Political Will and Family Planning: The Implications of India's Emergency Experience

Abstract

The application of political will to family planning in India produced all the critics of the governments earlier family planning efforts had expected of it plus a great deal that had not been anticipated. By the time the intensive family planning drive came to an end in 1976 although a 50% increase had been achieved in the proportion of Indian couples estimated to be protected by modern contraception millions had suffered harrassment at the hands of government officials bent on implementing it; many had died from it; the political leaders who had willed it were out of power and in disrepute; and the program itself collapsed. Finally the unanticipated costs came to outweigh the benefits that had been expected and the program could not survive. The family planning turmoil from which this emerged occupied the latter half of the 19-month period of emergency rule that lasted from late June 1975 until mid-January 1976. An integrated approach had been taken in which family planning became an integral if not dominant component of the program of all government departments rather than the primary responsibility of the health and medical authorities. The techniques used were the intensive crash program approach; surgical sterilization as an easily administered contraceptive method; the use of targets as an important means of controlling fieldworker performance; the assignment of principal field-level responsibility to the generalist administrative cadre; the payment of monetary incentives to sterilization acceptors; the use of sanctions; plus resort in some cases to compulsive sterilization. In the end family planning became the dominant virtually exclusive theme of the governments development efforts and the intermediate objective of increased family planning acceptance was pursued as if it were all that mattered.