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How has India’s family planning program evolved?
- India’s family planning program started in 1951– making it one of the oldest in the world.
- The earliest efforts involved the government undertaking communication campaigns to promote smaller family sizes. This saw only limited progress and the Indian population grew rapidly.
- The population control measures took a dark turn when the government declared the Emergency in 1975. The government implemented a mandatory sterilization program which involved thousands of vasectomies. Many of these were forcibly performed on the people.
- This forced sterilization became a major election issue in 1977. This election brought in the 1st non-Congress government at the Centre. It is considered as a strong evidence of popular rejection of such coercive policy action with regards to population control.
- The government stayed away from family planning for several decades following the Emergency.
- 1994 marked a landmark shift in how the governments across the world viewed population issues. In that year, the International Conference on Population Development was convened under the UN. At this conference, India along with 178 countries, made a commitment to a rights-based approach to family planning.
- In such an approach, the people’s needs for reproductive healthcare and family planning are catered to, along with basic requirements on the health and education fronts. In this approach, population stabilization can be achieved naturally, without the use of coercion.
- The conference inspired the National Population Policy of India in 2000.
- Its implementation picked up with the launch of National Rural Health Mission (now part of National Health Mission) in 2005.
- Though the 2000s saw a revival of interest in population stabilization, the burden mostly fell on women. Female sterilization was the most available method.
- A spate of egregious practices occurred due to low emphasis on quality of care. In 2014, 16 women died after undergoing sterilization procedure at a government camp in Bilaspur. Fact-finding team found that the deaths were caused due to gross negligence and compromise in quality of care.
- The report from this team formed the basis for a 2016 landmark judgement from the Supreme Court. A 2-judge bench, headed by Justice Madan Lokur, ordered the government to stop sterilization camps and to focus on providing contraception methods. This order changed the way family planning services are provided in the country.
What did the recent NFHS reveal?
- The total fertility rate or TFR has declined to 2.0. TFR is the average number of children born to a woman over her lifetime.
- The highest TFR (3.06) was recorded among women with no schooling.
- Women, who had 12 or more years of education, had a lower TFR of 1.71.
Why is this significant?
- The drop in TFR is a significant feat given that it stood at nearly 6 in the 1950s.
- It is a sign of changing aspirations among the people- especially the women. People are understanding the wisdom of bearing fewer children.
- The higher focus on providing family planning services in districts with high fertility rates has helped improve acceptance of such services.
- Higher reach of the media has altered women’s aspirations.
- The NFHS data show that women now desire to have less than 2 children. However, there is still significant inability among the women to access family planning services. This has led to unmet needs.
What is the way ahead?
- The credit for this significant feat goes to the Indian people and the government, especially the bureaucracy.
- Following the release of the NHFS-5 findings, there have been declarations in the media that the Indian population has ‘stabilized’. Some have been claimed the our population has started declining.
- This isn’t entirely true. The population stabilizes only when the TFR of 2.1 is sustained over a period of time, according to the UN. This means that we can’t assume that the Indian population has stabilized unless the TFR is maintained at or less than 2.1 over a period of decades.
- The country has a large young population with 30% falling in the 10-24 year age-group. In this light, the government needs to invest more in health, education and also creating economic opportunities for the youngsters.
- Education is the best contraceptive pill. Girls’ education is directly co-related to a decrease in fertility.
- Health and life-skill education must be provided at an early age.
- The government must ensure access to reproductive and sexual health services while swearing off coercive policies for good.
To sustain the population stabilization trends, what is needed is more collaborative efforts and less chest-thumping.