Kerala is well-known globally for the unprecedented fertility transition in the Indian subcontinent towards the end of the last century. The state has already reached below-replacement fertility level in the 1990s while the rest of India was experiencing high or mid-level fertility. With this backdrop, an attempt was made in this paper (a) to explore the plausible factors associated with sub-replacement fertility and consequent population momentum in Kerala and (b) to trace their socioeconomic and health policy implications. The underlying factors that led to the fertility transition was explored and discussed in some detail. An enhanced level of human development achieved during the last quarter of the 20 th century, mainly through developments in social and health sectors, is likely to be the main contributor. Unlike other states in India, there were historical factors as well that functioned as a catalyst for this, such as widespread education and women’s empowerment. As an inevitable demographic impact, population growth due to momentum is expected to be very strong in Kerala with an age-structural transition favouring the old. The so-called ‘demographic dividend ’ invoked by the increase of labour-force derived from the youth bulge in the age-structure is being lost in the state due to very limited capital investments and political will. Again, as a direct consequence of population growth, population density in Kerala will take a staggering level o
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