Education: Best Contraceptive

Defusing Population Bomb

Fred Pearce

Back in the 1960s, india faced an exploding population, with a fertility rate of nearly six children per woman. When famine struck, US President Lyndon B Johnson initially refused to deliver food aid, citing the country’s high birth rate. In response, India’s Prime Minister Indira Gandhi dramatically expanded the first national family planning programme in a major developing country, offering cash incentives for both men and women to be sterilised. The city of Madras, now called Chennai, paid men $6 a snip.

For the next 60 years, India continued to focus on sterilisation as well as contraceptives and education for girls. Now, Indian health officials say the task of defusing their population bomb is finally done. Late last month, the National Family Health Survey (NFHS), a periodic investigation of half a million households, announced a milestone: The country’s fertility rate had for the first time fallen below the widely accepted “replacement level” of 2.1 children per woman. (The U S rate is 1.8) “Women are seeing the wisdom in having fewer children,” says Poonam Muttreja, director of the nonprofit Population Foundation of India.

India’s population growth is not over yet, however. Thanks to past high fertility rates, two-thirds of the population is under 35 years old, and a large cohort of people is now entering childbearing age. Even at replacement fertility rates, the children of these young people will continue to push up numbers, and India may exceed China as the world’s most populous nation as early as next year.

Still, India’s population is set to decline in about 3 decades, putting the country on the same track as a growing number of developing nations, such as its neighbour Bangladesh and Indonesia. India remains well behind China in falling fertility. In China, where the population may be at its peak, official figures put the fertility rate at 1.7 children per woman.

State-sponsored family planning remains “the single most important driver” of India’s drop in fertility, says Srinivas Goli, a demographer at Jawaharlal Nehru University. More than 55% of couples use modern contraceptives, the latest NFHS survey found. Of these, one-fifth use condoms and one-tenth the pill. But sterilisation of women, generally in government-run clinics, accounts for two-thirds of all contraception.

Sterilisation has a checkered past in India. During the mid-1970s, Gandhi allowed states to operate compulsory sterilisation camps. An estimated 19 million people were sterilised, three-quarters of them men. The programme’s unpopularity helped bring down Gandhi’s government in 1977, says Monica Das Gupta of the Maryland Population Research Centre.

Das Gupta says sterilisation was compulsory for only 2 years, after which the government relented and “never went back.” Today, government sterilisation clinics are chiefly aimed at women; just 0.5% of contraceptive use is male sterilisation. On average, sterilisation is performed on women in their mid-20s who have already borne children, says epidemiologist Tim Dyson of the London School of Economics.

Some states offer payments of up to $15 for women to be sterilised, and Das Gupta says “mindless allegations” of coercion still surround sterilisation. But she argues financial incentives are not coercion, noting that such incentives “are routinely used across the world for innumerable purposes.”

Rural women in India tend to have more children than urban women, but both groups have steadily lowered fertility rates.

Dyson says declines in death rates in children under age 5—from 241 per thousand in 1960 to 34 per thousand today—have made women more receptive to family planning. That allows all families, including those who are poor and uneducated, to assume that every child is likely to grow up.

And education is playing an ever bigger role in encouraging smaller families. In the 1960s, about 90% of Indian women were illiterate, but by the 2011 census illiteracy had fallen to 35%, concentrated among older women. In the decade after 2005, better education contributed 47% of the fertility decline, according to an analysis by Milan Das, a research scholar at the International Institute for Population Sciences. “Women’s aspirations have changed,” Muttreja says. They look beyond the home for job opportunities and delay marriage and childbearing. “Education is the best contraceptive.”

The strikingly different fertility rates in different regions of India reflect the role of education, says EM Sreejit of the International Planned Parenthood Federation in South Asia. Kerala in the south, which has the country’s highest literacy rate, achieved replacement fertility back in 1988. Bihar in the east, with the lowest literacy rate, won’t get there until 2039, the government’s National Commission on Population predicted last year.

Some Indian politicians still talk of a population explosion and have proposed banning people with more than two children from government employment or, in Uttar Pradesh, even withholding welfare benefits. Critics say such rhetoric is often subtly aimed at the country’s Muslim minority. Muslim women on average had 0.5 more children than Hindus, according to the 2015–16 NFHS survey.

But religion is a small factor in fertility today, Muttreja says. “Hindus in Uttar Pradesh, for example, have a much higher fertility than Muslims in Kerala. There is no Hindu fertility or Muslim fertility.”

How low could India’s fertility go? Goli says the Indian states that reached low fertility first have “stalled at 1.6 to 1.9 children per women.” In contrast, “Highly educated couples in urban areas typically average 1.2 or 1.3,” on par with the lowest rates seen in Europe and East Asia. “If the country continues to pursue women and girls’ empowerment policies, this can push the country to … 1.4 or below,” he says.

This would have a massive impact on the country’s future size. The United Nations’ 2019 population projections for India suggested it will rise to 1.64 billion by 2050 before falling to about 1.45 billion by century’s end. But some demographers say a steep drop in fertility could drive a much faster decline and lead to an imploding economy.

That idea is controversial. Still, as India dips below replacement fertility, demographers are now arguing less about how scarily high its population might get.

[A version of the story first appeared in SCIENCE, Vol 374, Issue 6574]

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Vol 54, No. 31, Jan 30 - Feb 5, 2022