India’s advisory council urges end to sterilisation cash incentives as fertility drops below replacement

In a new working paper, the Economic Advisory Council to the Prime Minister warns that India’s total fertility rate has slipped to 1.9 in 2024, beneath the replacement threshold, and to 1.6 when Bihar and Uttar Pradesh are excluded. The report urges a complete rollback of direct benefit transfers linked to sterilisation—compensation for acceptors, wage-loss payments, and heightened incentives for providers and ASHAs. It also recommends eliminating motivational payments for terminal contraception methods and repealing two-child rules that restrict access to government benefits.

The council points out that roughly 80 % of incentive budgets still fund sterilisation, even in states such as Gujarat, West Bengal and Punjab where fertility has been sub-replacement for decades. It argues that family-planning policies should shift toward supporting reversible methods and natural fertility trends, especially as several southern and western states face ageing populations. The recommendations aim to align population policy with the country’s evolving demographic reality.