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Population Facts and Myths : Manish Choubey
1. Development is not possible in India unless there is population control:
Human development is concerned with the well being of people, and the belief that people are the most valuable resource of any country. There is also an increasing understanding that population is not just about numbers but about people. India is committed to the upholding the principle of equality concerning all its citizens. The common agenda of both development and population related concerns is the welfare of people, and this was clearly highlighted in the International Conference on Population and Development at Cairo (1994), and is an integral part of the vision of the National Population Policy (2000). Population control is only concerned with number and is devoid of any concern for the human being or their well being and has been rejected as being anti people. It has been clearly demonstrated in India that the most efficient way of ensuring the health and well being of people is to adopt a comprehensive approach including social, economic and political deprivation, addressing health and family planning needs through efficient, affordable and quality services and ensuring women's empowerment.
2. India is going through a "population explosion":
There is a common perception that the number of persons in India is growing at an uncontrolled rate and the term population explosion is often used to describe this growth. Fortunately this is not true. Over the last two decades the rate of growth of India's population has come down considerably and most couples now opt for smaller families. But India is like a very fast train which has applied its brakes. It cannot stop immediately, even though the brakes have been applied because of 'population momentum'. The number of young persons are very large and even if each of these couples were to produce only two children the birth rates will continue to be high because of the larger number of reproductive couples. It will take up to two generations for the impact of the slow down to be clearly visible.
3. India's population is growing because uneducated, poor rural people have more children now than they did fifty years ago. While the educated urban middle class has controlled its family size:
The reduction in family size has taken place over all sections of the community in the country. An idea of the family size can be understood in terms of Total Fertility Rate (TFR) that indicates the number of children a woman would have in terms of the prevalent fertility trends. Over the last thirty years the TFR of both urban and rural women has come down considerably and more or less equally. The rural TFR continues to be higher because it was higher to start with, and the availability of contraceptive services is far poorer, and unmet needs for contraception far higher in rural areas.
4. Checking population growth is the main objective of India's National Population Policy:
The overriding concern of the National Population Policy is economic and social development and to "improve the quality of lives that people lead, to enhance their well being and to provide them with opportunities and choices to become productive assets in society". A cross cutting issue is the provision of quality services and supplies, information and counseling, besides arrangement of a basket of choices of contraceptives, in order to enable people make informed choices and enable them to access quality health care services. The long term objective is to achieve a stable population which is consistent with "sustainable economic growth, social development and environmental protection".
5. Most couples in India who have many children do not appreciate the benefits of family planning:
Most couples in India want small families, and the desire for larger families contributes a very small proportion to the overall growth in the number of people. The main reasons why some couples still have more children is high levels of unmet needs( up to 25% in some states), or the inability to provide them with contraceptive services, high levels of infant mortality in many parts of the country, lack of social and economic security , early marriage and childbirth and last but not the least son preference.
6. Economic prosperity is the only way to development and population stabilization:
Economic prosperity is certainly not the only way to development and population stabilization. There is the example of Kerala, where despite Kerala not being among the economic powerhouses in the country it has development indicators which are the best in the country. Haryana on the other hand has much better economic accomplishments but certainly not so in matters relating to social development. There are many such examples among the world's countries also. Women's empowerment is a much better predictor of development and population stabilization than economic prosperity alone.
7. The world's natural resources are getting depleted at a very high rate because of high population growth in poor countries like India:
The depletion of natural resources is a serious sustainability concern. But the depletion of natural resources depends not only on the number of consumers but on the rate of consumption of consumers also. The rate of consumption of natural resources by affluent individuals and nations is far higher than that of the poor. The richest 20% consume up to 70% of all resources, while the poorest 10 % consume less than 5%. The same goes for pollution. High rates of consumption by the affluent are a far greater threat to the sustainability of natural resources than the survival needs of the poor, to paraphrase Gandhiji's saying there is enough for every poor persons need but certainly not for the greed of others.
8. Women in India live longer than men because they usually stay at home and are exposed to fewer hazards:
The fact that women have longer life expectancy than men is a very recent phenomenon in India, though globally in all developed nations the life expectancy of women is higher than that of men by more than 5 years in many cases. The differences in life expectancy in India between women and men is far less significant- and till the reproductive age group the death rates of women are consistently higher. Though women stay at home they are exposed to serious life threatening risks like unsafe motherhood due to unsafe abortion, early and multiple pregnancies, unavailability of appropriate services and so on. Besides this women's threat to life now starts right from the foetal stage and persists all through life as a consequence of numerous discriminatory practices. Violence against women constitutes a separate category of widely prevalent risks much of which takes place within the confines of the home.
9. Adopting a two child norm is not only useful from a population and development point of view but is also good for women's health:
A norm implies a state sponsored and promoted practice rather than an individually adopted one. The harm a two child norm can lead to has to be understood in the context of what good it could bring. Son preference is a very important feature of Indian society. If the government imposes a two-child norm � there will be widespread sex pre-selection and sex selective abortion. Himachal Pradesh is a case in point. HP has a TFR of 2.14 which is very close to the desired goal of 2.1. But the last census operations brought out a startling figure that sex ratio of children had come down from 951 to 897 in the last ten years. Punjab presents a similar picture with a TFR of 2.21 but a reduction of child sex ratio of 82. Even in states like Karnataka, Tamil Nadu and Andhra Pradesh the child sex ratio has come down even though the TFR is close to replacement level fertility. What this means is that the proportion of girl children comes down drastically when couples have less children. And this is due to neglect of girl children, high maternal mortality, sex selective abortions or female infanticide. All these factors clearly impact women who face neglect or deprivation or go through multiple abortions and all the risks associated with it. There seems to be clearly established pattern where two child norms in the presence of son preference lead to sex pre-selection and then to decline in the number of girl children.
The other fallout of a two child norm is that health functionaries will be preoccupied with family planning goals and terminal contraception which will seriously affect their work related to women's health, primarily that of safe motherhood. The maternal deaths in our country are unacceptably high ( around 1 lakh 30 thousand deaths each year) and are still rising. In addition to this, with a two child norm the poor and vulnerable will become targets of coercion and force. If we look at TFR figures, dalits, STs and OBCs have higher TFRs and they will become the targets of coercion . Women of course will continue to remain the ultimate targets of coercion because in our country male participation in contraception remains abysmally low ( 7.9 % condoms and 2% vasectomy, less than 10% of the total).
10. Family planning is a women's issue and is best done by women workers with women in the community:
The reality today is that women are the main clients in the family planning programs across all states in our country. But reproductive decisions are taken by men and this is not always in the interests of the women concerned. It is necessary to involve men in order to ensure that :
-More couples take the decision to adopt contraceptives
-More men are directly involved in using contraceptives- condoms or sterilization
-More men avoid taking decisions that are harmful for women's health like early marriage and pregnancy and prevent women from attaining economic and social well being
-Men become partners in promoting equality by providing women with opportunities and spaces for decision making in all aspects of life
-More men promote responsible behavior among each other.
11. Sterilization is the best way to ensure family planning and reduction in family size:
Sterilization is certainly an important contraceptive in the entire basket, but it has to be realized that sterilization can not and does not prevent early pregnancy nor does it ensure adequate spacing- two very crucial issues where women's health are concerned. Further more sterilization figures could also provide a false sense of achievement because these do not reflect when the method was adopted � after the second or after the fourth. Today the proportion of female sterilization is very high and is the single most important method being promoted. The need is to provide the basket of choice in the truest sense of the term with an em
phasis on spacing and male participation as core gender and health concerns.
12. Early marriage and preference for male child are primarily social issues and have little to do with health and family welfare:
Early marriage and preference for male child are certainly social issues, and their very significant health impacts have to be understood and accepted in the same manner we recognize that drinking polluted water or consuming high cholesterol foodstuff as being serious life threatening risks and not dismissed as mere social issues. Early marriage leads to early pregnancy, in many cases teenage pregnancy, multiple pregnancies, unsafe motherhood and maternal mortality all of which are clearly health and family welfare issues. Son preference may lead to multiple abortions, unsafe abortion, multiple pregnancies, greater exposure to unsafe delivery, all leading to maternal morbidity and mortality. Besides this there is the entire dimension of the culpability of medical professional in promoting and performing a criminal act.
Contributed by: Manish Choubey, Gorakhpur
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