The statistic shows the 20 countries with the lowest fertility rates in 2024. All figures are estimates. In 2024, the fertility rate in Taiwan was estimated to be at 1.11 children per woman, making it the lowest fertility rate worldwide. Fertility rate The fertility rate is the average number of children born per woman of child-bearing age in a country. Usually, a woman aged between 15 and 45 is considered to be in her child-bearing years. The fertility rate of a country provides an insight into its economic state, as well as the level of health and education of its population. Developing countries usually have a higher fertility rate due to lack of access to birth control and contraception, and to women usually foregoing a higher education, or even any education at all, in favor of taking care of housework. Many families in poorer countries also need their children to help provide for the family by starting to work early and/or as caretakers for their parents in old age. In developed countries, fertility rates and birth rates are usually much lower, as birth control is easier to obtain and women often choose a career before becoming a mother. Additionally, if the number of women of child-bearing age declines, so does the fertility rate of a country. As can be seen above, countries like Hong Kong are a good example for women leaving the patriarchal structures and focusing on their own career instead of becoming a mother at a young age, causing a decline of the country’s fertility rate. A look at the fertility rate per woman worldwide by income group also shows that women with a low income tend to have more children than those with a high income. The United States are neither among the countries with the lowest, nor among those with the highest fertility rate, by the way. At 2.08 children per woman, the fertility rate in the US has been continuously slightly below the global average of about 2.4 children per woman over the last decade.

The total fertility rate of the world has dropped from around 5 children per woman in 1950, to 2.2 children per woman in 2025, which means that women today are having fewer than half the number of children that women did 75 years ago. Replacement level fertility This change has come as a result of the global demographic transition, and is influenced by factors such as the significant reduction in infant and child mortality, reduced number of child marriages, increased educational and vocational opportunities for women, and the increased efficacy and availability of contraception. While this change has become synonymous with societal progress, it does have wide-reaching demographic impact - if the global average falls below replacement level (roughly 2.1 children per woman), as is expected to happen in the 2050s, then this will lead to long-term population decline on a global scale. Regional variations When broken down by continent, Africa is the only region with a fertility rate above the global average, and, alongside Oceania, it is the only region with a fertility rate above replacement level. Until the 1980s, the average woman in Africa could expect to have 6-7 children over the course of their lifetime, and there are still several countries in Africa where women can still expect to have 5 or more children in 2025. Historically, Europe has had the lowest fertility rates in the world over the past century, falling below replacement level in 1975. Europe's population has grown through a combination of migration and increasing life expectancy, however even high immigration rates could not prevent its population from going into decline in 2021.

In 2025, there are six countries, all in Sub-Saharan Africa, where the average woman of childbearing age can expect to have between 5-6 children throughout their lifetime. In fact, of the 20 countries in the world with the highest fertility rates, Afghanistan and Yemen are the only countries not found in Sub-Saharan Africa. High fertility rates in Africa With a fertility rate of almost six children per woman, Chad is the country with the highest fertility rate in the world. Population growth in Chad is among the highest in the world. Lack of healthcare access, as well as food instability, political instability, and climate change, are all exacerbating conditions that keep Chad's infant mortality rates high, which is generally the driver behind high fertility rates. This situation is common across much of the continent, and, although there has been considerable progress in recent decades, development in Sub-Saharan Africa is not moving as quickly as it did in other regions. Demographic transition While these countries have the highest fertility rates in the world, their rates are all on a generally downward trajectory due to a phenomenon known as the demographic transition. The third stage (of five) of this transition sees birth rates drop in response to decreased infant and child mortality, as families no longer feel the need to compensate for lost children. Eventually, fertility rates fall below replacement level (approximately 2.1 children per woman), which eventually leads to natural population decline once life expectancy plateaus. In some of the most developed countries today, low fertility rates are creating severe econoic and societal challenges as workforces are shrinking while aging populations are placin a greater burden on both public and personal resources.

Japan’s ongoing struggle with rapid ageing is well known. Fertility and migration policies have both been proposed as solutions to Japan’s ageing population. We used stock flow population models to estimate the impact of hypothetical fertility and migration policy interventions on measures of aging in Japan from 2015 to 2050. We evaluated policy models based on the Old Age Dependency Ratio (OADR) they produced at the specified end date. Start dates ranged from 2020 to 2030 to assess the time horizons of individual policies. Fertility policies were found to be highly time dependent and only slowed the rate of increase of OADR. It would require a Total Fertility Rate far above replacement levels to compensate for Japan’s already aged demography. Migration policy was less time dependent. However, such measures would require unprecedented, and ultimately unrealistic, volumes of migration over coming decades in order to reduce Japan’s OADR. Our results suggest that fertility and migration based policy responses will be unable to significantly reduce Japan’s OADR or reverse Japan’s ageing population within the next few decades. Japan should focus on activating its human capital through the prolongation of working lives, increasing participation, and improving productivity within the Japanese labour force to mitigate and adapt to the inevitable effects of ageing populations.

This statistic shows the total population of Brazil from 2020 to 2023, with a forecast through 2030. In 2023, the total population of Brazil was estimated at around 211.7 million inhabitants. Population of Brazil Brazil has a surprisingly low (and decreasing) population growth rate; despite it being home to the largest number of Catholics in the world, the majority of women in Brazil use some form of contraception, which is often government-subsidized or free, even though the Catholic Church retains its stance that the use of contraceptives is inherently wrong. Within the space of just one generation, families have gone from having more than six children to having just one or two, and the share of Catholics in the population is dwindling, too. The influence of 'telenovelas' — the overwhelmingly popular soap operas often with strong women figures and fewer than three children — could also be helping shape the population’s view of what an ideal family is. The fertility rate in Brazil fell below the replacement rate in 2006 and is still decreasing. The impending population imbalance in Brazil can be seen in the decreasing lower tier of the country’s age distribution. This follows a trend similar to the one Japan and many European countries are experiencing, which are now facing the problems of providing for an aging population with fewer young and working taxpayers. The trend is not quite as extreme in Brazil, giving it time to prepare for the fallout of decreasing family size. This preparation will be important to help the country maintain its emerging economic strength, which is watched with interest by many economists who have said that Brazil’s is one to watch — thus its position as one of the pillars of the “big four” BRIC countries.

The 2006-07 Sri Lanka Demographic and Health Survey (SLDHS) is the fourth in a series of DHS surveys to be held in Sri Lanka-the first three having been implemented in 1987, 1993, and 2000. Teams visited 2,106 sample points across Sri Lanka and collected data from a nationally representative sample of almost 20,000 households and over 14,700 women age 15-49. A nationally representative sample of 21,600 housing units was selected for the survey and 19,872 households were enumerated to give district level estimates (excluding Northern Province). Detailed information was collected from all ever-married women aged 15-49 years and about their children below five years at the time of the survey. Within the households interviewed, a total of 15,068 eligible women were identified, of whom 14,692 were successfully interviewed. The Department of Census and Statistics (DCS) carried out the 2006-07 SLDHS for the Health Sector Development Project (HSDP) of the Ministry of Healthcare and Nutrition, a project funded by the World Bank. The objective of the survey is to provide data needed to monitor and evaluate the impact of population, health, and nutrition programmes implemented by different government agencies. Additionally, it also aims to measure the impact of interventions made under the HSDP towards improving the quality and efficiency of health care services as a whole. All 25 districts of Sri Lanka were included at the design stage. The final sample has only 20 districts, however, after dropping the 5 districts of the Northern Province (Jaffna, Kilinochchi, Mannar, Vavuniya, and Mullativu), due to the security situation there. OBJECTIVES The objective of this report is to publish the final findings of the 2006-07 SLDHS. This final report provides information mainly on background characteristics of respondents, fertility, reproductive health and maternal care, child health, nutrition, women's empowerment, and awareness of HIV/AIDS and prevention. It is expected that the content of this report will satisfy the urgent needs of users of this information. MAIN RESULTS FERTILITY Survey results indicate that there has been a slight upturn in the total fertility rate since the 2000 SLDHS. The total fertility rate for Sri Lanka is 2.3, meaning that, if current age-specific fertility rates were to remain unchanged in the future, a woman in Sri Lanka would have an average of 2.3 children by the end of her childbearing period. This is somewhat higher than the total fertility rate of 1.9 measured in the 2000 SLDHS. Fertility is only slightly lower in urban areas than in rural areas (2.2 and 2.3 children per woman, respectively); however, it is higher in the estate areas (2.5 children per woman). Interpretation of variations in fertility by administrative districts is limited by the small samples in some districts. Nevertheless, results indicate that Galle and Puttalam districts have fertility rates of 2.1 or below, which is at what is known as ?replacement level? fertility, i.e., the level that is necessary to maintain population size over time. Differences in fertility by level of women's education and a measure of relative wealth status are minimal. FAMILY PLANNING According to the survey findings, knowledge of any method of family planning is almost universal in Sri Lanka and there are almost no differences between ever-married and currently married women. Over 90 percent of currently married women have heard about pills, injectables, female sterilization, and the IUD. Eight out of ten respondents know about some traditional method of delaying or avoiding pregnancies. Although the proportion of currently married women who have heard of at least one method of family planning has been high for some time, knowledge of some specific methods has increased recently. Since 1993, knowledge of implants has increased five-fold-from about 10 percent in 1993 to over 50 percent in 2006-07. Awareness about pill, IUD, injectables, implants, and withdrawal has also increased. On the other hand, awareness of male sterilization has dropped by 14 percentage points. CHILD HEALTH The study of infant and child mortality is critical for assessment of population and health policies and programmes. Infant and child mortality rates are also regarded as indices reflecting the degree of poverty and deprivation of a population. Survey data show that for the most recent five-year period before the survey, the infant mortality rate is 15 deaths per 1,000 live births and under-five mortality is 21 deaths per 1,000 live births. Thus, one in every 48 Sri Lankan children dies before reaching age five. The neonatal mortality rate is 11 deaths per 1,000 live births and the postneonatal mortality rate is 5 deaths per 1,000 live births. The child mortality rate is 5 deaths per 1,000 children surviving to age one year. REPRODUCTIVE HEALTH The survey shows that virtually all mothers (99 percent) in Sri Lanka receive antenatal care from a health professional (doctor specialist, doctor, or midwife). The proportion receiving care from a skilled provider is remarkably uniform across all categories for age, residence, district, woman's education, and household wealth quintile. Even in the estate sector, antenatal care usage is at the same high level. Although doctors are the most frequently seen provider (96 percent), women also go to public health midwives often for prenatal care (44 percent). BREASTFEEDING AND NUTRITION Poor nutritional status is one of the most important health and welfare problems facing Sri Lanka today and particularly affects women and children. The survey data show that 17 percent of children under five are stunted or short for their age, while 15 percent of children under five are wasted or too thin for their height. Overall, 21 percent of children are underweight, which may reflect stunting, wasting, or both. As for women, at the national level, 16 percent of women are considered to be thin (with a body mass index < 18.5); however, only 6 percent of women are considered to be moderately or severely thin. Poor breastfeeding and infant feeding practices can have adverse consequences for the health and nutritional status of children. Fortunately, breastfeeding in Sri Lanka is universal and generally of fairly long duration; 97 percent of newborns are breastfed within one day after delivery and 76 percent of infants under 6 months are exclusively breastfed, lower than the recommended 100 percent exclusive breastfeeding for children under 6 months. The median duration of any breastfeeding is 33 months in Sri Lanka and the median duration of exclusive breastfeeding is 5 months. HIV/AIDS The HIV/AIDS pandemic is a serious health concern in the world today because of its high case fatality rate and the lack of a cure. Awareness of AIDS is almost universal among Sri Lankan adults, with 92 percent of ever-married women saying that they have heard about AIDS. Nevertheless, only 22 percent of ever-married women are classified as having ?comprehensive knowledge? about AIDS, i.e., knowing that consistent use of condoms and having just one faithful partner can reduce the chance of getting infected, knowing that a healthy-looking person can be infected, and knowing that AIDS cannot be transmitted by sharing food or by mosquito bites. Such a low level of knowledge about AIDS implies that a concerted effort is needed to address misconceptions about HIV transmission. Programs might be focused in the estate sector and especially in Batticaloa, Ampara, and Nuwara Eliya districts where comprehensive knowledge is lowest. Moreover, a composite indicator on stigma towards HIV-infected people shows that only 8 percent of ever-married women expressed accepting attitudes toward persons living with HIV/AIDS. Overall, only about one- half of ever-married women age 15-49 years know where to get an HIV test. WOMEN'S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES The 2006-07 SLDHS collected data on women's empowerment, their participation in decisionmaking, and attitudes towards wife beating. Survey results show that more than 90 percent of currently married women, either alone or jointly with their husband, make decisions on how their income is used. However, husbands' control over women's earnings is higher among women with no education (15 percent) than among women with higher education (4 percent). In Sri Lanka, the husband is usually the main source of household income; two-thirds of women earn less than their husband. Although the majority of women earn less than their husband, almost half have autonomy in decisions about how to spend their earnings. The survey also collected information on who decides how the husband's cash earnings are spent. The majority of couples (60 percent) make joint decisions on how the husband's cash income is used. More than 1 in 5 women (23 percent) reported that they decide how their husband's earnings are used; another 16 percent of the women reported that their husband mainly decides how his earnings are spent.

Admissions to hospital of patients where a primary knee replacement is undertaken. The purpose of the indicator is to help monitor the level of provision of an operative procedure known to confer benefit in terms of improved mobility and pain relief to people with knee joint problems. This indicator has been discontinued and so there will be no further updates. Legacy unique identifier: P00824

Abstract

The second National Family Health Survey (NFHS-2), conducted in 1998-99, provides information on fertility, mortality, family planning, and important aspects of nutrition, health, and health care. The International Institute for Population Sciences (IIPS) coordinated the survey, which collected information from a nationally representative sample of more than 90,000 ever-married women age 15-49. The NFHS-2 sample covers 99 percent of India's population living in all 26 states. This report is based on the survey data for 25 of the 26 states, however, since data collection in Tripura was delayed due to local problems in the state.

IIPS also coordinated the first National Family Health Survey (NFHS-1) in 1992-93. Most of the types of information collected in NFHS-2 were also collected in the earlier survey, making it possible to identify trends over the intervening period of six and one-half years. In addition, the NFHS-2 questionnaire covered a number of new or expanded topics with important policy implications, such as reproductive health, women's autonomy, domestic violence, women's nutrition, anaemia, and salt iodization.

The NFHS-2 survey was carried out in two phases. Ten states were surveyed in the first phase which began in November 1998 and the remaining states (except Tripura) were surveyed in the second phase which began in March 1999. The field staff collected information from 91,196 households in these 25 states and interviewed 89,199 eligible women in these households. In addition, the survey collected information on 32,393 children born in the three years preceding the survey. One health investigator on each survey team measured the height and weight of eligible women and children and took blood samples to assess the prevalence of anaemia.

SUMMARY OF FINDINGS

POPULATION CHARACTERISTICS

Three-quarters (73 percent) of the population lives in rural areas. The age distribution is typical of populations that have recently experienced a fertility decline, with relatively low proportions in the younger and older age groups. Thirty-six percent of the population is below age 15, and 5 percent is age 65 and above. The sex ratio is 957 females for every 1,000 males in rural areas but only 928 females for every 1,000 males in urban areas, suggesting that more men than women have migrated to urban areas.

The survey provides a variety of demographic and socioeconomic background information. In the country as a whole, 82 percent of household heads are Hindu, 12 percent are Muslim, 3 percent are Christian, and 2 percent are Sikh. Muslims live disproportionately in urban areas, where they comprise 15 percent of household heads. Nineteen percent of household heads belong to scheduled castes, 9 percent belong to scheduled tribes, and 32 percent belong to other backward classes (OBCs). Two-fifths of household heads do not belong to any of these groups.

Questions about housing conditions and the standard of living of households indicate some improvements since the time of NFHS-1. Sixty percent of households in India now have electricity and 39 percent have piped drinking water compared with 51 percent and 33 percent, respectively, at the time of NFHS-1. Sixty-four percent of households have no toilet facility compared with 70 percent at the time of NFHS-1.

About three-fourths (75 percent) of males and half (51 percent) of females age six and above are literate, an increase of 6-8 percentage points from literacy rates at the time of NFHS-1. The percentage of illiterate males varies from 6-7 percent in Mizoram and Kerala to 37 percent in Bihar and the percentage of illiterate females varies from 11 percent in Mizoram and 15 percent in Kerala to 65 percent in Bihar. Seventy-nine percent of children age 6-14 are attending school, up from 68 percent in NFHS-1. The proportion of children attending school has increased for all ages, particularly for girls, but girls continue to lag behind boys in school attendance. Moreover, the disparity in school attendance by sex grows with increasing age of children. At age 6-10, 85 percent of boys attend school compared with 78 percent of girls. By age 15-17, 58 percent of boys attend school compared with 40 percent of girls. The percentage of girls 6-17 attending school varies from 51 percent in Bihar and 56 percent in Rajasthan to over 90 percent in Himachal Pradesh and Kerala.

Women in India tend to marry at an early age. Thirty-four percent of women age 15-19 are already married including 4 percent who are married but gauna has yet to be performed. These proportions are even higher in the rural areas. Older women are more likely than younger women to have married at an early age: 39 percent of women currently age 45-49 married before age 15 compared with 14 percent of women currently age 15-19. Although this indicates that the proportion of women who marry young is declining rapidly, half the women even in the age group 20-24 have married before reaching the legal minimum age of 18 years. On average, women are five years younger than the men they marry. The median age at marriage varies from about 15 years in Madhya Pradesh, Bihar, Uttar Pradesh, Rajasthan, and Andhra Pradesh to 23 years in Goa.

As part of an increasing emphasis on gender issues, NFHS-2 asked women about their participation in household decisionmaking. In India, 91 percent of women are involved in decision-making on at least one of four selected topics. A much lower proportion (52 percent), however, are involved in making decisions about their own health care. There are large variations among states in India with regard to women's involvement in household decisionmaking. More than three out of four women are involved in decisions about their own health care in Himachal Pradesh, Meghalaya, and Punjab compared with about two out of five or less in Madhya Pradesh, Orissa, and Rajasthan. Thirty-nine percent of women do work other than housework, and more than two-thirds of these women work for cash. Only 41 percent of women who earn cash can decide independently how to spend the money that they earn. Forty-three percent of working women report that their earnings constitute at least half of total family earnings, including 18 percent who report that the family is entirely dependent on their earnings. Women's work-participation rates vary from 9 percent in Punjab and 13 percent in Haryana to 60-70 percent in Manipur, Nagaland, and Arunachal Pradesh.

FERTILITY AND FAMILY PLANNING

Fertility continues to decline in India. At current fertility levels, women will have an average of 2.9 children each throughout their childbearing years. The total fertility rate (TFR) is down from 3.4 children per woman at the time of NFHS-1, but is still well above the replacement level of just over two children per woman. There are large variations in fertility among the states in India. Goa and Kerala have attained below replacement level fertility and Karnataka, Himachal Pradesh, Tamil Nadu, and Punjab are at or close to replacement level fertility. By contrast, fertility is 3.3 or more children per woman in Meghalaya, Uttar Pradesh, Rajasthan, Nagaland, Bihar, and Madhya Pradesh. More than one-third to less than half of all births in these latter states are fourth or higher-order births compared with 7-9 percent of births in Kerala, Goa, and Tamil Nadu.

Efforts to encourage the trend towards lower fertility might usefully focus on groups within the population that have higher fertility than average. In India, rural women and women from scheduled tribes and scheduled castes have somewhat higher fertility than other women, but fertility is particularly high for illiterate women, poor women, and Muslim women. Another striking feature is the high level of childbearing among young women. More than half of women age 20-49 had their first birth before reaching age 20, and women age 15-19 account for almost one-fifth of total fertility. Studies in India and elsewhere have shown that health and mortality risks increase when women give birth at such young ages?both for the women themselves and for their children. Family planning programmes focusing on women in this age group could make a significant impact on maternal and child health and help to reduce fertility.

INFANT AND CHILD MORTALITY

NFHS-2 provides estimates of infant and child mortality and examines factors associated with the survival of young children. During the five years preceding the survey, the infant mortality rate was 68 deaths at age 0-11 months per 1,000 live births, substantially lower than 79 per 1,000 in the five years preceding the NFHS-1 survey. The child mortality rate, 29 deaths at age 1-4 years per 1,000 children reaching age one, also declined from the corresponding rate of 33 per 1,000 in NFHS-1. Ninety-five children out of 1,000 born do not live to age five years. Expressed differently, 1 in 15 children die in the first year of life, and 1 in 11 die before reaching age five. Child-survival programmes might usefully focus on specific groups of children with particularly high infant and child mortality rates, such as children who live in rural areas, children whose mothers are illiterate, children belonging to scheduled castes or scheduled tribes, and children from poor households. Infant mortality rates are more than two and one-half times as high for women who did not receive any of the recommended types of maternity related medical care than for mothers who did receive all recommended types of care.

HEALTH, HEALTH CARE, AND NUTRITION

Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. One goal is for each pregnant woman to receive at least three antenatal check-ups plus two tetanus toxoid injections and a full course of iron and folic acid supplementation. In India, mothers of 65 percent of the children

The second National Family Health Survey (NFHS-2), conducted in 1998-99, provides information on fertility, mortality, family planning, and important aspects of nutrition, health, and health care. The International Institute for Population Sciences (IIPS) coordinated the survey, which collected information from a nationally representative sample of more than 90,000 ever-married women age 15-49. The NFHS-2 sample covers 99 percent of India's population living in all 26 states. This report is based on the survey data for 25 of the 26 states, however, since data collection in Tripura was delayed due to local problems in the state. IIPS also coordinated the first National Family Health Survey (NFHS-1) in 1992-93. Most of the types of information collected in NFHS-2 were also collected in the earlier survey, making it possible to identify trends over the intervening period of six and one-half years. In addition, the NFHS-2 questionnaire covered a number of new or expanded topics with important policy implications, such as reproductive health, women's autonomy, domestic violence, women's nutrition, anaemia, and salt iodization. The NFHS-2 survey was carried out in two phases. Ten states were surveyed in the first phase which began in November 1998 and the remaining states (except Tripura) were surveyed in the second phase which began in March 1999. The field staff collected information from 91,196 households in these 25 states and interviewed 89,199 eligible women in these households. In addition, the survey collected information on 32,393 children born in the three years preceding the survey. One health investigator on each survey team measured the height and weight of eligible women and children and took blood samples to assess the prevalence of anaemia. SUMMARY OF FINDINGS POPULATION CHARACTERISTICS Three-quarters (73 percent) of the population lives in rural areas. The age distribution is typical of populations that have recently experienced a fertility decline, with relatively low proportions in the younger and older age groups. Thirty-six percent of the population is below age 15, and 5 percent is age 65 and above. The sex ratio is 957 females for every 1,000 males in rural areas but only 928 females for every 1,000 males in urban areas, suggesting that more men than women have migrated to urban areas. The survey provides a variety of demographic and socioeconomic background information. In the country as a whole, 82 percent of household heads are Hindu, 12 percent are Muslim, 3 percent are Christian, and 2 percent are Sikh. Muslims live disproportionately in urban areas, where they comprise 15 percent of household heads. Nineteen percent of household heads belong to scheduled castes, 9 percent belong to scheduled tribes, and 32 percent belong to other backward classes (OBCs). Two-fifths of household heads do not belong to any of these groups. Questions about housing conditions and the standard of living of households indicate some improvements since the time of NFHS-1. Sixty percent of households in India now have electricity and 39 percent have piped drinking water compared with 51 percent and 33 percent, respectively, at the time of NFHS-1. Sixty-four percent of households have no toilet facility compared with 70 percent at the time of NFHS-1. About three-fourths (75 percent) of males and half (51 percent) of females age six and above are literate, an increase of 6-8 percentage points from literacy rates at the time of NFHS-1. The percentage of illiterate males varies from 6-7 percent in Mizoram and Kerala to 37 percent in Bihar and the percentage of illiterate females varies from 11 percent in Mizoram and 15 percent in Kerala to 65 percent in Bihar. Seventy-nine percent of children age 6-14 are attending school, up from 68 percent in NFHS-1. The proportion of children attending school has increased for all ages, particularly for girls, but girls continue to lag behind boys in school attendance. Moreover, the disparity in school attendance by sex grows with increasing age of children. At age 6-10, 85 percent of boys attend school compared with 78 percent of girls. By age 15-17, 58 percent of boys attend school compared with 40 percent of girls. The percentage of girls 6-17 attending school varies from 51 percent in Bihar and 56 percent in Rajasthan to over 90 percent in Himachal Pradesh and Kerala. Women in India tend to marry at an early age. Thirty-four percent of women age 15-19 are already married including 4 percent who are married but gauna has yet to be performed. These proportions are even higher in the rural areas. Older women are more likely than younger women to have married at an early age: 39 percent of women currently age 45-49 married before age 15 compared with 14 percent of women currently age 15-19. Although this indicates that the proportion of women who marry young is declining rapidly, half the women even in the age group 20-24 have married before reaching the legal minimum age of 18 years. On average, women are five years younger than the men they marry. The median age at marriage varies from about 15 years in Madhya Pradesh, Bihar, Uttar Pradesh, Rajasthan, and Andhra Pradesh to 23 years in Goa. As part of an increasing emphasis on gender issues, NFHS-2 asked women about their participation in household decisionmaking. In India, 91 percent of women are involved in decision-making on at least one of four selected topics. A much lower proportion (52 percent), however, are involved in making decisions about their own health care. There are large variations among states in India with regard to women's involvement in household decisionmaking. More than three out of four women are involved in decisions about their own health care in Himachal Pradesh, Meghalaya, and Punjab compared with about two out of five or less in Madhya Pradesh, Orissa, and Rajasthan. Thirty-nine percent of women do work other than housework, and more than two-thirds of these women work for cash. Only 41 percent of women who earn cash can decide independently how to spend the money that they earn. Forty-three percent of working women report that their earnings constitute at least half of total family earnings, including 18 percent who report that the family is entirely dependent on their earnings. Women's work-participation rates vary from 9 percent in Punjab and 13 percent in Haryana to 60-70 percent in Manipur, Nagaland, and Arunachal Pradesh. FERTILITY AND FAMILY PLANNING Fertility continues to decline in India. At current fertility levels, women will have an average of 2.9 children each throughout their childbearing years. The total fertility rate (TFR) is down from 3.4 children per woman at the time of NFHS-1, but is still well above the replacement level of just over two children per woman. There are large variations in fertility among the states in India. Goa and Kerala have attained below replacement level fertility and Karnataka, Himachal Pradesh, Tamil Nadu, and Punjab are at or close to replacement level fertility. By contrast, fertility is 3.3 or more children per woman in Meghalaya, Uttar Pradesh, Rajasthan, Nagaland, Bihar, and Madhya Pradesh. More than one-third to less than half of all births in these latter states are fourth or higher-order births compared with 7-9 percent of births in Kerala, Goa, and Tamil Nadu. Efforts to encourage the trend towards lower fertility might usefully focus on groups within the population that have higher fertility than average. In India, rural women and women from scheduled tribes and scheduled castes have somewhat higher fertility than other women, but fertility is particularly high for illiterate women, poor women, and Muslim women. Another striking feature is the high level of childbearing among young women. More than half of women age 20-49 had their first birth before reaching age 20, and women age 15-19 account for almost one-fifth of total fertility. Studies in India and elsewhere have shown that health and mortality risks increase when women give birth at such young ages?both for the women themselves and for their children. Family planning programmes focusing on women in this age group could make a significant impact on maternal and child health and help to reduce fertility. INFANT AND CHILD MORTALITY NFHS-2 provides estimates of infant and child mortality and examines factors associated with the survival of young children. During the five years preceding the survey, the infant mortality rate was 68 deaths at age 0-11 months per 1,000 live births, substantially lower than 79 per 1,000 in the five years preceding the NFHS-1 survey. The child mortality rate, 29 deaths at age 1-4 years per 1,000 children reaching age one, also declined from the corresponding rate of 33 per 1,000 in NFHS-1. Ninety-five children out of 1,000 born do not live to age five years. Expressed differently, 1 in 15 children die in the first year of life, and 1 in 11 die before reaching age five. Child-survival programmes might usefully focus on specific groups of children with particularly high infant and child mortality rates, such as children who live in rural areas, children whose mothers are illiterate, children belonging to scheduled castes or scheduled tribes, and children from poor households. Infant mortality rates are more than two and one-half times as high for women who did not receive any of the recommended types of maternity related medical care than for mothers who did receive all recommended types of care. HEALTH, HEALTH CARE, AND NUTRITION Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. One goal is for each pregnant woman to receive at least three antenatal check-ups plus two tetanus toxoid injections and a full course of iron and folic acid supplementation. In India, mothers of 65 percent of the children born in the three years preceding NFHS-2 received at least one antenatal

The statistic shows the total population of India from 2019 to 2029. In 2023, the estimated total population in India amounted to approximately 1.43 billion people.

Total population in India

India currently has the second-largest population in the world and is projected to overtake top-ranking China within forty years. Its residents comprise more than one-seventh of the entire world’s population, and despite a slowly decreasing fertility rate (which still exceeds the replacement rate and keeps the median age of the population relatively low), an increasing life expectancy adds to an expanding population. In comparison with other countries whose populations are decreasing, such as Japan, India has a relatively small share of aged population, which indicates the probability of lower death rates and higher retention of the existing population.

With a land mass of less than half that of the United States and a population almost four times greater, India has recognized potential problems of its growing population. Government attempts to implement family planning programs have achieved varying degrees of success. Initiatives such as sterilization programs in the 1970s have been blamed for creating general antipathy to family planning, but the combined efforts of various family planning and contraception programs have helped halve fertility rates since the 1960s. The population growth rate has correspondingly shrunk as well, but has not yet reached less than one percent growth per year.

As home to thousands of ethnic groups, hundreds of languages, and numerous religions, a cohesive and broadly-supported effort to reduce population growth is difficult to create. Despite that, India is one country to watch in coming years. It is also a growing economic power; among other measures, its GDP per capita was expected to triple between 2003 and 2013 and was listed as the third-ranked country for its share of the global gross domestic product.

Admissions to hospital of patients where a primary hip replacement is undertaken. The purpose of the indicator is to help monitor the level of provision of operative procedures known to confer benefit in terms of improved mobility and pain relief to people with hip joint problems. This indicator has been discontinued and so there will be no further updates. Legacy unique identifier: P00574

In 2021/22, it was found that nearly ** percent of patients who underwent a hip replacement procedure in England felt that their hip problems were much better afterward, a further ***** percent would rate their problems as a little better. On the other hand, *** percent of respondents reported feeling much worse after the hip replacement surgery.

According to Cognitive Market Research, the global Knee implant Market size will be USD 8264.5 million in 2025. It will expand at a compound annual growth rate (CAGR) of 4.00% from 2025 to 2033.

North America held the major market share for more than 40% of the global revenue with a market size of USD 3057.87 million in 2025 and will grow at a compound annual growth rate (CAGR) of 2.5% from 2025 to 2033.
Europe accounted for a market share of over 30% of the global revenue with a market size of USD 13056.48 million.
APAC held a market share of around 23% of the global revenue with a market size of USD 1983.48 million in 2025 and will grow at a compound annual growth rate (CAGR) of 6.6% from 2025 to 2033.
South America has a market share of more than 5% of the global revenue with a market size of USD 314.05 million in 2025 and will grow at a compound annual growth rate (CAGR) of 4.7% from 2025 to 2033.
The Middle East had a market share of around 2% of the global revenue and was estimated at a market size of USD 330.58 million in 2025 and will grow at a compound annual growth rate (CAGR) of 5.2% from 2025 to 2033.
Africa had a market share of around 1% of the global revenue and was estimated at a market size of USD 181.82 million in 2025 and will grow at a compound annual growth rate (CAGR) of 4.3% from 2025 to 2033.
Total Knee Replacement category is the fastest growing segment of the Knee implant Market industry

Market Dynamics of Knee implant Market

Key Drivers for Knee implant Market

Increasing elderly population drives demand for knee implants due to higher prevalence of osteoarthritis

The increasing elderly population is a major driver of the knee implant market, as aging is a key risk factor for osteoarthritis, the leading cause of knee degeneration. With advancements in healthcare and rising life expectancy, the global geriatric population is growing rapidly, particularly in developed nations. Older individuals are more prone to joint deterioration due to years of wear and tear, reduced cartilage regeneration, and increased prevalence of obesity, further exacerbating knee-related issues. As mobility plays a crucial role in maintaining quality of life, many elderly patients opt for knee replacement surgeries to relieve pain and regain functionality. Additionally, improvements in implant technology, such as minimally invasive procedures and longer-lasting materials, make knee replacement a more viable option for aging patients. The rising awareness of treatment options, coupled with better access to healthcare services, also contributes to increased demand.

Innovations in implant materials and robotic-assisted surgeries enhance market growth

As innovations in implant materials and advancements in robotic-assisted surgeries. The development of biocompatible and durable materials, such as titanium alloys, cobalt-chromium, and highly cross-linked polyethylene, has improved implant longevity and reduced wear, leading to better patient outcomes and lower revision rates. Additionally, the integration of smart implants with sensors for real-time data monitoring is revolutionizing post-surgical care. Robotic-assisted knee replacement surgeries further enhance market expansion by increasing precision, minimizing surgical errors, and improving implant alignment, which contributes to faster recovery times and reduced complications. These robotic systems enable personalized procedures by leveraging AI-driven preoperative planning and intraoperative guidance, ensuring optimal fit and functionality.

Restraint Factor for the Knee Implant Market

Expensive implants and surgical procedures limit accessibility

The high cost of implants and the associated surgical procedures. Advanced knee implants, particularly those made from high-quality materials like titanium or cobalt-chromium alloys, come at a premium price, often making them unaffordable for many patients, especially in developing regions. Additionally, the overall cost of knee replacement surgery, including hospital stays, surgeon fees, post-operative care, and rehabilitation, further restricts access. Many healthcare systems struggle with reimbursement limitations, forcing patients to bear out-of-pocket expenses, which can be prohibitive. In countries with inadequate insurance coverage, the financial burden discourages individuals from opting for the procedure, even when medically necessary. Moreover, pricing dispari...

Admissions to hospital of patients where a primary knee replacement is undertaken. The purpose of the indicator is to help monitor the level of provision of an operative procedure known to confer benefit in terms of improved mobility and pain relief to people with knee joint problems. This indicator has been discontinued and so there will be no further updates. Legacy unique identifier: P00826

The statistic shows the total population in the United Kingdom from 2015 to 2019, with projections up until 2025. The population grew steadily over this period.

Population of the United Kingdom

Despite a fertility rate just below the replacement rate, the United Kingdom’s population has been slowly but steadily growing, increasing by an average of 0.6 percent every year since 2002. The age distribution has remained roughly the same for the past ten years or so, with the share of the population over 65 years old seeing a slight increase as the baby boomer generation enters into that age bracket. That share is likely to continue growing slightly, as the United Kingdom has one of the highest life expectancies in the world.

The population of the island nation is predominantly white Christians, but a steady net influx of immigrants, part of a legacy of the wide-reaching former British Empire, has helped diversify the population. One of the largest ethnic minorities in the United Kingdom is that of residents of an Indian background, born either in the UK, India, or in other parts of the world. India itself is experiencing problems with rapid population growth, causing some of its population to leave the country in order to find employment. The United Kingdom’s relatively lower levels of unemployment and the historical connection between the two countries (which has also resulted in family connections between individuals) are likely reasons that make it a popular destination for Indian emigrants.

In the period 2021/22, a survey carried out in England found that around ** percent of patients who underwent a knee replacement procedure felt their problems were much better than before, while a further ** percent felt a little better post-surgery. On the other hand, around *** percent of patients reported feeling much worse after their knee replacement surgery.

Over the last decade, Japan’s population has aged more and more, to the point where more than a quarter of Japanese were 65 years and older in 2022. Population growth has stopped and even reversed, since it’s been in the red for several years now.

It’s getting old

With almost 30 percent of its population being elderly inhabitants, Japan is considered the “oldest” country in the world today. Japan boasts a high life expectancy, in fact, the Japanese tend to live longer than the average human worldwide. The increase of the aging population is accompanied by a decrease of the total population caused by a sinking birth rate. Japan’s fertility rate has been below the replacement rate for many decades now, mostly due to economic uncertainty and thus a decreasing number of marriages.

Are the Japanese invincible?

There is no real mystery surrounding the ripe old age of so many Japanese. Their high average age is very likely due to high healthcare standards, nutrition, and an overall high standard of living – all of which could be adopted by other industrial nations as well. But with high age comes less capacity, and Japan’s future enemy might not be an early death, but rather a struggling social network.

In 1800, the population of Japan was just over 30 million, a figure which would grow by just two million in the first half of the 19th century. However, with the fall of the Tokugawa shogunate and the restoration of the emperor in the Meiji Restoration of 1868, Japan would begin transforming from an isolated feudal island, to a modernized empire built on Western models. The Meiji period would see a rapid rise in the population of Japan, as industrialization and advancements in healthcare lead to a significant reduction in child mortality rates, while the creation overseas colonies would lead to a strong economic boom. However, this growth would slow beginning in 1937, as Japan entered a prolonged war with the Republic of China, which later grew into a major theater of the Second World War. The war was eventually brought to Japan's home front, with the escalation of Allied air raids on Japanese urban centers from 1944 onwards (Tokyo was the most-bombed city of the Second World War). By the war's end in 1945 and the subsequent occupation of the island by the Allied military, Japan had suffered over two and a half million military fatalities, and over one million civilian deaths.

The population figures of Japan were quick to recover, as the post-war “economic miracle” would see an unprecedented expansion of the Japanese economy, and would lead to the country becoming one of the first fully industrialized nations in East Asia. As living standards rose, the population of Japan would increase from 77 million in 1945, to over 127 million by the end of the century. However, growth would begin to slow in the late 1980s, as birth rates and migration rates fell, and Japan eventually grew to have one of the oldest populations in the world. The population would peak in 2008 at just over 128 million, but has consistently fallen each year since then, as the fertility rate of the country remains below replacement level (despite government initiatives to counter this) and the country's immigrant population remains relatively stable. The population of Japan is expected to continue its decline in the coming years, and in 2020, it is estimated that approximately 126 million people inhabit the island country.

In the United States, a knee replacement cost ** thousand U.S. dollars, while in Israel the average cost is ** thousand U.S. dollars. At the other end of the scale, a knee replacement costs *** thousand U.S. dollars in India. Knee replacements are more common in older patients because they are more likely to have problems with the knee joint from conditions such as osteoarthritis.

Knee replacement procedures Switzerland had the highest prevalence of knee replacement surgeries among OECD countries in 2019. In that year, there were *** procedures per 100,000 population in Switzerland, while in Finland there were *** per 100,000. The U.S. based company Zimmer Biomet had the largest global share of knee and hip implants in 2019, with a ** percent share.

Prevalence of osteoarthritis While not every case of osteoarthritis occurs in the knee joint or results in the need for a knee replacement surgery, it is an overriding cause. A knee replacement will also only be recommended once other therapies have not relieved the problem. In England, for example, over ** percent of women and ** percent of men aged over 50 years of age were living with arthritis in 2019. While in the United States, around ** percent of all women and ** of percent had been diagnosed with arthritis.