India's population: second and growing

Attention in this discussion of the population of India is directed to the following: international comparisons, population pressures, trends in population growth (interstate variations), sex ratio and literacy, urban-rural distribution, migration (interstate migration, international migration), fertility and mortality levels, fertility trends (birth rate decline, interstate fertility differentials, rural-urban fertility decline, fertility differentials by education and religion, marriage and fertility), mortality trends (mortality differentials, health care services), population pressures on socioeconomic development (per capita income and poverty, unemployment and employment, increasing foodgrain production, school enrollment shortfalls), the family planning program, implementing population policy statements, what actions would be effective, and goals and prospects for the future. India's population, a total of 684 million persons as of March 1, 1981, is 2nd only to the population of China. The 1981 population was up by 136 million persons, or 24.75%, over the 548 million enumerated in the 1971 census. For 1978, India's birth and death rates were estimated at 33.3 and 14.2/1000 population, down from about 41.1 and 18.9 during the mid-1960s. India's current 5-year plan has set a goal of a birth rate of 30/1000 population by 1985 and "replacement-level" fertility--about 2.3 births per woman--by 1996. The acceleration in India's population growth has come mainly in the past 3 decades and is due primarily to a decline in mortality that has markedly outstripped the fertility decline. The Janata Party which assumed government leadership in March 1977 did not dismantle the family planning program, but emphasis was shifted to promote family planning "without any compulsion, coercion or pressures of any sort." The policy statement stressed that efforts were to be directed towards those currently underserved, mainly in rural areas. Hard targets were rejected. Over the 1978-1981 period the family planning program slowly recovered. By March 1981, 33.4 million sterilizations had been performed since 1956 when statistics were 1st compiled. Another 3 million couples were estimated to be using IUDs and conventional contraceptives.     

Birth rate of Beijing population drops nearly 60% in 20 years

The birthrate of the Beijing (China) population dropped by 60% in the last 20 years. Consequently, population reproduction is characterized by a pattern of low birthrate, low mortality rate, and a low growth rate. The birthrate of the Beijing population was 36.30/1000 in 1950 and rose to 43.41/1000 in 1963. During the 1950-63 period, the average annual birthrate of Beijing population reached 36.71/1000 and the number of births was 2.23 million. Since the beginning of the 1970s, the rapid population growth has been effectively checked by great efforts made in practicing family planning. Over the 1970-83 period, the average annual birthrate dropped to 14.9/1000 and the number of births totaled 1.75 million. With the advance of the family planning effort, particularly acceptance of the concept of practicing family planning for the modernization drive, the people's reproductive notion has changed for the better. At this time, more and more men and women of reproductive age have broken away from the influence of old ideas such as "the earlier the couples have their sons, the soonner they will be helped." By 1982, the average age at 1st marriage was 25.8 years for males and 24.7 years for females. This was a remarkable change as compared with the 1960s. According to the 1982 population census, Beijing women over 60 years had 4.83 children, while those in the age groups 55-59, 50-54, 45-49, 40-44, 35-39, 30-34, and 25-29 has 4.81, 4.50, 3.72, 2.95, 2.32, 1.58, and 0.57 children respectively. Today, 0.66 million couples in Beijing volunteer to have only 1 child.     

Sum up experience to make continuous progress

Population control in China has been very successful in combatting the extremely rapid growth in population (birth rate: 1960's 33.65/1000; 1970's 24.57/1000; 1980's 18.3/1000). The female mean age for 1st marriage has increased from 19 in the 1950's to 22.63 in the 1980's. Infant mortality has declined substantially from the 1950's to the present (200 deaths/1000 vs. 81.3/1000 (cities)). Most people have embraced family planning and population control and have emphasized quality of childrearing vs. quantity. The goals of China's policy are as follows: economic development of the nation and well-being of individuals; coordination of population growth and socioeconomic development; implementation not only in accordance with state condition, but also according to the wishes of the people; continued success of the population and family planning organization network; integration of state guidance with individual voluntariness; and strengthening the unified leadership of the state. China's 3rd baby boom began in 1986 and will last through 1995. Unplanned children will count as 30% of the annual births. Government action is attempting to strengthen family planning education and research. These measures will help control the expected population boom.     

A tentative discussion on population reproduction in U.S.A. after World War II]

Immigration is an important factor in America's population growth. In the last 200 years over 50 million persons immigrated to the U.S.; 99.6% of the current total population are descendents of those immigrants. In the 1930s, American population decreased by about 7.2/1000, but during the 1950s the annual rate of natural increase rose to 18.5/1000. In the 1960s, this rate began to decrease until the 1970s when it was about 9/1000. By 1981 and 1982, the rate of natural increase declined to 7/1000. These changes are due to the relatively slow decline in the mortality rate of the last 30 years (10.6/1000 in 1945 to 9/1000 in 1981) and to the fluctuations in birth rates (from 19.5/1000 in 1945 to a high of 25.3/1000 in 1957 and back to 16/1000 in 1981). Birth rates are influenced by factors such as the number of fertile women, age structure, fecundity, marriage, family, occupation, and education. In 1950 there were 38,920,000 women aged 15-49, and by 1980 there were 57,630,000. Of these, in 1950, 31.28% were aged 20-29, the most fertile period for women, as compared with 35.04% in 1980. Thus, in postwar America, the changes in birth rate did not follow changes in the number of fertile women. Marriage patterns also underwent changes, particularly in the last 20 years. From 1930 to 1935, the marriage rate was 8.6/1000. By 1945, it rose to 16.4/1000. But during the 1960s, an increasing number of women aged 20-29 years remained unmarried. At the end of the 1970s, there was also an increase in the number of married women who did not have children. Furthermore, the number of divorces increased, an additional reason for a declining birth rate. Changes in family structure also influenced postwar American reproduction. In the last two decades, the traditional family has almost disappeared and the nuclear fammily is on the decline. By 1970 there were more people living alone, single parent families, and unrelated people sharing a domicile, than there were family units. Also, educated women who worked often married at a later age, thus placing restrictions on the birth rate.     

An analysis of the fertility transition in developing countries]

Most developing countries are in the demographic stage of early mortality, high birth rates and high rates of natural population increase. A characteristic of developing countries is that after World War ii, particularly since the 1960s fertility rates are on the decline, even though they still remain high. The fertility rate of developed countries fell from a 1950 rate of 22.9/1000 to 15/1000 in 1982, a decrease of 34.5%, whereas the fertility rate of developing countries hovered around 43/1000 between 1930-1950, 40.6/1000 during the 1960s and 33/1000 in 1982. Between 1950 and 1982 there was a decrease of 24.8%. But the main reason for this decrease is the decline in the last 20 years of the fertility rates of China and India, whose rates fell 34.9% from 1960-1980. Changes in fertility rates are influenced by the age structure of a country, as seen in the changing age structure of developing countries from 1960-80. For example, an increase in fertility rates was 1 consequence of an increase in the number of fertile women aged 15-45 from 42.6% in 1960 to 44.4% in 1980. Nevertheless, there exists some sort of birth control, whether conscious or subconscious, because the number of births per fertile woman is 3-4 fewer than the 14-15 children a woman can theoretically bear. The reason for changes in fertility rates in developing countries can be traced to marriage and family customs, and even more important, to social and economic factors. For example, Asian, African and Latin American cultures tend to support early marriages. When the fertility rates of developed and developing countries are looked at for a comparable period, then the rate of decrease for developing countries is slower than developed countries. But, if the comparison is made for a transitional period (i.e., industrialization), then the rate of decrease for developing countries is faster than for developed countries. Currently there are 25 developing countries that have attained a fertility rate of 25/1000 or lower, and 52 developing countries with a rate of 35/1000.     

Family planning achievements as suggested by changes of total fertility and party birth rate]

The dynamic characteristics of China's 5 distinct stages of population development since the People's Republic of China was established in 1949, namely, 1950-1958, 1959-1963, 1964-1970, 1971-1981, and 1982-present, are outlined and discussed. By tracing both the overall rate of population growth and age-specific fertility rates for women aged 15-45 (5-year groups), a clear pattern emerges which indicates that the rates of early and late fertility (ages groups 15-19 and 30-45) are significantly declining. This is interpreted as a key factor in the overall decline in fertility rate. Annual statistics showing the number of children per woman of childbearing age and interval between 1st marriage and 1st birth are compared and discussed. It is concluded that the overall decline in birth rate and fertility rate since the 1970's is attributable to China's successful family planning campaign.     

中国人口出生控制成效的比较分析

中国 ①的计划生育工作起始于 2 0世纪 5 0年代。从 1 95 5年到 1 971年 ,中国推行的是一般性的家庭计划生育政策 ,从 1 971年至今 ,中国推行的是家庭计划生育与国家计划生育相结合的政策。如果不实行任何形式的计划生育政策 ,2 0 0 0年末中国人口将会达到 1 8 5 8亿 ,如果象印度那样只倡导自愿实行家庭计划生育 ,将会达到 1 5 3 2亿。过去 45年中 ,中国一共少生了 5 88亿人 ,其中由于实行国家计划生育政策少生了 2 6 2亿人 ,而一般性的家庭计划生育政策少生了 3 2 6亿人。计划生育为中国的社会经济发展做出了巨大的贡献     

A survey of China's birth control among women of child-bearing age

To further implement China's family planning policy of "prevention first, birth control first," a study of the current family planning situation was conducted. A survey of the birth control methods employed by women of childbearing age and by men was based on a nationwide randomized sampling of 1/1000. In the different age groups, ranging from 15-49 years old, IUD users accounted for over 50%, tubal sterilization 25%, and vasectomy 10%. The main IUD users were women in the 20-24 age group. Tubal sterilization was more prevalent among the women in the 35-39 age group. The use of oral contraceptives (OCs) was more common among younger women but accounted for less than 10% of the total. The survey was based on the replies to questionnaires from 172,788 married women of childbearing age; 120,022 of them practiced contraceptive methods for a birth control rate of 69.46%. The breakdown was as follows: IUD, 34.84%; tubal sterilization, 17.63%; vasectomy, 6.94%; OCs, 5.86%; condom users, 1.39%; and other methods (including chemical suppositories, rhythm, or safe period method and withdrawal before ejaculation), 2.78%. There was a higher percentage of OC users in urban areas, and a marked preference for IUDs in the rural communities. The rural birth control rate was 68.58%; the urban rate was 74.17%. The use of the IUD has priority in all the areas; its percentage approaches the national average level. The use of vasectomy as a birth control method varies considerably according to area as does the use of OCs, condom, and tubal sterilization. Rural minority groups prefer the IUD and OCs; tubal sterilization, the condom, and vasectomy are preferred by the Han nationality. The birth control rate differed according to the different occoupation groups: 77.85%, workers; 76.01%, farmers; 85.15%, cadres; 59.52%, housewives; and 66.67%, others. The birth control rate was higher among those who received a college education than the illiterates, but statistics did not show a significant difference in the rate of those with a high school education and the illiterates. Mothers of 0-1 children generally preferred OCs; tubal sterilization was preferred by mothers with 2-3 children. The nonusers of contraception accounted for 30.54% among married women of childbearing age. A breakdown gives the following figures: menopause and infertility, 6.17%; divorced and widowed, 1.64%; planned parenthood, 10.51%; nonusers who should have practiced contraception, 12.22%. On a national level, the estimated number of nonusers of contraception among those who should be practicing contraception comes to about 20,000,000 women.     

Preliminary inquiry into changes among women in mountainous regions with regard to marriage and birth]

Research objectives were in China study the changes in marriage, birth, and birth and birth control of mountain women in the last 43 years. The methodology used was random sampling. The sample was taken based on 1% of the agricultural population. The findings show that the unmarried rate of women is currently very low. Remarriage occurs because of the loss of a spouse rather than divorce. Early marriage occurs more frequently with mountain women since they have gradually strayed from the traditional belief of marrying only once. Within the last 40 years, the average age when one married has gradually increased. The percentage of early marriages has decreased and the percentage of late marriages has increased. Prior to 1975, the birth rate was high and now it has decreased. The decrease in the birth rate in 1960 was due to natural disasters; however, the current decreases in the birth rate are due to family planning. The major factors influencing marriage of mountain farmers and birth rate are traditional feudalistic influences, economic life, marriage laws, population policies, culture, and education. The survey was conducted from August 1982 to April 1983. There were 20,174 women ranging from the ages of 15-67 who participated. Findings show that the majority of the unmarried women are now under the age of 25. The percentage of 1st marriages under the legal age reached 2.89%. The average 1st marriage age of women in the 1940s was 19.03. Between 1980-1982 it was 22.30, an increase of 3.27 years since 1940. The percentage of 1st marriages under the age of 18 in the 1940s was 35.96%. It decreased to 2.28% in 1980. The rate of 1st marriages over the age of 23 before 1970 remained approximately 5%. It increased to 56.84% in the early 1980s. The traditional feudalistic influences have greatly affected marriage of mountain farmers. The ratio of more than 1 child per couple reached a rate of over 40%. The improvement of economic life also increased the aggregate birth rate. It reached 7 in the 1950s. With the emphasis no longer on marriage laws and population policies but on family planning, the early marriage rate decreased to below 15% from a previous rate of 40%.     

The current situation and tasks of China's population control

During the 10 years from the late 1960's to the late 1970's, China's birth rate declined by 50%. Currently, however, China is in the midst of a baby boom. 3 statements characterize the birth rate: The growth rate is high (birth rate is 21.04/1000 in 1987 and natural increase was 14.39/1000); unplanned births are common; and population growth is varied in different areas of the country (10 provinces show 3rd or higher parity births at an average rate of 20%; the highest rate in a province is 45%). Several measures are suggested to deal with these population problems; increase nationwide awareness of population control; stabilize current family planning policies with only special case exceptions; expand contraceptive services and increase scientific research in the area of family planning; and enact economic and social welfare policies in line with population control.     

Service station established at villages and towns in Fufeng County pushed forward the family planning program there]

In 1985 the 15 villages and towns of Fufeng County, Shanxi Province, established service stations to promote family planning. The County invested over 90,000 yuan in an x-ray machine, operation table and necessary medical supplies. The service stations provided fluoroscopy, surgical and propaganda rooms. The purpose of each station, staffed by female physicians and family planning cadres, was to develop contraceptive birth control, teach eugenics, and counsel women. The establishment of service stations obviously proved significant and useful, as seen from the following data: for the years 1983-85, the county birth rate fell 2%; the multiple child rate dropped 7.7%; the birth control rate rose by 12.6%; the sterilization rate rose by 1.3%. By October 1986, these figures showed even more improvement. The success of the service stations was also due to: taking its services to the people, their homes, and their workplace; making family planning work a service, rather than a management; systematizing family planning work and making it available at all times.     

Curbing population growth: lessons from India

India was 1 of the 1st countries to establish a national population policy program to reduce the heavy social and economic burden of rampant population growth. The 1985 US Agency for International Development survey highlights 3 measures that could contribute significantly to the success of population policy and family planning goals: 1) increase the age at marriage for women, 2) lengthen the interval between births, and 3) improve communications. The younger a girl's age at marriage 1) the younger she is likely to get pregnant, 2) the more babies she can have over her lifetime, and 3) the higher the country's population growth rate. The answer to short birth intervals is childspacing through contraceptive methods. The Indian government has already begun to retrain its health workers and other functionaries to enhance their role as communicators. This should do much to counter the attitudes, practices, and lack of knowledge that contribute to India's population growth.     

Applying information to improve family planning in Gaoping County]

The scientific management method of improving family planning through information has produced a low birth rate and natural increase rate in Gaoping County, China, since 1976. In order to promote good family planning, Gaoping County incorporated the scientific management method with the establishment of an information network that included information banks, files, and newspaper columns. The officials of Gaoping County focused their efforts on women most susceptible to unplanned childbirth, e.g., women uneducated in birth control and prenatal care. The women were divided into groups according to their educational needs, e.g., women who were hesitant toward birth control, women who used birth control, women who never reproduced, and women who were newly married. By educating these women to the aspects of planned childbirth, prenatal testing, prenatal care, and contraceptives, Gaoping County effectively promoted good family planning in the areas of birth control and family health. The following statistics are the results of incorporating the scientific management system in family planning of Gaoping County. In 1983, the birth rate in Gaoping County was 11.3%, a 2.8% decline from 1982; the mortality rate decreased 0.2% to a rate of 7.6%; and the natural increase rate decreased 2.6% to a rate of 3.7%. The planned birth rate in 1983 was 90.1% and the rate of 1 child per couple was 91%. This was an increase from the 1982 rates of 21.3% and 25.2%, respectively. From January 1984 to June 1984 the planned birth rate reached 97.2%. These statistics are evidence of the positive results in using information in family planning.     

Family planning among the Maranaos

An effort has been made to introduce population education concepts and family planning practice to the Maranaos of Lanao del Sur province in the southern Philippines. A survey conducted in 1969 revealed that an overwhelming majority were opposed to family planning, because of the belief that it ran counter to the teachings of the Koran. In 1969, Dansalan College 1st opened a maternity clinic and, subsequently, established a family planning clinic on campus, the only one of its kind in the province. Since the clinic began operations, a total of about 1370 acceptors have been recruited. The oral contraceptive is the most preferred method among the acceptors, accounting for 60%, followed by the injectable. Additionally, the college has integrated family planning and population education into its Community Service Program. Despite several years of effort by Dansalan College, however, Maranaos have failed to respond significantly to practicing family planning. College officials continue to be optimistic, recognizing that the effort will take years of motivating and education.     

The elimination of contraceptive acceptor targets and the evolution of population policy in India

In 1966 the government of India announced a new national population policy that eliminated numerical targets for new contraceptive acceptors. This paper examines the history of target setting in India and factors that led to the elimination of targets. The analysis is based on published and unpublished reports on India's population policy and the family planning programme and interviews with senior Indian and foreign officials and population specialists. Five factors are identified as playing a role in the evolution from target setting to a target-free policy:(1) the research of India's academics; (2) the work of women's health advocates; (3) the support of officials in the state bureaucracy who approved the target-free approach; (4) the influence of the donors to India's family planning programme, especially the World Bank; and (5) the International Conference on Population and Development.     

Develop family planning work based on the reality of minority regions]

Pingtang County, Guizhou Province, is the home of the Bu-i and Miao minorities, who comprise 55% of the county's population. Since 1980, the county has vigorously followed family planning such that the rate of birth control rose from 20% in 1978 to 95% in 1985, the rate of natural growth went from 34/1000 to 3.6/1000, and the multiple child rate dropped to about 6% from 37.7% Following 5 years of work, the following observations are made: 1) The first step is to determine whether or not to have family planning because the common feeling about minorities is that by virtue of being a minority, family planning is not a serious issue. But family planning became a necessity when it was realized that population was growing faster than food production, creating problems in housing and public health, and in a dependence on the nation at large. 2) The initial step in family planning is ideological; a plan should be implemented whereby goals to reform old customs and thoughts (such as favoring males over females) are carried out by local leaders and cadres at all levels.     

Indonesia: family planning target stepped up for 1980; twofold success of integrated project

The recruitment of 3 million additional family planning acceptors for the fiscal year 1979/80 was the target of Indonesia's family planning program. Available data shows that Indonesia was the 1st country in the world to have consumed 200 million cycles of contraceptive since the program's inception 9 years ago. The achievement of a lower birth rate of between 20 and 22 per 1000 (present rate is approximately 38/1000) is possible within the next 10 years should the program maintain its present pace. Education of women; health of pregnant mothers, and nutrition of children are factors which strongly affect family planning. Current conditions are such that 30% of children aged 0 to 6 years and a large proportion of mothers are malnourished. A coordinated family planning-rural development project launched by the Indonesian Planned Parenthood Association and Indonesian Women's Association was launched 2 years ago and has proved successful. The project's core activity is the organization of income-generating projects such as poultry-raising, vegetable cultivation, handicrafts and small industries. Family planning and other health measures (eg, environmental sanitation) were also promoted. The project utilized selected cadres of married women who were then trained in community development. These women became trainers in their own villages. The project proved to be successful in terms of income-generating activities for the women and in terms of gaining 623 new family planning acceptors within a period of 5 months.     

Hong Kong: The Family Planning Association continues its pioneering role

Vital population statistics for Hong Kong are mentioned. The 1st efforts at providing birth control services in Hong Kong began in 1936 with the Eugenics League. The League was reorganized and formed into the Family Planning Association of Hong Kong (FPAHK) in 1950. The government began providing family planning services in 1974. Although there is no governmental incentive/disincentive policy, certain laws and practices do have the effect of encouraging population growth limitation. These are described. The FPAHK directs its efforts toward motivational activities. The Association is encouraging the concept of male responsibility for family planning. Personal visits to fisherfolk families have been instituted to combat their tendencies toward large families. Various separate activities of the government program and the FPAHK are discussed.     

Trends in fertility level in the Union of Soviet Socialist Republics during the years of Soviet rule

The birth rates of the USSR within its present boundaries are reconstructed for the period 1918-1940 on the basis of incomplete data and taking into consideration several changes in frontiers. Estimates for the years 1941-1945 are derived from data on school attendance during the 1949-1954 period, as well as from data provided by the censuses of 1959 and 1970 concerning cohort survival. Deriving an "effective fertility rate," which adjusts for the mortality wastage of young children, discussion focus is on fertility trends until 1976 and the changes in age patterns of reproduction at the national level and in the various republics. During the 1918-1940 period, the birth rate in the USSR never fell below 30/1000 and never exceeded 45/1000. There was a significant drop in the birth rate in the 1931-1936 period, and this is attributable to the problems of the period of collectivization and to the large-scale processes of migration involved in the country's industrialization. After the late 1940s, the overall birth rate in the USSR stabilized at a level of 25-27/1000, but from 1960 onwards, there was a steady decline in the rate. The level reached its lowest in 1969 and then rose somewhat. This increase reflects the transient influence of changes in the age-marriage structure of the population and in the "timetable" of births. A comparison of the present fertility level with the level in the 1920s indicates that the birth rate has declined by a factor of approximately 2.5, but in evaluating this decline the sharp decline in mortality, particularly infant mortality, must also be considered. The child mortality level in prerevolutionary Russia was very high. The overall mortality rate for the 20 provinces of European Russia in 1920-1922 was 33.2/1000, namely, 1/4 higher than it was before the Revolution. In subsequent years infant mortality continued at a high level and was 18.2% in 1940. In the last 25 years mortality in children under age 5 has markedly declined. In 1976 the overall birth rate was 18.5/1000 and the "effective" birth rate was 18.0/1000. The practice of birth control in families is spreading in various ways. In some cases the proportion of married couples using family planning is increasing, while in other cases couples already using birth control are beginning to use it after the birth of a child lower in birth order. In most areas of the country birth control is being practiced predominantly in such a way as to keep families down to 1 or 2 children. For the whole of the USSR in 1973-1974, the gross reproduction rate was 1.178, while the net rate was 1.118. Although there is ample population replacement in the country as a whole, in a number of republics even mere replacement is threatened.     

The change of fertility and factors impacting it in Shanghai City in the past thirty years]

In 1981 a 3% random sampling of women born between 1931-66 was taken in Shanghai to study their menstrual and marital histories, pregnancies, contraceptive use, education, and occupation. In the last 30 years the fertility rate and the rate of natural population increase began to decline beginning around 1957-58. The changes in fertility rate fall into 3 periods: 1) between 1958-61 the fertility rate fell from 238.6/1000 to 159.2/1000, averaging 26.5/1000 annually; there was a slight period of stability from 1961-63; 2) between 1963-67 it fell from 155.8/1000 to 56.3/000, averaging 24.9/1000 annually and between 1967-68 there was a slight increase; and 3) between 1968-74 it fell from 63.2/100 to 26.4/1000, averaging 6.1/1000 annually. The fertility rate of various age groups also declined during the last 30 years. The average number of children for married women was 1.92. Factors influencing the fertility rate include: 1) birth control policy: the changes in the fertility rates were dominated by the birth control policy; for instance, from 1956-60, after late marriages were officially advocated, the average age at 1st marriage for men was 1.64 years older than before; between 1962-64, those women with more than 3 children were sterilized. 2) Education: the higher the educational attainment, the later was the age at 1st marriage, the more effective was the use of contraceptives and the lower the standard was for fertility; 3) occupation: the type of job influenced the age at marriage, as well as the frequency of miscarriage and live births; 4) attitude towards children: the total number of children women reported they would like averaged out to be 1.7; 5) urban and rural differences: the fertility rate for Shanghai City was not only lower than for Shanghai County, it fell at a faster rate; 6) changes in the age structure of fertile women affected the fertility rate; and 7) others: nutrition, the ability to propagate, age at 1st marriage, plus economic and social factors all affected fertility.