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Following massive protests over the death of 13 women who underwent the
sterilization procedure of tubectomy in Bilaspur district of Chhattisgarh last
November, the Ministry of Health and Family Welfare has written to all States
reminding them that every person should be counselled about the different family
planning options available. The letter completely contradicts the Union
government’s intent of achieving population stabilization almost exclusively
through sterilization. In a letter sent in October 2014 to 11 high-focus States, the
Ministry had noted that the 2020 family planning goals had --underlined the
importance of sterilization surgeries in these States. Even the recently released
draft National Health Policy 2015 highlights the --challenge of population
stabilization in six of the 11 States. In order to achieve the annual targets, the
government recently increased the compensation given to women/men, motivators
(Accredited Social Health Activists) and doctors.
If the revised incentive given to motivators is Rs.200 for tubectomy and
Rs.300 for a vasectomy, the amount is as high as Rs.1,000 for a --permanent limiting
method (tubectomy or vasectomy) in the case of couples after up to two children.
The higher incentive earmarked for permanent limiting methods is another reason
why more women will now end up on the operating table. The government
recently added a new component -- post-partum sterilization done soon after or
within seven days of delivery. This approach works to the government's advantage
as more women are opting for institutional delivery to avail of the cash incentive
earmarked for it. Given the government’s primary focus on permanent and
irreversible family planning options, the question of counseling women on the
different options and giving them full freedom to choose the best one, will at best
remain on paper, and not in practice. Sterilization is the most prevalent form of
contraception in the country, constituting nearly 75 percent of the.2002