Kerala's Demographic Transition: Determinants and Consequences
BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7200.1771 (Published 26 June 1999) Cite this as: BMJ 1999;318:1771- John A Black, retired consultant paediatrician
- Victoria Mill House, Framlingham, Woodbridge

K C Zachariah, S Irudaya Rajan
Sage Publications, £29.99, pp 367
ISBN 0 8039 9392 7
Rating:
The achievement of demographic transition—with fertility at replacement level—by the south Indian state of Kerala, despite it being one of the poorest states in the country, has overturned the previous assumption that demographic transition could occur only in wealthy communities. This book covers the subject of Kerala's success in four sections:demographic transition, determinants of demographic change, consequences of demographic change, and migration.
Two questions arise from Kerala's experience: first, can the state's policies be applied to other parts of India, and, second, can they be transplanted to other low income communities, notably in sub-Saharan Africa? The first question is answered in the affirmative, although the discussion is not as full as I would have …
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