Curb population growth by relying on contraception. This is the great challenge facing India, which is on its way to dethroning China from its place as the most populous country in the world. According to United Nations forecasts, the country must pass this milestone on April 14, during which its population must reach the threshold of 1,425,775,850 inhabitants.

The population of India compared to the rest of the world in 2023. © FMM Graphic Studio

Surprisingly, over the past two decades as India's population growth has skyrocketed, its fertility rate has plummeted. In 1964, Indian women had an average of six children, whereas today they have only two. This is thanks in part to the public family planning service, which India claims to have been the first country to set up, in 1952.

"The primary objective was to slow population growth in order to support the economic development of the country, which was then only a few years old [India proclaimed its independence in 1947, editor's note]," says Anita Raj, director of the Center for Research on Gender Equality, Center Gender Equity and Health at the University of California at San Diego.

Contraception has become part of the customs

The program has had some success. A survey by India's Ministry of Health reveals that almost the entire married population of childbearing age knows about contraceptive methods. In addition, the State provides 68 per cent of contraceptives to those affected, including condoms, pills and IUDs.

Contraception used in India. © FMM Graphic Studio

"However, if the goal was truly women's reproductive choice and autonomy, more needs to be done," Raj said.

However, declining birth rates and women's freedom of choice are intimately linked. "Data from around the world shows that when women have the opportunity to control their fertility and benefit from the opportunities that come with it [such as education and economic opportunities], family sizes always shrink," says Alistair Currie, campaign director of Population Matters, a UK-based demographic charity.

Contraception: a "women's business"

Today, male and female sterilization is encouraged by financial incentives. Some Indian states have also introduced a two-child policy with penalties, such as banning those who do not comply from holding public employment.

The most widely used form of pregnancy prevention in India remains female sterilization. It accounts for 38 per cent of all contraceptives used, while male sterilization accounts for only 0.3 per cent of cases, according to a study by India's Ministry of Health.

This is partly due to the patriarchal mentality that largely dominates Indian society. The Family Health Survey reveals that more than a third of men consider contraception to be a "women's issue".

Male vasectomy also faces resistance due to memories of a policy conducted in the 1970s by the Indian government. Faced with economic and social stagnation, the executive then launched a massive campaign to sterilize men in order to control the birth rate. Men were forced to undergo vasectomy or face reduced pay or job loss. Men from the working classes could even be arrested by the police at train stations or bus stops to be sent to a "sterilization camp".

>> See also: Demographics in India: women take their destiny into their own hands

However, currently, in addition to placing the burden on women, the use of female sterilization after several pregnancies "does not promote birth spacing, which is important for the health and survival of mother and child. It is also not a solution for women to control the timing of pregnancies, but only to limit them," says Anita Raj. "If sterilization is a woman's choice and it contributes to her health, that's fine. But too often, these decisions are based on the expectations of the family and the community."

According to Debanjana Choudhuri, an Indian-based human rights specialist, the fact that the Ministry of Health recently made IUDs (a reversible contraceptive) available could "change the game", but it will take 5 to 10 years for it to become popular.

Family planning

As things stand, there is still a significant gap between the desired fertility rate (number of children women want to have) of 1.6 and the real fertility rate of 2. This suggests that a certain number of pregnancies are suffered, hence the role to be played by family planning.

"We hope that all pregnancies are desired and that people have the ability to choose [to get pregnant]," Currie said. "If that were the case, the fertility rate would be lower in India.

Another challenge for Indian family planning is to reach the working classes. Indeed, socioeconomic conditions determine many women's pregnancy choices, as the 2022 Family Health Survey revealed. Poorer and less educated Indian women living in rural areas are likely to have more children at a younger age and are less exposed to modern contraceptive messages.

Under-25s coasting

India's population is forecast to continue to grow in the coming decades. The "medium variant" of the UN projections sets the peak growth at 1.7 billion inhabitants in 2064. According to the projections of the "low variant", the growth curve would start to flatten in 2047.

This spurt in population growth is looming, as nearly half of India's population is under the age of 25. A category likely to have its own children in the years to come.

To make matters worse, a large part of this population lacks information about contraceptives, says Debanjana Choudhuri. "The family planning program comes with a bias: because it's family planning, many [unmarried] young people think it's not for them. The adolescent population must be included in the contraceptive debate. Right now, they are excluded, and that's alarming."

This text has been adapted from English. Find the original text here.

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