National Commission on Population

Population and
Human & Social Development
FACTS - II

Click here to See Chart

Perspective

Human development and improvement in quality of life are the ultimate objectives of all Planning. Planning takes into account the resources required for human development and human resources available for carrying out the Plan
Demographic transition is a global phenomenon. Population growth and changes in age profile of the population are inevitable during the transition
India, the second most populous country in the world/ has no more than 2.5% of global land but is the home of 1/6th of the world's population. Living in a resource poor country with high population density/ planners recognised that population stabilisation is an essential pre requisite for sustainable development. India became the first country in the world to formulate and implement the National Family Planning Programme in 1952
Successive five year plans have provided the policy frame work and funding for building up nation wide infrastructure and manpower. The family welfare programme provides additional manpower/ drugs, consumables and equipment needed for meeting the health care needs of women and children
During the next two decades there will be a massive increase in the population in 10-59 age group. The country will have to face the challenge and utilize this opportunity window during demographic transition to rapidly achieve both population stabilization and sustainable improvement in human development
Planners/ programme implementers and the people themselves have to expedite this process by promoting synergy between health/ education/ environment and development programmes

Family Welfare Programme

Basic premises of Family Welfare programme are:

Acceptance of Family Welfare services are voluntary.
Family Welfare programme will provide
Integrated Maternal and Child Health (MCH) and Family Planning services
Effective Information/ Education and Communication (IEC) to improve awareness
Ensure easy and convenient access to family welfare services free of cost

The performance under the Family Welfare Programme will depend upon :

Programme initiatives during the Ninth Plan
Financial resources available
Capability and effectiveness of the infrastructure and manpower to carryout the programme
Literacy and economic status of the families particularly of the women
Policy support by opinion leaders and the society

During the last five decades there has been a steep decline in mortality and relatively less steep but sustained decline in fertility

Goals to be Achieved by 2002
Indicator	Current trend continues	Accelerated RCH Targets
Crude BirthRate (CBR)	24/1000	23/1000
Infant Mortality Rate (IMR)	56/1000	50/1000
Total Fertility Rate (TFR)	2.9	2.6
Couple Protection Rate (CPR)	51%	60%
Neo-natal Mortality Rate(NNMR)	35/1000
-Maternal Mortality Rate	3/1000

The Ninth Plan period may be the beginning of a major acceleration in pace of demographic transition and improvement in health status of the population
If the acceleration begun during the Ninth Plan is sustained the country may achieve replacement level of fertility by 2010/ with the population of 1107 million
If this were done the country's population may stabilize by 2045

Population & Labour Force Projections

In the next two decades there will be an enormous increase in labour force

Challenge

To ensure:

Adequate investment in HRD-development of a work force of appropriate skills to meet the requirements of the growing economy

Creation of appropriate employment opportunities in different regions and in rural/urban locations

Ensure adequate emoluments for the labour force

Opportunity

Utilise available abundant human resources to accelerate economic development

Utilise the period with low dependency ratio to promote the improvement in quality of life and also promote saving

Invest the savings for development and improvement in quality of life

Paradigm shift needed

Optimal utilization of human resources to power economic/social and human development

Utilise the increasing connectivity to create an urban - rural economic and social continuum to improve quality of life of both urban and rural population

Food Security

Major achievement is self sufficiency in food grains in spite of population growth

Challenge

Continue to improve food grain production to meet the needs of the growing population

Increase coarse grain production tomeet the energy requirements of theBelow Poverty Line (BPL) families at lower cost

Increase pulse production/ improveaffordability of pulses and increase consumption

Improve availability of vegetables at affordable cost through out the year inurban and rural areas

Opportunity

Achieve substantial improvement in the food security

Achieve decline in macro andmicronutrient under nutrition

Paradigm shift needed

From self sufficiency in food grains to meet energy needs to providing foodstuffs needed for meeting all the nutritional need

From production alone to reduction in post harvest losses and value addition through appropriate food processing

Nutrition Security

Currently the major nutrition related public health problems are:

Chronic energy deficiency and under-nutrition
Chronic energy excess and obesity iciency
Micro-nutrient deficiencies
Anaemia due to iron and folate
Vitamin A deficiency
Iodine Deficiency Disorders

Chronic Energy Deficiency (CED)

Challenge

India with less than 20% global children accounts for over 40% under nourished children
There has been a reduction in mortality by 50% and in fertility by 40%/ but reduction in under-nutrition is only 20%
There is no decline in under-nutrition in pregnant women/ and 6-24 months children
No improvement in birth weight
Though there is 50% decline in severeunder-nutrition in children/ reductionin milder under-nutrition is marginal

Opportunity

Achieve substantial reduction in under-nutrition with targeted interventions and improved access to health care
Improve intra-familial distribution of food based on the needs, through nutrition education

Paradigm shift needed

Screen all vulnerable groups, identify the undernourished individuals
Provide focused health and nutrition interventions for prevention and management of under-nutrition

Urbanisation

Trend for urbanization is likely to continue over the next few decades. India may have five or more mega cities

Challenge

Meet the basic minimum services for the growing urban population
Minimise environmental deterioration-sanitation/ soil/ water and air pollution
Minimise ill effects associated with altered life style

Opportunity

There will be increase in access to education/ information/ communication/ employment and health care
By appropriate utilsation of all these it may be possible to rapidly improve quality of life of the urban population

Paradigm shift

Transform cities into engines of social and economic change and human development
Utilise the increasing connectivity to create an urban - rural economic and social continuum to improve quality of life of both urban and rural population

Water Supply

In India/ water withdrawal is estimated to be twice the rate of aquifer recharge; as a result water tables are falling by one to three meters every year; tapping deeper aquifers has resulted in large population groups being exposed to newer health hazards
Excessive use of water has led to water logging and increasing salinity in some parts of the country
Biotechnological research for development of food grain strains that would tolerate salinity and those which would require less water should get high priority
A movement towards making water harvesting/ storage and its need based use as a part of every citizen's life should be taken up

Environment

Rapid population growth/ developmental activities either to meet the growing population or the growing needs of the population as well as changing lifestyles and consumption patterns pose major challenge to preservation and promotion of ecological balance
Ensuring that there is no further deterioration depends on choices made by the population about family size/ life styles/ environmental protection and equity
Availability of appropriate technology and commitment towards ensuring sustainable development is increasing throughout the world. Because of these/ it might be possible to initiate steps to see that the natural carrying capacity of the environment is not damaged beyond recovery and ecological balance is to a large extent maintained
The environmental sustainability of all developmental projects should be taken care of by appropriate inputs at the planning/ implementation/ monitoring and evaluation stages

Energy Intake and Under Nutrition

Low dietary intake is the most important cause of under nutrition in children
Low birth weight, poor infant feeding practices and infections are other major factors responsible for under nutrition
In spite of low dietary intake/ prevalence of severe under nutrition is low in Kerala because of more equitable distribution of food between income groups and within the family and better access to health care.
In spite of higher average dietary intake undernutrition rates are higher in Uttar Pradesh/ Madhya Pradesh and Orissa because of lack of equitable distribution of food and poor access to health care
Screening/ Identification of under nourished children and appropriate nutrition and health intervention are essential for reduction in under nutrition in children

Undernutrition and Infant Mortality

Under nutrition increases susceptibility to infections
Infection aggravates under nutrition
If uninterrupted this vicious circle could result in death
Poor dietary intake, poor caring practices and lack of access to health care are major factors responsible both for under nutrition in children and high infant mortality
In most of the states with high under nutrition/ infant mortality is high; however there are exceptions e.g. Maharashtra
In Kerala both severe under nutrition and Infant Mortality Rate (IMR) are low
In spite of relatively high per capita income/ dietary intake and health care/ both under nutrition and IMR are relatively high in Punjab
Each district has to collect/ collate/ analyse and utilise their district data for planning interventions to improve nutritional status and reduce IMR; they should also monitor progress and effect midterm corrections

Population and Human & Social Development Socio-economic indicators

State/UT	Population in 000		Rural-Urban Differentials		% Literate (>7 Years)
	1991 Census	2000 ^{^⁸}	% Rural	% Urban	NSS^{^⁷} 53 rd Round	Census
	1991 Census	2000 ^{^⁸}	1991 Census		1997	1991
INDIA	846303	996944	74.3	25.7	62	52.2
MAJOR STATES
Andhra Pradesh	66508	75466	73.1	26.9	54	44.1
Assam	22414	26196	88.9	11.1	75	52.9
Bihar	86374	99942	86.8	13.1	49	38.5
Gujarat	41310	48252	65.5	34.5	68	61.3
Haryana	16464	19831	75.4	24.6	65	55.8
Karnataka	44977	52091	69.1	30.9	58	56.0
Kerala	29098	32262	73.6	26.4	93	89.9
Madhya Pradesh	66181	79747	76.8	23.2	56	44.2
Maharashtra	78937	91115	61.3	38.7	74	64.9
Orissa	31660	35857	86.6	13.4	51	49.1
Punjab	20282	23536	70.5	29.6	67	58.5
Rajasthan	44006	53559	77.1	22.9	55	38.6
Tamil Nadu	55859	61774	65.9	34.2	70	62.7
Utter Pradesh	139112	170188	80.2	19.8	56	41.6
West Bengal	68078	79006	72.5	27.5	72	57.7
Smaller States
Arunachal Pradesh	865	1192	87.2	12.8	60	41.6
Delhi	9421	13964	10.1	89.9	85	75.3
Goa	1170	1595	59.0	41.0	86	75.5
Himachal Pradesh	5171	6711	91.3	8.7	77	63.9
J&K	7719	9945	76.2	23.8	59	NA
Manipur	1837	2518	72.5	27.5	76	59.9
Meghalaya	1775	2434	81.4	18.6	77	49.1
Mizoram	690	952	53.9	46.1	95	82.3
Nagaland	1209	1684	82.8	17.2	84	61.6
Sikkim	406	559	90.9	9.1	79	56.9
Tripura	2757	3782	84.7	15.3	73	60.4
Union Territories
A&N Islands	281	386	73.3	26.7	97	73.0
Chandigarh	642	888	10.3	89.7	83	77.8
D&N Haveli	138	190	91.5	8.5	49	40.7
Daman & Diu	102	140	53.2	46.8	86	71.2
Lakshadweep	52	71	43.7	56.3	96	81.8
Pondicherry	808	1111	36.0	64.0	90	74.7
NNMB - National Nutrition Monitoring Bureau Pooled for 18 States Indian Nutrition Profile - 1998, DWCD Rural Combined (Urban+Rural) Planning Commission NSS - National Sample Survey Report pf Technical Group pm on Population Projection 1996 Registar General Of India Education Unemployed Pre capita State Domestic Product

State/UT	(%)EU^{^⁹} of age >15 Years NSS^{^⁷} - 50th Round	PCSDP^{^¹⁰}Current Prices (Rs.)	% of Population Below Poverty Line(BPL)	Average intake of Energy^{^³}	Moderately and Serverly Under nourished children (1-5 Years) (Wewight -for-age)
	1993-94	1996-97	1993-94	Kilo Calories	Boys	Girls
INDIA	9.6	12099	36.0	2308^{^²}	42.1	40.8^{^²}
Major States
Andhra Pradesh	9.2	10306	22.2	2430^{^{^4,1}}	48.6	49.6^{^⁴}
Assam	29.0	6928	40.9	1975^{^{^4,1}}	29.4	27.6^{^⁴}
Bihar	11.2	4231	55.0	2464^{^⁵}	56.6	55.4^{^⁵}
Gujarat	4.5	14675	24.2	2298^{^{^4,1}}	74.2	61.8^{^⁴}
Haryana	8.0	16392	25.1	2336^{^⁴}	34.3	33.0^{^⁴}
Karnataka	9.0	10504	33.2	2196^{^{^4,1}}	55.6	51.1^{^⁴}
Kerala	25.2	10309	25.4	2231^{^{^4,1}}	34.4	34.2^{^⁴}
Madhya Pradesh	9.1	7571	42.5	2238^{^{^4,1}}	57.9	49.6^{^⁴}
Maharashtra	7.0	17666	36.9	2065^{^{^4,1}}	52.7	55.6^{^⁴}
Orissa	17.2	5893	48.6	2106^{^{^4,1}}	55.1	51.4^{^⁵}
Punjab	6.0	18006	11.8	2341^{^⁴}	32.2	31.6^{^⁴}
Rajasthan	3.8	8974	27.4	2386^{^⁵}	42.3	42.6^{^⁵}
Tamil Nadu	11.8	11708	35.0	1814^{^{^4,1}}	40.9	39.7^{^⁴}
Utter Pradesh	5.1	6713	40.9	NA	NA	NA
West Bengal	15.2	9579	35.7	NA	NA	NA
Smaller States
Arunachal Pradesh	5.2	12032	39.4	1946^{^⁴}	59.2	54.5^{^⁴}
Delhi	2.1	22687	14.7	2183^{^⁵}	37.0	33.4^{^⁵}
Goa	15.0	23061	14.9	2095^{^⁵}	25.1	17.5^{^⁵}
Himachal Pradesh	8.0	NA	28.4	2323^{^⁴}	36.6	34.7^{^⁴}
J&K	7.1	6658	25.2	NA	NA	NA
Manipur	7.9	7510	33.8	2604^{^⁵}	31.0	28.6^{^⁵}
Meghalaya	1.8	8474	37.9	1702^{^⁵}	11.5	10.7^{^⁵}
Mizoram	6.3	13360	25.7	2017^{^⁵}	17.5	18.2^{^⁵}
Nagaland	5.9	11174	37.9	2189^{^⁴}	27.5	27.1^{^⁴}
Sikkim	4.3	NA	41.4	2191^{^⁵}	37.7	36.8^{^⁵}
Tripura	16.7	5432	39.0	2306^{^⁵}	33.6	40.6^{^⁵}
Union Territories
A&N Islands	14.8	12653	34.5	NA	NA	NA
CHandigarh	9.5	NA	11.4	2412^{^⁵}	21.1	25.2^{^⁵}
D&N Haveli	3.1	NA	50.8	1934^{^⁴}	44.9	37.7^{^⁴}
Daman & Diu	3.7	NA	15.8	2470^{^⁴}	29.7	35.5^{^⁴}
Lakshadweep	22.6	NA	25.0	NA	NA	NA
Pondicherry	12.0	11677	37.4	NA	NA	NA
NNMB - National Nutrition Monitoring Bureau Pooled for 18 States Indian Nutrition Profile - 1998, DWCD Rural Combined (Urban+Rural)6 Planning Commission NSS - National Sample Survey Report pf Technical Group pm on Population Projection 1996 Registar General Of India Education Unemployed Pre capita State Domestic Product

Inter-State/Intra-State Differences in Fertility and Mortality

There are marked differences in health indices not only between States but also between districts in the same State

Census 1991 has confirmed that:

Even in Kerala there are districts where IMR (Idikki) and CBR (Mallapuram) are higher than national levels
There are districts in UP with IMR (Almora) and CBR (Kanpur - Urban) lower than national levels

It is essential to

Remove or minimise the inter and infra-state differences by replicating the progress achieved in better performing districts
Undertake realistic Primary Health Centre (PHC) based decentralised area-specific microplanning tailored to meet the local needs
Involve Panchayati Raj institutions in microplanning and monitoring at local level for effective implementation of the programme and ensuring effective community participation
Achieve incremental improvement in performance in all districts

Statewise percentage Distribution of Births by Birth Order-1994

There are substantial differences between states in the proportion of births of birth order three and above
Bihar/ Uttar Pradesh (UP)/ Madhya Pradesh (MP) and Rajasthan are some of the states where birth order 3 and above constitute over 50% of all births
Number of sterilization/10,000 unsterilised couples with two or more children is low in Bihar (110), Uttar Pradesh (188), Rajasthan (447) and Madhya Pradesh (523) as compared to Tamil Nadu (934)/ Karnataka (1297) and Andhra Pradesh (1230)
Women in Bihar/ UP, MP and Rajasthan have reported high unmet needs for contraception
If all the unmet needs are met there will be substantial decrease in the CBR and higher order of births in these states
Undernutrition, ill health and deaths are more common among infants of higher order of births
Efforts to reduce higher order of births will therefore indirectly improve maternal and child health and reduce IMR


PART ONE	PART TWO	PART THREE