will fall further to 50 per cent by 2021 and remain around that level for next 20 years. This window of opportunity will slowly narrow in 2041 and close in 2061, when the dependency ratio would rise to 67 per cent.

Three demographic factors, namely, age, location and gender, will shape the future growth trajectory and in realising the demographic dividend.

The twin challenges of rising young population and old age dependents (by 2050, every fifth Indian will be an elderly person) will need investments in employment opportunities, education, health and geriatric care. 

SK: How can the latest trends impact India’s main capital, labour and how long is the bulge in working population going to last for?

PM: India has 62.5 per cent of its population in the age group of 15-59 years, which is ever-increasing and will be at its peak around 2036 when it will reach approximately 65 per cent.

According to the Economic Survey 2018-19, India’s demographic dividend will peak around 2041, when the share of the working-age population (20-59 years) is expected to reach 59 per cent.

India’s working-age population, since 2018 (people between 15 and 64 years of age) has grown larger than the dependent population — children aged 14 or below as well as people above 65 years of age. This bulge in the working-age population will last till 2055, or the next 35 years.

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