As per a report of the United Nations, India’s population is likely to surpass China by 2025; and is pinned to hit 1.7 billion by 2060. Although the Government of India has been implementing the National Rural Health Mission since 2005 in line with the policy framework of population stabilisation as envisaged in National Population Policy 2000, by helping to create a robust service delivery mechanism to address the unmet need for family planning – a lot remains to be done. Social determinants of health, paramount among which are literacy, women’s empowerment and age at marriage and to a certain extent religion are impediments to population stabilisation.
Taking steps to control population in areas where population growth is more than the national average, the Government of India has identified 264 high focus districts having weak health indicators pertaining to maternal health, child health and family planning that will receive focussed attention and supportive supervision. The interventions for population stabilisation include the following:
- The services of Accredited Social Health Activists (ASHA); instituted in 2005 by the Ministry of Health and Family Welfare as part of its National Rural Health Mission, are now being utilised to deliver contraceptives at the doorstep of beneficiaries in 233 districts of 17 states. ASHA charges a nominal amount from beneficiaries for her effort to deliver contraceptives at doorstep i.e Rs 1 for a pack of 3 condoms, Rs 1 for a cycle of oral contraceptive pills and Rs 2 for a pack of one tablet of emergency contraception pills. In future, with a view to ensuring spacing after marriage and between 1st and 2nd child, services of ASHAs
will be further utilised for counselling newly married couples.
- The Prerna strategy (responsible parenthood practices) of Jansankhya Sthirata Kosh (JSK), set up with a corpus of Rs 100 crores, promotes population stabilisation by encouraging delayed marriage among girls, by rewarding and publically honouring women who marry after the legal age and ensure proper spacing between the birth of their children. Around 800 families have been awarded so far under Prerna. For instance, a girl marrying at 19 and giving birth to a male or female child at 21 years of age would be rewarded with Rs 5000 or Rs 7000, respectively.
- The Santushti strategy provides for private sector gynecologists and vasectomy surgeons an opportunity to conduct sterilisation operations under public private partnership. Coupled with this the compensation package for sterilisation provided at present is Rs 1500 for each case of vasectomy for all categories in all states and Rs 1000 for tubectomy to all categories in high focus states and BPL/SC/ST population in non high focus states in public health facilities. However, for above poverty line categories in non high focus states, a package of Rs 650 has been provided for tubectomy only in public health facilities.