, Research Paper
India’s population is in peril. Without the implementation of stringent, effective population management policies, the country’s population will rise above 2 billion within the next 20 years (www.fpaindia.com). In the absence of control programs, India’s ever growing population will lead to increased incidents of famine, disease, environmental stress and result in a severe shortage of housing facilities. However, if the Indian government quickly administers population regulations so that couples have, on average, 2 children by 2001-2006, India’s population will stabilize at approximately 1.7 billion (www.fpaindia.com). A drop in both the fertility and birth rates is essential. To achieve this goal, the 5 Year Planning Commission intends to follow the new population control program outlined by India’s central government. We intend to explore reasons why family planning is essential, issues concerning the expansion of health care, and also sterilization practices and alternatives, proving that our 5-year plan for population management most plausible and logical method to control a rapidly burgeoning population.
Family Planning – An Essential for India
A swiftly growing population does not always seem like a nuisance. An increase in the number of citizens in a country, may for example, signify the improvement in health care, sanitation and a drop in death rates. Developments such as these, naturally lead to an expansion in population. Many areas may easily handle this increase in some areas, but what happens when the population continues to grow at an accelerated pace? The outlook is bleak. Uncontrolled population growth will lead to difficulties regarding food, environmental stress, health and housing.
Food shortages are commonly a symptom of high population growth rates, and as such, India is steadily losing the capacity to feed itself. Despite improvements in agricultural productivity, India’s population continues to grow at a faster rate than the countrie’s agriculture can support. The maximum efforts toward increasing agricultural output are just enough to meet the needs of the existing population, not for the additional population added each year (Mathur, 1995, 127). As a result, more than half of India is malnourished, and thousands are suffering from starvation (Mathur, 1995, 100). The solution to this situation is to seek out ways to decrease population growth, and maintain high yield agricultural production.
The desperate need for food has significant impacts on the environment. The soil can only produce so many yields before it becomes depleted and unproductive. In India, the soils are being stripped of their nutrients too quickly, thus speeding up environmental degradation and lowering crop yields. Beyond agricultural difficulties, a large population threatens to reduce water supply and contributes heavily to water pollution. With the additional raw sewage, an increasingly important issue is created, concerning what to do with it. While the earth can cleanse itself of many of these pollutions, global population is polluting at a rate the earth can’t keep up with.
For the majority of the world’s population the level of nutrition continues to be inadequate (Brown, 1974, 66). This is due to the surplus of people. The threat of disease also becomes a considerable factor each year. In large populations, disease is spread much more rapidly, and can survive longer periods if there are more people to incubate them. Where family health care programs exist, there is evidence to show that they have made significant contribution to improving child and maternal health.
As the population is increasing, the average number of persons per dwelling is expanding. There are severe housing shortages, especially in the small villages surrounding the cities (Mathur, 1995, 160). The pace of construction is much slower than the needs of the people. Construction lags further and further behind as the population continues to grow. There has been a steady increase in homelessness as a result of this trend.
Construction and Expansion of Health Care Facilities
As outlined in the central government’s new population control program, there is to be construction and expansion of health care facilities in the Karnataka region. This is an excellent first step in population control. Greater accessibility to health care translates into healthier people and thus lower infant mortality and crude death rates. This may result in an initial increase in population, however, with fewer child deaths, parents may decide to have less children as they will be assured that their children will grow to adulthood. Prolific clinics also mean greater access to health education. A smaller patient to care provider ratio means more one on one attention and therefore more time to focus on educating clients on contraceptives etc. Blalpuram, the rural village we plan to use as our pilot site for the new program has a population of 1000. One or two clinics set up in this area will greatly improve health and education.
One identified problem of expanding health care clinics is the heavy financial cost involved in constructing and maintaining them. Most of the services offered at these clinics would be free of charge, thus no revenue is generated and the clinics become a large financial drain on the government. However, to alleviate financial tension, the 5 Year Planning Commission intends to seek funding from outside sources such as the Untied Nations Population Fund (UNFPA). This fund is a politically neutral source of money and advice. It is the second largest source of grant assistance available to population programs in developing countries. Over the past 29 years, the UNFPA has contributed more than $4 billion for population projects in 171 countries (www.populationaction.org).
Sterilization Practices and Alternatives
The decision to aggressively pursue sterilization practices, as outlined in the governments new population program is ideal in theory, but in practice, may face some real challenges. It is for this reason that other, longer lasting forms of birth control should be examined and implemented.
Sterilization is a cost effective and permanent way to guarantee a decline in birth rate. This program, if carried out wide scale, would see a drastic and almost immediate decline in population growth. Although this program is an excellent one, it is also subject to objection from various social, religious and political groups. Much of the opposition may come from the Indian people as a result of their religious beliefs, or stem from a lack of education about sterilization. For this reason, the 5 Year Planning Commission wishes to propose 2 alternative forms of contraception. Each of these methods are less permanent than sterilization, yet they have long lasting effects.
The first proposed contraceptive for widespread use would be the Norplant system. Norplant is a system in which 6 match-stick sized tubes are placed under the skin of the upper arm of a female. This contraceptive device is 99% effective and lasts for 5 years (www. mjbovo.com/contracept). Insertion of the tubes is a one time, simple process and involves no further thought form the woman (until it is time to have them replaced). This from of birth control is excellent, especially for use among teens or women who wish to wait to have children (Please see attached graphs "Unmet need" and "Married Women…"). It is reversible, unlike sterilization, thus it still provides women with the right to choose when, or if, she will have family.
The second alternate option to sterilization would be Depo-Provera injections. This method of birth control is more than 99% effective and is simply administered through female injection every three months (www.mjbovo.com/contracept). This form of contraception is doubly beneficial as it requires no upkeep, other than to remember the re-injection date and also ensures that the woman will be seen in a clinic every three months. The regularity of these visits is an excellent plan as it will allow health care workers to monitor the woman’s health. It also provides the worker extra time through which they can further educate clients about women’s and family health.
A drawback to each of these proposed alternatives is cost. Norplant costs approximately $450 for 5 years and a removal fee of about $100(US) (www.mjbovo.com/contracept). Depo-Provera injections cost about $30 (US) and involves the use of needles (www.mjbovo.com/contracept). In this case, extreme caution would be used to ensure that each person was injected using a clean needle to avoid hepatitis or AIDS transmission. Although the initial costs of these contraceptive methods are high, it is very important that one recognizes the imperative need for reducing India’s birth rate. High government spending now, on this program will hopefully eliminate the need for even higher government spending in the future as a result of an unwieldily population size (Please see attached table "Karnataka’s population, 1991").
The 5 Year Plan
To implement the new population control program, the Planning Commission intends to execute it in phases, most of the developments to occur over a 3 year period.
YEAR ONE – The Commission has allotted approximately 20% of their budget to the construction of the clinics. The builders will be required to hire villagers to help in the construction of these clinics. By incorporating villagers in the erection if the facilities, it will build a sense of ownership and pride amongst the villagers, hopefully encouraging them to visit the clinic. The Planning Commission will also launch a lobbying effort to the UNFPA for extra funding. Teachers in the Balapuram village will be required to attend workshops on how to teach school children about birth control and health issues. As well, the first year of operations will see a wide scale door to door program focusing on the Dalits, to increase knowledge about the clinic, while distributing and explaining condoms and their use.
YEAR TWO – The Committee has designated 20% of its budget to this part of the agenda. This stage of the program will see the implementation of health and sexual education teaching in the schools. As well, villagers will be hired and trained to perform various clerical and cleaning tasks at the clinic. These will be paying positions, therefore promoting good relations between the clinic and population as a whole. Once the staff is fully trained, weekly health chats/ seminars will commence. To encourage participation, those who attend the seminars will be rewarded with a free meal.
YEAR THREE – This section of the program involves the most financial support (55%) and is the most intensive, in terms of pursuing sterilization and other contraceptive practices. The main idea for leaving the implementation of major birth control plans until the third year is that the Commission believes in allowing the citizens of Balapuram ample time to get used to the idea of using the clinic. The Commission wishes that the clinic be a friendly, non- threatening environment so to encourage wide-scale acceptance and participation.
To help speed the uptake of the contraceptive programs, the Commission has designed a financial reward system. Those who choose to undergo sterilization will receive 250Rs, the largest reward as the benefits of sterilization are the greatest. Women choosing to use Norplant will receive 100Rs and those choosing to go with Depo-Provera injections will be given 50Rs.
Year Four and Five will be a continuation of the practices outlined in Year Three. In the 5th year of the Commissions program, 5% of the budget will be used to conduct surveys, research and to gather general feedback about the program’s progression. At this point, the Commission will re-convene to assess and adjust the population control program.
Each day India moves closer and closer to the point where it will no longer be able to support its population. Without effective and immediate intervention on the part of the Indian government, India’s citizens face a perilous future. The implementation of the Planning Commission’s 5 year program is essential to reduce both the fertility and birth rates. The program delineated by the central government is strong. With proper execution, including the expansion of health care clinics, the use of sterilization and other alternatives, India’s future will be much brighter.
Brown, Lester R. In the Human Interest: A Strategy to Stabilize World Populaiton. NewYork: Norton & Co., 1974.
Mathur, Hari M., ed. The Family Welfare Programme in India. New Delhi: Vikas Publishing House, 1995.