India set to lead post-pandemic baby boom: UN

India will be at the centre of a baby boom triggered by the Covid-19 outbreak, which has prompted lockdowns across the world and confined residents indoors, according to a report by the United Nations. “The pandemic could strain health care capacities for mothers and newborns,” the report by Unicef, released on Thursday, warned.

“An estimated 116 million babies will be born under the shadow of the Covid-19 pandemic,” Unicef said. This represents a spike for the period assessed. “New mothers and newborns will be greeted by harsh realities.”

India, with 20.1 million births, tops the nations with the anticipated highest numbers of births in the nine months since the World Health Organisation (WHO) on March 11 declared the outbreak pandemic, the UN body said. India declared a three-week nationwide lockdown with effect from March 25 that has since been extended twice, until May 17.

Following India will be countries such as China (13.5 million births), Nigeria (6.4 million), Pakistan (5 million) and Indonesia (4 million).

According to estimates of the United Nations Population Fund, 141 million births were recorded worldwide last year, of which 27.2 were in India.

“Covid-19 containment measures can disrupt life-saving health services such as childbirth care, putting millions of pregnant mothers and their babies at great risk,” Unicef’s executive director, Henrietta Fore, said in the global report. Developing countries are especially at risk, she said.

The UN body made projections for a 40-week period between March 11 and December 16, 2020, in its estimate based upon the WHO’s March 11 assessment that Covid-19 can be characterised as a pandemic.

India has made considerable progress in social indicators, but still lags many countries in indices such as maternal health, access to contraception and immunisation.

While India is expected to become the most populous country by 2015, the country’s population is increasing at slower pace than before. The total fertility rate -- that is the average number of children a woman has in her lifetime -- for the country currently stands at 2.2 children for every woman; it was marginally higher, at 2.3, from 2013 to 2016.

“The government’s population policy objectives are in alignment with national development goals. There is considerable campaign towards family planning and two-child norm,” an official of Niti Aayog, the government’s policy think tank, said on condition of anonymity.

According to the National Family Health Survey (NFHS-4), the prevalence rate of anaemia among Indian women has witnessed just a speck of minor improvement from 55% in 2005-06 to 53% in 2015-16.

Unicef said most of the countries which will witness a baby boom (including India) had “high neonatal mortality rates” even before the pandemic and “may see these levels increase with Covid-19 conditions”.

“That’s very true. Family welfare has got a big knockdown. Access to birth-control measures during the lockdown has been scarce. There is a high possibility of unprotected sex among spouses. Adequate resources must be reserved for a birth boom,” said Dr Sushil Sharma, a public health expert and chairman of the Arthritis Foundation of India.

According to Purushottam M Kulkarni of the Jawaharlal Nehru University, data from the NHFS shows that between 2005-06 and 2015-16 (NFHS-4), there has been little improvement in access to contraception, indicating an unmet need for contraception.

Unmet need for contraception is measured as the share of women who are fertile and want to postpone their next birth or stop childbearing altogether but don’t have access to contraception.

Even wealthier countries are affected by this crisis, the UN body said. “In the US, the sixth highest country in terms of expected number of births, over 3.3 million babies are projected to be born between March 11 and December 16. In New York, authorities are looking into alternative birthing centres as many pregnant women are worried about giving birth in hospitals.”

Even before the Covid-19 pandemic, an estimated 2.8 million pregnant women and newborns died every year, or 1 every 11 seconds, mostly of preventable causes, data from WHO show. The UN body called for allocating dedicated resources to lifesaving services and supplies for maternal and child health.

India’s maternal mortality rate (MMR) declined from 130 per 100,000 live births in 2014-2016 to 122 in 2015-2018, according to the latest data available with the National Sample Registration System.

“We still do badly, despite improvements in several indicators... Better institutional health care for newborns and mothers are even more important now,” said Abishek Jaiswal, a demographer with Allahabad University.