Professor PS Nair, Department of Population Studies, University of Botswana.
Kerala, southernmost state (province) in India, is well known, globally, for the unprecedented fertility transition in the Indian subcontinent. The state has already reached below replacement level fertility in the 1990s while the rest of India was still grappling with high or middle level fertility. With this backdrop, an attempt is made in this paper, (i) to explore the plausible causes and underlying factors associated with sub-replacement fertility, (ii) to find the demographic consequences and (ii) to trace their socio-economic and health policy implications for the state.
An enhanced level of human development achieved during the last quarter of 20th century, mainly through developments in social and health sectors, is likely to be the main contributor for the fertility transition. Unlike other states in India, there were historical factors as well that functioned as a catalyst for this such as widespread education and women’s empowerment. As an inevitable demographic impact, population growth due to momentum is expected to be very strong in Kerala with an age structural transition favoring the old. The so-called ‘demographic dividend’ invoked by the increase of labour force derived from the youth bulge in the age structure is being lost in the state due to very limited capital investments and political will. Again, as a direct consequence of population growth, population density in Kerala will take a staggering level of 1100 persons per sq. Kim. in 2026. The ill effects of environmental deterioration and consequent changes in morbidity patterns will have to be dealt with seriously. The very foundations of health policy needs revamping in the light of demographic changes associated with sub-replacement fertility.
Further, the tempo of population aging is very high in Kerala. Proportion of population aged 60+ is likely to be 20 percent in 2026 whereas it will be around 12 percent only in India. The current level of social and health infrastructure in the state may not be sufficient to cope with the emerging demands of population aging since the financial and morbidity burdens of the elderly are already quite high. To conclude, Kerala portrays a typical case of the vagaries of the onset of sub-replacement fertility in the absence of reasonable structural changes in the economic and health fronts.