mal nutrition in South Asia

The World Bank and International Monetary Fund just concluded their annual meetings in Washington. At an event on nutrition in South Asia, the evidence presented was clear and astonishing. On the one hand, South Asia has experienced robust economic growth averaging 6% a year over the past 20years of poverty. other hand, the region continues to have unacceptably high rates of malnutrition with Bangladesh and India having a higher proportion of malnourished children than even the poorest countries in Sub-Saharan Africa. This seems inexplicable to many, and indeed is referred to as the ‘Asian Enigma’.

There is considerable evidence that malnutrition affects not only children’s chances of survival but also their cognitive capacity and learning ability. Losses of up to 13 IQ points have been attributed to micronutrient deficiencies in children under two. And children who learn less, earn less. A recent study in Guatemala showed that children who received nutritional supplements up to age three had significantly higher scores on cognitive tests and earned 34-47% higher wages as adults than those who had not received these inputs.
Some continue to question the data, even suggesting that South Asian children should be held to a different growth standard, despite the extensive evidence showing that the global growth references are credible. As documented by the World Health Organisation’s 2008 multi-country study, it is now well established that our children have the same genetic growth potential through two years of age as other children globally, if given the same opportunities in terms of food, healthcare, hygiene and environment. Indeed, a study by the Nutrition Foundation of India found that the growth curves of well nourished Indian children are indistinguishable from those of similarly nourished children in other parts of the world.

So, what explains this ‘enigma’? Researchers have spent considerable effort on this. We know that pregnant women in South Asia put on less weight during pregnancy than they should: 5 kgs on average compared to the worldwide average of close to 10 kgs. Too often, new mothers are still children themselves, a staggering 75% of them are anaemic, and some one-third of all babies in India are born with low-birth weights. We know that poor hygiene, combined with dense populations, leads to the frequent occurrence of infections which deplete young children of nutrients. We also know that while not genetic, malnutrition is inter-generational, meaning that it takes a few generations for the once malnourished girl to become the grandmother of a well-nourished child.

The ‘World Development Report 2012: Gender, Equality and Development’ highlights issues on the persistence of malnutrition in South Asia. Malnourished adolescent girls cannot deliver healthy babies. Literate and more empowered mothers have better nourished children. Recent analyses in Bangladesh reaffirm evidence that when women are involved in household decisions and have control over earnings, their children are better nourished, and that a woman’s experience of abuse and acceptance of domestic violence had a significant negative impact on her own nutritional status, affecting her ability to produce a healthy newborn. In general, efforts to improve gender equality will be critical to reducing South Asia’s disadvantage in nutrition.

In order to attain a fully healthy and well-nourished — and even more intelligent and productive — population, we need to improve access to nutritious and diverse foods, clean water, sanitary environments, female education, pre-natal services and knowledge and support for appropriate child care, such as exclusive breast-feeding for the first six months. It is possible. Take Mexico, for example. The country took a targeted approach to address malnutrition and achieved remarkable results. There was a marked reduction in infant mortality, increases in children’s height, higher enrolment rates in secondary and high school, better educational attainments, and a reduction in failure and drop-out rates between primary and secondary school.

Clearly, there are important lessons for South Asia from other countries as well, such as Thailand and Brazil that have reduced malnutrition to very low rates. First, an integrated multi-sectoral approach is needed. Second, if we invest in the right strategies, investing in nutrition has very high economic returns. Third, households respond to incentives, as has been demonstrated by the use of conditional cash transfers to encourage better nutritional practices. Fourth, the issue is not access to food alone, but access to income and information; more food per se will not necessarily solve the problem. And last, high level leadership is necessary to steer an initiative that if carefully designed and targeted can cost just about 0.5% of GDP annually.

The good news is that we see high-level commitment to addressing malnutrition across the region. Prime Minister Manmohan Singh has emphasised the importance of this issue and state nutrition missions have been launched. We know what works, what needs to be done and the remedies need not be expensive. We now need the political will to make sure that South Asians receive the adequate nutrition they need to become fully productive members of their societies. If we would take on the nutrition challenge, South Asia will build strong human capital for the future and we could experience even higher economic growth and far more impressive results in other indicators of development. 

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Problem of Organ Transplantation

Shortage of organs for transplantation is a worldwide problem and million of lives are lost every year because the organ transplantation option cannot be offered to them.






IN India nearly 200,000 persons develop terminal kidney failure each year and their life can be sustained only through lifelong dialysis or kidney transplantation. Unfortunately, only 10 per cent of them are fortunate to get the benefit of such treatment and the remaining 90 per cent succumb to their condition, often in a short time.
As dialysis centres are mostly located in major city hospitals and the procedure has to be carried out within urgent time frames, the benefit cannot reach common people living in remote areas. Affordability is another concern with chronic kidney disease treatment. Although the State Government of Andhra Pradesh has come out with a unique scheme of free dialysis for people Below the Poverty Line under the Arrogya Shree initiative, the quality of life on dialysis is far inferior to that after a successful transplantation. Hence, more and more patients with terminal kidney failure prefer to undergo a kidney transplantation rather than lifelong dialysis.
Over the years the number of kidney transplantation centres has steadily increased throughout the country. However, the number of transplantations is almost static at 4000-5000 operations per year, against the approximately 50,000 operations required. Shortage of human organs for transplantation is the single most important reason for such a low rate of organ transplantation in our country.
According to the Human Organ Transplantation Act passed by the Indian Parliament in 1994, only first degree relatives of the patient (parents, children, sibling and spouse) are entitled for organ donation. Unfortunately, either sufficient numbers of entitled organ donors are not coming forward for donation or else they are rejected on medical grounds, leaving the patients with no other option except continuing with lifelong dialysis.
Organs from “Brain Dead” donors are another source of organs for transplantation. As the brain controls most of the body functions, permanent loss of brain activity following extensive damage to the brain due to injuries, and consequent haemorrhage or stroke, a person can be pronounced dead on medical ground though major body functions can be sustained for a short period of time ranging from a few hours to a few days with artificial life support measures.
Even the Indian Parliament has accepted brain death as the end of life when diagnosed and confirmed meeting approved and validated guidelines and endorsed Clinical Pathways.
These “Brain Dead” individuals can be considered as potential organ donors and their organs can be used for transplantation after obtaining permission along stipulated guidelines and procedures from the next of kin. After brain death a person can donate corneas (eyes), liver, kidneys, lungs, heart or heart valves and pancreas for transplantation to the needy.
In most of the western countries more than 70 per cent of organ transplants are carried out using organs from brain dead donors. According to the United Network of Organ Sharing (UNOS), which oversees the cadaver transplant programme in the US, 28663 patients underwent cadaver kidney transplantation in 2010 and there are still 1,1100 patients with terminal kidney failure waiting for their turn to receive a kidney from a brain dead donor. Shortage of organs for transplantation is a worldwide problem and million of lives are lost every year because organ transplantation option cannot be offered to them. Organ donation rate is the highest in countries like Mexico and Spain where more than 30 per million population (PMP) agrees for organ donation after death against a dismal figure of about 0.1 PMP in India.
Lack of public awareness about usefulness of organ donation after death and non-acceptance of ‘brain death criteria’ as cessation of life are found to be the main reasons behind such a low rate of organ donation in our country. Due to the concerted efforts of many individuals, hospitals and NGOs, the organ donation rate is higher in the states of Andhra Pradesh, Maharashtra and Gujarat as compared to the rest of the country. The state government controlled deceased organ donation and transplantation programme in the state of Tamil Nadu is showing encouraging results and the Andhra Pradesh government too is planning to introduce a similar programme (Jeevan Daan) in the near future.
There are still thousands of such patients with terminal failure of vital organs at various hospitals in the country waiting for their turn to receive a human organ to save their lives. On the other hand more than a lakh persons die every year due to traffic accidents in our country.  Projections are that this is likely to increase to 1,50,000 by the year 2020. At any given point of time there are about eight to 10 brain dead patients in hospitals in any major Indian city sustained on artificial life support systems alone, who can be considered as ideal cadaver organ donors. Even if the next of kin of a small percentage of them agree for organ donation, it would be possible to save many more lives. Ultimately it is the responsibility of the government and society in general to create awareness about brain death and organ donation.  The medical fraternity can act only as facilitators in the process. 
A well-known quote in the organ transplantation circles says, “Don’t take your organs to heaven with you. Heaven knows we need them here.” Those who have learned to know and accept death rather than to fear and fight it, become our teachers about LIFE. Registered organ donors and enlightened kin of brain dead individuals who consent for cadaver organ donation are giving the world an ultimate and final gift…the gift of life!


Organ donation is still a topic not well understood

EVERY year in our country there is a need of approximately 175,000 kidneys, 50,000 hearts and 50,000 livers for transplantation. As against the need, only 5000 kidney transplants in 180 centreers, 400 livers in 25 centreers and 10-15 hearts in very few centers are done annually. 95 per cent kidneys and livers are from living donors.

Human organ donation yet to make a significant mark in India. India lags behind in the implementation of a cadaveric donation programme. For example: merely 3000 are lucky to get kidney donor, while over 100,000 Indians suffer from End Stage Renal Disease.

Although the contemporary science has brought in tremendous success in the field of healthcare. aAnd one such advancement is organ transplant, but due to lack of awareness, nobody comes forward to donate organ. People are not aware of organs that can be donated, other than eye.

Many patients succumb to death suffering from chronic illnesses, waiting for organ transplants and they die without receiving suitable organ. To encourage organ transplantation procedures and reduce mortality rate through timely transplant, a major improvement is required to happen in the existing organ donation and transplant system.

Facts on organ donation/transplant
COST:It is important to note that the cost of organ donation is incurred by the transplant recipient and the donor’s family is never charged for it. Also in case of cadaver transplant, the cost charged by the hospital to save the patient’s life is usually misinterpreted as the cost related to organ donation. While, the additional expenses that a living donor experiences like loss of wages, child care expenses during recovery, food, lodging and travel costs, are to be incurred by the donor only.

A person should be well aware of the cost of the donation, if he/she is considering to be an organ donor.

The cost of organ transplant, principally include preliminary testing, the surgery cost and the post-operative recovery costs. The cost of an organ transplant can be segregated in terms of Medical costs and non-medical costs.

 Medical costs may include:

n insurance deductibles

n pre-transplant evaluation and testing surgery

n fees for the recovery of the organ from the donor

n follow-up care and testing

n additional hospital stays for complications

n fees for surgeons, physicians, radiologist, anesthesiologist and recurrent lab testing rehabilitation

n Non-medical costs include:

n food, lodging and long distance phone calls for you and your family

n transportation, to and from your transplant center, before and after your transplant

n Air travel to get to your transplant hospital quickly

n lost wages if your employer does not pay for the time you or a family member spends away from work

The costs or organ transplant vary in different countries, hospitals and the type of organs.

One of the driving forces for illegal organ trafficking and for "transplantation tourism" is the price differences for organs and transplant surgeries in different areas of the world. According to the New England Journal of Medicine, a human kidney can be purchased in Manila for $1000–$2000, but in urban Latin America a kidney may cost more than $10,000. Kidneys in South Africa are sold for as high as $20,000. Price disparities based on donor race are a driving force of attractive organ sales in South Africa, as well as in other parts of the world.

In China, a kidney transplant operation runs for around $70,000, liver for $160,000, and heart for $120,000. Although these prices are still unattainable to the poor, compared to the fees of the United States, where a kidney transplant may demand $100,000, a liver $250,000, and a heart $860,000. Chinese prices have made China a major provider of organs and transplantation surgeries to other countries.

In India, a kidney transplant operation runs for around as low as $5000.

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Real Time Train Information System (RTIS)

Advanced Communication and Information Technologies have revolutionalised the ways we do our business. Indian Railways is no exception. Customer expectations have risen. Yesterday`s better services are today`s basic  necessities. Availability of  accurate train running information on a click  of a button is one such facility public would love to have.

Train information dissemination through 139 in the existing Train Information System over Indian Railway,  being dependent on manual collection & feeding of train running information has certain limitations.

              To overcome limitations of the existing Train Running Information System, it was decided to develop GPS based train tracking system  jointly by RDSO & IIT-Kanpur.  The system has been developed and working successfully in number of trains.  It has now been decided to open the  Real-time Train Information System (RTIS) to public in  few trains to begin with effect from today  i.e.19 October 2011.

At present , the facility can be availed for only 12 trains.

RTIS system deployed in the trains will provide the following information to public/passengers:
(i)        Train locations.

(ii)        Train running position (i.e. whether train is running on time or if running late and by how much.

(iii)    Train location with respect to next  stopping station in terms of  kms.

This information will be available on website “http://www.simran.in”. Public may also get the train running information through SMS  by sending a text  message  “ <train number>” to mobile number  09415139139.  A typical message received by passenger say for   train number 12004, aShatabdi Exp. train,  is as under:-
” On 19/10/2011 10:00, Train 12004 N Delhi – Lucknow Shat. is running at 129 kmph near Bharthana, 126 km from KANPUR CENTRAL. Presently Right on time ”

The above message is actual reply received to a SMS querry.

Ministry of Railways has decided to implement RTIS to track all trains, passenger as well as freight trains.  For this, a work has been approved in Railway Budget 2011 at a cost of Rs. 110.0 Cr.  The project  is likely to be completed by Dec.’ 2012.

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Upgrading NSG(National Security Guards)

SPECIAL Forces around the world are elite organisations held in high esteem. These play a vital role in crisis situations such as in anti-terrorist or stealth operation of the kind seen during the taking out of Osama bin Laden in Pakistan’s Abbottabad. In India, however, recognition of and importance to Special Forces has been slow to come by. Seemingly, now, the government appears to be waking up to the necessity of according serious attention to the National Security Guard (NSG), the country’s federal-level special response unit raised to counter terrorists, which had played a vital role in neutralising Pakistani terrorists during the 26/11 attack in Mumbai.

On the 27th raising day of this elite force this weekend, the NSG’s Director General announced plans of strengthening the force with two more units of 1,600 commandos and upgrading the force with more sophisticated weapon systems and other aids. Some of the gadgets are to be provided by the Defence Research and Development Organisation (DRDO). While the plan is laudable and in keeping with the security situation in the country, the government needs to bear in mind the record of the DRDO which has been high on promises but low on delivery. The government must ensure that it sticks to its plan to augment and upgrade the force. The government has not made much headway in its F-INSAS programme (Futuristic Infantry Soldier As a System) aimed at upgrading Infantry soldiers with similar equipment announced with much fanfare over half-a-decade ago.
The NSG is a vital Special Force for the country. In fact, it is the country’s only Special Force equipped and trained to handle a wide range of anti-terrorist operations at close quarters – be it evoking the surrender of terrorists from inside the Golden Temple during Operation Black Thunder-II in May 1988, neutralising a hijacker of an Indian Airlines aircraft at Amritsar airport in 1994, conducting hostage rescue operations in Jammu and Kashmir and from inside a temple in Gujarat, counter-insurgency operations in the mountainous terrain of Doda or, more recently, neutralising Pakistani terrorists in Mumbai. The government must accord the highest priority to this Special Force considering that challenges posed by terrorists have become far more complex and complicated.

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Stability in Nepal good for India

NEPAL Prime Minister Babu Ram Bhattarai will be on an official visit to India for three days in the third week of October. He had a meeting with Prime Minister Manmohan Singh at the UN and the latter had reportedly expressed India’s support for completing the peace process in Nepal.
Mr Bhattarai will have both economic and political agendas when he meets the Indian Prime Minister. In the political agenda, the peace process, and India’s support for its successful completion are bound to have the highest priority. Prime Minister Bhattarai will probably want to be re-assured of the Indian government’s backing for the ongoing peace process in Nepal so that the configuration of political forces in Nepal remains conducive to the promulgation of a new democratic constitution at the earliest.
A politically stable Nepal is in the interest of both Nepal and India, the South Asian region as a whole, and also Nepal’s northern neighbour, China. We, therefore, feel that India and other concerned international powers would be well advised to use their friendly influence, jointly or severally, to persuade all political formations of the country to agree to complete the peace process and strengthen national institutions for Nepal’s stability, democracy, development and progress.
On the economic side there are two major issues that are of concern to Nepal both from a short-term and long-term perspective. First, the rising imbalance in trade between Nepal and India, a problem that requires urgent and cooperative corrective action. In the short run, Mr Bhattarai will perhaps ask for the removal by India of the non-tariff barriers which crop up from time to time to hinder the flow of Nepal’s exports to India. Internally, to boost production and reduce supply disruptions, the Nepal government has to rein in trade unions in both industrial and transport sectors where Mr Bhattarai’s own party remains influential.
The other major issue pertains to the Nepal-India trade arrangements and the need, from a medium-term to long-term perspective, for Kathmandu and New Delhi to engage in discussion to work out a new model of interaction that will lead to the sharing of prosperity through adequate spill-over in Nepal of India’s high economic growth rate in the form of increased exports of Nepalese products to India, and vigorous flow into Nepal of direct investments by Indian companies. In this context, the India-Nepal trade treaty, signed in the mid-1990’s, which had helped increase Nepalese exports to India and also Indian investments in Nepal, could be the model. On its part, the Nepal government should create a receptive political and economic environment for investment by Indian business houses. The two governments should jointly discuss ways and means of reviving the liberal trade and investment regime of the mid-nineties.
Proper, mutually agreed harnessing and utilisation of Himalayan water resources will be to the benefit of people in both countries. Economic growth in the Gangetic plain of India with over 400 million people will require an increasing volume of water for irrigation and power, and for industrial and urban use. Himalayan waters are the most important natural resource of Nepal that must be tapped for energy, irrigation, navigation and flood control for Nepal’s growth and development. Utilisation of this resource should be viewed in an integrated manner for the benefit of the people of both countries. In doing all this, experiences of the past, which still rankle in Nepalese minds, must be borne in mind.
Flood-control measures in the border areas, which cause inundation or other damage in one or the other country, must be avoided. Water resource utilisation models of the 1950’s are no longer relevant. An independent non-governmental agency, with participation from the apex organisations representing industry and commerce in both Nepal and India, could be set up to look at the issues of trade and water resources in a holistic framework and come up with suggestions that are geared to new realities.
In a study of this kind, the necessity of involving Indian states of Bihar and UP, the two states that have the most interest in the way the Himalayan water resources are harnessed, should be given due consideration. In a short-term perspective, however, Prime Minister Bhattarai may sound India for the export of power to Nepal for the next four or five years till the new hydro-projects in Nepal, now being constructed with both Nepali and foreign capital, become operational. India should consider any such request favourably.
One important issue that has been of concern to India is security. The two countries have not been on the same wave-length in their perceptions of the term “security”, and misunderstandings persist in this regard. Nepal is an independent and sovereign country that borders the two would-be super powers of the world in the 21st century. This is a ground reality. Another ground reality is that Nepal’s long border with India is an open one, and there have been cases of infiltration of undesirable elements that have carried out activities against the national interests of both nations.. There was also the high-jacking of an Indian plane from Kathmandu airport by terrorists.
While China’s interest in Nepal and the importance of Nepal-China relations is to be recognised and understood, India’s concern about undesirable activity, across the open border, must also be given serious consideration. Nepal should leave no stone unturned to ensure that Nepali soil is not used for any kind of terrorist and other destructive and undesirable activities directed against India. In this context, Nepal and India had signed, more than a decade ago, an agreement to institute a monitoring mechanism ( record keeping and a registration system, etc) all along the border without giving up the traditional free border concept between the two countries. That agreement should be reviewed with a view to its operationalisation. Our open border should continue to be our strength and not become a source of undesirable activities harming Nepal-India relations.
In a fast-changing world, it is incumbent on the leaders of the two countries to start a new era of understanding and cooperation that takes cognisance of the changing dynamics of economic and power relations in the region. This would mean, in our view, efforts by both countries to promote the idea of “shared prosperity” as an umbrella concept for their relations in the 21st century.
Adjustments are needed in the perceptions and thought processes of both countries. While India should re-examine the existing assumptions defining its unbalanced economic relationship with Nepal, the latter’s political elite should, in the context of the present geo-strategic realities, forge consensus and unity and shed the “small nation psychology” to define Nepal’s national interests with clarity and vision, so that India as a close southern neighbour comes to trust the capability and strength of the Nepali state to remain sensitive to its vital interests.

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Discovery of India's Old Sunken garden

A sunken garden was discovered during the restoration of Isa Khan's tomb in the precincts of the Humayun's Tomb World Heritage site. The sunken garden can be considered as the earliest example of sunken garden in India.
Isa Khan:
Isa Khan was a noble under Sher Shah Suri, the afghan ruler who had overthrown Humayun. The octagonal shaped tomb was built in 1547

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China and India: How they are managing population issue?

While delivering the lecture on “Approach to 12th Five Year Plan” at the HCM Rajasthan Institute of Public Administration, Jaipur, India on April 12, 2011[1], the Planning Commission Deputy Chairman Dr. Montek Singh Ahluwalia said the Indian economic growth has been impressive in the past two decades but lacked "inclusiveness". He pointed out that “the percentage of people below the poverty line has gone down, but the common man's access to basic services such as water, health and education has not improved satisfactorily”. He highlighted that "deprivation" was much greater than the economic growth rate. And this is also supported by the Human Development Index, commissioned by the United Nations Development Programme (UNDP) since 1990. It indicates enlarging people’s choices. The most critical of these wide- ranging choices are to live a long and healthy life, to be educated and to have access to resources needed for a decent standard of living.  The 2010 HRD Report indicates that gap between India and China has increased significantly   as compared to the situation in 1990. India ranked 121 among 169 countries as compared to China, which ranked at 89 in 2010.

The main reason behind this, as per Dr. Ahluwalia, that “we have inclusive politics, now we need inclusive economics”. No doubt, the Indian economic growth has been impressive since nineties however, lacks inclusiveness and this is mainly due to galloping population growth (see Table 1, Blog dated August 29, 2011). It appears that the successive governments and various political parties at the national level have not shown the will to resolve the population issue since the emergency (1975 – 1977). This Blog argues that India’s massive population base, a threat to sustainable development, demands immediate attention.

When India became independent in 1947, population growth was seen as a major impediment to the country's socio-economic development and population 'control' was seen as integral to the sustainable development process. In 1952, a sub-committee appointed by the Planning Commission asked the government to provide sterilization facilities and contraceptive advice through existing health services to limit family size. The National Health Policy of 1983 emphasized the need for "securing the small family norm through voluntary efforts and moving towards the goal of population stabilization" by achieving replacement level fertility of 2.1 children per woman by 2000. The National Population Policy 2000 proposed a long-term and holistic view of development, population growth and environmental protection. Its stated goal is to achieve replacement level fertility by 2010 to achieve stable population by the year 2045. Following the announcement of a National Population Policy, a number of states have formulated their own policies. In 2005, Government of India launched the National Rural Health Mission (2005-12) to achieve the replacement level fertility by 2012. But it is unlikely to be achieved. As the total fertility rate in India remains at the high number of 2.8 children per woman so it is highly unlikely that the goal of replacement level fertility will be achieved by even 2020. Thus, India’s population will continue to grow at a rapid rate. The U.S. Census Bureau does predict a near-replacement total fertility rate of 2.2 to be achieved in India in the year 2050.

In spite if all these policy statements,  India’s population has grown from 361 million in 1951 to 1210 million in 2011 in last sixty years and is growing by around 16 to 17 million every year. We have to agree that efforts made over the years for improving quality of life have been partially neutralized by the rapid growth of the population. It is well recognized that population stabilization measures and economic growth initiatives, when effectively synchronized, synergistically maximize the socioeconomic well-being of the people.

Now question arises as how to forge ahead? While making a public presentation at the International Development Research Centre[2], Canada on March 18, 2009, Dr. Isher Judge Ahluwalia, one of India’s known economists, stated that the “distinguishing feature of India’s growth story is that India has followed a gradualist path. We do not believe in a big bang”. But I do believe that the time has come to think in terms of “a big bang” at least in certain areas like reducing population growth in a broader context of reproductive rights. Otherwise our policy makers will be forced to take some drastic measures like one child family norm in near future. Most of the Members of Parliament (Loksabha)  during the debate on ‘population stabilization in India’ on August 4, 2010  argued  that  “the recent increase in the population of India and the pressure exercised in the limited resources of the country have brought to the forefront the urgency of the problem of family planning and population control”[3]. One of the young Members of the ruling party Mr. Deepender Hooda (ROHTAK, Haryana) voiced that: “The demographic dividend that we talk about, I think we are inching closer to demographic disaster”. In short, Ms. Paramjit Kaur Gulshan (Faridkot, Punjab) expressed the views of many members of Parliament when she said “it is high time that we awake from our deep slumber and take the bull of population-explosion by the horns. Only then can we stabilize our population. The future generations will never forgive us if we fail to rise to the occasion”.

Are Indians against small family norm? While India’s population continues to grow by 16-17 million people annually, 25 million women, mostly belonging to the “bottom of pyramid” especially in Four Large North India (FLNI) States of Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh seek to postpone childbearing, space births, or stop having children, but are not using a modern method of contraception. Often, these women travel far from their communities to reach a health facility, only to return home “empty handed” due to shortages, stock outs, and/or non availability of doctors and paramedical staff. When women are thus turned away, they are unable to protect themselves from unwanted/unplanned pregnancies and sexually transmitted infections, including HIV/AIDS. And this type of incomplete control over the reproductive process leads to relatively high levels of unwanted childbearing. Around 26 million children are born in India every year and out of this about 5.5 million births have been classified as unplanned. Further, as per the latest National Family Health Survey (2005-06) about 30% (around 240 million) of the total population in the young age group 0-35 years in India was the product of unwanted childbearing.

Based on the data obtained from the National Family Health Surveys, I came to the conclusion that out of 1210 million people in 2011, there are around 370 million people who are the product of unwanted fertility.  As a result, India currently stands at a very disadvantageous position. India is now forecast to surpass china in total population in the next nine and ten years and definitely before 2020 unless we focus on this issue during the 12^th Five Year Plan (2012-17). India’s population is stated to rise by almost 300 million over the next twenty years (2010-2030). While China is currently (2010) larger than India’s by over 120 million, by 2030 India’s population is expected to exceed China’s by 130 million. It is important, therefore, to design a suitable strategy to reduce unwanted pregnancies.

Two general options are available to the policy makers who are interested in achieving a breakthrough on the population front or where population growth has stalled at an undesirable high level: strengthen the management of family planning program and encourage socio-economic development with special reference to female education. The former is aimed primarily at reducing unwanted fertility, while the latter is aimed at reducing the demand for children. There is no need to implement coercive measures like China or to provide incentives and disincentives. The real need is to provide family planning servicers services in un-served and underserved areas.

Unfortunately, so far, most sections of India’s elite and policy makers have done little to push for a serious population policy. In large part this has been because they have been benefitted  from this unending supply of ‘cheap’ vote or labor. But this unending supply of cheap and largely unskilled labor also has serious unrecorded economic and political consequences. For example, in the global market, this put Indian industry at a competitive disadvantage rather than advantage.  In 2010, China stood at 17^th in a global league of “national competitiveness” and it has risen from 73^rd place in 1990 and had left India, which was ranked at 42^nd[4].

INDIA IS   AT THE CRITICAL JUNCTURE BECAUSE PROBLEMS INDIA HAS FOR LONG SET ASIDE HAVE COME TO THE FORE AND GALLOPING AND UNEVEN POPULATION GROWTH MAKES THEM PRESSING. ADDRESSING THIS ISSUE OF POPULATION IS THE ANTIDOTE TO THE VARIOUS CONCERNS PLAGUING THE NATION (LIKE CORRUPTION, POOR GOVERNANCE, POVERTY, WOMEN EMPOWERMENT, ETC.).  AS SUCH, THE POPULATION ISSUE SHOULD NOT BE ALLOWED TO BECOME A “STUMBLING BLOCK” TO SOCIO-ECONOMIC PROGRESS AS WELL AS THE UNITY OF THE COUNTRY.  IT IS ARGUED THAT TOWARDS FASTER AND MORE “INCLUSIVE GROWTH”, THE INDIAN ECONOMIC ROAD MAP ESPECIALLY DURING THE 12^TH FIVE YEAR PLAN MUST GIVE DUE IMPORTANCE TO THE ISSUE OF POPULATION STABILIZATION AND EDUCATION.

The writing is on wall. The question is not whether we act or not, but whether we act now or later and deal with much more dire and expensive consequences. What India does in the next few years especially during the period of Twelve Five Year Plan (2012-17) will determine its future. 

We have to understand that China’s one child family policy, which was first announced in 1979, has remained in place despite the extraordinary economic  and social changes that have occurred over the past three  decades. And it emerged from the belief that development would be compromised by rapid population growth. And at least we can learn it from the Chinese experience to give top most priority to reduce unwanted fertility in order to have a reasonable population growth at the level consistent with the requirements of sustainable economic growth, social development and environmental protection.

About 30 years ago, China was behind India in economic prosperity. Today, it is ahead. China is what India’s future could look like once we get our act right. But if we insist on saying that ‘we are like that only’, then we will remain like this only. To remain eternally fatalist would be fatal. We simply have to change to be able to compete effectively in the world, as argued by Vikram Sood[5]. We have to remember that all talk of harmonious development does not make any sense. Nobody will give us space voluntarily. We have to make that space ourselves by taking vital policy decisions to reduce population growth.

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