Controlling population is considered to be one of the major challenges in every country. While different countries have adopted various measures to curb population growth, India continues to struggle in developing population control strategies.
Even in the midst of urbanisation, industrialisation and economic development, India continues to witness huge population growth.
According to the United Nations 2016 data, the current population of India stands at 1.3 billion and the country has the fastest growing population after China.
As statistics indicate, the increasing rate of India’s population is quite alarming and requires immediate action. Research suggests that the birth rate is higher among low-income families as they believe that if they produce more children, there will be more earning members.
Scholars have for quite some time identified the family to be the central unit for achieving population control goals.
In fact, India was the first country to adopt family planning as one of its socio-economic development policies in 1952. Post independence, in the first to third Five Year Plans (1951-1966) various methods such as condoms, jellies and foam tablets were advocated for birth control.
Additionally, service clinics were set up in rural areas to educate people about family planning. Advertisements and the media were used to spread awareness and the necessity of using contraceptives for the overall wellbeing of the family.
It was only in the fourth Five Year Plan (1969-1974) that the target was set and a birth rate reduction from 39 per cent to 25 per cent per 1,000 people within the next decade was proposed.
To meet this target, sterilisation clinics were set up and incentives as well as compensations were offered to undergo sterilisation.
Since then sterilisation as a method has been a target-oriented programme and the practice of forceful sterilisation has often been reported in the media.
In fact, it is important to note that among all population-control measures, sterilisation camps have been most enforced by the Government of India.
One cannot deny that such camps have been the reason for a large number of deaths in the country. Reports highlight that from 2009-2012, over 700 women died because of failed sterilisation procedures (United Nations, 2013; Population Foundation of India, 2014).
Though public health experts, demographers and women groups have criticised the functioning of sterilisation camps on several instances, they continue to exist.
Even though concerns of “quality of care” provided in these camps have been questioned by several studies, no particular action has been taken against the doctors and staff involved in sterilisation.
Thirteen women lost their lives at a sterilisation camp in Chhattisgarh in 2014 and strict action was expected from the Centre.
However, it was only on September 16 this year that the Supreme Court ordered the state government to shut down all sterilisation camps in three years.
With this order it is important to understand what alternate approaches can be used to curb population.
Various scholars have said even though sterilisation is the most accepted form of population control measure, it is also one of the major causes of increased mortality rates among women in India.
In this context it is important to reflect on population control policies being followed by other highly populated countries.
Examples outside India
Since population control is a concern for many countries, it is important to understand the different policies adopted by nations experiencing high population growth.
In the United States of America, the Title X Family Program was launched in 1970 to provide contraceptive services, supplies and information regarding birth control.
In particular, families in the low-income group were given priority under this. In 2014, the programme successfully prevented two million unintended pregnancies.
Similarly, Indonesia follows the Banjar system, which involves the community to spread awareness on birth control measures.
Village family planning groups are created by the government to mould fertility behaviour among people. The country has also involved religious leaders to cater to its Muslim population.
The Banjar programme has seen a major shift in the attitude of religious leaders, who have actively supported it.
Bangladesh has achieved the lowest total fertility rate in South Asia through family welfare assistants. Under this, volunteers pay door-to-door visits and advise mothers about the use of contraceptives and provide free ones after every two weeks.
If we look at the different policies used by other countries, it can be suggested that through trained health workers and by involving religious leaders, the use of various contraception measures can be made popular.
Alternative approaches
In India, women are paying a high price in terms of their health due to sterilisation. In this context, it is important to identify alternate approaches that can be used to curb population growth.
Drawing from examples set by other countries, one can say that use of condoms and intrauterine devices can be used to maintain a balance between usage of contraception methods by men and women.
By training members of the village community, the government can also create village self-help groups. These groups can educate villagers on available birth control measures.
In particular, men in rural areas should be motivated and urged to use contraception to reduce the burden on women.
In cities, areas should be identified with low-income families and trained health workers should be sent to spread awareness on other contraception methods. The main goal of population control programmes should be that both men and women should make informed choices. With the Supreme Court’s order to shut down all sterilisation camps and urge for a national health policy, it is important for the Indian government to revaluate population control goals.
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In a diverse country like India, where each State is socially, culturally, economically, and politically distinct, measuring Governance becomes increasingly tricky. The Public Affairs Index (PAI 2021) is a scientifically rigorous, data-based framework that measures the quality of governance at the Sub-national level and ranks the States and Union Territories (UTs) of India on a Composite Index (CI).
States are classified into two categories – Large and Small – using population as the criteria.
In PAI 2021, PAC defined three significant pillars that embody Governance – Growth, Equity, and Sustainability. Each of the three Pillars is circumscribed by five governance praxis Themes.
The themes include – Voice and Accountability, Government Effectiveness, Rule of Law, Regulatory Quality and Control of Corruption.
At the bottom of the pyramid, 43 component indicators are mapped to 14 Sustainable Development Goals (SDGs) that are relevant to the States and UTs.
This forms the foundation of the conceptual framework of PAI 2021. The choice of the 43 indicators that go into the calculation of the CI were dictated by the objective of uncovering the complexity and multidimensional character of development governance
The Equity Principle
The Equity Pillar of the PAI 2021 Index analyses the inclusiveness impact at the Sub-national level in the country; inclusiveness in terms of the welfare of a society that depends primarily on establishing that all people feel that they have a say in the governance and are not excluded from the mainstream policy framework.
This requires all individuals and communities, but particularly the most vulnerable, to have an opportunity to improve or maintain their wellbeing. This chapter of PAI 2021 reflects the performance of States and UTs during the pandemic and questions the governance infrastructure in the country, analysing the effectiveness of schemes and the general livelihood of the people in terms of Equity.
Growth and its Discontents
Growth in its multidimensional form encompasses the essence of access to and the availability and optimal utilisation of resources. By resources, PAI 2021 refer to human resources, infrastructure and the budgetary allocations. Capacity building of an economy cannot take place if all the key players of growth do not drive development. The multiplier effects of better health care, improved educational outcomes, increased capital accumulation and lower unemployment levels contribute magnificently in the growth and development of the States.
The Pursuit Of Sustainability
The Sustainability Pillar analyses the access to and usage of resources that has an impact on environment, economy and humankind. The Pillar subsumes two themes and uses seven indicators to measure the effectiveness of government efforts with regards to Sustainability.
The Curious Case Of The Delta
The Delta Analysis presents the results on the State performance on year-on-year improvement. The rankings are measured as the Delta value over the last five to 10 years of data available for 12 Key Development Indicators (KDI). In PAI 2021, 12 indicators across the three Pillars of Equity (five indicators), Growth (five indicators) and Sustainability (two indicators). These KDIs are the outcome indicators crucial to assess Human Development. The Performance in the Delta Analysis is then compared to the Overall PAI 2021 Index.
Key Findings:-
In the Scheme of Things
The Scheme Analysis adds an additional dimension to ranking of the States on their governance. It attempts to complement the Governance Model by trying to understand the developmental activities undertaken by State Governments in the form of schemes. It also tries to understand whether better performance of States in schemes reflect in better governance.
The Centrally Sponsored schemes that were analysed are National Health Mission (NHM), Umbrella Integrated Child Development Services scheme (ICDS), Mahatma Gandh National Rural Employment Guarantee Scheme (MGNREGS), Samagra Shiksha Abhiyan (SmSA) and MidDay Meal Scheme (MDMS).
National Health Mission (NHM)
INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS)
MID- DAY MEAL SCHEME (MDMS)
SAMAGRA SHIKSHA ABHIYAN (SMSA)
MAHATMA GANDHI NATIONAL RURAL EMPLOYMENT GUARANTEE SCHEME (MGNREGS)