The Rise of Sterilization and the Cost of Neglecting Birth Spacing in India

Zoe Matthews, University of Southampton
Sabu S. Padmadas, University of Southampton
Juliet McEachran, John Snow International, UK
B.M. Ramesh, J.S.S. Institute of Economic Research

Recent stagnation in the decline of infant mortality can arguably be attributed to the lack of progress in lengthening birth intervals. Meanwhile, recent family planning efforts have been successful particularly in states such as Andhra Pradesh, although family limitation is almost exclusively by means of sterilization at increasingly early ages (median: 23 years, 1998-99). This paper quantifies the effects of neglecting strategies that encourage delaying and spacing of births in India. Firstly, the possible number of infant deaths that would be averted by increasing birth intervals is calculated by using results from multivariate mortality models. Secondly, the effects of adopting a ‘later and longer’ family planning strategy are compared with the continuation of fertility concentrated in younger age groups. Results from the population projections suggest that a policy encouraging birth spacing would achieve a substantial reduction in the future total population size.