International Journal of Health Policy and Management

International Journal of Health Policy and Management

Rethinking Population Policy: Values, Structural Constraints, and Implications for Health System Sustainability

Document Type : Viewpoint

Authors
1 Health Intervention and Technology Assessment Program Foundation (HITAP), Nonthaburi, Thailand
2 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
3 Population Reference Bureau, Washington, DC, USA
4 Population Foundation of India, Delhi, India
5 Division of Social Science, The Hong Kong University of Science and Technology, Hong Kong, China
6 The PEMA Secretariat, Thimphu, Bhutan
7 Youterus Health, Freetown, Sierra Leone
8 Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
9 Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
10 Human Development Department, Japan International Cooperation Agency, Tokyo, Japan
11 FHI 360, Bangkok, Thailand
12 International Health Policy Program Foundation, Nonthaburi, Thailand
Keywords

1.               Joulaei H, Morshed-Behbahani B, Ghadimi P, Nadimi Parashkouhi S, Mansoori Y. Contentious population policy-making and its consequences: a health policy analysis. Int J Equity Health. 2025;24(1):96. doi:10.1186/s12939-025-02469-4
2.               Yeh MJ, Lee PH. The ethics of population policy for the two worlds of population conditions. Health Care Anal. 2024 ;32(1):1-14. doi:10.1007/s10728-023-00462-y
3.               Whyle E, Olivier J. Social values and health systems in health policy and systems research: a mixed-method systematic review and evidence map. Health Policy Plan. 2020;35(6):735-751. doi:10.1093/heapol/czaa038
4.               Family Planning Association of India (FPA India). FPA India. About Us. https://fpaindia.org/about-us/who-we-are.
5.               Nandini Raizada. India’s Gigantic Population: Need For A Population Control Law. Indian Journal of Law and Legal Research. 2024 Feb 3;5(6). https://www.ijllr.com/post/india-s-gigantic-population-need-for-a-population-control-law.
6.               Sam Rowlands, Pramod R. Regmi. The Use of Forced Sterilisation as a Key Component of Population Policy: Comparative Case Studies of China, India, Puerto Rico and Singapore. Indian Journal of Public Administration. 2022;68(2):271-284. doi:10.1177/00195561221082984
7.               Bilal Kuchay. Why two-child plan in India’s most populous state is ‘coercive’. Aljazeera. July 21, 2021. https://www.aljazeera.com/news/2021/7/16/why-two-child-policy-in-indias-most-populous-state-is-coercive.
8.               Blackorby C, Bossert W, Donaldson D. Foreign aid and population policy: some ethical considerations. Journal of Development Economics. 1999;59(2):203-232. doi:10.1016/S0304-3878(99)00010-3
9.               Organisation for Economic Co-operation and Development (OECD). Bhutan’s Gross National Happiness (GNH) Index. https://www.oecd.org/en/publications/well-being-knowledge-exchange-platform-kep_93d45d63-en/bhutan-s-gross-national-happiness-gnh-index_ff75e0a9-en.html. Published August 23, 2024.
10.           Jumana Alaref, Alvin Etang Ndip, Cheku Dorji, Laurine Martinoty. Migration Dynamics in Bhutan: Recent Trends, Drivers, and Implications. Washington, DC: World Bank; 2025. https://documents1.worldbank.org/curated/en/099071025222089550/pdf/P509392-07140ea4-b0fa-489b-a384-7e7494758a5e.pdf.
11.           RAWLS J. A Theory of Justice. Harvard University Press; 1971.  doi:10.2307/j.ctvjf9z6v  
12.           Diana Chung, Mehrin Ahmed Mahbub. World Bank Supports Bhutan’s Reform Efforts to Create Jobs. https://www.worldbank.org/en/news/press-release/2026/04/01/world-bank-supports-bhutan-s-reform-efforts-to-create-jobs. Published April 1, 2026.
13.           The PEMA. Royal Bhutan Police, The PEMA Secretariat, and Ministry of Agriculture and Livestock sign a Tripartite Agreement to Establish Yarju OAP for Prisoners’ Reintegration. https://thepema.gov.bt/royal-bhutan-police-the-pema-secretariat-and-ministry-of-agriculture-and-livestock-sign-a-tripartite-agreement-to-establish-yarju-oap-for-prisoners-reintegration/. Published March 14, 2025.
14.           Cordeiro-Rodrigues L, Metz T. Afro-Communitarianism and the Role of Traditional African Healers in the COVID-19 Pandemic. Public Health Ethics. 2021;14(1):59-71.
15.           Jacques Charmes. The Unpaid Care Work and  the Labour Market. An analysis of time use data based on  the latest World Compilation  of Time-use Surveys. Geneva: International Labour Organization; 2019. https://www.ilo.org/sites/default/files/wcmsp5/groups/public/%40dgreports/%40gender/documents/publication/wcms_732791.pdf.
16.           Jones E, Ruiz I, Undurraga S. Repositioning care in economics: concepts, measurement, and policy implications. Oxf Rev Econ Policy. 2025;41(3-4):653-675. doi:10.1093/oxrep/grag001
17.           Forati R, Bartz D. The rise and fall and rise of pronatalism: a disingenuous policy that harms the health of people and society. J Law Med Ethics. 2025;53(3):435-443. doi:10.1017/jme.2025.10129
18.           Boydell V, Mori R, Shahrook S, Gietel-Basten S. Low fertility and fertility policies in the Asia-Pacific region. Glob Health Med. 2023;5(5):271-277. doi:10.35772/ghm.2023.01058
19.           Lorenzo Beadle. Demographic decline and the role of immigration. 2025. https://clubmadrid.org/wp-content/uploads/2025/09/DEMOGRAPHIC-DECLINE-AND-THE-ROLE-OF-IMMIGRATION.pdf.
20.           Bachrach CA, Morgan SP. A cognitive-social model of fertility intentions. Popul Dev Rev. 2013;39(3):459-485. doi:10.1111/j.1728-4457.2013.00612.x
21.           Schwartz SH. An Overview of the Schwartz Theory of Basic Values. Online Readings in Psychology and Culture. 2012;2(1). doi:10.9707/2307-0919.1116
22.           Vélez CM, Wilson MG, Lavis JN, Abelson J, Florez ID. A framework for explaining the role of values in health policy decision-making in Latin America: a critical interpretive synthesis. Health Res Policy Syst. 2020;18(1):100. doi:10.1186/s12961-020-00584-y

Articles in Press, Accepted Manuscript
Available Online from 10 November 2026

  • Received Date 19 May 2026
  • Revised Date 15 October 2026
  • Accepted Date 01 November 2026
  • First Published Date 10 November 2026
  • Published Date 10 November 2026