Pathanamthitta district in Kerala may soon have the unique distinction of achieving zero population growth. A recent UNICEF-sponsored survey revealed the district has a birth rate of 5.3 per thousand and a death rate of 4.1, compared to the state average death rate of 5.6 per thousand and birth rate of 19 per thousand. District health department statistics reveal that the population growth rate fell from 0.3 per cent in 1990 to 0.09 in 1993. In the same period, birth rates steadily dropped from 6.54 per thousand to 5.3. Disclosing the survey results, district collector D Ravi and district medical officer George Kurien said the average family size in the district of 1.19 million people was 3.86.

The zero population growth is credited to the effective immunisation drive, which makes the district's infant mortality rate one of the lowest in the state, a male literacy rate of 94.85 per cent and a female literacy rate of 93.29. More than 1,000 non-governmental organisations are involved in development programmes in the district. Pathanamthitta's primarily agrarian economy has also benefitted from overseas remittances. Its extensive health care network consists of 158 private hospitals.