India's Family Planning Program Needs an Overhaul

You may already have heard the news that 13 women died in India a few days ago after attending a government organized sterilization camp. A BBC News team went to the area and found a health clinic "full of cobwebs and dust."

Laparoscopic tubectomy, the operation the women had, takes only about five minutes, but preparing the patient before the surgery and administering anaesthesia means that it should take at least 25 minutes per person, says Dr Ramneesh Murthy, the medical superintendent at the Chhattisgarh hospital." According to government rules, a surgeon should perform at the most 35 surgeries in a day and most doctors do follow this," he adds. In Pendari though, 83 operations were conducted by a single doctor and his assistant, and villagers allege it was all done in just six hours. The place where the operations were done is a big white building in an empty patch of land. It looks desolate, with overgrown grass and bushes all around it.

The problem is that tubal ligation is the dominant theme of India's official family planning program, as the graph below shows.

Mass sterilisation camps are held frequently in India to try to control the burgeoning population of the country. While they are voluntary, campaign groups like Human Rights Watch point out that since health workers are given incentives by the government to bring in more women for surgery, they are often indirectly pressurised into doing so.

Besides these health risks--which shouldn't exist because tubal ligation is not complex--the focus on female sterilization in India means that Indian women still marry young, have children, and only after having children undergo sterilization. This bunches up the generations and actually causes the Indian population to grow more quickly than would otherwise be the case and, of course, this pattern also holds back the emancipation of women from early marriage, early motherhood, and domination by her husband and mother-in-law. 

India needs to be part of a new program announced just today in which Pfizer Inc., the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation (CIFF) will expand access to Pfizer’s injectable contraceptive, Sayana® Press (medroxyprogesterone acetate), for women most in need in 69 of the world’s poorest countries. India's young women will hopefully be part of this effort.