India’s Fertility Rate Drops Below Replacement Level for the First Time

Total Fertility Rate (TFR) of the country has fallen below the replacement level for the first time. According to the Sample Registration System (SRS) Statistical Report 2024 which was released by the Office of the Registrar General and Census Commissioner as India’s fertility rate  declined to the 1.9 children per woman and showcasing the long-term trend of declining births.

India’s Total Fertility Rate Falls Below Replacement Level

The replacement fertility level is generally considered to be the 2.1 children per woman and the level required for a population to replace itself from one generation to the next without migration.

India’s TFR has witnessed a dramatic decline from,

• 1985: 4.6
• 2024: 1.9

This milestone signifies that India is transitioning towards the more stable population structure.

However, the national average had the substantial regional differences.

State-wise TFR Highlights

• Bihar: 2.9 (Highest in India)
• Delhi: 1.2 (Lowest in India)
• National Average: 1.9

Delhi has recorded the sharpest decline in the fertility over the last decade, while the state of Bihar experienced the slowest decline.

A Growing Demographic Divide Between North and South India

The report also highlights the widening demographic gap between India’s southern and northern states.

Southern states such as Kerala and Tamil Nadu have already reached to the advanced stages of demographic transition, characterized by the,

• Low fertility rates
• Ageing populations
• Higher life expectancy

In contrast, states like the Bihar and Uttar Pradesh continue to have younger populations and relatively higher fertility levels.

Ageing Population Trends

• Kerala: Total 15.1% population aged 60 and above
• Tamil Nadu: 14.2% population aged 60 and above
• Bihar: Nearly the one-third of the population are below 14 years

Decline in General Fertility Rate Across India

The report also measures the fertility through the General Fertility Rate (GFR), which indicates the number of births per 1,000 women aged between 15-49 years.

Between the 2012–14 and 2022–24 cycle, India’s GFR declined from 78.8 to 64.6, a reduction of nearly 18%.

Key GFR Trends

• Rural GFR: 86.2 to 71.9
• Urban GFR: 61.2 to 51.0
• Delhi recorded the steepest decline
• Bihar remained the highest at 96.0
• Kerala: 42.9
• Tamil Nadu: 42.1

Interestingly, urban Bihar was the only major region where the fertility increased slightly during the decade.

Child Mortality Continues to Show Regional Disparities

As the fertility rates have declined, child survival outcomes has been remain uneven across states.

Under-Five Mortality Rate (U5MR)

• Madhya Pradesh: 41
• Uttar Pradesh: 41
• Kerala: 9

The urban-rural divide remains important,

• Rural India: 32
• Urban India: 19

This findings indicates that access to quality healthcare, nutrition, sanitation and maternal services continues to differ significantly across regions.

Most Infant Deaths Occur Within the First Month

The SRS report also highlights that neonatal health remains a major challenge.

Infant Mortality Findings

• 52.7% of the infant deaths has occur within the first week of birth.
• 72.8% occur within the first 28 days.
• Neonatal mortality remains as the largest contributor to infant deaths.

These figures underlines the importance of the improving maternal healthcare, institutional deliveries, newborn care and postnatal services.

Institutional Deliveries Continue to Rise

One of the positive trends which highlighted in the report is the continued expansion of institutional childbirth.

Key Findings

• 71.7% of births occur in to the government hospitals.
• Institutional deliveries have increased significantly over the decades.
• Maternal and child health services have also improved access to healthcare facilities.

Government health program such as the Janani Suraksha Yojana (JSY) and expanded healthcare infrastructure have played a key role in encouraging institutional births.

Sex Ratio at Birth Remains a Concern

The report also sheds the light on the India’s gender balance at birth.

Sex Ratio at Birth (2022–24)

• India: 918 girls per 1,000 boys
• Uttarakhand: 872 (Lowest)
• Chhattisgarh: 978 (Highest)
• Kerala: 974

Although the improvements have been observed in some  of the regions, gender disparities at birth continue to pose social and policy challenges.

Healthcare Access Before Death Shows Limited Improvement

The report has revealed that access to the qualified medical care at the time of death remains inadequate.

Key Statistics

• 45.5% of deaths has been occurred without qualified medical attention.
• In which rural areas recorded 48.9%.
• Only 40.2% of deaths occurred in to the hospitals.
• Government hospitals accounted for the 24.7% of medically attended deaths.
• Private hospitals accounted for 15.5%.