India's Total Fertility Rate (TFR) as per NFHS-5 (2019–21) is 2.0. The replacement level TFR conventionally used for India is approximately 2.1. This is because:

• A The sex ratio at birth favours boys (>1.05 males per female) requiring compensation in TFR calculation
• B Population momentum from a young age structure requires TFR above 2.0 to prevent depopulation
• C Rural-urban differential in contraceptive prevalence mandates TFR adjustment
• D Each couple must have slightly more than 2 children to account for sub-fertility among a proportion of couples and female mortality before reproductive age ✓

Explanation

The replacement level TFR of approximately 2.1 (not exactly 2.0) accounts for the fact that not all female births survive to reproductive age (mortality between birth and completion of reproduction), and a small proportion of women remain childless (sub-fertility, voluntary). The extra 0.1 essentially compensates for these losses. In higher-mortality societies, replacement TFR can be 2.5 or higher. India's NFHS-5 TFR of 2.0 is below replacement, though population growth continues due to population momentum.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.