Cash incentives alone won't reverse India's falling fertility: JNU expert

A cash incentive of Rs 30,000 might influence a vote, but it will never convince a couple to have a third or fourth child, says Professor Sanghamitra Acharya, faculty at the Centre of Social Medicine and Community Health, Jawaharlal Nehru University (JNU).

As fertility rates plummet across various Indian states, local governments are frantically introducing free IVF treatments and cash rewards for larger families to stave off a demographic crisis. But Acharya believes that state governments are completely missing the mark by equating fertility behaviour with voting behaviour.

The sudden pivot of governments from decades of population-control policies to offering incentives to have more children raises deep concerns regarding regional representation, unorganised labour welfare, and changing generational values. In an interview with The Federal, Acharya explains why quick-fix financial incentives fail and what structural support systems are required to reverse the decline.

Several developed states in India, like Tamil Nadu, Karnataka, and Goa, are offering free IVF treatments, while Andhra Pradesh recently introduced cash incentives for a third child. Do you think these measures will actually boost the birth rate, or are they merely symbolic?

Thank you for posing this question. For a long time, our national population policy focused heavily on curbing numbers, and we have now reached a stage where we are suddenly concerned about the sharp declines we achieved through those exact efforts.

You cannot expect people to change their intimate choices overnight because of state incentives or disincentives. Modern family sizes are conscious choices driven by urbanisation, career pressures, and unequal gender roles.

I am quite sceptical about these new incentives making any real difference. Reaching our current low fertility levels took decades of concerted effort and behavioral shifts. Reversing this trend by simply subsidising IVF or offering cash handouts will not be easy. Infertile couples make up a very small percentage of the total reproductive-age population, so targeting them through IVF subsidies will not bring about the macro-level demographic changes that states desire.

Furthermore, fertility is a deeply behavioural aspect. You cannot expect people to change their intimate choices overnight because of state incentives or disincentives. Modern family sizes are conscious choices driven by urbanisation, career pressures, and unequal gender roles. Young people are marrying later, and a significant number are choosing to remain single altogether.

Additionally, structural factors like the exorbitant cost of education, housing shortages, and massive migration toward urban areas heavily influence these choices. When young couples look at their absorption into urban employment and the daily pressures attached to it, they decide against larger families. It is a combination of numerous socio-economic factors, not just one or two.

Developed nations like Japan, South Korea, and several European countries have spent heavily on cash incentives, childcare support, and fertility treatments to boost their birth rates. Which international model or example is most relevant to India’s current situation?

It is crucial to learn lessons from other countries because there is a wide range of pro-natalist and anti-natalist experiences globally. Countries like France and Germany have consistently incentivised higher fertility, but their success rested on establishing comprehensive childcare regimes. If childcare is affordable and supported by policy—such as robust paid maternal, paternal, and parental leaves—then family-building becomes feasible. Yet, even France and Germany struggle to hit their desired targets.

The Nordic countries provide an excellent example. They achieved positive changes because they maintain strong gender parity, offer flexible working hours for mothers, provide liberal parental leave policies, and possess excellent public services for maternal and child health.

For India, the key takeaway is making the cost of raising a child affordable through structural policy. We often praise working mothers for being "superwomen" who handle career, childcare, and family effortlessly, but we fail to provide institutional support systems, especially since a vast majority of Indian women work in the informal sector.

The Nordic countries provide an excellent example. They achieved positive changes because they maintain strong gender parity, offer flexible working hours for mothers, provide liberal parental leave policies, and possess excellent public services for maternal and child health.

Conversely, look at Japan. Despite investing a massive share of its GDP into boosting fertility, it has failed to reverse the decline. This is due to long working hours, lack of affordable urban housing, and an oriental societal structure with a rigid gender division of labour. State incentives fail when they conflict with structural societal pressures.

How far have we progressed as a country in implementing maternity and paternity leaves? Do corporate and public institutions still view these leaves as an unnecessary cost to the company or a disruption to workflow?

This is a vital point to take on board. To understand where we stand, we must look back at Dr B.R. Ambedkar’s pioneering efforts in the 1940s. While serving on the Labour Commission during the British period, he led a study on mica mine workers to understand their health and working conditions. The findings revealed severe respiratory and skin diseases tied to their labour.

Based on this study, it was stipulated that women workers should not work underground, their working hours must be regulated, and they must receive maternity leave alongside essentials like clean water and food. That foundational vision has evolved today into six months of paid maternity leave, along with provisions for paternity leave.

However, the catch is that this progression is almost entirely limited to the formal sector. India’s unorganised and informal sectors contribute the absolute bulk of employment, and there we see massive variations. In the private or informal sectors, leave often depends entirely on the employer's discretion.

If we genuinely want to raise fertility levels, the state must rope in the private and informal sectors. Employers must be convinced to align with demographic goals. The informal sector must work hand-in-hand with the state to provide conducive working conditions so that a woman does not feel penalised for choosing to work and have a child simultaneously.

In the 1980s, southern states aggressively implemented family planning programme with slogans like 'We Two, Ours Two' and 'We Two, Ours One.' Now, these states are seeing falling birth rates and are worried about losing Lok Sabha seats during delimitation. What major factors caused this massive decline in South India compared to the North?

If campaigns alone were the driving force, they would have worked equally well in northern states, but they did not. Southern states adhered to the national demographic requirements and are now essentially being penalised for it via political delimitation, while northern states appear to be benefiting from their lack of demographic control.

From a personal standpoint, one could argue whether the state should even be the agency dictating individual family sizes; it should not be the primary factor. However, since we operate within a state system, certain expectations exist. When comparing the North and the South, the fundamental disparity lies in literacy—specifically, female literacy.

While female literacy is heavily emphasised in fertility discussions, male literacy is equally critical. In India, reproductive decision-making does not rest solely with the woman; it is a shared couple responsibility. When both partners are educated, they make conscious choices regarding family size and composition, rather than looking at it from a purely traditional standpoint.

Higher educational attainment naturally pushes the age of marriage upward, which significantly shrinks the reproductive window. There is also a major socio-familial barrier regarding contraception. In India, we often adopt a highly moralistic stance on contraception, believing that informing young girls about it will lead to immorality. This narrative fails to hold water given the vast access to information today.

Beyond education, the level of urbanisation in southern states, particularly in their metropolitan hubs, sets it apart from the North (excluding outliers like Delhi). High urbanisation impacts the housing market. Young individuals cannot find affordable, conducive housing in major cities to start a family, which delays marriage and childbearing. Additionally, the exorbitant cost of private, English-medium education over public schooling causes parents to delay or limit the number of children, as private schooling is marketed as the only viable path to success.

State governments are announcing financial packages—for instance, Andhra Pradesh is offering Rs 30,000 for a third child and Rs 40,000 for a fourth child. Can these cash handouts actually motivate educated, aware couples to expand their families? Or are policymakers acting short-sighted?

As I mentioned, policymakers are mistakenly equating fertility behaviour with voting behaviour. A financial incentive of Rs 30,000 or Rs 40,000 might influence a vote, but it will absolutely not influence a couple's lifelong decision to raise an extra child.

If the state guarantees affordable pathways to educate a child, ensures accessible urban housing, and promises stable employment opportunities for people moving from rural to urban spaces, couples will feel incentivised.

What actually works is infrastructural security. If the state guarantees affordable pathways to educate a child, ensures accessible urban housing, and promises stable employment opportunities for people moving from rural to urban spaces, couples will feel incentivised. Parents want to know that their child will grow up in a conducive environment with the potential to be well-educated and well-employed. Handouts cannot replace that foundational security.

Historical evidence proves that once a fertility decline sets in, reversing it is incredibly difficult. While Nordic countries, France, and Germany have seen slight upward blips after implementing deep structural benefits like extended parental leaves, subsidised housing, and employment protections, the recovery period is incredibly slow—often much slower than the initial decline.

It is a deep psychological contradiction. For decades, the state conditioned citizens to believe that a small family is the ideal norm. Suddenly, the state changes its mind and demands a fourth child. This flip-flopping causes couples to look at state policies with doubt.

It is easy to announce cash incentives, but our society hasn’t fully addressed who will share the actual burden of raising a child, especially with rapid urbanisation breaking down traditional support systems. How can we build a genuinely supportive infrastructure for couples?

There is a well-known proverb that it takes a village to raise a child, but rapid urbanisation makes us wonder where to start or stop solving this puzzle. A child represents the future of both the community and the nation. Therefore, the structure of support must extend from the individual couple to the family, and ultimately to society, with the state acting as an anchor at every layer.

Nuclearisation is a core reason why child rearing has become overwhelmingly difficult. We need to rethink how we structure our living spaces and support systems to reintegrate senior citizens into the family fabric, rather than siloing them away in affluent old-age homes or retirement complexes.

This supportive infrastructure must begin long before a child goes to school. It starts with comprehensive healthcare for the mother and reproductive counselling to prepare couples for parenthood. It requires stable employment, workplace flexibility, and urban housing units designed to accommodate growing families.

Sociologically, South Asian and Indian societies have traditionally relied heavily on grandparents for child rearing. The presence of three-generational households provided a natural, built-in support system. However, the modern shift toward nuclear families has broken this dynamic, leaving young working couples with absolutely no one to look after their children. This nuclearisation is a core reason why child rearing has become overwhelmingly difficult.

We need to rethink how we structure our living spaces and support systems to reintegrate senior citizens into the family fabric, rather than siloing them away in affluent old-age homes or retirement complexes. Bringing back the conceptual ease of three-generational living arrangements could alleviate the daily burdens of childcare and naturally incentivise couples who want to build families.

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