The principal message for India from the UN Population Fund’s State of World Population Report 2025 is that it needs to adopt a new paradigm towards health and family welfare, with a focus on women’s empowerment.
For the country as a whole, a fall in the total fertility rate to 1.9 births per woman on average and a population estimate of 1.46 billion people in 2025 frame the macroscopic policy priorities, but drilling down into the data paints a worrying picture of women feeling a lack of reproductive agency.
Besides, social and economic instability seem to be affecting family size, and socially backward states continue to experience high birth rates. Evidently, the failure of governments to spend significantly on social determinants of a healthy population, in spite of robust economic growth since liberalisation, has cast a shadow on the vulnerable in general and women’s freedoms in particular.
This is reflected most glaringly in access to good education, housing, reproductive health services, and the lack of childcare systems. It is revealing, for instance, that 36% of women encountered an unintended pregnancy while 30% could not have a child when they wanted, besides 23%, who experienced both situations at some point.
Nearly 40% of the women surveyed said their decisions on their family were constrained by financial limitations. Unlike Kerala and Tamil Nadu, states such as Bihar, Uttar Pradesh and Jharkhand continued to have fertility rates well above the national average, touching even 3.0. These insights from the report should convince governments that development is synonymous with freedom.
The UNFPA report underscores the need for urgent intervention using a public health approach towards major factors affecting women’s development. Studies show, for instance, that anaemia among those of reproductive age may be as high as 50%, and the incidence of breast cancer among younger women has been on the rise since 2000 compared to cervical cancer.
It is a relief that maternal mortality has fallen in India, but chronic challenges still lack focused policies. Access to good reproductive services helps exercise choice, but this has received low attention. This is probably why the fertility rate among the 15 to 19-year-old adolescent age group in India is much higher than in China, Sri Lanka and Thailand.
Also, many in the medical community apply moral rather than ethical standards when it comes to unmarried women. The biggest barriers to women’s agency are structural since nutrition, affordable education, healthcare, housing, employment, and mobility depend on enlightened policies.
Many women have also spoken about their decisions being determined by long-term concerns for family health posed by climate change, war and economic instability. The signs are all there for political parties to read. An overreliance on market mechanisms to provide key social determinants and making individuals feel solely responsible for their fortunes can only add to the despondent feeling among younger Indians.
