Shift Focus from Population Control to Informed Choice, Urges PFI
New Delhi: In a significant shift for public health policy, the Population Foundation of India (PFI) has issued a clarion call for the nation to pivot away from outdated population-control mandates. The organisation argues that as India’s fertility rates fall below replacement levels, the focus must transition toward individual autonomy, equitable healthcare, and demographic preparedness.
This call for policy reform follows the recent release of a working paper by the Economic Advisory Council to the Prime Minister (EAC-PM), titled “The Ghost of Population Past: How Population Control Persists in India.” The paper highlights that India’s Total Fertility Rate (TFR) has dropped to 1.9, prompting a rethink of state-sponsored incentives that view population growth as a challenge to be suppressed.
Addressing the Demographic Divide
Poonam Muttreja, Executive Director at PFI, emphasised that while the national fertility rate is declining, the country’s demographic transition remains highly fragmented.
“National averages often obscure deep-seated disparities,” Muttreja noted. “States like Bihar and Uttar Pradesh continue to have a younger age structure and unique developmental requirements, whereas southern and western states are already grappling with the implications of an ageing population and a shrinking workforce.”
PFI maintains that the goal of family planning should no longer be the reduction of numbers, but rather the promotion of reproductive health. This includes prioritising maternal well-being, birth spacing, and ensuring that every individual—particularly women—has the agency to make informed decisions about their own reproductive lives.
Dismantling the Sterilisation Burden
Currently, India’s modern contraceptive landscape is heavily skewed, with female sterilisation accounting for nearly two-thirds of all methods used. Conversely, male sterilisation remains negligible, contributing less than 1% to the method mix. PFI points out that this imbalance is not a product of genuine choice but rather a reflection of a system that has historically offloaded the burden of contraception onto women.
To rectify this, the foundation suggests that family planning budgets be reallocated to provide a diverse array of options, including oral contraceptive pills, injectables, and IUDs. Furthermore, they stress that the reliance on target-driven incentives must end.
“We must move away from incentivising sterilisation,” the PFI stated. “Any shift in policy must be supported by the regularisation and proper compensation of ASHA workers, who serve as the backbone of our frontline health services and are essential for building community trust.”
A Call for Policy Evolution
The EAC-PM paper echoes these sentiments, formally recommending the discontinuation of rewards tied to terminal methods and the repeal of two-child norm disqualifications currently enforced in various states. The experts argue that India must scrub its official frameworks of language rooted in “population stabilisation” and instead foster an environment that respects individual rights.
Ultimately, PFI warns against the pitfalls of “fertility panic.” As the annual number of births in India continues to decline—having dropped from a peak of 29.3 million in 2001 to approximately 23.2 million in 2023—the role of the state should remain neutral.
The mandate for the future, according to the PFI, is clear: move from the fear of population growth to the preparedness of a changing society, ensuring that healthcare investments are directed toward quality, equity, and the lived realities of India’s diverse population.
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