19 Population policies

Gautam Kshatriya and Anjali Kumari

Contents:

1. Learning Objective

2. Introduction: Population policy

2.1 History

3. Objective of Population Policy

4. Types of Population Policy

4.1 Explicit

4.2 Implicit

5. Population policy making procedure

6. National Population Policy

7. Concept of a population policy

8. Evolution of India’s population policy

9. Programmes/Schemes

10. The policy for Rajasthan

12. Population Commission

13. State level population policies

13.1 Example: Tamil Nadu

14. Summary

Learning Objectives:

To learn the aims of population policy which are focused on global monitoring of government views and policies on key population issues, such as population size and growth, population age structure, fertility, reproductive health and family planning, health and mortality, spatial distribution, and internal and international migration.
To explore the factors population growth and the government’s initiative in controlling population growth.

Introduction

Population policy

Population policy is defined as a measure formulated by a range of social institutions including government which may influence the size, distribution or composition of human population. Driver (1972).
As per Organski & Organski (1961) it is a deliberate effort by a national government to influence the demographic variables like fertility, mortality and migration
Biurgeois-Pichat (1974) stated it as a set of coordinated laws aimed at reaching some demographic goal

History

In the 1950’s, the Indian government introduced Population policies: hospitals and health care facilities made birth control available, however, no effort to encourage use of contraceptives and limitations of family size was made.
In 1952, India launched a National family planning programme for social acceptability for small family. Though the birth rate started decreasing, it was accompanied by a sharp decrease in death rate, leading to an overall increase in population
In India, the first National Policy Programme was formulated in 1976 and tabled in Parliament. However, the statement was neither discussed nor adopted
In 1986, National Health policy was designed and it stressed the need for ‘securing the small family norm, through voluntary efforts and moving towards the goals of population stabilization’. While adopting the Health policy Parliament emphasized the need for a separate National Population Policy.
Following above activities, National Population policy of India was formulated and adopted by the Cabinet in the year 2000

Objectives of population policy

The immediate objective of the policy 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 (Total Fertility Rate) to replacement levels by 2010, through vigorous implementation of inter-sectoral operational strategies (TFR is the average number of children each women would have in her life time).
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.

The importance of long term goals make a serious concern for few people to think about future. So, greater attention needs to be paid to the other socio-economic goals, which include the attainment by 2010 of:

Free and compulsory school education up to age 14 and lowering of the dropout rates at primary and secondary level to 20% for both boys and girls. (The task is particularly difficult in rural areas of backward states and among the scheduled tribes and agricultural or rural labourers.)
Lowering IMR to 30 and maternal mortality rates to below 100 per 100,000 live births.
Universal immunization of children against all vaccine preventable diseases.
Promotion of delayed marriage among girls to after age 18, and preferably after 20 years of age. (The rule of law and the perceptions about the safety of unmarried women are the critical issues.) Raising the institutional deliveries to 80% and those by trained persons to 100%. (The rural infrastructure is the main bottleneck here.)
100% registration of births, deaths, marriages and pregnancies. (While the goal is laudable, its attainment is not likely to be easy even over a 15 to 20 year period.)
Containment of AIDS and treatment of RTIs and STIs.
Prevention and control of communicable diseases.

Types of Population Policy

Explicit – Document by a national government announcing its intention to affect the population growth and composition
Implicit- Directives not necessarily issued to influence the population growth and composition but may have the effect of doing so.

Population policy making procedure

Developing the Constituency in favor of Population Policy
Identifying the arguments favoring population policy
Addressing the issues to a right place
Visualizing the form a policy should take
Recognizing the most advantageous time

National Population Policy

Government has adopted a National Population Policy in February 2000, which provides for holistic approach for achieving population stabilization in the country. The Policy affirms the commitment of the 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 Policy enumerates certain socio-demographic goals to be achieved by 2010, which will lead to achieving population stabilization by 2045. The Policy has also prescribed an Action Plan for implementing the strategic themes listed in the Policy.

Concept of a population policy:

The size of the population, its characteristics, spatial and rural-urban distribution, rate of growth and its determinants decide the quantum, pattern and distribution of consumption and production. It is, therefore, only natural for the state or the government to be concerned about population. Such concern is most essential for a complex democratic society seeking to eradicate poverty and ensure adequate standards of living for its people. Of course, even an authoritarian leader must consider the actual or potential supply of workers (including army personnel), the requisite equipment and the consumption needs of people. Therefore, the three determinants of population change – birth rate, death rate and migration to or from a territorial unit – have naturally received explicit or implicit attention from rulers or governments since the days of Kautilya.

A policy is defined as a statement of important goals, accompanied by a specified set of means to achieve them. A well-elaborated set of means constitutes a programme. A good policy has to be based on a sound theory linking the means with the ends, although on social issues it is often likely to involve an element of judgment about the connection between inputs and outcomes or the process.

The choice between alternative policies has to be made not just in terms of their prospective contribution to the achievement of goals but also their legitimacy, cost, potential popularity and, among other things, effect on other goals. Given the large number of variables that are influenced by and that influence population trends, there is a temptation to make it into a comprehensive development plan. Population policy could easily be drowned in an elaborate framework. However, a flexible, broad framework is certainly imperative.

Evolution of India’s population policy:

The major landmarks in the evolution of India’s population policy are listed in Annex I. This list can be expanded if one considers the several inevitable shifts in emphasis of the programme over the past 50 years. However, it is important to reflect on the antecedents of the first steps taken by the Planning Commission during 1951-52.

The National Population Policy, 2000 envisages constitution of the following bodies:-

(i) National Commission on Population:

The National Commission on Population has been constituted on 11th May, 2000 under the Chairmanship of the Prime Minister to oversee and review the implementation of the Policy.

(ii) State/UT Commission on Population:

State/UT Commission of Population has been constituted in Andhra Pradesh, Arunachal Pradesh, Assam, Haryana, J & K, Himachal Pradesh, Kerala, Maharashtra, Meghalaya, Mizoram, Rajasthan, Sikkim, Tamil Nadu, A & N Island and Lakshadweep.

The National Population Policy, 2000 has identified meeting the unmet needs for contraception, health care infrastructure and health personnel and to provide integrated service delivery as the immediate objective with the following interventions:

(i) Strengthen, community health centers, primary health centers and sub-centres;

(ii) Strengthen skills of health personnel and health providers;

(iii) Explore the possibility of accrediting the private practitioners for a year at a time and assign to each a satellite population, not exceeding 5000 population, for whom they provide reproductive and child health services.

(iv) Review the earlier system of the licensed medical practitioners who, after appropriate certificate from the Indian Medical Association, may participate in the provision of clinical services.

(v) Involve the Non-medical fraternity in counseling and advocacy so as to demystify the national family welfare efforts.

A Strategic Support Group (SSG) was constituted by the National Commission on Population (NCP) on 23rd May, 2000 to obtain the support and cooperation of the concerned Ministries/Departments of the Central Government for implementation of the National Population Policy, 2000. The first meeting of the Strategic Support Group was held on 31.5.2000.

The NCP constituted 11 Working Groups/Advisory Groups to examine various issues having a bearing on population stabilization. Most of these working Groups/Advisory Groups have submitted their reports/recommendations and meetings are being convened to consider the reports/recommendations.

There are significant inter-sectoral differences in the demographic transition among the States and UTs. As such the National Population Policy, 2000 envisages strengthening and energizing the family planning services in 8 demographically weaker States; viz. Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan, Orissa, Jharkhand, Chhattisgarh and Uttaranchal. At the first meeting of the National Commission on Population, Prime Minister announced the formation of an Empowered Action Group within the Ministry of Health and Family Welfare in particular for paying focused attention to these States with deficient national socio-demographic indices.

Accordingly, an Empowered Action Group (EAG) has been constituted in the Ministry of Health and Family Welfare for the area specific programmes with special emphasis to States that have been lagging behind in containing population growth. Presently the States of Uttar Pradesh, Madhya Pradesh, Rajasthan, Bihar, Orissa, Uttaranchal, Jharkhand and Chhattisgarh are being covered. Success of population stabilization efforts in these States will impact the socio-demographic indicators at the national level.

PROGRAMMES/SCHEMES

The NPP 2000 refers to five schemes that involve incentive payments.

For individuals, these include:

The Balika Samridhi Yojana run by the Department of Women and Child Development to promote survival and care of the girl child, with a cash incentive of Rs 500 given at the time of birth of a girl child of birth order 1 or 2.
The Maternal Benefit Scheme run by the Department of Rural Development awards an incentive of Rs 500 for the birth of the first child after 19 years of age and is limited to the first and second births only. The cash award is now to be linked to ‘antenatal check up, institutional delivery by a trained birth attendant, registration of birth and BCG immunization.’
A Family Welfare-linked Health Insurance Plan is to be established to offer health insurance (for hospitalization, not exceeding Rs 5000) to couples (and their children) below the poverty line, if the couple undergoes sterilization with no more than two living children. The spouse undergoing sterilization is also to get a personal accident insurance cover.
Couples below the poverty line, who marry after the legal age at marriage, register the marriage, have their first child after the mother reaches the age of 21, accept the small family norm, and adopt a terminal method after the birth of the second child, are to be rewarded.

A group incentive is also provided by fifth scheme that will reward panchayats and zila (district) parishads for ‘exemplary performance in universalizing the small family norm, achieving reductions in infant mortality and birth rates, and promoting literacy with completion of primary schooling.’

During the past few years, Haryana and Rajasthan have passed laws that prospectively debar persons who do not adopt the two-child norm from contesting elections for panchayats, zila parishads and nagarpalikas. In Rajasthan, the High Courts have upheld the rationale of the laws. The population policy document of Rajasthan proposes to consider an extension of the law making candidates with two or more children ineligible to contest elections to ‘other elected bodies like cooperative institutions.’ It may also be made a ‘service condition’ for state government employees.

The Population Policy of Madhya Pradesh also states that, ‘Persons having more than two children after 26 January 2001 would not be eligible for contesting elections for panchayats, local bodies, mandis or cooperatives in the state. In case they get elected, and in the meantime they have the third child, they would be disqualified for that post.’

The policy for Rajasthan

It proposes ‘legal registration of marriage,’ compulsory observance of minimum age at marriage for availing of ‘government facilities and services’ and ‘stiffer penal provisions for violation of the legal age at marriage.’

Madhya Pradesh also lays down that, ‘From 26 January 2001, persons marrying before legal age at marriage will not be eligible to seek government employment.’ Madhya Pradesh also proposes to enact

a Compulsory Marriage Registration Act to increase the age at marriage for women and to conduct campaigns to inform the public with the help of government departments, non-governmental organizations, and panchayati raj institutions. In addition, the legal age at marriage is to be made ‘a criterion for those seeking jobs especially public jobs, getting admission in educational institutions, applying for loans, etc.’

In effect, the proposals of Rajasthan/Madhya Pradesh go beyond any that have been thought of so far. The case for raising the age at marriage is certainly undeniable; but for a society in which compulsory registration of births and deaths is yet a distant goal, the verification of age is difficult. Further, in our hierarchical society, any such rule or legislation becomes a tool for harassing the disadvantaged and collecting an illicit tax from them. The legal system is so involved and has such a large backlog of pending law suits to be decided by the judiciary that enactment of more laws that cannot be enforced is likely to be counterproductive.

The linking of family size to the right to contest elections is presumed to demonstrate a degree of political commitment that is considered essential in a country likely to become the most populous nation on earth within the next 50 years. The argument that it would adversely affect the interests of women or the disadvantaged sections of society does not seem convincing, particularly in a setting where people themselves have realized the need to regulate family size. However, feminists have been vociferous in their opposition to this bill and it is unlikely to be passed.

Population Commission:

Following the announcement of NPP 2000, a large Population Commission was constituted on 11 May. The Department of Family Welfare serves as the Secretariat to the Commission, which is expected to ‘oversee and review’ the implementation of NPP 2000. Similar commissions are envisaged at the state and union territory level. The performance of these commissions will be clear only over time.

State level population policies:

The preceding discussion has noted the formulation of state level population policies in Andhra Pradesh, Rajasthan and Madhya Pradesh over the past three years. In some sense, the pioneer in this respect was Tamil Nadu, even though it did not release a separate document called state population policy. However, all the states have been ambitious in their targets with respect to decline in fertility and mortality.

Andhra Pradesh: Andhra Pradesh, which has attracted considerable attention over the past few years because of its rapid fertility decline from 4.7 during 1970-72 to 2.5 during 1995-97, seeks to lower its TFR to 2.1 in 2000 and 1.5 by 2010. (In fact, in Himachal Pradesh also, TFR has dropped from 4.7 during 1970-72 to 2.5 during 1995-97.)

Tamil Nadu:

The prospects for these states may be illustrated by some aspects of the policy adopted by Tamil Nadu, which had prepared an ambitious early statement of its goals about fertility and mortality. Tamil Nadu has done extremely well in lowering its TFR to the below-replacement level during 1996-97. With an IMR of 53 per 1000 live-births (40 in urban areas and 60 in rural areas), it has already achieved an NRR of 1.0. There is still substantial scope for a further decline in the level of infant and child mortality as well as adult mortality. The life expectancy at birth in Tamil Nadu during 1991-95 was 63.3 years, 3 years above the national average of 60 years but more than 9 years below the high of 72.9 years achieved by Kerala.

The 15-point programme for child welfare, adopted by the Government of Tamil Nadu in the early l990s, had aimed to reduce the IMR to less than 30 per 1000 live-births and the birth rate to 15 by the year 2000. The goals for 2010 are an IMR of 20 and a birth rate of 10. The population was expected to reach a stationary level of around 65 million by 2010. These ambitious goals overlooked the momentum of growth built into the age distribution.

Prima facie, the goal with respect to the IMR should not have been impossible to realize, particularly if the state had succeeded in ensuring that 90% of all births are delivered in institutions by 2000 (100% by 2010), and malnutrition among children as well as pregnant women is eliminated. But given the record upto 1997, there is no hope of such an outcome. According to past international experience, an IMR of 30 would have meant a life expectancy at birth of the order of about 68.5 years or an increase of more than 5 years relative to 1993. An acceleration of the pace of decline in mortality becomes progressively difficult to achieve as the life expectancy at birth crosses 60 or 65 years.

As for the birth rate, in 1991 Tamil Nadu had almost 31% of its population in the age group of 0-14. (The corresponding figures for Kerala and India as a whole were 30% and 36%, respectively.) Again, the TFR would have to drop to 1.8 by 1998, 1.7 by 2003 and 1.6 by 2008. Once again, such changes are not impossible, as has been illustrated by Kerala’s low TFR of 1.7 in 1992 and even lower TFRs seen in several European countries. Some couples would need to adopt a one-child family.

The National Family Health Survey has reported a contraceptive prevalence rate of 58% in Tamil Nadu. The mean age at marriage among women in Tamil Nadu in 1991 was probably already around 21.5 years and thus the target of raising it to 21 has indeed been achieved. Some 15% of women aged 15-19 years were married, but there may not be many violations of the law relating to minimum age at marriage.

Summary

India has already witnessed some remarkable shifts in the pattern of reproductive behaviour. The community of scholars must together ensure that these momentous changes are carefully documented and their implications are properly analyzed. However, the ongoing changes constitute a revolutionary change in a centuries-old civilization, and merit multi-disciplinary studies by scholars with a mature and balanced judgment.

It is also essential to recognize that irrespective of the radical rhetoric, state efforts to promote lower mortality and fertility are legitimate and (despite the occasional superficial signs of resistance) basically popular. They are also consistent with the goals of a welfare state, that seeks to eliminate illiteracy, disease, poverty and want in order to build an India that can compare with the developed countries of the world.

The apparent aberrations from this central fact are a result of the temptations for short-term gains that the elite in positions of power and decision-making are unable to resist. It is important to separate wheat from chaff and to focus on the long run concerns and interests of the people, whose lives are affected by the delays in the attainment of these ends and goals.

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Bibliography

Government of Andhra Pradesh, Department of Family Welfare. Andhra Pradesh State Population Policy: A Statement and a Strategy. Hyderabad, 1997.
Government of India, Ministry of Health and Family Welfare, Department of Family Welfare, National Population Policy 2000, New Delhi, p. 4.
Government of India, NPP 2000. pp. 2-3.
Government of Madhya Pradesh, Department of Health and Family Welfare. Population Policy of Madhya Pradesh. Bhopal, 2000.
Government of Rajasthan, Department of Family Welfare. Population Policy of Rajasthan. Jaipur, 1999.
Mayone Stykos, ‘Population Policy: Overview’ in John A. Ross (ed.), International Encyclopedia of Population. Vol. 2. New York: The Free Press, p. 530-533

Web link sources:

www.undp.org/content/dam/india/docs/population_policy.pdf