Prime Minister Narendra Modi, in his usual style, appealed to the nation about Population control from Red Fort in his Independence day speech that “Family planning is itself a patriotism” After Sanjay Gandhi’s compulsory sterilization program which gulped the power of Congress, the same fear loomed over successive governments, and they never dared to touch the population policy. This electoral fear of implementing population control strategy has resulted in a population growth that can make India most populous country on the Globe. It is less likely that the masses will respond to a patriotic plea of The Prime Minister, and Contraception will be accepted like demonetization or become a mass movement like Swach Bharat or Yoga Day. Apart from linking Contraception to patriotism in speeches on popular forums, much more needs to be done on war footing level.
Every family and in the long run country needs to decide on concrete population strategy considering which stage our country falls. Presently India is in late expanding phase of the population which results from decreased death rate but birth rate falling at a slower pace. This stage where the birth rate is more than the death rate is such that a better population control strategy can result in an ideal stationary phase of population. At the same time, a neglected population policy can push the country in an Early expanding stage worsening the situation. Our population strategy never crossed the line of advertisements of Mala D and slogans like ‘Hum do hamare do’. In the course of time even these campaigns also gradually faded. An ordinary citizen is miles away from Economic or Foreign policy, and population policy cannot be another addition to be implemented in isolation. Population policy is something that begins and ends in bedrooms. It makes the arena extremely sensitive and intricate. The complexity of the issue demands a definite answer to the question of whether we are planning to control the population through public awareness or law and regulations. This debate is similar to the Tilak – Agarkar school of thinking, arguing on freedom first or social reform first. Some grass-root observations of doctors need to be considered to give a verdict on the debate,
Today very few married couples are aware of the best and most efficient mode of contraception after a single child and after having two children. In a country with the vast majority of illiterates and oppressed, even if some weak soul desires to get information about this, there is no reliable and easily accessible source of information. A family cant decides on its family size because it has never heard of the country’s policy on the best family size and never been convinced about this. R. D Karve was probably the last social reformer who dared to talk openly about contraception. After the 15 august statement of Prime Minister Modi about family planning, it would be a great social move if he talks about the contraceptive methods in the next few episodes of Man Ki Bat. Most of the masses know very less about the best contraceptive methods and their knowledge is limited to condoms and vasectomy popularly called nasbandi. In the eighties when private players jumped into condom sale, they very well marketed it as a medium of sexual pleasure when no such connection exists. Condom with a maximum failure rate of 14 % grabbed a significant position in the minds of people, and this shadowed other valuable modes of contraception. Copper T, Oral contraceptives, and injectable depo preparations are some of those who lost relevance in comparison to condoms. Although all these modes seem to be female-centric, this keeps the decision of contraception in the hands of female, and this is very important in a male-dominated society with violated reproductive rights of women.
Today, if we have to formulate a successful population policy, two couple should be targeted. The first is the one with one Child and later is with two children but who haven’t yet resolved to limit the family. The illiterate and the oppressed neither return to the hospital for contraception nor do they have access to a health facility for termination of an unplanned pregnancy. Even though they are not determined to have a child after the first one they get trapped in a positive feedback cycle of Conception – Poverty – Child malnutrition – maternal illness. The best way to break this cycle is the immediate insertion of copper T in the delivery room as soon as the child is born. Counselling of The couple on antenatal visits for this contraception will strengthen the practice. Since it’s an arduous task to get this mother back to the hospital, this is the best mode and most effective way to limit family. The contraception will offer protection against pregnancy for the next five years. But this way has received less attention at the level of policymakers and authorities. Population policy is never pondered so deeply and micro-planning of such efforts done. The couple with two children are in a different position.
Terminal sterilization methods tubectomy and vasectomy are best at this point. We don’t have moral right to convince them for terminal sterilization since cant assure this couple healthy under-five children. Hence Copper T or subcutaneous injectable contraceptives which are relatively painless. But all these modes have not yet geared up. For terminal sterilization, vasectomy for males is a far better and cheaper alternative as regards to public health. The jargon Nasbandi conveys a negative impact, and rural males associate this with sexual weakness.
Contrary to popular belief, this can be beneficial on the sexual front as fear of conception is an essential cause of performance anxiety. This surgery needs an urgent name change operation. BJP should recruit some of its branding experts working on famous slogans to suggest a better name for this surgery. Prime Minister should declare this name in a national address as was done on the eve of demonetization.
We can debate whether the nation needs to have legislation for population control. China has suffered a social set back due to the one-child policy. Mimicking the same would be throwing the baby out with the bathwater. But at least a two-child policy and refusal of government schemes, subsidies for couples with three children or a positive reinforcement with additional benefits for those who comply with the policy. Social and educational upliftments are vital prongs of the multipronged approach of population control. But they will happen at their own pace. Apart from these gradual social changes, revamp and thoughtful additions to the population control policy are need of the time.