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Jehangir Ali
Srinagar-based independent journalist
National policy is needed in order to avoid governmental dependency.

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India's population boom presents both opportunities as well as adversities

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A comprehensive national policy can mould the population surge to drive an economic boom but without direction, more people will become only a burden for the government

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Astha Rajvanshi

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How India’s Record-Breaking Population Will Shape the World

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India is set to become the world’s most populous country. That makes it a major player on the global stage, experts say.

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Hannah Ellis-Petersen

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The cry of a baby born in India one day next year will herald a watershed moment for the country, when the scales tip and India overtakes China as the world's most populous nation.

Yet the story of India's population boom is really two stories. In the north, led by just two states, the population is still rising. In the richer south, numbers are stabilising and in some areas declining. The deepening divisions between these regions mean the government must eventually grapple with a unique problem: the consequences of a baby boom and an ageing population, all inside one nation.

India is currently home to more than 1.39 billion people - four times that of the US and more than 20 times the UK - while 1.41bn live in China. But with 86,000 babies born in India every day, and 49,400 in China, India is on course to take the lead in 2023 and hit 1.65 billion people by 2060.

As the world's population passes another milestone, our series Beyond 8 billion examines the impact on some of the countries projected to have the greatest growth, as well as those facing the opposite problem: plunging birthrates and rapidly ageing populations.

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On 15 November the world's population will reach a total of 8 billion people. Between now and 2050, over half of the projected increase in the global population will happen in just eight countries: the Democratic Republic of the Congo, Egypt, Ethiopia, Nigeria, Pakistan, the Philippines, the United Republic of Tanzania - and India.

The growth will place huge pressure on India's resources, economic stability and society, and the repercussions will reach far beyond its borders. As a country on the forefront of the climate crisis, already grappling with extreme weather events 80% of the year, diminishing resources such as water could become decisive factors in what India's future population looks like.

India projected to overtake China - graph

One country, two stories

Fears of "population explosion" in India - where development caves in beneath the weight of an uncontrollably expanding population and the country's resources are overrun, leaving millions to starve - have abounded for over a century.

Post independence, India's population grew at a significant pace; between 1947 and 1997, it went from 350 million to 1 billion. But since the 1980s, various initiatives worked to convince families, particularly those from poorer and marginalised backgrounds who tend to have the most children, of the benefits of family planning. As a result, India's fertility rate began to fall faster than any of the doomsday "explosion" scenarios had predicted.

A small family is now the norm in India, and with the annual population growth rate less than 1%, fears of population-driven collapse are no longer seen as realistic. In the 1950s, a woman in India would give birth to an average of over six children; today the national average is just over two and still continuing to fall.

Nonetheless, the curbs on population growth have not been uniform across India, and India's entrenched north-south divide has played out significantly in demographics, with ongoing social and political consequences.

For the next decade, one-third of India's population increase will come from just two northern states, Bihar and Uttar Pradesh. Bihar, the only state in India where women still typically have more than three children, is not expected to hit population stability - 2.1 children per woman - until 2039. Kerala, India's most educated, progressive state, hit that figure in 1998.

In Bihar's poverty stricken area of Kishanganj, which has one of the highest rates of fertility in India, women said they had only recently begun to learn about the benefits of a having fewer children.

The urge to have sons, who in parts of India are still considered much more desirable than daughters, remained a key motivator for women in the village. Surta Devi, 36, said she had six children in order to make sure she had two sons to "carry on our lineage".

"It was only after I gave birth to all my children that doctors told me about family planning," said Devi.

Phullo Devi, 55, an illiterate labourer who had six children before she opted for sterilisation, said she wished she had done things differently. "If I had less children, I would have been able to raise them better and been able to educate them," she said.

But Devi said things were slowly changing in the village. "Now health workers campaign house-to-house and make people aware about contraception and condoms. I absolutely want my sons and daughters to have less children so they don't have to live in poverty," she said.

A bus for migrant workers stops to pick up passengers in Noida, south-east of New Delhi. Photograph: Harish Tyagi/EPA

The 'youth bulge'

A particular demographic challenge, widespread across India but particularly concentrated in poorer northern states, is that of the "youth bulge". The median age of an Indian is 29 and the country is grappling with a vast, ambitious and increasingly restless young population, the majority of whom are unskilled, and for whom there are not enough schools, universities, training programmes and most of all, not enough jobs. Across India, youth unemployment is 23% and only one in four graduates are employed. While female literacy is growing, only 25% of women in India participate in the workforce.

In Uttar Pradesh, where the median age is 20, there are over 3.4 million unemployed young people. Earlier this year, riots broke out in Bihar after more than twelve million people applied for 35,000 positions in the Indian Railways.

Vishu Yadav, 25, from Ghazipur district in Uttar Pradesh, has a masters degree, an education diploma and passed a teacher eligibility test, but is unemployed, with teaching jobs scarce and over a million people now applying for officer positions in the state civil service. "It's a depressing, hopeless situation. I am eligible to become a teacher but I can not secure a position. There are too many young people with qualifications and not enough jobs," he said.

Poonam Muttreja, the executive director of Population Foundation India, said there was still time for this young population to work to India's benefit.

"India has a fantastic window of opportunity but it will only be there for approximately the next two decades," said Muttreja. "We have the capacity to tap into the potential of the youth population but we need to invest in adolescent education, health and sexual health right away if we want to reap the benefits.

"Otherwise, our demographic dividend could turn into a demographic disaster."

Muttreja said India's youth risk fuelling population growth unless contraception and family planning services are improved, describing the situation as "woefully inadequate".

Female sterilisation is still the most widely used contraceptive method in India, and that's mostly by older married women. Of India's tiny health budget, only 6% is put aside for family planning, and just 0.4% of that is invested in temporary methods such as the contraceptive pill or condoms.

"Currently we have almost 360 million young people, the majority of whom are at a reproductive age, and that number is only going to increase over the next few decades," Muttreja said.

"The need for more temporary contraception methods is urgent. It will be very problematic if this need is not met."

According to the UN, there are 10 million unwanted pregnancies in India every year. Abortion is legal in India, but was only legalised for single women this year. It remains taboo for married women and most abortions are carried out by village "quacks", often with long-term health consequences.

Yet for several states in the south which now have falling populations, another challenge lingers on the horizon, one which is rarely mentioned. In the next 15 years, the average man from the southern state of Tamil Nadu will be 12 years older than someone from Bihar.

Residents of Tamil Nadu will be on average 12 years older than those from Bihar, in the next 15 years Photograph: Idrees Mohammed/EPA

"The crisis that the south will soon be facing is that of an ageing population," said Aparajita Chattopadhyay, a professor at the International Institute for Population Sciences.

"India will soon have over 10% of the population who are ageing, which in our context is a huge number. That presents significant problems in terms of employment, in terms of social security but most of all for healthcare, where spending is still very low and the prevalence of diseases such as diabetes is very high among older people. This should not be ignored."

A political problem

The north-south divide has also enabled the politicisation of population in India. In the northern state of Uttar Pradesh, ruled by a hardline figure from the Hindu nationalist Bharatiya Janata Party (BJP), the high population has been used to justify the drafting of a population control bill, proposing coercive methods to ensure two children per couple.

The draft bill is seen by some as a thinly veiled attack on Muslims, fuelled by a pervasive yet inaccurate myth promoted by Hindu nationalists that the number of Muslims is fast outpacing Hindus, as part of a conspiracy by Muslims to become the majority in India. Muslims make up 14% of the population, Hindus are 80%.

"All this talk of population control measures in Uttar Pradesh is only to keep the controversy going and to give Muslims a bad name, stir up hatred and win the Hindu majority vote," said SY Quraishi, a former Indian civil servant who recently published The Population Myth, a book demolishing the myths around Islam and family planning in India.

"As the data clearly shows, this suggestion of Muslims overtaking the Hindu population is a blatant lie."

Quraishi emphasised that while Muslims in India do have higher fertility rates than Hindus, this is not due to religion but because Muslims are often poorer, less educated and with less access to health services. The Muslim fertility rate in India is also now falling faster than the Hindu rate.

BJP leader Ashwini Upadhyay recently submitted a petition to the supreme court calling for "an effective population control policy like China" to cope with the "population explosion", though such policies have been rebuffed by the central BJP government.

Quraishi said rather than trying to emulate China's population control measures, policymakers in Delhi should take them as a warning.

"In India people used to admire China's policy of one child norm," he said. "But now look, China has a population crisis on their hands, 70% of their population are ageing. That should be an important lesson for anyone talking about coercive measures: otherwise in a few decades that could be us too."

Cities under pressure

Though fears of an Indian "population bomb" have eased, one area already creaks under the strain of a rising population. India's cities are some of the biggest and overburdened in the world, and in the next few decades they will get even bigger.

India is still largely rural, with about 33% of the population living in cities, but urbanisation is picking up pace. By 2035, 675 million Indians will live in cities and, according to UN projections, by 2050, more Indians will live in urban environments than villages. With a population of 20 million, India's capital Delhi is already one of the largest and most polluted cities in the world. It's expected to grow to 28 million by 2041, according to the city masterplan.

India's capital, Delhi, is expected to grow to 28 million people by 2041. Photograph: Kabir Jhangiani/ZUMA Press Wire/REX/Shutterstock

In the biggest metropolises of Delhi, Mumbai, Chennai and Kolkata, housing, water, transport and sanitation infrastructure are already struggling to cope, and this will only be exacerbated by climate change. In India's financial capital Mumbai, which is predicted to grow from 20 million to 27 million by 2025, 40% of people live in slums. In 2019, the city of Chennai ran out of water entirely.

"Urbanisation will drive important changes in this country in the coming decades but at the same time, the quality of life in Indian cities is already deteriorating fast," said Rumi Aijaz, a fellow at the Delhi thinktank Observer Research Foundation.

"Adaptation of urban areas is one of the biggest challenges India faces as its population grows - but right now the government response is weak."

What happens next

Despite the continued rise in population in the north over the next few years, India's overall trajectory is one of declining fertility and eventual population stability. Yet just how far fertility will fall is still up for debate. Unlike in the west, India's declining fertility rate so far has not coincided with a change in family structure or marriage patterns, such as women choosing to marry and have children later, or not at all.

Instead, so far, the maternal expectations of Indian women have remained largely unchanged; the majority still get married by their early twenties, have two children while relatively young and then stop, often by opting for sterilisation.

As India develops and more women are educated and enter the workforce, experts say fertility norms will continue to shift. Back in the Bihar village of Kishanganj, Nazia Parveen, 19, who is studying at university, said she had already noticed the difference that women's education had made to the number of children being born locally.

"Now much fewer children are being born in the village and around 60% of the families are using family planning," she said. "This is such a change from the past when there was no awareness, and it is all because of women's education. No one of my generation wants to have more than two children."
Mohammad Sartaj Alam contributed reporting from Bihar

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India faces deepening demographic divide as it prepares to overtake China as the world's most populous country

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India's entrenched north-south divide is growing as its population changes, with serious social and political consequences

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Alessandra De Poli

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India's population may have already surpassed China's; however, there are profound differences between city and country, north and south. The greatest concerns are stress on metropolitan infrastructures and job creation for young people.

Milan (AsiaNews) - Even before China recognised its demographic decline, the United Nations released demographic forecasts in July 2022 indicating that India's population would overtake China's this year.

Since 1960 India's growth has been phenomenal, from 450 million to more than 1.4 billion today. Uneven and marked by a slight slowdown in recent years, the fertility rate dropped from 5.9 in 1960 to 2.24 in 2020, with a huge gap between rural and urban areas, and between northern and southern states.

Despite lower fertility, experts do not expect India to undergo the same demographic slump as China; on the contrary, the National Commission on Population expects the population to increase to 1.52 billion by 2036, while the United Nations sees 2064 as the peak year with 1.7 billion.

It is necessary to point out, however, that uncertainty surrounds data collection in India. The census takes place every 10 years, but the last one, in 2021, was postponed by the government to a later date. For this reason, many international observers believe that India may have already overtaken China.

What is certainty though is that India today has the highest number of births in the world, with 24 million newborns per year according to the UN.

Compared to the past, more and more children are born in megacities like Mumbai, which has 22 million inhabitants, 40 per cent living in slums.

Migration to cities will be one of the factors shaping demographic trends in the coming years, placing urban infrastructures under unprecedented stress, even if, compared to rural areas, urban fertility rates are already falling.

Government data indicate that today about a third of India's population lives in urban areas, rising to 40 per cent by 2030.

In big cities, women are already having fewer children than their rural counterparts, resulting in different fertility rates: 2.4 in the countryside compared to 1.7 in the cities (2017 data).

This gap is also regional. India's north is still comparatively underdeveloped, while the south is richer, more progressive and with slower population growth.

According to some observers, India may even be facing a baby boom and an aging population all at once: It is estimated that over the next 15 years, people in the southern state of Tamil Nadu will be on average 12 years older than their counterpart in Bihar.

Over the coming decade, one third of the population increase will be driven by just two northern states, Bihar and Uttar Pradesh.

In Bihar, a woman still gives birth to three or more children, with population stability, defined by a fertility rate of 2.1, expected only in 2039, a level that Kerala, one of the most developed states in the country, reached in 1998.

What everyone is asking is whether the Indian government will be able to cope with the challenges posed by such fast and unequal growth. The median age in India is 28.4 years, while female participation in the labour force was only 19 per cent in 2021.

Youth unemployment stands at 23 per cent, a percentage that translates into huge numbers. In Uttar Pradesh, for example, where the median age is 20 years, 3.4 million unemployed are under 25.

To absorb young workers into the labour market, India needs to create at least 90 million non-agricultural jobs (a sector in which 45 per cent of the population is engaged) by 2030.

The coming decades therefore present a great opportunity for the Indian economy, but if the Indian government fails to deal with the problems related to such rapid and uneven growth, the Indian population boom risks turning into a catastrophe.

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INDIAN MANDALA Baby boom and aging, the two faces of India's population growth

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India's population may have already surpassed China's; however, there are profound differences between city and country, north and south. The greatest concerns are stress on metropolitan infrastructures and job creation for young people. Milan (AsiaNews) - Even before China recognised its demographic decline, the United Nations released demographic forecasts in July 2022 indicating that India's population would overtake China's this year.

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Verified, Official Account of MyGov

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Priyanka Sharma
Indian officials setting up emergency medical teams. Speaks to their previous lack of viable healthcare options in the event of another COVID surge.

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NEW DELHI : The government is setting up 100 teams that will respond to health emergencies, including pandemics, along the lines of the National Disaster Management Authority (NDMA).

Officials from the health ministry, AIIMS, National Centre for Disease Control, National Disaster Response Force (NDRF) and NDMA are devising a mechanism along with state governments to put it into action.

The new strategy will be presented next week to health minister Mansukh Mandaviya.

"We are going to create an emergency medical response team for states to deal with future pandemic and environmental disasters like cyclone, earthquake or for any disease outbreak," said a government official aware of the matter.

"During covid-19, we had set up central teams to manage the pandemic. At present, whenever any crisis occurs, the government deploys a team and sends them to the site. But once these teams are in place with the right training and knowledge to tackle any emergency then only a dedicated team will be deployed," the official added.

The emergency medical response team will be a group of healthcare professionals who will provide direct clinical care to populations affected by outbreaks and emergencies to support the local healthcare system.

"The plan is to set up 100 teams consisting of specialist doctors like burn surgical specialists, public health experts and logistic experts who would access PPE (personal protective equipment) kits etc., administrators, officials from NDRF, NDMA.

"We have been working on it for 20 days (about 3 weeks) and are likely to give the comprehensive plan to the minister by next week," said the official.The training of the teams would start once the roadmap gets approved by the government.

"Internationally, these teams are apt, standardized and deliver immediate disaster response on the ground. This is what we want to create in India," said the official.

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India to set up expert teams to deal with health emergencies

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NEW DELHI : The government is setting up 100 teams that will respond to health emergencies, including pandemics, along the lines of the National Disaster Management Authority (NDMA). Officials from the health ministry, AIIMS, National Centre for Disease Control, National Disaster Response Force (NDRF) and NDMA are devising a mechanism along with state governments to put it into action.

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Lauren Frayer

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MUMBAI, India - In a sparse, one-room apartment on the far periphery of a booming megacity, the piercing cry of a newborn baby marks a population milestone for India.

He's a boy named Vehant, born on Nov. 9 and weighing nearly 8 pounds. His first days were difficult; he developed a blood infection and was hospitalized for 10 days. Now he's back home.

In many ways, Vehant embodies the new India. He's the first in his family to be born in a hospital. His parents married for love - a rarity in a country where matchmaking is a tradition. And their young family - now settled on the fast-growing edge of India's biggest city, Mumbai - is the product of a massive wave of migration out of India's countryside.

"I cannot imagine him being born back in our village, without the kind of facilities we've had access to here," says his 24-year-old mother, Naina Agrahari, who was born on the floor of her grandmother's rural home.

Vehant has another distinction: He is one of the many babies who, in the months ahead, will bring India a new global title.

The United Nations says that sometime in 2023, India will officially overtake China as the most populous country in the world. It may actually have happened already: India hasn't had a census since 2011.

India, not China, will soon have the largest population in the world

According to the U.N.'s World Population Dashboard, China still had slightly more people than India at the end of 2022: 1.4485 billion, compared to India's 1.4066 billion. But China's population has stabilized and is set to shrink, while India's is still growing - pretty fast.

More babies are born each year in India than any other country in the world. (The U.N. estimates more than 24 million annually, but the true number is likely higher because many births never get registered.) And more of them are born in burgeoning megacities like Mumbai - with a population of more than 22 million - than ever before.

Compared to previous generations, these newborn Indians are more likely to be born in a hospital than at home; more likely to survive to adulthood; more likely to become literate, educated and multilingual; and more likely to migrate within their lifetime, to different parts of their own country or the rest of the world.

And if efforts to eradicate female feticide are successful, the next generation of Indians will have more females than in recent decades.

Women and girls are the big beneficiaries of India's population boom, and they're changing the country in profound and unexpected ways, demographers say. The story of Vehant's mother - and the choices she's made - reflect the way that this new generation will grow up with far different prospects than past generations and will change the country itself.

Meet Vehant's mom

In October 2022, a racy Bollywood love song bounces off the concrete walls of Naina Agrahari's otherwise empty, dank little apartment in northern Mumbai. Two frames adorn the wall: a photo collage of Agrahari and her husband, arm in arm, and a cartoon poster of two cherubs in a garden.

Agrahari sings Hindi lyrics as she waddles around in a ruffled pink maternity dress while folding laundry. She jokes that she should probably learn "Baa Baa Black Sheep" instead, because she's nine months pregnant.

"It never occurred to me to learn nursery rhymes!" she says, laughing. "I have been so involved in my job as a financial consultant, but now that I'm about to give birth, I should probably learn some baby stuff."

In 2010, Agrahari moved to Mumbai with her parents and siblings from their native village in India's most populous state, Uttar Pradesh. The family settled in Nala Sopara, a small suburb on Mumbai's northern outskirts that has seen its population double to nearly 200,000 in the past 20 years, with an influx of migrants like them.

Agrahari is the first woman in her immediate family to have a paid career outside the home. And she's the first in her family to give birth in a hospital. She and her siblings were all born at home in their village with the help of a local midwife.

This kind of transition from rural/village life to urban life by many Indians is having a profound impact. India's infant mortality has more than halved in recent decades, from 65 deaths per 1,000 live births in 1990 to 27 deaths per 1,000 live births in 2020, according to World Bank data. That dramatic drop is credited at least in part to better overall health outcomes from better access to medical care in cities, rather than the countryside.

And these children will find a brighter future than the newborns of past decades. Agrahari's child is more likely than his ancestors to be healthy, in an urban setting rather than a rural one. He's more likely to learn languages in polyglot Mumbai, where migrants arrive speaking hundreds of regional languages from all over India. And with relative prosperity, Vehant is also more likely to travel, for work or for tourism.

"I want my child to study medicine and to go abroad for an even better education," Agrahari says, laughing off the idea that she's already grooming a little overachiever.

Unlike the Agrahari family, most Indians still live in rural areas. About a third of the country lives in areas classified as urban. But according to government data, that'll surpass 40% by 2030 - and continue to rise.

The wave of migration that Agrahari is part of has only just begun.

Each year, tens of millions of Indians move out of rural agricultural areas and into huge, crowded urban centers like Mumbai. It's a change that'll characterize her baby's generation. And it may also saddle them with some environmental problems associated with densely populated cities: smog, inadequate infrastructure and economic inequality.

There's one especially important way urbanization is changing India's demographics: Even as the country's population rises, women in cities are having fewer babies than rural women.

"Given the cost of living in urban areas, but also higher income and access to services, we see the population stabilizing in Indian cities," says Andrea Wojnar, India representative for the U.N. Population Fund (UNFPA). "It tends to be in rural areas, where families are still living agrarian lives, that they need to have - or want to have - larger families."

In the 1960s, India's fertility rate was nearly six children per woman. But by 2017, it had fallen to 2.4 children per woman in rural areas - and 1.7 in urban ones.

How female infanticide and feticide left India with a sex gap

When NPR first visited the home of Agrahari and her husband, 27-year-old Sumit Chauhan, in October, they did not know their baby's sex. Ultrasounds to determine that are illegal in India.

"We're not allowed to learn the sex of an unborn baby, because if the child is female, some mothers feel family pressure to abort. In villages, this happens a lot," Agrahari explains. "Some people don't want a girl child."

India, like many developing countries - including China under its "one-child" policy - has long had a preference for sons. In extreme cases, that has resulted in female infanticide, when parents actually kill their own newborn girls. In the 1980s, when prenatal sex determination tests became more affordable and widespread, India saw a steady increase in abortions of female fetuses. (Abortion was legalized in India in 1971.)

All of that has left India - like China - with a wide sex ratio. Government data shows that in 1991, there were 945 females ages 0-6 in India for every 1,000 males. In 2011, that figure declined to 918 females per 1,000 males.

But a new report by the Pew Research Center suggests that trend may be reversing. In the past few years, more girls have been born in India. Experts are trying to figure out why.

It could be due to the success of an Indian government program called Beti Bachao, Beti Padhao -- "Save the daughter, educate the daughter." Or it could be a mere blip in the statistics, because of the COVID-19 pandemic, says A.L. Sharada, a demographer and director of Population First, a social welfare group based in Mumbai.

"Some of the latest data shows sex ratios are improving, but it could be because people might not have been able to access abortion services during the pandemic," Sharada notes. "So we have to see if this trend will continue."

How female education is changing India's birthrate

Agrahari says the message of the Beti Bachao, Beti Padhao campaign has rubbed off on her family. Her 46-year-old mother, Gudiya Vaishya, who has a sixth-grade education, moved her family to Mumbai, in part, so that her daughters - Agrahari and her younger sister Khushi Vaishya - could have careers.

"It's all about the mindset. Because of my mother's dedication, I took English tuition [after-school classes] in Mumbai, at a time when our other relatives [in rural Uttar Pradesh] were saying, 'What difference does it make?'" recalls Khushi Vaishya. "My mother came from a background where this wasn't common. But because of her, I got into college."

Vaishya is now studying for a bachelor's degree in economics. Agrahari graduated from 12th grade and has since started her own financial consulting company, specializing in various types of loan products. She plans to return to paid work, outside the home, after a six-month maternity leave.

She also had a love marriage - a rarity in India, where most marriages are arranged by families.

Agrahari and her husband, a fellow migrant from Uttar Pradesh, say they want one or possibly two children - not five like Agrahari's mother, or six like her grandmother, who never went to school.

"On average, a girl who studies up to 12th grade has fewer children than a girl who's not literate, and a woman who works has fewer children than a woman who does not work," says Sharada, the demographer. "A family which earns more has fewer children than a family that doesn't earn much."

Agrahari's father is also from a big family. He's one of six children, she notes.

"But that is only because his father died before his wife - my grandmother - could become pregnant again!" she laughs.

How far India has come and what challenges lie ahead

India celebrated its 75th birthday last year. Since 1947, India has transformed from a subcontinent impoverished by British colonial rule, to an Asian regional power with big urban centers of technology, innovation, constant construction and growth.

When we talk about booming Asian megacities, we used to think primarily of China. But India has now joined those ranks.

"China will achieve its peak population size [this year], whereas India will continue to experience momentum for several decades to come, before the population actually stabilizes," the UNFPA's Wojnar says. "This represents a great opportunity for India. With the largest number of young people anywhere in the world, there's a huge opportunity - a huge potential - to tap into, to enjoy greater economic growth and development."

But the challenge, Wojnar and others say, is for India to create enough opportunities in education and employment for all of these young people streaming into India's big cities or being born in them.

"This is the most important thing for a country: to keep pace with growth of the population by providing health care, education, and the conditions for jobs," Wojnar says. "The challenges are anywhere where women and girls don't have decision-making power, where they have lower levels of literacy and where they're not able to exercise their reproductive rights and choices."

Those challenges are especially acute in Dharavi, one of the biggest slums in Mumbai - and in all of Asia. It's a step down from the northern suburb where Agrahari lives. In Dharavi, there are shared toilets for dozens of families.

Offering prenatal care to women who don't realize they need it

The narrow lanes of Dharavi are a cacophony of sights, smells and regional languages from all over South Asia. Officially, the less than 1-square-mile neighborhood is home to at least a million people, but the real figure is probably way more. This is one of the first stops for migrants seeking affordable housing as they arrive in Mumbai from rural areas.

Many of the women who arrive here are pregnant and anemic.

"They are coming here for their livelihood, but many of them have no knowledge health, hygiene - or how to care for a malnourished child," says Vanita Vittal Sondhe, a social worker and program coordinator at SNEHA, a nonprofit organization that works with women, children and public health in Mumbai.

Sondhe's job is to go door to door in Dharavi, offering prenatal care to women who often don't realize they need it. She gives them information on maternal and childhood nutrition and helps them book medical appointments at Sion Hospital, a big public facility nearby.

For some of them, it's not only their first childbirth in a clinical setting. It's their first time setting foot in any hospital altogether.

"I didn't know that I should eat eggs, drink milk and consume more vegetables while I'm nursing. They told me all of that when I visited the hospital," says Shabana Khatoon, 23, who is one of Sondhe's clients.

Khatoon recently moved to Dharavi from Jharkhand, a relatively poor state in eastern India. She and her husband, who works as a tailor, have rented a single-room apartment that measures about 40 square feet for the equivalent of about $42 a month. They share the flat with their toddler and Khatoon's brother-in-law, who works as a day laborer. There's barely enough room for them all to stretch out on the floor, with their feet out the door.

Their toddler - a little girl - was born in Jharkhand and diagnosed as malnourished when she arrived in Mumbai. Now Khatoon is pregnant again.

"She is not getting a proper diet. But they are still doing better in Mumbai than in their native place," Sondhe explains. "That's why they come."

NPR asks Khatoon how many children she wants to have.

"As many as my husband wants," she replies quietly, fiddling with the bangle bracelets on her wrist.

If the child she's pregnant with now turns out to be a boy, she'd like to stop after that. But if it's a girl, she'll try to get pregnant again, she says.

A bouncing baby boy, with a blood infection

Several weeks later after our first meeting, NPR returns to visit Agrahari, the financial consultant. She's just given birth, on Nov. 9, to a baby boy. They've named him Vehant, a Hindi word meaning intelligent.

Agrahari's mother and sister are helping her take care of him. As they coo over the baby, the women marvel at how it's only recently, in their family, that women could choose how many babies to have.

"I don't think my mother had any choice over how many kids to have," says Vaishya. "Her mother-in-law - my father's mother - wanted to have the house filled with children."

"In a way, it was our grandmother's choice, how many siblings we have," Agrahari chimes in.

Her own birthing experience was painful, she says. "One is enough! I don't want to even talk about having a second baby."

Newborn Vehant developed a blood infection and was hospitalized for 10 days. He had to get injections, in the bottoms of his tiny feet, three or four times a day, Agrahari recalls.

She shudders to think what would have happened had he been born at home, like all of his ancestors before him.

"My child is so strong, so calm. He didn't flinch in the face of all these complicated procedures," she says with pride. "If we'd been in our village, I wouldn't have even known what was wrong with him."

Instead, little Vehant is now healthy and will grow up in Mumbai in a new generation of Indians - in the most populous country in the world.
NPR producer Raksha Kumar and freelance producer Sumita Chauhan both contributed to this story from Mumbai.

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This baby could push India past China to become the world's most populous country

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MUMBAI, India - In a sparse, one-room apartment on the far periphery of a booming megacity, the piercing cry of a newborn baby marks a population milestone for India. He's a boy named Vehant, born on Nov. 9 and weighing nearly 8 pounds.

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Andrew Mark Miller

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India set to overtake China as world’s most populous country in next 3 months: UN report

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India is expected to become the most populous country in the world in the next four months as China continues to struggle with declining birth rates and the coronavirus.

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Stephanie Hegarty

# data[].attributes.attachment_link.readable_text
More than half the growth we will see in the next 30 years will happen in just eight countries - the Democratic Republic of the Congo, Egypt, Ethiopia, India, Nigeria, Pakistan, the Philippines and Tanzania.

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World Population Day: India will overtake China in 2023, says the UN

# data[].attributes.attachment_link.description
More than half the growth we will see in the next 30 years will happen in just eight countries - the Democratic Republic of the Congo, Egypt, Ethiopia, India, Nigeria, Pakistan, the Philippines and Tanzania.

# data[].attributes.body
Tomas Pueyo Verified User
Located in Silicon Valley. CPO of tech unicorn Ankorstore

# data[].attributes.wish_content.attachment_props.text
India just passed China as the most populous country in the world. Why?

Because of the biggest accident in history

Look at where people live in India. What's that band up north?

# data[].attributes.wish_content.attachment_props.original_text
India just passed China as the most populous country in the world. Why?

Because of the biggest accident in history

Look at where people live in India. What's that band up north? https://t.co/91Atp9t8HL

# data[].attributes.attachment_link.embed_code
India just passed China as the most populous country in the world. Why?

Because of the biggest accident in history

Look at where people live in India. What's that band up north? pic.twitter.com/91Atp9t8HL
— Tomas Pueyo (@tomaspueyo) February 7, 2023

# data[].attributes.attachment_link.metadata.attachment_props_source.data.text
India just passed China as the most populous country in the world. Why?

Because of the biggest accident in history

Look at where people live in India. What's that band up north? https://t.co/91Atp9t8HL

# data[].attributes.attachment_link.metadata.attachment_props.original_text
India just passed China as the most populous country in the world. Why?

Because of the biggest accident in history

Look at where people live in India. What's that band up north? https://t.co/91Atp9t8HL

# data[].attributes.attachment_link.metadata.attachment_props.text
India just passed China as the most populous country in the world. Why?

Because of the biggest accident in history

Look at where people live in India. What's that band up north?