India reaches demographic milestone on World Population Day, but roadblocks remain
In these troubled times of the COVID-19 pandemic, World Population Day on July 11 brings positive news – India has entered an ideal demographic zone that will continue for another two to three decades. Half of India’s population is under the age of 29, which means that during this period, a greater proportion of young people will be the engine of India’s economic growth and social progress. Thus, they must not only be healthy, knowledgeable and skilled, but must also have the rights and choices to fully develop their potential, including, and most importantly, sexual and reproductive health and rights (SRHR).
The Guttmacher-Lancet Commission (Starrs et al, 2018) in researching how to improve SRHR in populations formulated a comprehensive definition of SRHR that encompasses a wider range of issues. These include SRHR and issues such as violence, stigma and respect for bodily autonomy, which have a significant impact on the psychological, emotional and social well-being of individuals.
India’s population growth is now stabilizing. Despite the decline in overall fertility, the population will continue to grow due to the effect of “population dynamics”. It’s like a Jumbo Jet that has started to descend but will take some distance to stop. The total fertility rate (TFR), currently at 2.2 children, will soon reach the replacement level (2.1). However, the TFR remains above the national average of 2.2 children among women who live in rural areas, have little formal education, and are in the lowest income quintile – a majority of them. live in the poorest states.
Changing social norms is one of India’s biggest challenges in meeting the needs of the next generation. For example, India’s population stabilization strategy needs to be adjusted with the rights of women and girls in mind. Women need to have more say in choosing the size of their families. Prescriptive or coercive methods, such as one or two child standards, have rarely worked well anywhere for a long time. It goes without saying that for women and girls, empowering them to make choices leads to better health outcomes, such as knowing how to prevent unwanted pregnancies or giving birth with the help of a skilled birth attendant.
The COVID-19 pandemic exposed weaknesses in health systems and resulted in serious gaps and challenges in the provision of sexual and reproductive health (SRH) information and services. Even before the pandemic, pervasive negative social norms, health system barriers, and gender inequalities hampered universal access to SRHR as envisioned in the Program of Action of the International Conference on Population and Health. Development (CIPD) of 1994. On World Population Day this year, the United Nations Population Fund (UNFPA) in India recognizes that while health systems are naturally strained, the provision of these services can not wait. Any further delay will reduce the health and well-being of women and girls, the consequences of which can last a lifetime.
Over the past two decades, India has made substantial gains with SSR indicators. Progressive maternal health policies have resulted in improved institutional delivery rates and a drop in the maternal mortality rate (MMR) from 327 in 1999-2001 to 113 per 100,000 live births in 2016-18, according to data from the Sample Registration System (SRS).
There have also been significant changes in family planning over the past decade, and data from the National Health Family Survey 5 for the year 2019-20 (NFHS-5) shows how contraceptive prevalence has improved. in most states. We must celebrate India’s success as it contributes significantly to global progress.
The current government, with programs such as Beti Bachao Beti Padhao (BBBP), has made efforts to challenge existing social norms and stressed that investments in social causes must go hand in hand with economic progress. All sections of society must embrace this call for positive change, each doing its part, from the individual to the institutional level. UNFPA wants to learn from India’s successful models and further strengthen South-South collaboration.
But success is hard earned and never guaranteed. There are many challenges on the road to 2030, the goal to achieve the Sustainable Development Goals (SDGs).
Each year, two million adolescent girls (15-19 years) have had a pregnancy, and of these, nearly 63% were unwanted or unwanted (Guttmacher Institute, 2021). This indicates a lack of information and access to SRH services for this age group. Among girls aged 15 to 19, 22.2% had an unmet need for contraception, according to the NFHS-4.
Girls still marry too young – 26.8% of women aged 20-24 are married before the age of 18, often having their first child in the first year of marriage. Far too many girls and women face gender-based violence and harmful socially sanctioned practices. All of these practices are rooted in social norms, beliefs and practices that deny women their bodily autonomy.
India fell 28 places to rank 140 out of 156 countries, becoming the third worst performance in South Asia in the Global Gender Gap Report (2021) of the World Economic Forum (WEF). The time to achieve the ambitious goals of the SDGs is running out. India must therefore choose its priorities carefully. Our analysis seems to suggest that placing young people, women and girls at the center of policy and service development could trigger a positive spillover effect. If young people, and adolescent girls in particular, have access to education, skills, information and services relevant to making healthy choices, including SRH, are empowered to exercise their rights and have access to employment opportunities, then India will be on a clear path to achieving its goals.
What research and practical experience show is that when women can make informed choices about their sexual and reproductive health, and when they have access to services to support their choices, societies are healthier. and more productive. A woman in control of her body gains not only autonomy but also through advances in health, education, income and security. She is more likely to thrive, just like her family. UNFPA calls on stakeholders to help build a new set of social norms to drive this mission.
Author is Representative, UNFPA India and Country Director, UNFPA Bhutan