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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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