CHENNAI: Contained within the National Family Health Survey, one of the most important statistical exercise that deals with health and healthcare in the country, is a detail that is about health and society, and increasingly political: the falling fertility rate of Tamil Nadu.
Even as its southern peers have shown signs of stabilisation or modest recovery, Tamil Nadu’s fertility rate has fallen further, highlighting a widening demographic divide that could have significant political consequences when parliamentary constituencies are redrawn after the next delimitation exercise.
Data from the National Family Health Survey (NFHS-6) for 2023-24 show the State’s Total Fertility Rate (TFR) declining from 1.8 in the previous survey in 2019-21 to 1.7 children per woman. Tamil Nadu is the only southern State to record a decline during the period and remains well below the replacement level fertility rate of 2.1.
The trend comes a month after the BJP-led NDA government’s move to increase the seats in the Lok Sabha and State Assemblies by 50 per cent – raising the Lok Sabha’s strength from 543 to 816 – ostensibly to implement 33 per cent reservation for women in legislative bodies across the country.
The opposition parties, however, defeated the move, with the southern states expressing fear that a population-based reallocation would shift parliamentary weight to higher-population states, especially in the northern and western parts of the country where BJP holds sway.
The contrast is evident in the latest fertility data. Telangana’s TFR rose to 1.9 from 1.8, while Andhra Pradesh and Karnataka recorded increases from 1.7 to 1.8. Kerala remained unchanged at 1.8.
In the Hindi heartland, fertility levels continue to be significantly higher. Bihar, despite a decline from 3.0, remains the country’s most fertile State with a TFR of 2.7. Uttar Pradesh and Jharkhand stand at 2.2, while Rajasthan and Madhya Pradesh have 2.1, all at or above replacement level.
India’s overall fertility rate remained unchanged at 2.0 in NFHS6, suggesting that while the country has broadly achieved population stabilisation, regional demographic trajectories are diverging sharply. There is another concern for Tamil Nadu: A sustained period of low fertility points to a rapidly ageing population, a shrinking share of working-age citizens, and increasing pressure on welfare and healthcare systems. At the same time, slower population growth could weaken the State’s relative weight in Parliament if future seat al- location is determined by population figures.
The issue has become significant enough for some southern States to consider pro-natalist policies. Andhra Pradesh has announced “Poshana-Shiksha-Suraksha” package, offering incentives for families opting for a third child, including a one-time assistance of Rs 30,000, monthly support of Rs 1,000 for five years, and free education up to the age of 18.
Even while welcoming financial assistance for families choosing to have a third child, VCK general secretary and MP D Ravikumar said the government should be cautious about intervening in family planning decisions.
“Just as compulsory family planning is wrong, asking families to increase their size for the sake of population growth is also problematic,” he said, noting how family size is influenced by household income levels and growing urbanisation.
Ravikumar highlighted NFHS-6 data that the use of family planning methods among married women aged 15 to 49 had fallen to 68.5 per cent. Female sterilisation stood at 56.6 per cent, while male sterilisation remained at just 0.1 per cent. The corresponding national averages were 36.5 per cent for female sterilisation and 0.5 per cent for male sterilisation.
Also, female sterilisation is higher in rural areas (58.2%) compared to urban areas (54.5%), which could be linked to poverty and economic insecurity, he said. “The government should address these underlying factors if it wants to encourage higher fertility rates,” he said.
Tamil Nadu
NFHS-5: 1.8
NFHS-6: 1.7
Keralam
NFHS-5: 1.8
NFHS-6: 1.8
Karnataka
NFHS-5: 1.7
NFHS-6: 1.8
Andhra
NFHS-5: 1.7
NFHS-6: 1.8
Telangana
NFHS-5: 1.8
NFHS-6: 1.9
INDIA
NFHS-5: 2
NFHS-6: 2
Bihar
NFHS-5: 3
NFHS-6: 2.7
Uttar Pradesh
NFHS-5: 2.4
NFHS-6: 2.2
Rajasthan
NFHS-5: 2.3
NFHS-6: 2.1
Madhya Pradesh
NFHS-5: 2
NFHS-6: 2.1