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Focus 1992 April - June |
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Volume. VI. No.2.
Aprll- June, 1992
Phulbani Project to Accelerate Decline in Infant Mortality and
Fertility through Strategic Interventions
On June 17, 1992 was
launched in Phulbani
district of Orissa a unique
health care project which may prove
a significant step towards realising
the dream of putting people's health
in people's hands. Though primarily
designed to accelerate the pace of
decline in infant mortality and
fertili ty through stra tegic
interventions, the basic premise
underlying the project is that a
different approach, backed-up by
appropriate in-depth training of health cadres and equipping them with the essential
technical resources, can facilitate the use of existing systems to deliver a high quality
health service on a sus~ined basis.
The project which is in the nature of a problem solving exercise as well as an
attempt to field-test certain strategies covers the entire Tikabali block of Phulbani
district comprising 142 villages with a population of 40,000. It is the first of a series of
three projects, the other two are slated to be launched in Tehri Garwhal (U.P.) and
Damoh (M.P.) after gaining some experience in Orissa which has the highest infant
~ortality rate in India and in Tikabali block which presents several critical features
relating to the problems of infant mortality, maternal morbidity and high fertility.
The Tie-up---
The Family Planning Foundation, the Government of Orissa and a Phulbani-
based reputed N.G.O. - Jagruti - have joined hands to implement the Orissa project
whose main thrust is to strengthen the primary health care (PHC), particularly the
Material and Child Health (MCH) service delivery, immunisation, ante-natal, intra-
partum and post-natal care, care of infants and toddlers and properly counselled
contraception. Mr. A.Joseph, Director, 'Jagruti', will be the Project-coordinator-cum-
Administrator and Dr. Almas Ali of the Institute of Tribal Health & Social Sciences,
Bhubaneswar will guide the project as Adviser.
While the Family Planning Foundation is responsible for the funding and
overall coordination of the project, development of project design, planning of
interventions as well as supervision and monitoring support, the detailed implementation
rests with the Orissa government through its nodal agency of Primary Health Centre
at Tikabali. Jagruti in concert with other NGOs operating in the areas of enVironment,
literacy, social and economic development, are expected to ensure enhanced 'social
mo"ili~tion for ~ommunity support and health service delivery throu~ strengthening
of Information, Education and Communication programme, training of government
10 Million Low Birth
Weight Babies
Neonatal mortality con-
stitutes 50-60 per cent of the
infant mortality. While the
infant mortality has shown a
reduction of about 50 per cent
in the past two decades, the .
neonatal mortality has not
shown any fall- it has remained
around 67 per thousand live
births. In Orissa, according to
the 1988 SRS of the Registrar
General India,n.eo-natai mor-
tality rate was 70.8 which ac-
counted for 58.16 per cent of
the total infant deaths in the
State.
Of the 26 million babies
born in India each year, 8 -10
million are low birth weight
(LBW)babies weighing less that
2500gms. In fact, 80 per cent of
all neonatal deaths and 50 per
cent of infant deaths occur
among LBWs. The reduction
of LBW babies and
improvement in the mean birth
weight of babies is the key to
improve neonatal and infant
survival in the country. This
and other high risk factors are
sought to be tackled in Tikabali
project throuoh appropriate
interventions.
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functionaries and community volunteers and inter-sectoral tT:ba1/bac~<waTdareas who /Vas also asscciaied wifu Phase 1oi
collaboration.
the proj€C!. Jo the light of these suggestions a d consultations,
Mr. G.B. Muk·erji, Secretary Health and Family Welfare Dr. Nalini Abraham, Senior Project Cpordinarorof the FPF, has
Department, Orissa, has evinced keen interest in this innovative developed Phase II of the project to be implement@d in U,P.,
project and promised all-out support for its expeditious M.P. and Orissa in the same blocks in which the research study
implementation. While expressing his satisfaction in effecting was conducted. The start has been made with Orissa.
the tie-up between the State government, local voluntary
The estimated cost of one project-year is Rs.I0 lakhs and
organisa tions and Fam ily Planning Founda tion, an enthusiastic the total cost of the three year project is Rs.30 lakhs, of which
Mr. Harish Khanna says: "This unique mcdel could be repeated Rs.81akhs is FPF's project management cost and the remaining
in other States to validate the hypothesis that the pace of Rs.22 lakhs is funding for field activities in Orissa.
reduction oHnfant mortality can be hastened by filling the gaps
and developing a more dynamic relationship between the Demographic Profile
community and the PHC".
Tikabali is predominantly a tribal belt with 77 per cent of
The Genesis
The Family Planning Foundation in collaboration with
the IORC, Canada undertook a two-phase action research
project untitled "Infant Mortality in Relation to Fertility". The
phase-I study conducted in 38 socio-economic segments located
in five States - V.P., M.P., Orissa, Karnataka and Maharashtra
- was completed in 1988. Its main objective was to identify the
determinants of infant mortality and fertility and how they
influence one another, and are in turn influenced by other risk
its population belonging to the Scheduled Tribes or Scheduled
Castes.
Out of a tptalliteracy rate of 35 per cent, S.T., and S.c.
literacy rate is 8 per cen t and 12per cent respecti vel y. Tne break-
up of male and female literacy rate is 20 and 15 per cent.
About 90 per cent of the households are nuclear families
and the family size is below 5 in 73 per cent cases while it is 6-
9 in 26 per cent cases.
Health Infrastructure
factors. As was natural the study threw up appropriate
Tikabali has got an upgraded PHC : Community Health
interventions to prevent and control the risk factors in order to Centre (CHC) with nine sub-cenrres, each sub-centre catering
-- - accelerate the rate"of decline in infant mortality and fertility. to about 15 villages. The CHC has got 30 beds with facilities for
These research findings were discussed in a National
Sem inar chaired by Mr. J.R.D. Ta ta and a ttended by field project
leaders, experts and policy makers. Thereafter, consultations
were held With an expert group consisting of Dr. Shanti Ghosh,
Dr. Banoo J. Coyaji and Prof. Meharban Singh of AIIMS, as also
X-ray and routine lab investigations. There are two specialists,
besides the regular CHC staff. It is also equipped with an
ambulance and a jeep.
Since a majority of the villages are located in the hilly areas
and not connected by pucca roads, the use of the PHC by the
. .with Prof Almas Ali, a notable health specialist working in tribals is poor .
Family Welfare in Organised Sector: lUth-Regional Workshop Held at Hyderabad
As part of its on-going programme
to secure active involvement of
employers and managers in
Indian Industry for promoting in-plant
family welfare activities, the Family
Planning Foundation in collaboration with
the Federation' of Andhra Pradesh
Chambers of Commerce and Industry
organised its 10th regional Workshop at
- -Hyderabad on March 26,1992.
Inaugurating the workshop, Mr. K.
Rosaiah, Minister for Medical and Health,
Andhra Pradesh, urged industrial a;d
business houses to supplement the efforts
of the state government in the field of
family welfare.
The Minister said that family
planning brought more benefits to the
people at less cost than any other single
"technology".1t saved the lives of many
women who were vulnerable to
pregnancy-related problems, besides
several million children annually.
In his welcome address, Mr. A.
Krishna Murti, President, FAPCCI, called
upon the employers and chief executives
of industries to
take up family
planning as one
their corpora te
goals.
In
her
prefatory
re-
marks, Begum
Bilkees Latif, a
member of FPF
Governing Beard,
and Chairperson,
A.P. State Social
Welfare Advisory
Board, called for
coordinated and
concerted efforts
on the part of the
government and
the people in curbing population
boom. She laid stress on linkage of
social welfare programmes with the family
welfare activities at the grass-root level.
In a special message, Mr. J.R.D.
.Tata, Chairman FPF, urged all companies,
large and small, to support the activities
organised by Chambers of Commerce
and Industry in collaboration with the
Family Planning Foundation. as a starting
point of a mass movzment to defuse
population explosion.
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lvIcNamara Spells Out a
Global Population Policy for 21st Century
Former World Bank President
Robe;t S. Mct'J" amara. suggested
a multi-pronged strategy to In-
Here we present some excerpts from
McNamara's thought-provoking lecture
reductions in fertility rates should focus
on two components:
1) For sustained medium and long-term
dia for the success of its population con- which have a special rele''.:IDce to the
effect, increasing the pace of eco-
trol efforts while delivering in New Delhi situation in India.
nomic and social advance, with par-
on May 23, 1992, the first Rajiv Gandhi
"There is evidence that high popu-
ticular emphasis on enhancing the
Memorial Lecture titled "A global popu- lation growth rates:
status of women and on reducing
lation policy to advance human develop-
A&,OTavatdeegrading poverty ih the
infant mortality, and,
ment in the 21st century with particular deve-}oping countries, which is affecting 2) For maximum short-term impact,
reference to India".
ever greater numbers, if not ever greater
The function organised by the Rajiv percentages, of their inhabitants.
introducing or expanding compre-
hensive family planning program-
Gandhi Foundation and presided over
Adversely affect the role and stat1.!s
mes.
by the Prime Minlstf.r 5hri P.V. Nara- of women and the health and opportuni-
India has failed to give adequate
simha Rao was attended by Cabinet ties of their children; and, !i'lcrease the attention to other factors which also af-
Minist<':r5p, oiitkal ~,ndsocial leaders and danger that the present paths of eco- fect fertility : in particular, the age at
thinkers, top bureaucrats, foreign diplo- nomic developm(mt - in developing and which women marry; and status of women,
mats and other dignitaries.
developed co;mtr'es alike, - are unsus- especially as reflected in their educational
Introducing Mr. McNamar as a tainable and. risk.the destruction of their levels.
"friend of India", the Prime Minister physical euvirm1ment.
Let me indicate briefly how these
said that-high rate of population growth.
It.is{hi~evidence which leads me to factors,directly and indirectly affectIndian
;as a matter of serious concern, and the urpsea: rene,wed effort both in India and fertility.
Government not satisfied with the past a~ss the developing world - an effort
First, age at marriage. The use of
family planning programmes, has now Ijl,'hichmust be concentrated in this dec- contraception is linked to reduction in
evolved a national plan on population ade --toreduce rates of population growth marital fertility. However, total fertility
with special emphasis on female literacy <HIdlong-term population stabilisation has a second component - the proportion
and reduction in infant mortality. He levels.
of unmarried women, whose births are
said in the past whenever such plans
From the viewpoint of the family, there-fore postponed and, ultimately, likely
were formulated there was overt and high fertility levels mean not high na- to be fewer as well. Indian women are
covert resistance with political motiva- tional growth rates - a fairly abstract married at relatively young ages. !his
tions. But now there has been a growing concept - but rather, too many children, early marriage is preventing a more rapid
consensus among the leaders on this is- too closely spaced. The result is added fertili ty decline in India; it also puts the
burdens but the entire household, young brides at high risk of damage to
but particularly for women and their health from premature pregnancy
children.
as well as putting their infants at high risk
The first benefit of family of early death. I
planning - of choosing the number
It is difficult to exaggerate the
and spacing of children - is the importance of the links between educa-
benefit of better health for the mother tion and the grea ter acceptance of contra-
and child.
Geption and lower infant mortality - this
Anyone of the adverse con- linkage exists in India as it does through-
seguences of the high population out the developing world. The process at
growth rates - enVironmentally work here is far broaderthan the learning
unsustainable development; adverse that is directly conveyed in classrooms;
effects on the rate of economic and rather, it stems from the 'empowerment'
social advance and the impact on effect that school attendance can imply
the status and welfare of women for girls and women.
and children - would be reason
The more educated a woman is, the
enough for developing nations more likely she is to want, and be able to
across the globe, and particularly obtain: contracepti ve services for herself;
in India, to move more quickly to immunisation, modern health care, and
reduce fertilityrates. Taken together education for her children; and delayed
they make an overwhelming case. marriage of her daughters.
Assuming a nation, in par-
Tf lndia is to succeed in reducing
ticular India, wishes to reduce fer- projected rates of population growth,
tility rates to replacement levels at changes in both organisational structure
McNamara makes out a mighty case to reduce
more quickly rates of population growth
the fastest possible rate, what should
be done?
Any campaign to accelerate
and education and family pl~nning pro-
grammes are required.
1) The establishment of a National
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Popula:ion Council, and associated
:::tate Councils, would appear to be
essential. These should function at
the highest levels of the Central and
State governments to affirm sustained
and unequivocal commitment to the
rapid reduction of population growth.
The Councils would need a mandate
to broaden the framework for popu-
lation concerns, coordinate the in-
volvement of the public and private
sectors, and monitor progress. A key
task would be coordination of a
campaign to promote delayed mar-
riage of women.
2) Provision should be made for greatly
expanded support of primary edu-
cation, particularly of enrolment and
retention of girls. Given the serious
deficiencies of Indian primary school
systems, particularly in rural areas,
strengthening primary education will
require additional financial support
for schools, teachers, books and ma-
terials, and other related measures.
Although enhancing the role and
status of women is essential to maximise
reductions in fertility, it is clear that the
effect of action to achieve tha t goal will be
felt primarily in the medium rather than
in the short-term. If a short-term impact
on fertility is also to be achieved, it is
necessary to take steps immediately to
strengthen the family planning pro-
Cause for Concern
o The number of human beings suffering from hunger, globally, has increased
to over 1 billion, including at le:lst 170 million in India.
o The number of illiterates has risen to 900 million - 482 million in India.
o Maternal mortality has increased: 500,000 women now die each year from
pregnancy and childbirth-related causes with a disproportional number of
these deaths - over 25% -- occurring in India; and
o Infant and child mortality remains at totally unacceptable levels: 40,000
children, including more than 10,000 Indian children -- at least half of whom
could be saved - die each day.
Country
POPULATION SIZE SCENARIOS
(population in millions)
1990
Ultimate
Population
If ~';JR= 1
Ultimate
Population
if NRR= 1 in
Population
In 2010
predicted year
Difference due delay
In reaching NRR = 1
% of 1990
Population Population
Bangladesh
Ghana
Nigeria
Pakistan
India
114.8
15.0
118.8
114.6
853.0
277
46
341
334
1,648
300.0
66.2
617.3
556.2
2,101.0
23.0
20.2
276.3
222.2
452.0
21.0
134.9
232.6
193.9
53.0
Predicted year for NRR = 1: Bangladesh 2015; Ghana 2035; Nigeria and Pakistan 2040; India 2035.
Source: World Bank estimates for column 2; Population Reference Bureau estimates for column 3.
gramme.
Given the severity of the environ-
mental and poverty problems facingIndia,
the other developing countries and. the
global community, reducing population
growth rates below currently projected
levels, is a necessary, humane and low-
cost step which will contribute to their
solution. Reducing ferh1ity will allow
political leaders more time to come to
grips with the immense pressures build-
ing on natural resources and it will per-
mit Third World governments to devote
more resources to human development
by increasing investment in education,
health, welfare, and job creation.
Active Involvement of Women a Must in Population
Control Programmes
India was adding
more than a
Lakshadweep to its
population every
day; more than a
- Mizoram every week;
more than a Goaand
Pondicherry every
Mrs.D .K. Thara month and more than
Devi Siddartha
a State of Haryana
every year.
Thiswas stated by the Union Minister
of State for Health and Family Welfare,
Mrs. D.K. Thara Devi Siddhartha while
inaugurating an Orientation Course on
Population Policies and Programmes at
the Centre for Parliamentarians on
Population and Development.
Underscoring the need for
improving the quality of delivery systems,
Mrs. Thara Devi said her Ministry
proposed to develop a special strategy
for the 90 poor performing districts in the
country, where the birth rate was
unacceptably high.
Women could playa vital role in
checking the population growth and
making it a successfulpeople's movement,
the Minister said. ''The place we give to
the women in our society is ultimately
gong to determine how successful we are
in implementing our policies", she said.
It has been found all over the world,
and rome of our own States such as
Kerala, that where the literacy of women
is high, and where the status of women
commensurate with the men, economic
development nas come about
au toma tically and the birth-rate has also,
as a consequence, been low. We therefore,
need to involve women, especially rural
women more actively in all family
planning programmes" she told the
gathering of Legislatures and members
of Parliament.
Environment Award for
S.P. Godrej
The Prime Minister, Mr .. P.V.
Narasimha Rao, presented three
p.restigious annual national awards for
protecting and preserving the
environment in New Delhi on February
18,1992.
The awards are the India Gandhi
Paryavaran ~ Puraskar,
Indira
Priyadarshini Vrikshmitra Puraskar and
the National Award for Control of
Industrial Pollution, which has been
given for the first time.
The noted industrialist Mr. S.P.
Godrej has been awarded the Indira
Gandhi Paryavaran Puraskar for 1991
in the individual capacity. Mr.Godrej is
the Vice-President of the Indian Chapter
of the Worldwide Fund for Nature and
has been involved in the promotion of
environmental awareness and .in
advocating sustainable development.
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.31..::';2 j' 3 _7i.'J,10-r?Clf:C2.1 :~-:?:":S·~ ":/\\j~3~S2(j:::8 to ~:;Ti:.:lg :~:'/2is.3U~·)i ?O~::;Ui2 :.:0.i1-=ai1i::i·0~':..J C~-:;.2 : 27'..~7"= s~~~~:=:;,::"::n=::r2~
i:hi~jng. This y./as ?1'oviced oy tne Priille Ivlinis"cer S~lri P.\\/. t-·jara5iiTI~a R20 J\\j~'1i1z acc:2s31:".g c::e r.adoTI ~-=-Dmn:'2
~~:;~~~~~:t~~~~:~: d~~~~¥~~~~~~~~~~a:~::,~~,~~~~~~~~t~~~~,~:~~:;::~;~~~~~;~~:~~~~~;~!t:'~~,~,~~
Council meeting; to hammer home the urg€ncy of defusing the populadcn bomo ti'1:zatz~-:L.:.gto blo-rl up 311Oill
efforts tc.va:ds scci~onomic advancemeni. Tne constitution or a special sub-com:mittee of tb.e National
De'/elooment Council was a further eXDression of a practical consen:;u3-based aporcach.
O'n ~1ispart the H€al~1 and Family Welfare NIiI)ister,Shn M.L. Fotedar, set th~ toOneof a national debate when
he made the radical proposal to debar from elective'offices--there are about 25lakh of them at various levels - all
those who violate the two-child norm. The proposal yet to ce enacted inio a law has come to be :Ega"ded as an add-
test of politica,l will at a time when many legislators are still hesitant to propagate small family norm in their
constituencies.
Political will and administrative support go hand in hand. In this conte:d the new action-plan of the Ministry
of Health and Family Welfare has not come aday too soon. T'ne most outstandingf~tureofthe plan isa new criterion
to judge the performance of t.~eStates and Union Territories. Hitherto Central funds were made available to the
States/Union Territories on t.'lebasis of their achievements in realising the targets set - often arbitrarily - for them
such as sterilisations, LU.Ds. Tnis methcd had an inbuilt mechanism for fudging the figures to enable the States to
claim maximum allocations. Under the new criterion Central grants will be given on the basis of actual r€duction
of birth rates. Tnus, the new formula strikes a t the very TOotsof the tendency to inflate performance figures. As such
it should be most welcome. We have no doubt that it will mark a water-shed in the history of family planning
programme.
The other featur·es or the action-plan such as increased rde of vcbr.tary a6e~::ies, streng!bening of !nter-
sectoral ccordination, improving the reach and quality of family welfare services etc., though oft-repeated, need
dynamic and imaginative implementation. Just as the proof of the pudding lies in eating the success of an action-
plan lies in its proper implementation.
Now when the overall climate is conducive to a big push to population control measures, let's not miss this
opportunity to free the family planning programme from the bureaucratic strangle-hold. The need of the hour is to
involve voluntary organisations a.71dgrass-root institutions such as panchayats in a much bigger and meaningful
way through decentralisation and streamlining of procedures. Otherwise, this action-plan tC{)will go the way of
such action-plans formulated earlier.
New 10-Point Action. Plan. fOrt Population Control
he l\\Ilinistryof Health and Family
Welfare has launched its new
10-point action plan to contain
population growth. The plan evolved
through full involvement of the States
and Union Territories and approved by
the National Development Council
envisages a new formula for disbursement
of Central grants to States and Union
Territories on the basis ofreduction in the
actual birth rate instead of the existing
target-achievement formula, vis-a-vis
sterilizations and other contraceptive
methods. The main features of the action
plan intended to give a new thrust to the
Family Welfare Programme are:
Improving the quality and out-reach
of family welfare services in the field.
A new package of compensation/
incentive funds to be targeted to
reduction in the actual birth rate,
giving more flexibility to State
Governments/UTs Administrations
in managing the progrilmme, rather
than b~i;;,g baSed oniy on the figures
of sterilizations etc. furnished by
them.
Initiating innovative programmes
in urban slums for propagating family
welfare acti vities.
Launching the "Child Survival and
Safe Motherhood Project" this year.
aiming to give tremendous boost to
the Universal Immunisation
Programme and control of diseases
causing death of infants and children
and to initiate practices for safe
motherhood ror bringing down
maternal mortality.
Adopting a Differential Strategy for
focussing attention on 90 districts of
the country where the crude birth
rate is above 30 per thousand.
Improving the quality of existing
contraceptives and introduction of
new contraceptives.
improving the distribution of
contraceptives tnrough expansion
of the scope of the social marketing
scheme.
increased invol veffiei1tofvo!untar:i
agencies and r:.o!'!.-g'.)'1e!"~!!!efl"ta!
organisations in the Family Welfare
Programme through procedural
simplification and delegation of
Dowers with a view to making the
Programme a people's movement.
Increased Information, Education
and Communication inputs and
decentralisation of communication
strategies to take into account. the
local socio-cultural ethos.
Strengthening the inter-sectoral
coordin'ation mechanism by setting
up a high level bcdy for this purpose
at the Centre and involvement of
Chief Ministers, Chief Secretaries
and District Collectors in the
implementation of the Population
Control Programme.
The experience of pursuing the
family planning programme over the last
four decades has brought out the
importance of taking a holistic approach
towards population control and not
consider it as the sole responSibility of
org-adsa
Honsse~to:p Fe. J3l'IWidi~.gfam iI y
.
welfare services.
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StDte oj }\\/oild Pop-ulal-iofJ 1992
G1Dbal Popuh1:ion neiliS 5.3 Billion, 9'7iYlillion Annu.al Jncr2.as,e:Forecilst in TIeAl Der::3de
li
~
orld oOlJulation in mid-1992
b: will 5'.48 billion.Ie ",Allreach
6 1:0::::0:: i:: 1998. A..,nual
11.6 billion in 2150.
On the most optimistic assump-
rion,tO\\a1populationcQuldpeakinmid-
non ~Qwth t~nded \\0 ha'lB higher sav.
ings and investment ratios.
PriD/ity Agenii.a
additions to the world population in the century, and would begin to fall then'!ar-
Ending absolute poverty, improv-
next decade will average 97 million, the ter.
ing health and education and raising the
highest in history. Nearly all of this
But growth could go the other way, status of women will contribute to slower,
population growth will be in Africa, Asia reaching12.5 billior:in 2050,and heading more balanced population growth. The
and Latin America. Over half will be in towards 20.7 biilion a century later.
aim should be to bring f'.ltur.epopulation
Africa and south Asia.
Some 83 per cent of pooulation growth towards the United Nations lower
Th.eseare some ofthe highlights of growth in the ~ext decade ·will be in population lJroiection, 1.5to2 billicr.less
the "State of World POlJulation, 1992" urban areas. Cities have grown faster th~n the m~di~m and 4 billion less than
report released recently· by the United where national populations are growin~ . the high projection by the' year 2050.
Nations Population Fund <UNFPA) which faster.
Specialattentio~wittyn ~ucha programme.
warns that any delay in action to reduce
According to the Report the prog- should be given to Africa and south Asia,
family size during the next decade could ress so far towards the desirable goals of where more than half of the increase in
make a difference of upto four billion to slower population growth, sm~J~r oy.er- population a..,dthe Jmljorityof the world's.
the size of the world's population in 2050 all totals, and more balanced population absolute poor are found.
- equal to the whole of world population distribution, within and between cotin-
Women's access to better education,
in 1975.
tries, has been mixed. Developingcoun-
Calling upon the countries of the trieshaveimprovedlivingconditionsfo~
healthcare~familyplannin&and
work at a fair wage raises persop.al
~rld_J9r
'mmediate-and detey:mined--irrcreasing proporfionsof tfi€upopufa-
incomes, speeds economic develop-
action to balance population, consump- tions. Butthenumbers of the poor, illiter-
ment and reduces family size.
tion and development patterns with a ate and malnourished have continued to
A reduction in family size can make
view to putting an end to absolute pov- climb. About 1156million people live in
a direct contribution to better educa-
erty, providing for human needs and yet absolute poverty, 212 million more than
tion, health and nutrition: children
protecting the environment, the Report in 1970. There are an extra 60 million
commends a 10-point strategy to achievecWldren out of school, anextra6S million
from smaller families are healthier
and better nourisl\\ed, stay longer in
these laudable objectives.
.
illiterates, an extra 50 million malnour-
school and do better there than chil-
The revised long-range populatioI). ished.
dren from large families. <)
projections from the U.N. Population
However, countries which suc- 0 Avoiding births to mothers under 20
Division, the first such figures for ten ceeded in slOWing-population growth
years, reveal that:
saw the benefit in the 1980s. During the
could cut deaths of under fives by 17
per cent. .
The medium, or most likely, pro- 1980s countries with slower population ;fj Avoiding births spaced closer than
jection of population growth implies a growth saw their average incomes per
two years apart could cut underfive
near doubling of world population to 10 . person grow 2.5 per cent a year faster
mortality by the same amount.
billion in 2050. Growth will probably than those with more rapid population
Eliminating both these types of poor
continue for another century after that to growth. Countries with slower popula-
timing could reduce ma ternal mor-
The two-India$-- women's stata.s
tality by 40 per cent.
Equalizing women's access to edu-
ii
@i<e la
! II .
I
r
!
!,
cation should be a top priority, says the
Report. It contributes to their personal
development, to smaller famjlies and to
better health fOJm; other and children.
Sustolinable Development
Balanced development, between
urban and rural areas, and between
countries, is an essential component of
sustainable development.
"Fixed" or "non-renewable" re-
sources have so far adjusted to meet
demand. New reserves and new tech-
nologies have been found. But the simul-
taneous explosion of population and
consumptionper person might overwhelm
9()(J
1000
F~malas-per 1,DOn main
adjustment mechanisms.
The Report says that, paradOXically,
tne immediate threat might be to "re-
newable" or "unlimited" resources, in-
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capita ircomes in 1987 were ady 71 per
cent of the Indian average, only 27 per
SpDtlight on India
cent of its population were in poverty. In
the r.orthem states the poverty rate ranged
from 34 to 49.5 per cent.
The UNFP A Report on World
Kerala's low average incomes are
Population highlights the dramatic con- the heritage of the past, rather than the
trast between the southern State of Ker- result of diverting investment into hu-
ala and the five northern States of Rajast- man resources - incomes in Kerala have
han, U.P., M.P" Bihar and Orissa. Here is grown at similar rates as in other States.
what the Report says about this study in Slower populati~n growth rates may have
contrasts:
helped the poor by lowering labour supply
The most dramatic contrast is be- "" and raising wages. Between 1970-73and
tween the southern state of Kerala, and 1982-85,real wages rose at over 3 percent
the five northern states of Rajasthan, Uttar a year - against less than 2 per cent in 15
Pradesh, Madhya Pradesh, Bihar and out of 16 districts of the northern state:>.
Orissa, which between then make up
more than 40 per cent of the national
population. Where Kerala has matched
the human resources development of the
very best performers among developing
countries, the five northern States have
been among the worst. And the place of
women is central to the difference.
Kerala's female literacy rate of 66
per cent is almost double that of its near-
est rival. In the five northern states only
11-21 per cent of women can read.
Kerala has the lowest infant mor-
tality rate in India, only 26'per 1,000 live
births. In the northern States infant mor-
Income per person in the five Northern
states in 1986-87 were all lower than in
tality is between four and five times higher. Kerala, despite the presence of the na-
Kerala's fertility rate "has fallen to tional capital, Delhi, and many other
the astonishingly low level of 2.3 chil- industrial towns.
dren per woman -- lower than Thailand
Kerala has more roads in relation to
or China, the former USSR or Ireland. its area than any other state, and is the
Contraceptive prevalence is three times only Indian state where all villages are
the.national rate.
connected to all-weather roads. It has the
Yet Kerala has not suffered eco- highest newspaper circulation in India,
nomically. The state has performed well the highest rate of hospital beds to popu-
in eradicating poverty. Although its per lation. A high educational level has helped
KeraJa to att:act industrial jces -~::1lS8C
it had more factory jobs per l,CCO urban
popubtion than any other state in lndia.
And women made up the highest pro-
portion of the workforce in India - 35 per
cent overall, 45 per cent in the private
sector.
Kerala does not appear to have
sacrificed its natural environment to
industrial development. Although it has
the highest population density of any
state - 655 persons per square kilometre-
forest still covers 29 per cent of its area,
third highest rptio among the large states,
and well ahea~of other states with half
its population aensity.
Two factors explain Kerala's suc-
cess in human development. One is the"
priori ty given by the sta te government to
spending on education and health, con-
tinuing a tradition than reaches far back
into colonial times. Spending has also
been equitably distributed - Kerala is the
only state in India (and one of the few in
the developing world) where the rural
death rate is lower than the urban. A far-
reaching land reform from the 19605has
benefitted three million tenants and lan-
dless.
The second factor, whose roots reach
even further into history, is the status of
women. In Kerala - unlike the north -
women inherit land. In Kerala the hus-
band'"s family pays a brideprice to 'the
wife's family on marriage~ women are
considered an asset. In the north they are
seen as a burden; in reality they are a
wasted asset. The waste of that asset has
immense human costs, and has led to
economic stagnation and rapid popula-
tion growth.
"
Nations do not respect the system of sustainable development. The earth is sick from under development and sick
from excessive development.
-- U.N. Secre(ary-General, Mr. Bou.ros Boutros Ghali
We cannot have an environmentally sound planet in a socially unjust world.
-- Brazil's President, Mr. Fernando Collor De MeJlo
We inhabit a single planet, but several worlds. There is the world of abundance, where plenty brings pollution. There
is the world of want, where deprivations degrade life. Such a"fragmented planet cannot survive in harmony with
nature and the environment, or indeed with itself .... we must ensure that the affluence of some is not derived from
the poverty of many.
-- Mr.' P. V. Narasimha Rao, Prime Minister of India
What we see emerging in the U.S. is something like ecologism - fear of a new communism hidden behind ecology.
-- Mr. Klaus Topfer, Environment Minister of Germany
We must leave this earth in better condition than we found it,
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Cooperation in the Cause of E-nvirotnnent and DeDeloplnent
RaD/S Call at RiD Summit
The P~ime
Minister, Mr. r.v.
Narasimha Rao.l
made an impas-
sioned plea for inter-
national cooperation
to reverse the tide of
Earth's degradation
Prime Minister P.V. through environ-
Narasimha Rao
ment-friendly tech-
nologies while speak-
ing at the Earth Summit in Rio de Janeiro
(Brazil) on June 12, 1992.
. Mr. Rao who had the honour of
being the first of the 56 world leaders to
address the plenary session ofthe United
Nations Conference on Environment and
De'!el0!J~e::t (UN"""::: ), out of a cOtalaf
116 a~~endin&said; '''''''''nereve~sal of ou!
planet's degradation will be tha: lUuch
easier a;:<ds?eedie, ~f we were to join
hands together in such endeavours. I
suggestthe setting up of joint ventures or
joint research and development projects
between the developed and developing
countries, to tackle environmental issues
together. We need to tackle these practi-
cal questions through international co-
operation."
During his entire speech, Mr. Rao's
emphasis was upon what he called·'a
symbiosis of environment and develop-
ment.' ''We cannot have conservation of
the environment without the promise of
development, even as we cannot have
sustained development without the pres-
e~fa-:ionof the €n-:n!'Or.~.•er:t,1J r.€ ~Cx:T""~1
The l'dme Minister cited how India
had emDar~<edon a massive programrr.€
to develop non-conventional scur.:es of
energy, particularly solar and wind en-
ergy. Although such know-how was
available, it was said to be un-economi-
cal at the moment. "I have no doubt an
earnest effort as well as a determined bid
to achieve economies of scale, will make
it economically attractive and acceptable."
Mr. Rao said that the north had to
bear an equitable financial burden for
accessing environment-friendly technolo-
gies. Indeed, the precess had to start with
stopping the tr,msfer of destructive tech-
nologies, which alone will give incentive
to the development of environment-
friendly technologies.
Earth Summit - the mother
of all summits - which
ended at Rio de Janeiro
on June 14,1992 made a history of sorts.
As many as 172 countries out of a total of
178 U.N. members were represented at it
while no fewer than 115 heads of state or
governments participated in it.
From Stockholm where the first UN.
conference on environment was held in
1972 - incidentally only two heads of
state were present there - to Rio has been
a long and tortuous journey.
Whether it was just another junket
or the beginning of a global effort for a
global cause is a matter of opinion.
However, there is no denying the fact
tha t a colossal effort and expendi ture had
gone into this grand show intended to
save the planet Earth for future genera-
tions. At the end of it - North-South
bickerings and the games of one u pman-
ship notwithstanding - the world leaders
Signed their pledges and made promises
in the 27 principles of the Rio Declara-
tion, the 40 cha pters of Agenda 21and the
Declarations of the principles of Forestry.
At the parallel conference of NGOs 30
alternate treaties were worked out whereby
the NGOs reaffirmed their own commit-
ments to caring for the earth and its
people, as also in fighting hunger and
-illiteracy.
The most unfortunate part of the
official proceedings was the torgetful-
ness about the population problem which
received just a passing reference.
As leader of the Indian delegation,
Environment Minister Kamal Nath's was
an impressive performance in putting
across the concerns of the developing
countries, though at times he appeared to
be overdoing in the "hol y war of words",
as one delegate termed the Summit dis-
cussions.
According to Mr. Anil Agarwal of
the Centre for Science and Environment,
Ahmedabad who was a member of the
Indian delegation, India had immense
stakes in each of the three major issues -
climate, biodiversity and forestry. India's
biggest victory", Mr. Agarwal avers was
to "force the inclusion of the Third World
perception that forests are a community
resource which belong to the people
of a country and cannot be handed
over for global management".
In another vein Ms. Vandana Shiva,
an environment activist who participated
in the NGO deliberations at Rio,described
Rio as the ''biggest green wash in his-
tory". She regretted the "painful refrain
that money is the bottom line. Our gov-
ernment more than any other talked ofit,
and we hit rock bottom."
In his final press conference, the
Secretary-General of the Earth Summit,
Maurice Strong, warned: 'We did not
succeed 20 years after the Stockholm
conference and we don't have another 20
years to waste. The evidence is v;;ry
powerful. The present course of economic
behaviour will lead to tragedy. We have
goUo get this message through to people
and they must hold their governments
accountable" .
I also wish that the Brazil Earth Summit shall specifically highlight the fact that
environmental balance has to be restored by wise technology choices and containing
world popUlation. Thus, as a follow-up to the Summit, I would like to see greater
importance being given to the goal of popUlation stabilisation which. in effect. means
wider access to means of reducing infant mortality, maternal mortality, nutritional
deficiency, exposure to debilitating diseases, and, of course, restricting the family size.
It will also mean much more investment in education. because demand for contraception
can be sustained only if the people have the right education to take the right deCisions.
The secret of demographic transition, in my judgement, is awareness. Nothing but
education can create awareness and sustain the momentum of constructive change
(From a Press interview given by Mr. J.R.D. Tata to'lchiro Kikuchi. Special
Correspondent of "Shanke Shimbun", Japan on March 12. 1992.
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