COURTESY HT JULY 13
Why Bihar lags in population control
NEIGHBOUR FARES BETTER : To bring down fertility levels, state could learn how to encourage the use of modern contraceptives from UP
Roshan Kishore and Vijdan Mohammad Kawoosa
letters@hindustantimes.com
New Delhi : The latest Sample Registration System (SRS) findings show that Bihar is a laggard when it comes to controlling population growth in India. Total fertility rate (TFR) for Bihar in 2018 was 3.2. This is the highest among the eight large states where TFR is greater than 2.1, referred to as the replacement fertility level. A comparison with previous SRS rounds shows that Bihar and Uttar Pradesh had the same TFR of 4.2 in 2006. Uttar Pradesh’s TFR came down to 2.9 in 2018, while Bihar’s still stood at 3.2. So, what went wrong in Bihar? Answering this question requires an understanding what drives TFR. (See Chart 1)
The World Health Organization defines TFR as the total number of children born or likely to be born to a woman in her lifetime if she were subject to the prevailing rate of age-specific fertility in the population. A TFR of about 2.1 children per woman is called replacement-level fertility and represents the average number of children a woman would need to have to maintain the population (see https://bit.ly/2ZjgAB3).
TFR is calculated by summing up age-specific fertility rates (ASFR) for women in the age groups of 15-49 years, broken every five years (thus, 15-19, 20-24, 24-29 toll 45-49). ASFR is the number of live births in a particular age group divided by the mid-year population in that particular age group multiplied by thousand.
TFR is, thus, a function of two factors. First is the age of marriage. If women get married at a younger age, ASFR for the younger age groups will be higher, which will contribute to a higher TFR. The second is the use of family planning methods, which determines the ability to maintain a gap between children or limit child birth.
A comparison of these two factors can throw some light on why Bihar has failed to bring down its TFR . (See Chart 2)
As can be seen, ASFR in the younger age group of 20-24 has declined in both Bihar and Uttar Pradesh.
This is in keeping with the all-India trends, and suggests that the average age of marriage and child birth are rising in the country. In fact, Bihar has done better in reducing ASFR in the age-group of 20-24 than Uttar Pradesh. However, in the 25-29 age group, the ASFR decline has been lower in Bihar than in Uttar Pradesh and in the 30-34 age group, the ASFR growth in Bihar has been much higher than in Uttar Pradesh.
To be sure, Bihar witnessed a large growth in the ASFR for the 15-19 age groups, but the overall ASFR for this category in Bihar was quite small (11.9) and less than the all-India average (12.2).
The average age of marriage is almost the same in Uttar Pradesh (22.3 years) and Bihar (21.7 years) according to the SRS findings.
This brings up the question of use of family planning methods in determining ASFRs, and hence TFR.
The 2015-16 National Family and Healthy Survey (NFHS) ranks states by unmet need for family planning. This is a sum of two categories – unmet need for spacing of birth, and unmet need for limiting births. Among large states, women in Bihar reported the highest unmet need for family planning. In 2005-06 as well, when the third round of NFHS was conducted, Bihar ranked second among big states, after Jharkhand, in terms of unmet need for family planning.
Unmet need for family planning is directly correlated with TFR levels across states. Bihar has the highest fertility rate among big states and also ranks first for the highest unmet need of family planning. (See Chart 3)
What explains the higher levels of unmet need for family planning in Bihar compared to Uttar Pradesh? NFHS also gives data on use of modern contraception methods.
Female sterilisation, which can only work for limiting childbirth, is the most common contraception method in India. Male sterilisation is among the least used methods. Bihar actually fares better vis-a-vis Uttar Pradesh when it comes to female sterilisation.
However, it lags behind Uttar Pradesh by 8.5 percentage points when it comes to current use of modern family planning methods. The biggest reason for this gap is a nearly 10 percentage point lead for Uttar Pradesh in the use of condoms. Uttar Pradesh was ranked eight among the 36 states and union territories when it came to the use of condoms. Bihar was ranked 32nd. (See Chart 4)
Share of married women and men who use any modern method of contraception has largely remained unchanged in India between 2005-06 and 2015-16, according to NFHS. However, in Bihar, the share of currently married women and men who use any modern method of contraception has decreased by 5.7 percentage points (from 28.9% to 23.2%). The share of women, whose husbands used condoms has also decreased from 2.3% to 1%.
On the contrary, the share of women and men who use any modern method of contraception in Uttar Pradesh increased by 2.4 percentage points (from 29.3% to 31.7%). And the share of women whose husbands used condoms has increased from 8.6% to 10.8% between 2005-06 and 2015-16.
If the 2015-16 trends have persisted, the gap between Bihar and Uttar Pradesh, as far as use of modern family planning methods is concerned, must have grown by 2018.
In 2015, TFR in Bihar and Uttar Pradesh was almost similar. If Bihar is interested in bringing down its TFR levels, it needs to learn how Uttar Pradesh has been able to encourage the use of condoms