The demographic data released by the United Nations Population Fund (UNFPA) in April 2023 estimates India’s population at 1.4286 billion. However, as per the government’s own data, India’s annual population growth has averaged at 1.2 per cent since 2011, compared with 1.7 per cent in the 10 years previously.
Further, the latest National Family Health Survey, 2019-20 (NFHS-5) data shows that almost 24 states have already attained a replacement level of fertility. The Desired Fertility Rate is 1.8, which also indicates that women in India prefer to have no more than two children. The Census data also showed that the decadal growth rate during 2001-2011 had reduced to 17.7 per cent from 21.5 per cent over 1901-2001.
Despite the steady decline in fertility rates in most states, state governments have been proposing coercive family planning measures. The draft Uttar Pradesh Population (Control, Stabilization, and Welfare) Bill, 2021 contain many punitive measures against those couples who have more than two children. For example, it proposes those couples who have more than two children will be denied access to government jobs and schemes and, if they are already employed, they will be denied promotions and increments. They will be debarred from all benefits of the government-sponsored welfare schemes.
Similarly, in 2021, the then-chief minister of Assam announced a similar two-child norm for state social schemes, arguing that tackling population growth was “the only way to eradicate poverty and illiteracy”.
Over the past several years, many of us have strongly opposed the two-child norm policy that continues to be implemented in several states. Madhya Pradesh (MP), which implemented such a policy in 2004, has withdrawn it in light of its discriminatory stances.
Studies have highlighted that any enforcement of the two-child norm on Panchayat representatives has encouraged gender-biased sex selection, increased discrimination against the girl child, and worsened the already declining sex ratio, given the strong preference for sons in society.
A retrospection and interrogation of the family planning programme are critical to be linked to updates around the two-child norm or similar populist stances by the governments. To recall briefly, the trajectory of India’s family planning programme has unfortunately been blotted with grave questions about the callous treatment of women, as well as violations of ethical and quality assurance standards in health service delivery.
The deaths of fifteen women in the sterilisation camp incident in Chhattisgarh in November 2014, which is well known within the public knowledge and conscience, is a testimony to this. Situated in the larger context of population control, the family planning programme continues to be unacceptably mired in targets and disincentives, a far cry from the realisation of reproductive rights, bodily autonomy, and integrity. The politics and policies of coercive measures and impudent (dis)incentives favour such control over the reproductive health and human rights of women. The discourse on reproductive and sexual health and rights is thus restricted mainly to the control of fertility, especially of women belonging to marginalised communities of the poor, Dalit, Adivasi, and Muslim women. The state’s intervention on when such control is to be executed and how, undoubtedly violates all reproductive and sexual rights that have been the mainstay of most population policies.
We strongly believe that incentives and disincentives will neither increase healthcare quality nor address issues of equity and access to healthcare facilities. They will not improve service providers’ accountability to the community, particularly women and the poor.
In relation to these discourses globally, the International Conference on Population and Development (ICPD) Programme of Action (POA) had clearly stated in 1994, “Over the past century, many governments have experimented with such schemes, including specific incentives and disincentives, in order to lower or raise fertility. Most such schemes have had only a marginal impact on fertility and, in some cases, have been counterproductive. Governmental goals for family planning should be defined in terms of unmet needs for information and services.”
India, too, being a signatory, had long ago committed to a target-free approach based on informed and voluntary choice of people, and getting rid of setting population control targets (National Population Policy 2000).
It is clear, then, how the two-child norm or any such restrictive policy, by being coercive, works against development agendas, goals, and commitments, both nationally and internationally.
It would be worthwhile to mention here that in December 2020, in an ongoing petition in the Supreme Court, the Ministry of Health and Family Welfare (MoHFW) stated in its affidavit (in response to a petition) that “the Ministry will not implement a mandatory two-child policy by denying government jobs and subsidies and has reportedly remarked in it that the Programme of Action of the ICPD, to which India is a signatory, is unequivocally against coercion. The MoHFW pointed out that there is a decline in India’s total fertility rate as per the NFHS 4.”
Women need health services, including access to contraceptive methods, contraceptive education, and counseling. However, the unmet need for women’s contraceptive access is regrettably met with poor treatment and discriminatory norms.
The top-down agenda of ‘managing demographic targets’ takes precedence over women’s reproductive autonomy and integrity to make informed decisions about their own bodies, health, and life.
Women having the right to decide whether, when and how many children to have also implies the availability of comprehensive, safe and affordable sexual and reproductive health services. Providing adequate opportunities and resources to women should be a priority so they can decide freely for themselves, as a matter of their right to equality, non-discrimination, and the highest attainable standard of health.
(Views expressed are personal)
(This appeared in the print as 'Coercion is Not An Option')
Sarojini Nadimpally and Adsa Fatima work on gender and health issues. They are associated with Sama Resource Group for Women and Health