WAKEUP CALL
First of all I would like to introduce you about what is a fertility rate, specifically the total fertility rate (TFR), which refers to the average number of children a woman is expected to have in her lifetime. A very high TFR leads to rapid population growth, potentially straining resources and infrastructure. Conversely, low fertility can lead to a shrinking population, potentially causing an aging workforce and economic challenges.
Fertility rate is a key demographic indicator, significantly impacts population dynamics, influencing population size, age structure, and growth patterns, with both high and low rates presenting unique challenges and opportunities.
There are various factors which have an influencing force on the fertility rates:
Socioeconomic Factors which include Education, urbanization, economic development, and access to healthcare and family planning services, all play a vital role. Cultural norms and religious beliefs also influence fertility decisions in every civilized society.
Now lets us see what can be consequences of Declining Fertility in any region:
- Economic Challenges: A shrinking workforce and an aging population can lead to economic challenges, including reduced productivity and increased healthcare costs.
- Social Challenges: Declining fertility can also lead to social challenges, such as a decline in the number of young people and a potential strain on social security systems.
- Dependency ratio: As fertility declines, the proportion of children in the population falls and the proportion of the population of working age increases, resulting in a lower dependency ratio (defined as the number of children and older persons per 100 persons of working age).
The demographic dividend, the economic growth potential from a shift in population age structure, is strongly influenced by population growth, particularly when a larger share of the population is in the working-age group. The demographic dividend refers to the economic growth potential that arises when a country experiences a shift in its population age structure, specifically when the proportion of the working-age population (typically 15 to 64 years old) is larger than the non-working-age population (children and the elderly).
As fertility declines, the share of the young population falls and that of the older, dependent population rises. If the fertility decline is rapid, the increase in the population of working ages is substantial yielding the ‘demographic dividend’.
Low fertility rates can significantly impact a country’s demographic dividend, which is the potential for economic growth stemming from a large working-age population relative to dependents. While initially, lower fertility can lead to a smaller youth dependency ratio, a decline in fertility beyond a certain point can lead to an aging population and a shrinking workforce, ultimately diminishing the demographic dividend.
A shrinking workforce can negatively impact economic growth as there are fewer people to produce goods and services and support the economy. Aging population also creates fiscal challenges, as there are fewer workers to support a larger number of retirees, potentially straining social security and healthcare systems.
Unemployment
The unemployment rate nowadays is a very significant predicting factor in the fertility rate of any country. A very high percentage of unemployment rate is deceptive in any State/Country. We must account for underemployment to understand where we truly stand in terms of income. Parents now prefer their daughters to be financially secure and employed before marriage, which further delays the process of fertility in them. Completing education, finding a job, finding a match, marrying, and planning a family – all of this takes away crucial time in this reproductive life cycle of a women.
Family Health Policy and Family Size
The health and family sizeare very important for overall development of any country but the family health policies that implicitly dictate family size need to be introspect.
Mortality Rates
Improved child survival rate is a very good indicator but have a potential to decline in fertility as parents have fewer children to ensure their survival. This low TFR indicates a significant decline in fertility rates and raises concerns about population stability and the region’s future. This significant decline of TFR in some parts of the country has led to the risk of fertility below the replacement level for any nation.
Late Marriages
The new trend of women of reproductive age group marrying at late 20ees and early 30ees has a direct impact on the fertility pattern in any region of the country. This delay significantly reduces the reproductive window. The importance of having children before the age of 28, has a good quality and number of eggs which decline thereafter leading to infertility issues and further limiting the chances of multiple children. Also the reasons for late marriages has been found to be financial, societal, and personal factors.
Gynae Health
In the recent last two decades there has been a paradigm shift in the life style diseases of women especially in the reproductive age group where there has been seen an exponential growth in NCDs in the form obesity, PCOD, Metabolic Syndrome, Hypertension and Diabetes. Consequences of these diseases especially PCOD further declines the chances of fertility in these women.
Urbanization
Urbanization generally leads to a decline in fertility rates. This is primarily due to a combination of factors, including the increased availability of education and employment opportunities for women, changes in social norms, and the greater accessibility of family planning resources. Additionally, living in urban areas often means a higher cost of living, which can make raising large families more financially challenging:. More couples now a days are moving to urban areas in search of employment, leaving behind extended families who could have provided crucial childcare support. This has also further led to decrease in fertility rates which will have its repercussions on the demographic dividends in the country.
Migration
Increasing numbers of young people migrating abroad for education and employment, often settling and having families outside of India, also impact the fertility rate.
Stress
While stress itself doesn’t directly cause infertility, it can significantly interfere with a woman’s ability to conceive and can negatively impact treatment outcomes. Stress triggers the release of hormones like cortisol, which can disrupt the balance of reproductive hormones like estrogen and progesterone. This imbalance can affect ovulation, the menstrual cycle, and the quality of eggs. Additionally, chronic stress can increase the time it takes to get pregnant and may decrease the success rate of fertility treatments like IVF.
Now let’s see what is happening in Jammu and Kashmir. The Total Fertility Rate (TFR) in J&K has reached to 1.4, which is significantly below the replacement level of 2.1, according to the National Family Health Survey-5 (NFHS-5) which is prepared by Ministry of Health and Family Welfare (MOHFW) Government of India in collaboration with International institute of Population Science (IIPS).
TFR, a complex demographic indicator influenced by multiple factors, currently stands at 1.5 in rural areas and 1.2 in urban areas in J&K. (Replacement level means, the average number of children per woman needed to maintain a stable population size) This low TFR indicates a significant decline in fertility rates and raises concerns about population stability and the region’s future.
The TFR in J&K is also significantly lower than the National average of 2.0 and has reached below the replacement level. It has dropped by one child per woman in just 15 years, from 2.4 in 2005 to 1.4 in 2021 as per the previous survey records of these organizations. This gap sheds light on the composite reasons contributing to the decline in the number of children a woman is expected to have in her lifetime.
There are many attributing factors for this low TFR in J&K, one amongst them is rapid urbanization and thinning family incomes. More couples are moving to urban areas in search of employment, leaving behind extended families who could have provided crucial childcare support. This trend creates “nuclear islands with thin populations. A solo-living, support-less, working couple cannot fancy a big family. It comes at a cost. Another important factor is a very high unemployment rate of 30 percent which is deceptive as per the last quarter report of (Periodic Labour Force Survey) PLFS survey in 2024.
We must account for underemployment to understand where we truly stand in terms of income. There are many postgraduates who are working as peons, SHGs and while they might be counted as employed, their earnings are inadequate to support larger families. In this situation, families are reluctant to forego the income of either parent and prefer to limit the number of children they have. Often, couples now prefer to have just one child not knowing the consequences of this trend is leading them.
We must understand somewhere, things have gone awry in trying to enforce an ‘ideal family size, these policies often disincentives families with more than two children by withholding benefits like childcare leave, Education Allowances, scholarships, and even maternity leave in some cases. Another feather in the cap is added by J&K’s contraceptive prevalence rate among married women aged 15-49 which stands 60 percent, further influencing family planning methods.
Late Marriages of women in J&K where they marry at an average age of 26 – the highest in India, compared to the national average of 22.1 years is another contributing factor in dropping of fertility rate in this part of the country.
Life style changes in the society where young girls in J&K have adopted a sedentary life style by not involving themselves in home chorus, followed by a big change in dietary habits consuming junk foods have led to poor Gynae health in the form of PCODs and Metabolic Syndrome disorder have further added fuel to the fire.
Completing education, finding a job, finding a match, marrying, and planning a family – all of this takes away crucial time which has further led to the drop in the fertility rate in the UT. The highest percentage (26.1%) share of youth (15-29 years) who never married was observed in Union territory of J&K in 2019.
Time has come for J&K to actively respond to very low fertility rate as young population size is shrinking day by day and elderly population is rapidly growing. To address this fall of demographic dividends we need to provide childcare subsidies and making school education free for 3rd child from all levels of schooling (Public or Private), if we really want to try boost the declining population.
We should provide comprehensive childcare / family adoptive policies and formulate “sound plans” for a childcare service system, including progressively making school education and social security of their children, providing housing subsidies to the citizen on priority in the UT. We need to put efforts on pronatalistic family policies and customized our family planning policies in the UT as it may be leading to decreased economic growth potential in the UT whose economy is already very low.
Rapid aging has become a growing concern in the world’s 4th largest economy with the number of those aged 60 and older expected to rise at least 20.8% by 2050 which constitutes 347 million people, and J&K UT has no different projections. Like rest of the Country, J&K aging population will outnumber children further by 2050 because of its very low TFR and the working –age population will be declining further.
The People, policy Makers who are at helm of affairs selected by democratic process in the J&K UT must prepare a legislature and bring an ordinance bill in the legislative assembly for making changes in the family planning policy of the UT.
This is a very tricky situation for the policy makers where not only we may have to raise minimum basic old age benefits for both rural and urban residents but also put some social welfare schemes for parents and offer family allowances to help with the financial burden of raising children who wish to plan to extend their families beyond the 2nd child.
Authorities at the helm of affairs should also prudently advance the reform to gradually raise the statutory retirement age from 60 to 63 years till the demographic dividends which we may aim to achieve are tangible. The change should come into effect as early as possible and the dividends of these reforms can be seen over a period of 2-3 decades.
Much of our demographic downturn is the result of two- child policy which was laid down in 1967when the country was at Early Expanding (Stage 2 ) of demographic cycle, but now times has come to review and revamp our family planning policy so that Couples are willing to adapt a three-child policy by fostering a birth-friendly social atmosphere.
Policies must be designed to help women reconcile their careers with motherhood, allowing them to return to work after childbirth without significant financial strain beyond 2nd child also. Otherwise we will have very few people to take care of our Elderly growing Population in the UT due to the current scenario of shrinking young workforce.
And as a Public Health Specialist we may have to produce more Geriatricians than Pediatricians in near future which will not be a cost-effective measure. I would like to pen down here with a message that “it is easier to build strong children than to repair broken men”
(Author is working as Medical Officer in department of health. Feedback: [email protected])
