Family planning and budgeting for human rights in India

Abstract

Purpose The purpose of this paper is to analyse the budget of the Indian family planning programme from a human rights perspective. Family planning services play an important role in the realisation of the reproductive rights of women. In India, the family planning programme is one of the largest in the world with thousands of patients, mostly women, accessing services every year. Although the Indian legal system guarantees the right to health, Indian women from marginalised sections of society still battle inadequate services and the absence of health care that respects their right to reproductive autonomy and choice. Therefore, the question is: in the presence of a strong legal framework, what are the factors that contribute to this phenomenon? Design/methodology/approach The authors have gathered data from the project implementation plans at the state level comparing year-wise expenditure for family planning against overall expenditure for reproductive, maternal and child health expenditure. The data are then compared to the number of women using sterilisation to suggest a relationship between both. Finally, the article relies on desk research to review scholarship on the Indian family planning programme and applicable human rights obligations. Findings The paper finds that social-economic rights such as the right to health are applicable to government spending and budgeting. It also finds current spending in the NHM is insufficient to guarantee women’s reproductive rights as the vast majority of resources are spend on sterilisation, thus limiting women’s ability to choose the number and spacing of children. Research limitations/implications The data used in this research bears one limitation: the propensity of the government to change the guidelines as to how States should present their budgets in the project implementation plans. The authors have adjusted the data so that it remains comparable. However, the adjustment was not possible for all expenditure data, which is why the current study is limited to the family planning programme alone. Practical implications The paper argues that to be human rights compliant, health budgets of the NHM need to be geared towards the specific needs of women in terms of family planning. Finally, the article briefly outlines the role played by human rights and human rights litigation in impacting government budgets. Originality/value India’s family planning programme has been examined from a performance and medical standpoint, focussing on medical indicators such as total fertility rate, unmet needs for family planning, amongst others. Academic scholarship has investigated through statistical analysis patterns of contraceptive use and contraceptive mix. What is absent, however, is an assessment of the programme from a right-based perspective by looking at the human rights obligations of India and their normative implications for the Indian family programme.