II
Population Situation
Gyanendra Kumar
Introduction
Today no problem is made urgently important to the well being of mankind than the limitation of population growth. It is a problem, the effects of which are world-wide demanding the attention of all nations- east and west large and small, developed and developing. Too rapid population growth hinders a nations ability to progress and to satisfy the growing demands of its people for a better life.
Population growth around the world effect all people through its impact on national economies, the environment, safety and health and the habitability of the world children will inherit. Two points on the interaction of population dynamics and human well being stand out. Population growth may have different impacts depending on when, where and how it occur through decreases/increases, death rate birth rate or immigration. The impact depend not just on the rate of growth but on the size and age structure of the existing population, the resources as water and crop land and the adaptability of the societies in which population growth is occurring. The second point is that population growth influences many areas of human affairs. The issue is not merely food security or health or environmental quality or economic growth, but all this and more because high population growth rate cause of poverty, low standard of living, malnutrition, ill health, environmental degradation and a wide other social problems. If we discuss about the population cycle too rapid, a population growth rate yields negative economic consequences and psychological problems associated with the conditions of under employment. Population growth retards the prospects of a better life because problem of population is not simply of numbers. It also evolves the quality of life and material well being. The population size also intensify the problem of under development.
In our lifetimes humanity has become a force on the planet. The reasons for this are complex and linked to changes not only in human population but in technologies consumption patterns, unequal distribution, choices made by people business and governments. The consequences of rapid population growth can be vivid in light of the carrying capacity of the earth but also and more importantly in relation to human capacities to improve welfare and reduce poverty. Rapid population growth raises concern at three levels of human experience: global resource sufficiency, national and local institutional capacity and individual family welfare.
The growth of world population and production combined with unsustainable consumption patterns places increasingly severe strain on the life supporting capabilities on our earth. These interactive processes effect the use of land, water, air, energy and other resources. Rapid growth and the high dependency ratio lead to another phenomenon called the "Hidden Momentum of Population Growth" means the population has the tendency to grow rapidly even after achieving the low fertility rates. The basic reason for this hidden momentum is that high birth rates cannot be brought down overnight.
The social, economic and institutional forces that has influenced the fertility rates over the course of centuries increase in population, within the last two centuries. The rural as well as the urban poor have been hardest hit. The available resources do not suffice for number of people we have. If the population growth is not effectively and immediately checked, the population bomb may prove to be more dangerous than the atom bomb.
World Population – Main Features
The worlds human population currently number about 6 billion, people and the figure goes by more than 80 million people each year or around 220 thousand each day. The growth rate itself has actually declined since 1970. If the population growth rate does not fall further, world population will double by the year 2040. It took all of history up to the early 1800 for world population to reach one billion people and until 1960 to reach 3 billion. On 11th July 1987, total world population was 5 billion, today the world gains one billion people every 12 years. Projected world population in the year 2025 will reach 8 billion 80 crores. Whatever its size, over 90 percent of net addition will be in today’s developing countries. World population once was 3 billion, the global growth rate was 2 percent but 2.4 percent in developing countries and annual additions were about 58 million. Today the global growth rate is 1.4 percent and 1.7 percent in developing countries and annual additions are about 80 million.
World Population at Glance (1650-2025)
| Year | Population in Crores |
Period in Years | Growth in Crores |
| 1650 | 50 | - | - |
| 1850 | 100 | 200 | 50 |
| 1930 | 200 | 80 | 100 |
| 1960 | 300 | 30 | 100 |
| 1975 | 400 | 15 | 100 |
| 1987 | 500 | 12 | 100 |
| 2000 | 1600 | 13 | 100 |
| 2025 | 820 | 25 | 220 |
Source : Writer’s research work and world population data sheet.
The average rate of population growth in the third world countries is about 2 percent whereas almost all developed countries have an annual growth rate of only 0.4 percent to 0.7 percent. In the United States natural increase is about 0.6 percent a year but 1.4 percent in Asia, 1.6 percent in Latin America and 2.6 percent in Africa.
Density of population is greatest in Asia with more than 108 persons per sq. km., 23 persons in Latin America, 24 persons in Africa and 14 persons in North America. A demographer calculated in 1974 at the current growth rate in 7 centuries only one sq. feet of land would be available for each human being. It is projected that if woman began having two children on average today population will still grow from today’s 6 billion to more than 8 billion before stabilising in the next century.
Developing countries have made historic gain in the last 40 years in improving health especially infant and child health lengthening life span and allowing profile to choose the size of their family, this is a unique success both for national policy and for international co-operation. In a minority of developing countries, most of them having fertility and mortality very high. A women’s chances of dying as a result of pregnancy are more than 1 in 20. Life expectancy is below 60 years and 10% of new borns do not survive during the first year of life.
Youth Population :
Today 1.05 billion is the biggest even generation of young, people between 15 to 24 years. This age group is rapidly expanding in many countries specially in the third world, population is very youthful particularly where children under the age of 15 constitute almost 40% of the population, as compared with the 21% of the developed world. In Sweden and U.K the work force constitute almost 65% of the total population while only 18-19% are youth dependence is almost 50-50. Thus we see that the more rapid the population growth rate, the greater will be the proportion of the dependent children, they have special needs for health care and education, including the most important area of sexual and reproductive health.
The least developed countries are early in the transition from high to low birth and death rates, their population are concentrated in the younger ages. In time as fertility and mortality fall, their population structure will more closely resemble between now and 2010. 7 hundred million young people will enter the labour force in developing countries which is more than the entire labour force of the developed countries in 1990. In many developing countries the next 10 years will be the critical years.
Ageing Population :
Better medical care is preserving life through low death rate resulting more people living longer. In the more developed regions, the proportion of the population above 65 years has increased from 7.9 in 1950 to 13.5 percent today and is expected to reach 24.7 percent by the year 2050. The most rapidly aging countries will exceed 40% of their population at older ages. In some countries, population above the age of 85 years will more than double in the same period. Currently about 77% of the increase in older population is taking place in developing region. Over the first decade of the next century, there will thus be a gradual demographic shift towards an older population in all countries.
Poverty and Food :
The earth’s land total area is 13 billion sq. Hectares. The food of the future will be produced on today’s farmland. Only 11% of the world’s land surface i.e. 1.44 billion hectars is now farmed. There is little additional land that can be converted to crop land and farm sustainability. Many countries will be unable to pay for the food their people need, raises the risk of dependence on food aid.
An estimated 20 to 25% of the world’s population live in ‘Absolute Poverty’ (a per capita income of less than $370 a year.) More than 90% of such people live in developing countries which are having the same percentage of the population growth. Rapid population growth is commonly assured to be root cause of poverty. Population growth, high fertility, and poor maternal and child health reduced per capita availability, with lack of adequate housing and lack of social services.
Industrialization and urbanisation has led to environment disorder. Urban population is growing faster. The average growth rate for cities in developing countries is 3.5 percent a year compared to 1.9 percent for these countries as a whole. People move to cities to improve their economic and educational standards and quality of life but unskilled migrated labour is bound to live in slums at low standard and below poverty line.
Population growth cannot continue indefinitely on a finite planet. Policy initiatives that result in lower birth rates bring societies closer to the day when population growth no longer act as a complicating force in human life. Slowing population growth brings societies closer to population stability a prerequisite for true natural resource sustainability for the economic and social under pinnings of human well being.
If we look at the demographic figures, according to the World Population Data Sheet demographic factors 1996, the population of more developed countries will be doubled in 500 years and population of less developed countries will be doubled in 37 years. The per capita Gross National Product of more developed countries is 18130 and the GNP of less developed countries is only 1090 US dollars in 1994. There are number of countries in Africa and Asia whose GNP is between 300-500 US dollars. Regarding Infant Mortality, more developed countries controlled up to 9 per thousand, whereas the less developed countries could control around 70 per thousand.
Population Policy at International Level
The International conference on Population and Development (ICPD) was held in Cairo from 5-13 Sept 1994. The programme advocates making family planning universally available by the year 2015 or sooner as a part of broadened approach to reproductive health and rights, empowering women and providing them with more choices through expanded access to education and health services and promoting skill development and employment.
Actions are recommended to help couples and individuals meet their reproductive goals to prevent unwanted pregnancies and reduce the incidence of high risk pregnancies and morbidity and mortality, to make quality services affordable, acceptable and accessable to all who need and want them, to improve the quality of advice, information education communication, counselling and services, to increase the participation and sharing of responsibility of men in the actual practice of Family Planning.
Population Policy in Asia-Pacific Region
Many countries in Asia have formulated effective population policies and successfully implemented family planning, maternal and child health programmes in order to achieve their demographic goals like lowering fertility rates, raising the expectation of life at birth, reducing infant mortality rates and thereby slowing population growth rates. The Population growth rate among Asian countries divide the regions into two groups : one group of countries with high population growth rates exceeding 2.0% per year and the other with moderate or low growth rates of 1.4% or lower. Population policy and programmes are different in these two groups. Where fertility is high the main demographic goals is to reduce responsible demographic factors as birth rate, death rate, infant mortality rate, growth rate, in addition to creating employment opportunities for the rapidly expanding working group population and also concentrating more on improving the quality of life of their population.
In 1974, World Population Conference was organised. Since then population issue drew the attention of the demographers policy makers and economists. Regional conferences have also helped to create a better understanding of important dimensions of population issues. One of the recommendations of the 1982 Asia-Pacific call for action on population and development stated "Countries are urged to review and modify existing targets and goals in the implementation of population and development programmes for reducing birth and death rates so as to attain low levels as early as possible and to attain a replacement level fertility by the year 2000" Replacement level fertility is estimated to be a total fertility rate (TFR) of about 2.1 to 2.2 children per women.
Over the past three decades, the development of National Family Planning Programmes has passed through three distinct evolutionary stages. In 1960’s heightened awareness of the adverse consequences of rapid population growth had led a number of countries in the region to introduce family planning programmes to curb the population growth rate. A clinic based approach was mainly used for the delivery of family planning services. In the 1970’s this approach was slowly supplemented by the extension and community approaches that bring supply points close to the potential acceptors. In the 1980’s there was further development of national family planning programmes.
The declaration on population and sustainable development adopted at the Fourth Asian and Pacific Population Conference in 1992 adopted a series of goals and recommendations for population and sustainable development into 21st century. The declaration for the population goals is as follows.
"Within the overall objectives of sustainable development the goals of population policy should be to achieve a population that allows a better quality of life without jeopardizing the environment and the resources base of future generations. Population policy goals should also take cognizance of basic human rights as well as responsibilities of individuals, couples and families. To help reduce high rates of population growth, countries should adopt strategies to attain replacement level, fertility equivalent to around 2.2 children per women, by the year 2010 or sooner. Countries should also strive to reduce the level of infant mortality to 40 per 1000 live births or lower during the same period where maternal mortality is high, efforts should be made to reduce it by at least half by the year 2010"
Strategies for Expanding Coverage
For most successful population control/family planning programme should have the following features :
a) Strong political commitment and public support
b) Well co-ordinated national strategies and programmes
c) Availability of adequate resources and an effective distribution system
d) Involvement and participation of men as well as women
e) Strong emphasis on the quality of services
f) Effective FPMCH programmes and services
g) Community awareness and participation in the formulation and implementation of programmes
h) National and International Co-operation.
Population Policies and Strategies in some Asian Countries
India
India is located in Asia continent with the total land area of 328763 sq. km. i.e. 2.4% of the worlds’ land area. It is the second most populated country in the world. India is the home of 16% of worlds population. India’s population as on 1st March 1991 stood at 846.30 million, out of which 439.23 million males and 407.07 million females. The population of India as recorded decenial census from 1901 has grown steadily except for a decrease during 1911-21. We know the year 1921 as great divide year in the demographic history of India. India’s population has already reached the billion mark. As of mid 1997 the population of the country was estimated to be 970 million based on projection from 1991 census figure. The population has multiplied four times since 1901 and almost trippled since 1941. In these 90 years since 1901 almost 80% of the increase has come after 1951. In terms of growth rates, though there has been a slight decline during the decade 1981-91 as compared to the previous decade.
Considering the increase in terms of growth rate rather than numbers, India grew at 2.21 percent per annum during 1981-91 and during the next 20 years it is expected to grow at 1.5% per annum. Today our birth rate is 29 per thousand and death rate 10 per thousand resulting growth rate 1.9%. According to projected population in the year 2025, India’s population will be around 1385 million and the doubling time at current rate of growth will be 36 years.
If we look at the table Population of India according to the census data since 1901-1991, it increased from 238 million to 846 million. With annual growth rate from 0.6% to 2.11%, the crude birth rate per thousand decreased from 49.2 per thousand to 32.5 per thousand. During the same period death rate decreased rapidly from 42.6 to 11.4 per thousand which is the main cause of population explosion in India. According to the projection India’s population in the year 2016, it will be 1264 million with average annual growth rate 1.39%, at that time birth rate will be 21.4 per thousand, death rate will be 7.6 per thousand which will lead to the population stabilization.
Population of India
| Year | Population (in millions) |
Average Annual Exponential Growth rate (%) |
Crude Birth Rate (per 1000 population) |
Crude Death Rate per (1000 population) |
Growth Rate (percent) |
| CENSUS DATE | |||||
| 1901 | 238 | ||||
| 1901-1911 | 252 | 0.56 | 49.2 | 42.6 | 0.66 |
| 1911-1921 | 251 | 0.03 | 48.1 | 47.2 | 0.09 |
| 1921-1931 | 279 | 1.04 | 46.2 | 36.3 | 0.99 |
| 1931-1941 | 319 | 1.33 | 45.2 | 31.2 | 1.40 |
| 1941-1951 | 361 | 1.25 | 39.9 | 27.4 | 1.25 |
| 1951-1961 | 439 | 1.96 | 40.9 | 22.8 | 1.81 |
| 1961-1971 | 548 | 2.20 | 40.0 | 17.8 | 2.22 |
| 1971-1981 | 683 | 2.22 | 37,8 | 15.4 | 2.24 |
| 1981-1991 | 846 | 2.14 | 32.5 | 11.4 | 2.11 |
| PROJECT FIGURES | |||||
| 1991-1996 | 934 | 1.98 | 27.5 | 9.4 | 1.81 |
| 1996-2001 | 1012 | 1.61 | 24.1 | 9.0 | 1.51 |
| 2001-2006 | 1094 | 1.55 | 22.8 | 8.3 | 1.45 |
| 2006-2011 | 1179 | 1.49 | 22.3 | 7.8 | 1.45 |
| 2011-2016 | 1264 | 1.39 | 21.4 | 7.5 | 1.39 |
The alarming population growth is creating increased pressure on the infrastructure, economy, environment, availability of health services and nutrition. Rapid population growth affects various socio-economic aspects and the quality of life. Despite the rapid population growth, certain development indicators show heartening achievements; advances in health care and overall socio-economic progress is reflected in the demographic transition that has occurred over the last few decades.
There are number of factors that contribute to population growth. Some of the reasons for high fertility are, low age at marriage, illiteracy and unmet need for contraceptives. Other factors such as poor health care services also have impact on population growth. If people already have big family size before accepting FP, this does not lead to a reduction in population growth. In Indian context, it has been observed that a poor status of women and low female literacy also contribute to high fertility. Cultural factors such as son preference, the desire for old age security and perceiving children as assets have also contributed to rapid population growth in India.
Higher age at marriage lowers fertility. This has a corresponding impact on the health of mothers and children as well as increased educational and economic opportunities leading to responsible parenthood and quality of life. According to current demographic trend in India, replacement fertility can be achieved in 2026. But in states like U.P., Bihar, Rajasthan replacement fertility cannot be achieved even in a 100 year time unless the current trend is reversed because U.P. has the highest crude birth rate 34.8 per thousand. This is about two times the crude birth rate of Kerala i.e.18 per thousand. Regarding death rate, highest crude death rate is in M.P. which is 11.2 per thousand about two times the crude death rate of 6 in Kerala. According to the Census 1991, only 5 states namely U.P., Bihar, M.P., Maharastra and Andhra Pradesh accounted for about half of India’s population.
It may be pointed out that the natural growth is very high in rural areas due to comparatively higher fertility. In rural areas, child survival rate and utilization of health services is very low. In 1994, rural total fertility rate was higher by 1.1 children per woman compared to urban areas (3.8 children per women in rural areas while 2.7 in urban areas). Most of the deliveries in rural areas are conducted by untrained dais or relatives at home. Government of India has been aiming at long term demographic goals of Total Fertility Rate of 2.1 (replacement fertility or goal of a NRRI). For India by 2011-16 this goal would depend on decline in fertility of large North states. Approximately 40% of India’s population is experiencing the fertility i.e. just double of the goals of 2.1 children per women.
Because of India’s rapid population growth rate, the number of poor people has increased from around 120 million at the time of independence to 312 million in 1993-94. This leaves India with the largest concentration of poor people in the world particularly in the villages where 74% of the population live. Out of 312 million 240 million are rural poor and 72 million urban poor. In India, presently poverty is officially linked to a nutritional based line measured in calories. The Planning Commission defines the poverty line as a per capita monthly expenditure of Rs. 49 for the rural area and Rs. 57 in urban area (at 1973-74, prices) or a daily intake of 2400 calories per person in rural areas and 2100 in urban areas. Individuals who do not meet these calories norms fall below the poverty line.
Age and Sex Composition
Another aspect of population is its composition age wise and sex wise. These influence economic activities, as also the growth of population itself
Age Composition : The information on the Age Composition is of significance to know the size of labour force (normally 15-49 years). This number constituted 50.5% of the population in 1994. Another significant segment is that of children who fall in the age group 0-14 years. This accounted for 36.5% of the population. This is quite a high proportion. The major cause of the same is the high birth rate. A large fall in the infant mortality rate from 183 per 1000 in 1951 to 74 per 1000 live birth has also contributed to this. The large proportion of children is indicative of the large number of dependants. Old people above 60 years are about 6.5 percent of the population.
Sex Composition : As per 1991 census, there are 929 females per thousand males. Over time, the number of females per 1000 males has been falling except in the year 1981. The reason being that the girls in India are not as adequately looked after as boys as a result infant mortality among girls is high. Secondly, the burden of bearing children at an early age, the lesser use of birth control devices and the greater frequency of births at short interval lead to the death of many women. Thirdly, it is doubtful whether at the time of census, women are counted correctly.
Sex Ration (Females per 1,000 Males in India, 1901-1991
| Census Year | Sex Ratio |
| 1991 | 972 |
| 1911 | 964 |
| 1921 | 955 |
| 1931 | 950 |
| 1941 | 945 |
| 1951 | 946 |
| 1961 | 941 |
| 1971 | 930 |
| 1981 | 934 |
| 1991 | 929 |
Life Expectancy : The number of years for which people of a country expect to live at the time of birth is the average life expectancy of that country. till very recently life expectancy in the country was very low. The rise became substantial from 1951. Life expectancy was 41.3 years in 1961, and at present it is 60 years (1997) The recent increase in life expectancy has been caused by a substantial fall in the death rates and infant mortality rate due to medical and health facilities.
Density of Population
Density of Population is the number of persons per sq. km. and is arrived at dividing the number of persons by the total area of a region/country. In the last more than 70 years since 1921, the density of population has been rising and particularly since 1951, there has been a rapid rise. As per the latest census (1991) it is 274. The change in the density has varied from state to state. In some states it has increased much in others comparatively less. Reasons being India is primarily an agricultural country and factors like climate, rain fall, irrigation facilities etc. have a great influence on density of population. Another factor has been the development of industries in different states/regions. Besides, there are other factors that have influenced density in different places such as religions and historical importance of places, availability of educational facilities and the existence of administrative offices etc.
Distribution of Population - Rural-urban
Another striking feature of India’s population which has persisted for long is the predominance of rural population. As per 1991 census as much as 74.3 % of the population lives in rural areas. The urbanites constitute 25.7 percent, as against 78 percent in England, 77 percent in Sweden and 74 percent in U.S.A. Over time since 1951 there has been a change in the ratio of rural urban population but of only some significance. The Indian economy can be described as a rural economy, as against western economies, often designated as industrial/urban economies.
Strategies for Faster Achievement of Population Stabilisation - Family Welfare Programmme in India
India was the first country in the world to have an official family planning programme. The National Family Planning Programme was launched in India in 1951-52 with the objectives of reducing the birth rate to the extent necessary to stabilize the population at a level consistent with the requirement of national economy. India had a model population policy, which aims to provide family planning services within a broader context of maternal and child health care, emphasizing voluntarism and informed choice among contraceptive methods and community participation.
Initially the programme started mainly for controlling population but it has evolved over the decades in the light of experience gained within the country and in the light of international experience.
Origin of Family Planning Programne
Prof. R.D. Karve opened the country’s first Family Planning clinic in Pune in the year 1923. After that a society for the study and promotion of family hygiene was formed in Bombay in the year 1935. In the year 1938, Subash Chander Bose, President of Indian National Congress advocated a restriction of India’s population size. He set up the National Planning Committee under the Chairmanship of Pt. Jawaharlal Nehru. All India women’s conference began advocating the adoption of voluntary birth control. Under the leadership of Smt. Dhanvanti Rama Rao Family Planning Association of India (FPAI)was established in 1949. After independence, Pt. Jawaharlal Nehru appointed a sub committee chaired by Dr. Radha Kamal Mukherjee to look into various aspects of India’s population problems. The Committee recommended the establishment of birth control clinics.
The Planning Commission set up in March 1950 accepted the recommendations of the committee on population growth and Family Planning. The final draft was released in December 1952, highlighting the urgency of the Family Planning and Population control. The commission created two committees, one to address policy and approach and other to address research and programmes on population and Family Planning. In the second five year plan (1956-61) Family Planning and other supporting programmes for raising the standard of the health and the people throughout rural India under the umbrella of a community development programme were enviseged. In 1959, our Government accepted sterilization as one of the recognised methods of family size limitation.
The Shift from Clinics to an Extension Approach
The number of family planning clinics were proposed to increase from 147 to 8200 during 1952-1966 period. Through clinics the Family Planning programmes broadened by intensified sterilization programme, the use of condoms and IUD were promoted. The fourth plan proposed recruitment of more female doctors, involving private medical practitioners and implementing the programme on a co-ordinated basis by involving other ministries. The medical termination of pregnancy act was passed by the Indian Parliament and come into force from April 1972.
National Population Policy - 1976
Dr. Karan Singh then Minister of Health and Family Welfare submitted National Population Policy on 16th April 1976. In the document it has been mentioned that on 1st January 1976, India has crossed the six hundred million mark. As per policy, our real problems are poverty, illiteracy, ignorance and superstition which should be eliminated only then the nation will be able to move forward to its desired ideals. He further stated that simply waiting for education and economic development to bring down the fertility is not a practical solution. Some important features of the policy are given below:
a) Raising the age of marriage will not only have a demographic impact but will lead to responsible parenthood and safeguard the health of the mother and child. It has therefore, been decided that the minimum age of marriage should be raised to 18 years for girls and 21 years for boys.
b) There is direct co-relation between illiteracy and fertility. In the case of girls education, it is therefore, necessary that special measures be taken to raise the levels of female education.
c) It was felt essential that the younger generations should grow up with an adequate awareness of the population problem and a realization of their national responsibility. In this regard, population education programme was advocated for the younger generation.
d) Monitoring benefits should be given as these have a significant impact upon the acceptance of FP particularly poorer section of society.
e) Family planning cannot get success unless the involvement of voluntary organisations particularly youth and women’s organisations, which will be expanded.
f) Full rebate will be allowed in the Income Tax assessment for amounts given as donations for the cause of family planning.
g) In order to spread the message of FP, a new multi-media motivational strategies is being involved.
h) It was also decided that the representative in the Lok Sabha and the State Legislatures will be frozen on the basis of the 1971 census until the year 2001.
i) Restructuring the health care delivery system on a three tier basis going down to the most far flung rural areas where the majority of our people resides.
In nutshell it can be concluded that the success of Family Welfare programme is dependent on i) adequate availability of resources ii) effective public support by opinion leaders and citizens iii) effectiveness of the health system and efficient services for delivery iv) effective collateral programmes for educating literacy for women, empowerment of women and fast economic improvement.
Some Facts About Population - All India
1. Population (in million) (1991 Census)
| Total | Males | Females |
| 846 | 439 | 407 |
2. Decennial Growth rate
| (a) | 1971-81 | 24.66 |
| (b) | 1981-91 | 23.85 |
3. Area (million Sq. Kms.) Growth Rate
| (a) | 1971-81 | 2.22 |
| (b) | 1981-91 | 2.14 |
4. Area (million Sq. Kms.)
| 3.29 |
5. Density of Population
(per Sq. Km. (1991 Census)
| 27455 |
Number of Districts (1991 Census) KK
| 466 |
7. Number of towns (1991 Census)
| 4689 |
8. Percentage of urban population to total Population (1991 Census)
| 25.73 |
9. Sex ratio (No of females to 1000 males
| (i) 1981 Census | 934 |
| (ii) 1991Census | 927 |
10. a) Estimated number of couples with wives in the age group 15-44 years :
| i) per 1000 population (1971 Census) | 170 |
| ii) per 1000 population (1981 Census) | 169S |
b) Estimated total number of married couples
(with wives in the age group 15-44 years)
as of March, 1997
| 165 million |
II. Percentage of married females to total females in the age group 15-44 years (Census)
| 1951 | 82.94 |
| 1961 | 85.75 |
| 1971 | 83.90 |
| 1981 | 80.515 |
12. Mean age at marriage @ (Census) 1971 1981
| Males | 22.36 | 23.29 |
| Females | 17.16 | 18.33 |
$ Excludes Assam @ Singulate Mean age at marriage
SS The density has been worked out on comparable data.
KK For J&K number of districts as per 1981 census have been included.
National Health Policy - 1983
Government of India, Ministry of Health and Family Welfare framed National Health Policy in the year 1983. To attain the goal of ‘Health for all by 2000 AD’ comprehensive primary health care services at an affordable cost relevant to the actual needs and priorities of the Community are to be provided.
Goals for Health and Family Welfare Programme
Based on National Health Policy Document
| Sl.No. | Indicators | Current level | Goals of 2000 | Expected Level by 2002 |
| 1 | 2 | 3 | 4 | 5 |
| 1. | Infant Mortality Rate | Rural 78 (1996) Urban 46 (1996) Total 72 (1996) |
- - below 60 |
- - 56-50 |
| 2. | Pre-natal Mortality | 42.5 (1994) | 30-35 | - |
| 3. | Crude Death Rate | 9.0 (1996) | 9.0 | - |
| 4. | Pre-School Child (1-5 Years) Mortality rates | 23.9 (1994) | 10 | - |
| 5. | Maternal Mortality Rate | 4-5 (1976) | below 2 | - |
| 6. | Life Expectancy at Birth Male (years) Female |
62.4 (1996- 63.4 2001) |
64 64 |
- - |
| 7. | Babies with Birth Weigh tbelow 2500 gms (Percentage) | 30 |
10 |
- |
| 8. | Crude Birth Rate | 27.5 (1996) | 21.0 | 24-23 |
| 9. | Effective Couple Protection Rate (Percentage) |
45.4 (March ’97) |
60.0 |
51-60 |
| 10. | Total Fertility Rate (TFR) | 3.5 (1994) | 2.9-2.6 | |
| 11. | Net Reproduction Rate (NRR) | 1.5 (1990) | 1.00 | |
| 12. | Growth Rate (annual) | 1.85 (1996) | 1.20 | |
| 13. | Family Size | 3.5 (1993) | 2.3 | - |
| 14. | Ante-Natal Care (%) Deliveries by Trained Birth |
40-50 | 100 | 100 |
| 15. | Attendants (%) Immunization status (%) coverage TT (for pregnant women) TT (for school children 10 Years 16 Years |
50.0 (1994) 78.70* (96-97) 55.1* (96-97) 47.6* (96-97) |
100 100 100 100 |
100 100 100 100 |
| 1 2 DPT (infants) Polio (Infants) BCG (infants) DT (New School ent. 5-6) Yr. |
3 89.3* (96-97) 90.7* (96-97) 97.1* (96-97) 58.7* (96-97) |
4 100 100 100 100 |
5 100 100 100 100 |
|
| 16. | Leprosy-percentage of disease arrested cases out of those detected | 91 (96-97) | 100 | 100 |
| 17. | Blindness-Incidence of (%) | 1.4 | 0.3 | - |
* Provisional
Source : National Health Policy Document, M/O Health and Family Welfare, Dte. General of Health Services and Planning Commission.
Progress to Date
A high level population committee was formed in December 1991. In 1992, the committee made recommendations to improve the FW programmes. In addition, the committee recommended formulating a national population policy and establishing mechanism for its implementation. A committee of experts headed by M.S. Swaminathan was constituted to draft the policy in May 1994, the report proposed establishing population and social development committees, at the national, district and local levels of Government to promote an enhancing political environment and community involvement in addressing Family Welfare issues.
Launching of Reproductive Child Health Programme
For over 44 years, the FP programmes in India has popularised the small family norm. People have not responded enthusiastically to this because they were not sure if children born to them would survive and be healthy. Government launched several successful initiatives that reduced child mortality such as universal immunisation programme (UIP) child survival and safe motherhood (CSSM) programme and the reproductive and child health programme. The Reproductive and Child Health Programme was undertaken on 15th October 1997 drawing its mandate from the programme of action of the international conference on population and development in 1994. Under the RCH programme, a comprehensive package of services for FP, maternal and child health and management of reproductive track infection (RTI) including Sexually transmitted diseases (STD) will be implemented. Inputs will be provided to improve the services to bridge the gap between services provided and unmet needs. In addition, efforts will be made to improve the availability of the services from bottom to top. In a nutshell RCH will cover the services offered under the CSSM and FW programme as well as two new interventions namely management of RTI and adolescent reproductive health. This programme will cover mothers and children adolescents, parents and eligible couples.
Programme Strategy
The RCH programmes will address the problems by using the following strategies:
a) Community participation in planning for services and prioritizing.
b) Client centered approach to service provision
c) Upgraded facilities and improved training’s
d) Emphasis on good quality care
e) Absence of contraception targets and incentives
f) Making services gender sensitive
g) Multi sectorial approach in implementing and monitoring services
There is a wide gap between awareness about health and family welfare and acceptance of services. Although services are available but people do not k now about them. Even when awareness is high, attitudes do not necessarily change or new behaviour practiced. For the purpose IEC activities will be planned at the Primary Health Centre level after identifying service and communication needs in the area. Through this, IEC will promote awareness regarding increasing age of marriage, nutrition, pregnancy, feeding of calustrum practices, birth spacing, good sanitary practices.
Finally, it can be concluded that the responsibility of making the RCH programme a success lies in the hands of health managers, workers and the people. It is expected that the programme will have wide acceptance and ownership not only because it will be developed with people’s inputs but also because it will raise the standards of quality. Quality will determine the effectiveness of this programme in relation to reducing fertility which will lead to population control of the nation.
Impact and Achievements of Family Welfare Programme
National Family Welfare programmes has been successful in generating universal awareness of FP. A vast infrastructure comprising of health workers and health facilities has been established to provide FP information and services to couples. As a result of FP measures about 210 million births have been averted up to 1997. There has been a decline in the total fertility rate or the average number of children born to a woman. The TFR has dropped from 6 at the time of independence to about 3 in 1994, (for the urban population it was 2.8.) the crude birth rate has also gone down from 41.7 in 1951 to 28 per thousand in 1998. The couple protection rate in 1971 was 10.4% which increased to 46.5% in 1996.
Achievements under the Family Welfare Programme
| Parameter | 1951-61 | 1981 | 1991 | 1995 |
| Crude Birth Rate (per 1000 pop.) |
41.7 | 37.2 | 29.5 | 28.3 |
| Death Rate (per 1000 pop.) |
22.8 | 19.0 | 9.8 | 9.0 |
| Natural Growth Rate (per 1000 pop.) |
18.9 | 18.2 | 19.7 | 19.3 |
| Total Fertility Rate | 5.97 | 4.5 | 3.8 | 3.5 (1993) |
| Infant Mortality Rate | 146 | 110 | 80 | 74 |
| Couple Protection Rate (%) | 10.4 (1971) |
22.8 | 43.5 | 46.5 (3/96) |
| Cumulative Number of Births Averted (in million) |
0.04 (1971) |
44.19 | 155.63 | 210 (3/97) |
| Life Expectancy (Yrs) Male Female |
41.9 40.6 (1951-61) |
55.4 55.7 (1981-85) |
58.1 58 - 6 (1987-91) |
59.0 59.7 (1989-93) |
In the years to come, the Family Welfare Programme must build further on these achievements.
Sources : 1. Registrar General, India 2. Department of Family Welfare. Government of India.
China
China is most populous country in the world. Population has always been an extremely important issue in China’s economy and social development. As per 1990 Census China’s population had exceeded 1140 million. The Government has paid full attention to this problem. Family Planning has become a basic policy of the country. The strategy of advocating a one child family began in 1980. The country has made great efforts to improve and expand Family Planning services. In China, during last two decades many specialized research institutes of Family Planning have been established.
The National Research Programme for Family Planning in the sixth and seventh five years plans (1981-1991) has been successfully implemented. According to "Family Planning Book", 88.80 percent of Chinese couples in the fertile age group practice contraception. FUDs have been the most popular method among women. Female sterilization is a well accepted contraception method for couples who have completed child bearing. The current ratio of male sterilization to female sterilization in China is about 1:3 which depicts the better status of women and male involvement in the Family Planning Programme. In the year 1997, the total population of china was 1236.7 million, the birth rate was 17 per thousand and the death rate 7 per thousand, the natural increase was only 1 percent. At current growth rate, the doubling time of the population is 67 years. The infant mortality rate is as low as 31 per thousand and total fertility rate is only 1.8 child per women. The life expectancy at birth is 68 years of males and 72 years of females. 29 percent of the total population is living in the cities. The per capita annual gross national product is 620.
Pakistan
In Pakistan, Muslims constitutes 96.7 percent of the population. In the year 1984, the Government appointed a Council of Islamic Ideology, which issued a statement prohibiting contraception unless pregnancy would place a women’s life at risk. Shortage of funds hinders the extension of health and educational facilities. Illiteracy, unemployment and poverty are the major problems there. Health care provided is not satisfactory.
The population of Pakistan is estimated to have increased 7 times since 1901, rising from 16.6 million to 115 million to 1991. The estimated population for the year 2000 is around 150 million, nine fold increase during the 20th century. The total fertility rate is around six children. The infant mortality has shown rapid decline from 147 to 90 in 1990. Illegal abortion are undertaken and complications, septic abortions lead to maternal deaths.
The Government considers the current rate of population growth as too high for sustaining highest rateof socio-economic development. The Government has introduced a new population policy aimed at reducing the population growth rate to 2.5 percent by 2000 AD. The integrated multi sectrol approach with emphasis on birth spacing maternal and child health care and the provision of services through Government agencies and family welfare centres has been adopted the legal age of marriage for women is 18 years and 20 years for men. There is a lack of sufficient health care in rural areas. A majority of married women of reproductive age who wanted to control their fertility did not have access to Family Planning information and services.
In 1997 the population of Pakistan was 137.8 million, with birth rate as 39 per thousand, death rate as 11 per thousand and the growth rate 2.8 percent. At current rate the doubling time of population will be 25 years. Infant mortality is 91 per thousand and the total fertility rate is 5.6 children. The life expectancy is 61 years and 28 percent population is living in urban area. The per capita annual gross national product in Pakistan is $460.
Bangladesh
The population in Bangladesh is largely Muslim and social emphasis is on early marriage and son preference. The public is generally indifferent to Family Planning. There is wide spread illiteracy, landlessness, high rate of unemployment and lack of social security for the elderly. According to a survey, in rural Bangladesh the children between 6-35 months old were getting only 55% of their required energy intake: 31% of the babies were born with a low birth weight.
The Government considers the country’s high population growth as its main socio-economic problem. Between 1975 and 1985, a separate FP department was formed in Ministry of Health and FP and a Population office was created in 1986 in the Ministry of Labour and Manpower. In 1990, the estimated population of Bangladesh was 115.6 million with a density of population of 803 per sq. km. The crude birth rate was 41 and crude death rate 14 per thousand. The growth rate was 2.7 percent. On this rate, the population doubling time is only 28 years. The life expectancy was 53 years and couple protection rate only 31 percent. Abortion is legal only to save a women’s life. The legal age of marriage is 18 years for girls and 21 years for male but these ages are not strictly enforced due to economic and social causes. Family Planning is voluntary and economic incentives are provided for those who accept it. The Government aims to provide universal health care by the year 2000.
The Government is deeply committed for providing FP services and considers the current rate of population growth too high. The Government encourages NGOs involvement in service delivery and education. It is worth mentioning that during last 8 years, Family Planning programmes in Bangladesh got a great success due to Community involvement. In 1997, the population increased to 122.2 million the birth rate decreased from 41 to 31 and death rate from 14 to 11 per thousand, thus growth rate decreased from 2.7 percent to 2.00 percent. Doubling time increased from 28 years to 35 years. Infant mortality rate decreased very rapidly from 108 to 77 and fertility rate 5.1 to 3.6. Life expectancy increased from 53 to 58 years. The per capita of GNP of Bangladesh is $ 240.
Nepal
Nepal is a neighbour country of India with a total population of about 22.6 million. Illiteracy and poverty are wide spread. Current infrastructure is insufficient. The lack of social security and son preference creates a desire for large family. The most significant factors relating to population are high infant mortality rate, malnutrition, illegal abortions, high maternal mortality etc. The Government views the countries high population growth as an obstacle to socio-economic development. In 1968 Government established the family planning mother child health project and in 1983 adopted the National population strategy which involves socio-cultural economic and educational reforms programmes for maternal and child health care and family planning programmes. There are monetary incentives and indirect incentives for families with only two children. In seventh five year plan 1985-89 the focus was on improving accessibility to family planning services and making population programmes a part of all environmental and rural developmental projects. Abortion is only legal to save women’s life and for other maternal health reasons.
The legal age of marriage is 18 years for women and 21 years for men. Govt. attempts to improve maternal and child health with an emphasis on oral dehydration nutrition,. immunization, basic health care, natal care, birth spacing and Information Education & Communication. The involvement of NGOs is in service delivery. The Govt. delivery system for Family Planning, Mother Child Health Care are inadequate. All health centre provide birth control pills and condoms free of charge.
In 1997 the total population of Nepal was 22.6 million, the birth rate was 35 per thousand and death rate 12 per thousand, the natural increase was 2.3 percent. The doubling time at current rate was 31 years. The infant mortality rate was 79 and the total fertility rate was 4.6 per women. Maternal deaths is very high i.e. 1500 on one lac live births. Only 10 percent population was living in urban areas. The per capita GNP of Nepal was $200.
Sri Lanka
In 1997 the population in Sri Lanka was 18.7 million with birth rate 20 per 1000 and death rate 5 per 1000 with a growth rate 1.5%. The population doubling time at current rate will be 47 years. The infant mortality rate in Sri Lanka is 17.2 per 1000 live births, total fertility rate is 2.3 children per women. The life expectancy at birth is 72 years, for males it is 70 years and for females it is 74 years. Maternal mortality rate is 140 per one lac live births. Percentage of married women using contraception is 66%. Abortion is only legal to save a women’s life. Trained nurses, midwives and chemists can distribute contraceptives and both males and female sterilization is permitted without restriction.
Literacy rate among males is 92% and females 81%. In property and inheritance matters, women have equal rights to men. In 1981 the average age at marriage was 24 for females and 28 for males.
The Government views that current rate of population growth too high and has had a population policy since 1978. The Government plays a key role in family planning by opening subsidized clinics and providing contraceptives and monetary incentives for sterilization. The success of Family Planning lies in implementation of that policies, availability of adequate health and IEC services and male involvement.
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