Fall in fertility rate

THE public health indicators of 2017-19 captured by NFHS-5 (National Family Health Survey), though a mixed bag, stand out for a couple of milestones registered. Sustained efforts by the government and society over the long term to check population growth have at last borne fruit. The latest data shows that the country is headed for a heartening reversal of population explosion – a much-anticipated goal, given the stress on limited resources. With the total fertility rate (TFR) falling to 2.0 (average number of children born to a woman), it is for the first time that an arrest in our rising numbers has been felt. Comparatively, the 2015-17 survey recorded a TFR of 2.2 and the 2005-07 survey 2.7. This achievement assumes greater importance in view of certain pockets even registering more women than men. It certainly raises hopes of acceleration in meeting our development goals.

Significantly, the credit largely goes to women for bringing the TFR below the replacement level of 2.1, which paves the way for an eventual reduction in our population figures. For, the onus of family planning, as has been seen all along, continues to lie with women. This is apparent from the considerable increase in the use of contraceptives or sterilisation by women as compared to men. At the same time, it reflects positively on the strategies aimed at the empowerment and education of women as they own up their agency inasmuch as having a say in matters of their health and reproduction. Of course, improved and easier access to hospital care and reduction of infant mortality rates played key roles.

However, this in no way spells a hunky-dory scenario. The health and nutrition parameters are not only still far from ideal, but they also show a slide in certain areas. Particularly grim is the struggle against anaemia. Its prevalence is, worryingly, up among both men and women and children have been the worst hit, predisposing them to health concerns. The efforts to stem stunted growth among children too have not been encouraging, even as malnourishment remains a formidable challenge. An increase in public health investment is called for.

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