#India -Do you know incentive and target based health services can be coercive ? #Vaw

Permanent sterilization-incentive based and target based health services: a glimpse from Rajasthan

– Leena Uppal

My elder sister in law was the one who suggested that I should go for female sterilization, if I get lucky I may win a motor cycle in the lottery….. 

The Ration Unit and Fair Price Shops in Bundi District of Rajasthan have been given instructions by the State Health Department to meet the target of at least two sterilizations before 30th March. There is also an incentive attached. The dealer s with the maximum cases will be certified and rewarded.  Targets are distributed further to the fair price dealers because the health department workers could not meet their family planning targets, which focus heavily on sterilization….. (Source: local newspaper, Rajasthan Patrika, 22.03.2013).

In a family planning camp held in a Community Health Centre (CHC) in Raipur Block of Pali district of Rajasthan on 22.03.2013, though the district collector announced various prizes including motorcycles, Colour TVs and home appliances to be distributed to ‘lottery winners’ among couples who opted for permanent sterilization as well as targets of village health providers to motivate women for sterilization; this camp did not see much of a turnover. The service providers shared that this could be because of Holi (a festival of colours in India) and during Holi people in the villages were busy.

Women present in the camp at Raipur were going under the knife without fully understanding the risks, precautions, consequences and their rights as claimants in case of failures, as nothing was explained o them or read out to them from the consent forms on which they gave their thumb impressions.

There are national guidelines of the Ministry of Health and Family Welfare that have a detailed description of the contents of medical history, Personal characteristics and reproductive history, menstrual history, obstetrics history, contraceptive history that is to be recorded in detail before female sterilization is done, however, this has not yet been built into the MIS system of the facilities. The only records that were maintained were the social-demographic profile and the consent form of the acceptors.

Follow up instructions, discharge cards, monitory incentive to sterilization acceptors were not given to the women before they left the facility. The families of women arranged their own transport to get back homes after the camp concluded at 3:00 pm on 22.03.2013.

Family planning should be regarded as a matter of choice and rights by both the service providers and the community. But this is not at all the case of what is being recorded and reported. While the National Population Policy has seen no place for targets, rural women continue to be seen as family planning targets and family planning camps as best models to meet these targets. This approach is problematic as there is no equal precedence given to post operative care and follow-up.

The government must audit and ensure strict compliance to the quality assurance mechanisms that have been established. There is an urgent need to understand both population issues and health service delivery within in the perspective of ‘women’s rights’ and justice, by the service provide

UP Govt announces target sterilization against National Policy # Coercion


The UP Government announces sterilisation targets for Azamgarh District for the months Novermber and December:


According to the letter issued by the Chief Medical Officer (Azamgarh), dated 30.10.2012, number P.K. Camp/2012-2013/14896-03

  • The target for sterilisation announced for the district of Azamgarh for the months of April-November 2012 was 23085.
  • The targets met by the government in the month of November 507.
  • The sterilisation camp locations and dates along with the doctors responsible for conducting operations have also been announced through this letter.
  • The CHCs and PHCs can organize additional sterilisation camps as per their convenience.
  • Third and forth camps have been deemed as ‘special camps’

There are clear directives and indications to show that the states governments announcing targets for family planning in various states, like in the district of Azamgarh. This approach is clearly is not aligning with the National Population Policy (2000) which specifically talks about bottom up planning and community needs assessment approach.

It is urgent that a vigil is kept on these camps. This is possible such information and letters are circulated among all of widely.

It is an appeal from the Coalition Against Two-Child Norm and coercive Population Policies that such news and orders if widely circulated will help generate momentum to the advocacy against coercive family planning programmes in India.

Please share information from states with us. Visit our website www.2cnpop.net.


The original letter as cited above is attached herewith.

Family Planning Camp- download


Man commits suicide after wife’s sterilization

 | Apr 27, 2012

 BHOPAL: The sterilization fiasco in Madhya Pradesh refuses to die down.

Lamenting the decision of making his wife undergo sterilization two months ago, a 35-year-old man, father of six daughters committed suicide in Betul district on Wednesday. His wife, who went under the scalpel in February, alleged that her husband was promised a plot of land and cash by the panchayat secretary and sarpanch of the village in exchange for the sterilization.

On the woman’s complaint, the district administration has ordered an inquiry into the case. Kanchan Dongre, CEO of the Janpadh panchayat in Maultai said, “Action will be taken based on the inquiry report.” The police also registered a case and started its probe into the suicide.

Prakash Deshmukh, resident of Sandiya village, seven km from Betul town and 150 km south of Bhopal, consumed poison on Wednesday afternoon. Neighbours rushed him to the district hospital where he was declared dead. Deshmukh and his wife Kala worked as agricultural labourers.

In the beginning of the year, the state saw a sharp rise in vasectomy surgery numbers after chief minister Shivraj Singh Chouhan declared 2012 as the year for family planning and welfare. District administration officers went all out to fix targets for number of sterilisations and implementation. Reports of forced vasectomy and allurement to make people go under the scalpel poured from across the state.

Wife of the deceased, Kala Deshmukh, accused that her husband too asked her to undergo sterilisation after panchayat secretary Hemant Barde and sarpanch Vijay Thakre of the village lured with promises of a plot of land and money.

On February 14, I was operated upon. After that day, my husband kept meeting the panchayat secretary for the land and money without any success.

Panchayat secretary Hemant Barde could not be contacted but sarpanch Vijay Thakre said, “The couple have six children and have no money to feed them. We did not lure them with impossible dreams but informed them of the various schemes of the state government for BPL families.”


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