Population Policy in India

India’s population policy is over half a century old. In fact, India was perhaps the first country in the world to announce an official population policy, in 1952. The policy took concrete shape as the National Family Planning Programme. Its broad objectives have remained the same: to influence the rate and pattern of population growth in socially desirable directions.

In the early days, the most important objective was to slow down the rate of population growth. This was to be done through three main routes: promoting various birth control methods, improving public health standards, and increasing public awareness about population and health issues.

Over the past half-century, India has many significant achievements in the field of population. Census data shows that population growth has been on the decline since 1991. The average number of children a woman was expected to give birth to during her life (the Total Fertility Rate, or TFR) was 3.8 in 1990, and it fell to 2.7 children per woman by 2011. Even so, India’s population is projected to increase from 1.2 billion to an estimated 1.6 billion by 2050. This is due to population momentum — a situation where a large cohort of women of reproductive age will fuel population growth over the next generation, even if each woman has fewer children than previous generations did.

Additionally, the drop in Crude Death Rate (CDR) and Crude Birth Rate (CBR) over the past four decades indicates that India is progressing towards a post-transitional phase. From 1950 to 1990, the drop in CBR was less steep than the drop in CDR. However, during the 1990s, the decline in CBR became steeper than the decline in CDR, which resulted in a reduced annual population growth rate of 1.6 percent.

The Emergency and its Aftermath

The Family Planning Programme suffered a major setback during the years of the National Emergency (1975–76). During this time, normal parliamentary and legal procedures were suspended, and the government tried to intensify the effort to bring down the growth rate of population by introducing a coercive programme of mass sterilisation.

Sterilisation refers to medical procedures — vasectomy for men and tubectomy for women — that prevent conception and childbirth. Vast numbers of mostly poor and powerless people were forcibly sterilised. There was massive pressure on lower-level government officials (like school teachers and office workers) to bring people for sterilisation in camps organised for this purpose. There was widespread popular opposition to this programme.

After the Emergency, the new government abandoned the coercive programme. The National Family Planning Programme was renamed the National Family Welfare Programme, and coercive methods were no longer used. The programme now has a broad-based set of socio-demographic objectives.

National Population Policy 2000 and National Health Policy 2017

A new set of guidelines was formulated as part of the National Population Policy of the year 2000. Later, in 2017, the Government of India came out with the National Health Policy 2017, in which most of these socio-demographic goals were incorporated with new targets.

Some of the important goals of the National Health Policy 2017 include:

• Increase health expenditure by the government as a percentage of GDP from the existing 1.15 percent to 2.5 percent by 2025.
• Increase life expectancy at birth from 67.5 to 70 by 2025.
• Reduction of Total Fertility Rate (TFR) to 2.1 at national and sub-national level by 2025.
• Reduce Under Five Mortality to 23 by 2025 and Maternal Mortality Rate to 100 by 2020.
• Reduce neo-natal mortality to 16 and still birth rate to “single digit” by 2025.
• Achieve the global target of 90:90:90 for HIV/AIDS by 2020 — that is, 90 percent of all people living with HIV know their HIV status, 90 percent of all people diagnosed with HIV infection receive sustained antiretroviral therapy, and 90 percent of all people receiving antiretroviral therapy will have viral suppression.
• Achieve and maintain a cure rate of over 85 percent in new sputum positive patients for TB, and reduce incidence of new cases to reach elimination status by 2025.
• Reduce the prevalence of blindness to 0.25 per 1000 by 2025 and reduce disease burden by one third from current levels.
• Reduce premature mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases by 25 percent by 2025.
• Increase utilisation of public health facilities by 50 percent from current levels by 2025.
• Antenatal care coverage to be sustained above 90 percent and skilled attendance at birth above 90 percent by 2025.
• More than 90 percent of newborns to be fully immunised by one year of age by 2025.
• Meet the need for family planning above 90 percent at national and sub-national level by 2025.
• 80 percent of known hypertensive and diabetic individuals at household level maintain “controlled disease status” by 2025.
• Relative reduction in prevalence of current tobacco use by 15 percent by 2020 and 30 percent by 2025.
• Reduction of 40 percent in prevalence of stunting of under-five children by 2025.
• Access to safe water and sanitation to all by 2020.
• Reduction of occupational injury by half from current levels of 334 per lakh agricultural workers by 2020.
• Increase State sector health spending to over 8 percent of their budget by 2020. …