Understanding below-replacement fertility in Kerala, India

Area of Science:

• Demography
• Public Health
• Socioeconomics

Background:

• Kerala achieved below-replacement fertility in the 1990s, diverging from the rest of India.
• This transition was driven by enhanced human development, particularly in social and health sectors.
• Historical factors like education and women's empowerment also catalyzed this demographic shift.

Purpose of the Study:

• To explore factors behind Kerala's sub-replacement fertility and population momentum.
• To analyze the socioeconomic and health policy implications of these demographic changes.
• To examine the impact of population aging and density.

Main Methods:

• Analysis of demographic trends and fertility transition.
• Exploration of socioeconomic and health policy factors.
• Projection of future population dynamics and density.

Main Results:

• Sub-replacement fertility in Kerala is linked to high human development, education, and women's empowerment.
• Significant population momentum is expected, with an aging population and high population density.
• Kerala faces a loss of demographic dividend due to limited investment and political will.

Conclusions:

• Kerala's demographic changes require a revamp of health policies to manage an aging population.
• The state's infrastructure may be insufficient for the growing elderly population's financial and health burdens.
• Kerala exemplifies the challenges of sub-replacement fertility without adequate economic and health sector structural changes.