Tamil Nadu could consider introducing incentives to encourage couples to have more children in the future amid a declining Total Fertility Rate (TFR) and the growing challenge of an ageing population, Health Minister K G Arunraj said on Sunday.
Addressing the mid-year workshop of the Obstetrics and Gynaecological Society of South India, Arunraj expressed concern over the state’s declining fertility rate, which has fallen below 1.4, significantly lower than the replacement-level TFR of 2.1.
The minister pointed out that nearly 16 per cent of Tamil Nadu’s population is now aged above 60, describing the demographic shift as a major public health challenge. He said the government would need to examine the long-term implications of declining fertility and an ageing population and consider appropriate policy responses.
Arunraj referred to neighbouring Andhra Pradesh, where, he said, government schemes reportedly provide incentives to couples for having a third child. He indicated that Tamil Nadu could consider similar measures in the future to address the declining fertility rate.
“We were told that in places like Andhra Pradesh, there are government schemes providing incentives for couples to have a third child. Therefore, in the future, there could definitely be such things (here) too,” he said.
The minister also discussed the changing pattern of institutional deliveries in the state. While nearly 99 per cent of childbirths in Tamil Nadu currently take place in hospitals, the proportion of deliveries conducted in government facilities has declined considerably.
According to Arunraj, the share of deliveries in government hospitals fell from 65.8 per cent in 2017-18 to around 51 per cent currently. He attributed part of the decline to the expansion of private medical colleges offering free maternity care and the extension of the Muthulakshmi Reddy Maternity Benefit Scheme to private hospitals.
To reduce the financial burden on poor and middle-class families seeking treatment in private healthcare facilities, the government has also recently introduced the ‘Thaai Maaman Thangam’ scheme, he said.
The Health Department will conduct a detailed study to determine why more women are choosing private facilities despite the availability of quality maternity care in government hospitals. Arunraj noted that government facilities provide Comprehensive Emergency Obstetric and Newborn Care services.
On medical education, Arunraj criticised the previous administration for allowing three private medical colleges to obtain ‘Deemed University’ status. He alleged that the decision had affected social justice and had implications for the 7.5 per cent reservation for government school students in medical admissions.
He said the present government had acted quickly to meet the requirements of the National Medical Commission and secured 150 additional medical seats across three government medical colleges this year. The state’s medical counselling schedule and merit list, he said, would be published on August 10.
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Arunraj also warned private medical colleges against illegally collecting fees beyond the stipulated period. He said a newly constituted committee was examining complaints regarding excess fee collection and assured that strict action would be taken against institutions found violating the rules.
Responding to reports of pregnant women facing long queues at outpatient registration counters in government hospitals, the minister clarified that an Aadhaar card is not mandatory for availing treatment. No government hospital, he said, can deny treatment because a patient does not possess an Aadhaar card. He also highlighted a facility that allows patients to generate outpatient registration receipts from home using a smartphone.
On the political front, Arunraj rejected opposition allegations that the ruling government was merely renaming or rebranding welfare schemes introduced by previous administrations. He said continuity in public policies was necessary for effective governance and accused the opposition of compromising on issues of social justice and state rights by aligning with the BJP to protect its leaders from earlier corruption allegations.
Reiterating Tamil Nadu’s position on the Cauvery water dispute, Arunraj said the state government and Chief Minister C Joseph Vijay would not yield to pressure from the Centre. He said the government would remain united in protecting Tamil Nadu’s federal rights and opposing Karnataka’s proposed Mekedatu dam project.
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