LUCKNOW // Fatigue and anxiety line Raj Rani's gaunt face as she worries about fixing the next meal for her five children. Her family gleans a pitiful living from the 60 rupees (Dh4.60) she earns as a construction labourer for each day's work. Her husband used to work in a local tannery, but was laid off a year ago during the economic slowdown and has been unable to find work since.
Ms Rani survives on one meal each night so that she can feed all of her children, aged between 11 months and 12 years. She developed anaemia during her last pregnancy about a year ago, and sometimes is too weak to work. "When I don't work, my children go hungry," she said, craning her neck to watch one of her children, lolling in a mud path nearby, naked and with a distended belly. "Deciding how many children to give birth to is not in my hands. They are an act of God."
Here in Uttar Pradesh, India's largest and most populous state, home to 180 million people, the use of contraception is rare. Fewer than 30 per cent of married women use condoms or birth control pills, well below the national average of 48.5 per cent, according to India's National Family Health Survey. In economically depressed states such as Uttar Pradesh, an average woman bears up to four children in her lifetime. The average birth rate for the entire country has fallen to three, down from six in 1950. But the country's population still grew by 1.4 per cent over the past five years. At this rate, India is expected to eclipse China as the world's most populous nation by 2050.
It is a problem that India's health minister, Ghulam Nabi Azad, described as a "population growth volcano" waiting to explode. Last week, Open, a national weekly, reported the grim predictions of an independent Indian think tank. According to the Kesroli group, "India is poised on the brink of anarchy and could hurtle very fast into an ungovernable mess" if it does not curb its population growth.
It could also lose its hard-won economic gains and witness civil unrest rooted in issues of right to livelihood as the resource-scarce country struggles to feed its growing population. Analysts cite over-population as the main reason for India's social ills such as poverty and illiteracy. According to the Multidimensional Poverty Index, developed by the United Nations Development Programme, about 645m people, or 55 per cent of India's population, are defined as "poor" based on 10 indicators including standard of living, education and nutrition.
Eight of India's 28 states, including Uttar Pradesh, account for more poor people than in the 26 poorest African nations combined. AR Nanda, the executive director of the New Delhi-based Population Foundation of India, said: "India's population growth can be compared to a fast-moving express train, which has applied its brakes but cannot stop immediately because of its momentum," But the health ministry is largely conflicted over ways to curb it.
With 50 per cent of the population now at the reproductive age of between 15 and 49 years, the government is worried about the 69.1 per cent of people who do not use contraceptives. Unlike China, India has a strong aversion to controlling reproductive habits of people by using punitive measures. "Let me make it very clear: we are not in favour of controlling population growth through any kind of legislation," Mr Azad said.
At the heart of that aversion, is former prime minister Indira Gandhi's aggressive sterilisation programme in the 1970s, which promoted compulsory vasectomies for men with two or more children. The programme was deeply unpopular; in large swathes of rural India, people liken vasectomies to castration. According to the latest National Family Health Survey, 37 per cent of Indian women have undergone sterilisation, against just one per cent of men.
"The only way is to generate awareness and persuade people to have small families for the betterment of the health of mothers and their babies," Mr Azad said. India's National Population Stabilisation Fund said it was making rapid strides in getting people in impoverished states to adopt new forms of birth control like intrauterine devices. But analysts point out that these measures will not produce long-term results until mindsets change. Large families have been the norm in India, with children seen as old-age security, especially among the poor.
In a largely patriarchal society, women often enjoy little freedom of choice over their own reproductive rights. The decision to have more children is often influenced by the obsession of Indians for a male child. Ms Rani said her husband was staunchly against sterilisation until they have a son. The couple have five daughters. "My husband is desperate for a boy," she said. email@example.com