A year ago, a TDP MP in Andhra Pradesh offered Rs 50,000 to women giving birth to a third girl child, provided the first two children are also daughters. He promised a cow if the third child is a boy, spending from his salary as a parliamentarian. The announcement from Vizianagaram MP Kalisetti Appala Naidu was met with surprise and some derision back then.
But now, Chief Minister Nara Chandrababu Naidu himself has made a very similar promise – Rs 30,000 and Rs 40,000 for the birth of a third and fourth child, respectively. This is the latest in a series of policy measures by the Andhra Pradesh government to manage the state’s slowing population growth.
First, it lifted the ban on people with more than two children contesting local body elections. Then, Naidu said he was considering barring people with fewer than two kids from contesting. In March, Naidu announced a Rs 25,000 incentive for families with two or more kids, while telling the Assembly that about 58% families in the state had only one child.
The government has also floated the idea of providing state-supported IVF treatment for couples dealing with infertility.
Naidu has repeatedly stressed that the state's Total Fertility Rate (TFR) has declined to 1.5, which is well below the replacement level of 2.1 – the level at which a population replaces itself from one generation to the next, with each set of parents replacing themselves when a woman has two children.
Offering cash to have babies is not unique to Andhra – many European and East Asian countries have done the same, though these incentives often come in the form of recurring monthly payments, sometimes combined with tax and housing subsidies, among other benefits.
But can the women of Andhra Pradesh afford to have more kids, not just financially but physically and mentally, given their socio-economic circumstances? Here’s what data and activists from the state say.
Targeting ‘poorest of the poor’
Naidu has often ridiculed the DINK (Dual Income, No Kids) lifestyle, where partners who both make money consciously choose not to have kids. While announcing incentives for having three and four kids, he said, “As people’s incomes rise, they’re stopping at having just one child.”
But such one-time paltry incentives are clearly targeted at the most vulnerable, poorest of the poor communities, said C Bhanuja, founder of the Anantapur-based non-profit Rural Environment and Development Society (REDS).
“There are many vulnerable semi-nomadic communities that still do not have access to or awareness of family planning. What sustainable livelihood can the government provide with Rs 30,000 or Rs 40,000, which will barely last them a month with such big families?” she asked, adding that providing nourishment and protection for the children would become a huge burden on mothers.
According to the latest Survey on Household Social Consumption: Health conducted by the National Statistics Office (NSO), the average medical expense for childbirth alone in 2025 was Rs 21,770 in Andhra Pradesh. The national average was Rs 15,595.
Overall, the Human Development Index score – which measures the population’s lifespan, education and standard of living – was the lowest in Andhra Pradesh across south India at 0.679 according to an independent study for 2022-23. The state ranked 23rd in India.
Child care services
K Dhanalakshmi, Convener of the Working Women’s Coordination Committee, Centre of Indian Trade Unions (CITU) Andhra Pradesh, said that given the current wages, inflation, lack of job security, state of public education, healthcare, housing, etc., it is difficult for households to run on a single income. And women working in the informal sector not only lack benefits such as paid maternity leave, but risk being fired with each pregnancy, or are forced to forego proper rest to retain their jobs, she said.
In Andhra Pradesh, 37.1% of working women are engaged in casual labour – the highest among the five southern states and way above the national figure of 17.6% – according to the 2025 annual report of the Periodic Labour Force Survey (PLFS).
“Not just in the informal sector, even women working for civic bodies on a contractual basis as sanitation workers do not have protections such as maternity leave. Even ASHA workers in Andhra Pradesh were granted paid maternity leave only in 2025 after a prolonged struggle by the union,” Dhanalakshmi said.
Bhanuja, who works with young girls experiencing child marriages and teen pregnancies, as well as widows of farmers who have died by suicide, pointed out that single mothers, including widows, and women who are abandoned by their husbands or have left abusive marriages, struggle even more with a higher number of children due to a lack of support systems.
On the one hand, utilisation of Integrated Child Development Services (ICDS) is pretty high in Andhra Pradesh. According to the fifth National Family Health Survey (NFHS-5), conducted in 2019–2021, 78% of children under six had received some service through ICDS – immunisation, food supplements, health check-ups, and so on. The national average is 67.5%.
But Anganwadi workers in the state have been agitating for better pay and other benefits for years. In 2023-24, they went on strike for over a month. Protests were revived in March this year with the same demand.
K Subbaravamma, the state general secretary of the Andhra Pradesh Anganwadi Workers and Helpers Union, noted that one of their demands – to promote mini Anganwadi workers as main workers – has been met by the present government, which is upgrading around 4,687 mini workers who have passed class 10.
But Anganwadi workers still get paid an honorarium of only Rs 11,500 per month, of which Rs 4,500 is borne by the Union government. Anganwadi workers across states have been demanding pay hikes, saying they are severely underpaid. In Andhra Pradesh, the union has demanded a salary of Rs 26,000.
“Our main demands have been a pay hike and gratuity implementation as per Supreme Court orders. A government order has been issued for gratuity, but it has yet to be implemented. We are hoping that the salary is raised at least on par with Telangana (Rs 13,650),” Subbaravamma said, adding that after the summer break, workers were planning to launch an agitation again if no hike is implemented.
Women’s health at stake
Despite ICDS being accessible, anaemia and malnutrition are prevalent in Andhra Pradesh, Dhanalakshmi noted.
NFHS-5 showed that 59% of women aged 15-49 years in Andhra Pradesh were anaemic. Among pregnant women in this age group, too, 54% were anaemic. Both figures were slightly higher than the national average, despite significantly higher ICDS utilisation.
Around 60% of girls aged 15 to 19 were anaemic in Andhra, similar to the national average. However, Andhra Pradesh had the third-highest teenage pregnancy numbers after Tripura and West Bengal, with 13% of girls aged 15 to 19 having begun childbearing. For all of India, this figure is much lower at 6.8%.
Anaemia is found to be prevalent in women bearing multiple pregnancies, and is associated with “poor maternal and birth outcomes, including premature birth, low birth weight and maternal mortality.”
As per the latest Sample Registration System (SRS) Bulletin for 2024, the Infant Mortality Rate (IMR) for Andhra Pradesh was 18, the highest among the southern states. India’s IMR was 24.
IMR is the number of infant deaths (aged under one year) per thousand live births.
NFHS-5 also found significant malnutrition among kids in Andhra Pradesh. It found that 31% of children under 5 were stunted (too short for their age), 16% were wasted (weighed too little for their height), and 30% were underweight (weighed too less for their age).
Hyderabad-based paediatrician Dr Sivaranjani Santosh said that often, pregnant women from low-income households are visibly malnourished and anaemic.
“Pregnancy takes a toll on women's bodies, especially when they're anaemic. It's not just about bearing children but also taking care of them, which requires not just physical but also mental and emotional strength. It's not good for the mother or the children, and raises chances for dysfunction in the family,” she said.
In the past, too, whenever the government has tried to “manage” population through sterilisation, women’s bodies have borne the brunt disproportionately, Bhanuja pointed out.
This trend has continued for years, and even in NFHS-5, among married women aged 15-49 years in Andhra, 69.6% opted for female sterilisation procedures such as tubectomies for family planning, while only 0.4% opted for male sterilisation. Only 0.5% used condoms, as opposed to the nationwide average of 9.5%. At the national level, male sterilisation was similarly low at 0.3%, but female sterilisation was only 37.9%.
“Women are being treated like machines by the state, as if their freedom, personhood, self-respect, and health don’t matter,” Dhanalakshmi said.
Like similar studies across the world, data from Andhra Pradesh also shows that as women received more education, their financial independence, autonomy in movement and decision-making improved. Women with more education also tended to have fewer children, and the preference for sons also went down.
NFHS-5 shows that in Andhra Pradesh, 92% women (and 89% men) who already had two children did not want more.
In a culture where women are often unable to exercise choice in having children, especially due to son preference (CM Naidu himself pointed out that most couples have a second child only if the first is a girl), Bhanuja said announcing such incentives is disrespectful towards women.
“While designing such policies, the government must conduct surveys and interact with the beneficiaries to gather their opinions in a meaningful way. Have they done any of that with women in the state?” she asked.
