While the subject of population control is widely discussed by the Indian public, it is not a subject that has received much political attention. No doubt, the prime minister had referred to it in his Independence Day address in 2017. But nothing noteworthy had happened.
Four years later, we suddenly have population becoming a very important subject with two states in the country–Uttar Pradesh and Assam–bringing it on the front burner.
On the World Population Day, Chief Minister of Uttar Pradesh Yogi Adityanath not only unveiled a population policy for the state, but he also had the draft on the website seeking comments. There seems to be a very short time given to the public to react, which means that there is every expectation of it being introduced in the assembly.
Uttar Pradesh Should Have Controlled Population 3 Decades Ago
It is important to look at what the aims and objectives sought to be served are, and whether the strategies will have desired effect?
First and foremost, I am not quarrelling with the need for population stabilisation. If anyone has to do something drastic, it is Uttar Pradesh. I will come to how huge that problem is and paying attention to it should have started 30, 20, or 10 years ago in right earnest. But it did not.
As the first executive director of the National Population Stabilisation Fund or the Jansankhya Sthirata Kosh, which is now folded up, I made it a mission to try and meet the two chief ministers of Uttar Pradesh and Bihar in 2008.
Though I wanted to meet the Chief Minister Ms Mayawati for which the preliminaries were gone through, at the last minute I was told to meet her top state bureaucrat. I made an impassioned plea about what was happening, the very high fertility, and what was needed to be done by Uttar Pradesh. I was generally heard with politeness and with assurances that something would be done but I did not get the feeling that anything important would follow..
Therefore, when the Chief Minister of Uttar Pradesh has brought it on centre-stage it should be applauded.
What Does the UP Population Policy Aim to Achieve?
What the policy tries to focus on is firstly to try and reduce the fertility rate—Uttar Pradesh (along with Bihar, and other Hindi belt states) is still to achieve the 2.1 level of fertility, which most of India has already attained in the last few years -some like the Southern states having achieved it decades ago .
Second, the policy seeks to lower maternity and infant mortality rates and under- 5 year mortality.
Population Control in North India as a Sequel to the Emergency
India was the first signatory to the population policy of 1951 but after the Emergency and the public reaction to forced sterilisations the whole subject of population went underground. For generations after the Emergency, politically, to mention population has always been a "no-no" subject.. To that extent its revival as a public issue is excellent.
Yogi Adityanath's Focus on Government Employees and Coercion
What I find odd is that there is a huge focus on what will happen to government servants who have two or, even better, only one child. They will get all kinds of incentives .
There is also a distinct feeling in the policy and in the draft law that there would be some sort of punitive visitation if a Government employee does not subscribe to what is expected of him.
Of course, maternity leave, paternity leave, all those things which are very progressive have also been thought through but the question is - even if Uttar Pradesh has a very large number of government servants, their numbers are nothing compared to the size of the state. The population of Uttar Pradesh is about 212 million which is the size of a huge country like Brazil.
Uttar Pradesh itself, along with Bihar, is about 23 percent of the whole country so to talk about government servants alone and give them so much primacy when they are already a captive group under your control and you can pretty much do whatever you want—is odd. If you are going to visit them with any kind of punishment, that will also lead to all kinds of of constitutional issues.
As far as the general public is concerned, the law as well as the policy speaks about their getting certain benefits. Those below the poverty line would get Rs 80,000 if they stick to the norm that has been specified-Rs 80,000 if it is a boy and Rs 1 lakh if it is a girl.
The numbers sound generous but is at the cost of ensuring that those couples go in for sterilisation because it is only then that one can conclude that they have complied. Whether that kind of compliance can be upheld legally or constitutionally is yet to be seen.
The Need to Analyse Population at a Granular Level
Without going into the legality of the matter, the action to prevent unwanted pregnancies, particularly in Uttar Pradesh and Bihar, is urgently required.
Women in rural UP are still giving birth to four or more children in some districts and the contraceptive rate is less than 10 percent!
In many districts, neither Hindus nor Muslims practice any modern family planning methods at all. The whole subject of population, fertility, and contraception must be addressed.
But at a granular level, it should really rivet on “where is the problem?”
The problem does not lie in the urban areas, it does lie in the towns or the cities. It lies in rural districts and there is substantial variation across the 75 districts of Uttar Pradesh according to NFHS 4 data and this data is not going to change drastically when the NHFS 5 data which is yet to come is published.
What comes out of NFHS-4 data is that women in Uttar Pradesh are having children ranging between 1.6 to 4.4 children per woman. The Terai belt, which is where the hills meet the plains towards northern UP and the adjacent central districts have high fertility while the Bundelkhand region has comparatively low fertility.
In UP, couples rely on—much more than anywhere else in the country— traditional methods notably periodic abstinence, which is two times higher in the state compared to the rest of India.
The failure rates of traditional methods of contraception have been reported as being very high and women always remain anxious and at-risk. They have often to go into abortions which is unfair to them and also risky because not all of them go in for medical termination early enough, with the result that other methods are used, which can be extremely harmful.
Will the UP Law Help Curb the State's Population?
We have 12 states in the country starting with Rajasthan, which in 1992 promulgated laws that stated that you can only have two children or face punishment – mostly aspiring for political office.. However, it has had very little effect on the reproductive practices of most people in the state.
Apart from Rajasthan, states like Orissa, Haryana, Andhra Pradesh, Himachal Pradesh, Madhya Pradesh, Chattisgarh, Uttarakhand, Maharashtra, Gujarat, Bihar, Assam all have these laws.
If these laws were so effective , why would we have the kind of high fertility that we see in the Hindi belt states?
The laws may deter those who are seeking political office but they will not affect the rest of the people?
Just focusing on the political element and the cohort of government servants is not going to make any difference at all, apart from the fact that the legality of all this will be questioned.
UP Bill Goes Against the Centre's 2020 SC Affidavit
What I find very surprising is that this draft bill has been put forward despite what the Centre had told the Supreme Court in an affidavit as recently as 2020.
The Centre told the apex court:
“Coercing people to have fewer children would be counterproductive, leading to demographic distortion.”
The Centre in its affidavit also expressed its disinclination towards forced family planning or population control laws.
Further, the Centre stated that India is a signatory to the Program of Action of International Conference on Population and Development (ICPD) 1994, where it unequivocally stated that there should be no coercion in family planning.
The affidavit also underscored that such a law could have the unintended impact of sex-selection, unsafe abortions, and a further skew in India’s sex ratio.
Latest research in The Lancet shows that female foeticide has spread even to rural areas and increase with the birth of one daughter and then the second daughter.
When you talk about population stabilisation, the sex ratio is really important, and the fall out there must be confronted.
Policy Measures Which Have Been Effective
When I was in the Jansankhya Sthirata Kosh, certain pilots schemes worked. These were tried in some of the high fertility districts like Rajnandgaon in Chhattisgarh, Barmer, and Dholpur in Rajasthan and Nabrangpur in Odisha.
With the approval of the Ministry of Health and Family Welfare, we incentivised responsible parenthood in these districts with high fertility rates.
In the period from 2006-09, we told families that if a girl is married at 19 and not 18, which is the legal age, and she gives birth to the first baby at 21 and the second baby is born three years apart, you will rewarded for reaching every one of these milestones. If it's a boy, you will be paid a post office savings certificate of Rs 5,000, and if it's a girl, Rs 7,000 and cashable in six years.
I do remember that in one of these districts the collector had a function where we gave these awards and people said “how did they receive this money just by sitting at home ?"
The local media covered such events which built awareness about the responsible parenthood programme. People were held up as examples and and got money for being responsible, for allowing the girl to marry later and stay free of anaemia and malnourishment to be in good health when she became a mother.
UP could have carried this forward, made it more attractive, and given a post office saving certificate to anyone in the high fertility districts below a specified income threshold.. Out of 75 districts, UP needs to mostly focus only on some 35.
Registration of Birth, Death and Marriage
I do feel that registration of marriages, deaths, and births has to be looked at with fresh eyes. During my tenure at the Jansankhya Sthirata Kosh, we found that local administrative heads or sarpanches were merrily signing off wrong birth certificates because people wanted to marry their daughters young.
When we asked the sarpanches, they said that “if we don’t sign these certificates, no one will give us their votes when the elections are held.”
We had recommended that this responsibility should be taken away from the local administrative level and be given to the Sub Divisional Officer, who is mostly an IAS officer. However, this recommendation was not taken forward.
The Call Centre Strategy which Worked
Most importantly, we had also set up a call centre—not a helpline—in an industrial estate to give information on reproductive and child health in both Hindi and English, and we had trained people who used to answer questions coming from very remote districts like Purnia in Bihar or Shravasti in Uttar Pradesh. People were starved of basic information like- how to get contraceptives, where to get them, side effects, and a lot more.All from the privacy of their homes!
Male Contraception Ignored. Why?
The National Health Policy 2017 states that male sterilisation or vasectomy was to be pushed up above 5 percent. At present, it is still below 0 percent, which is just not acceptable.
The Chief Minister of Uttar Pradesh has been bold enough to say a lot of good things about the need for population stabilisation but he really needs to adopt strategies that will work. I don’t think much will be gained from spending time and money going after government servants who are not the target group.
A Golden Opportunity for Uttar Pradesh
The whole question of population stabilisation is extremely important and even the economy depends on how you handle it.
With proper skilling, Uttar Pradesh could be a goldmine but not if you are going to use coercion because it flies in the face of the policies that India has adopted.
(Shailaja Chandra is the former Secretary in the Ministry of Health and first Executive Director of Jansankhya Sthirata Kosh—National Population Stabilisation Fund. This is an opinion piece and the views expressed are the author’s own. The Quint neither endorses nor is responsible for them.)
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