Poverty
and Population
 Data
shows that the poor tend to have larger
families.
Across vast
parts of India, children are seen as
additional hands to till the land and
perform labour, which helps the family
income to rise. Not much is invested in
children in such cases, and more children do
not necessarily require much investment in
upbringing.
The poor also
have limited access to quality health and
contraceptive services, including timely
counselling, availability of contraceptives
and follow-up care, which are all essential
for continuous contraceptive use.
With poor
healthcare, child mortality remains high,
and larger numbers of children per family
are seen as an insurance against high child
mortality. Children in poorer families are
also seen as providing support in old age
because many families do not work in any
organized sector and have no access to old
age social security, savings, pension or the
like. Thus, lack of access to development
resources results in a larger family size
among the poorer sections.
Is
sterilizing people an option?
Any
form of coercion is in principle wrong and
militates against basic human values and
violates human rights. The suggestion that
coercive sterilisation is an option flows
from a mindset that looks at people as
targets rather than as human beings with
their own rights and needs.
That apart,
experience of some of the Indian States
clearly shows that it is possible to achieve
replacement levels of fertility without
compromising human rights and liberties. A
comparison of the fertility decline in China
and Kerala shows that Kerala achieved more
than China without ever having to adopt any
coercive policies. China's Total Fertility
Rate (TFR) of 2.8 in 1979 dropped to 2.0 in
1991, while Kerala's TFR of 3.0 in 1979
dropped to 1.8 in 1991. Tamil Nadu had a
similar decline from TFR of 3.6 in 1979 to
2.2. in 1991. Easy access to health services
and women's education helped the fall in
fertility rate in Kerala, while the most
important factor in Tamil Nadu was the
successful child nutrition support programme
with focused interventions to meet
contraceptive needs.
One of the
most important factors which would bring
down fertility levels is to meet the unmet
need for contraception. This step can reduce
fertility levels by almost 20%. Ensuring
child survival can prevent another 20% of
births.
The goal of
child nutrition must be addressed
separately. The "mid-day-meal"
scheme in schools has increased enrolment as
well as improved the nutritional status of
children. This has proved to be effective in
improving child survival and reduced the
desire for larger families.
Incentives
and Contraception
 India's
population programme in its early stages was
driven by incentives in cash or in kind.
Incentives were also given to service
providers for motivating people to use
contraception. Incentives were justified as
inducements, compensation for loss of pay,
and as a reward. Any incentive based
programme is linked to targets and brings
with it all the ills of a target-led
approach and the possibility of misuse. What
often follows is ill-informed consent,
coercion, and resultant trauma to families.
The situation gets worse when incentives are
given to service providers to achieve
contraception targets. This often leads to
fudged figures and poor services.
So providing
incentives is not a good way to promote
contraceptive use. People have to be
convinced about the need to space and limit
families for their own good.
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