Population is a subject of which the perception varies with the viewpoint of the observer. To the demographer it is an exercise in statistics, to the politician a matter of votes, to the economist it is dissipation of wealth, to the bureaucrat a problem of feeding, clothing, educating and housing the masses and to the industrialist a source of labour. For the affluent countries and the small affluent class in the poor countries it poses a threat to the existing order on which they thrive.
A variety of quick fix Western ‘scientific’ techno-managerial solutions have been devised to control the fertility of the proliferating masses of the world. This highly coercive strategy is being operated through the health departments of the developing countries against the ‘eligible’ female. This is strongly promoted by international agencies with massive funding for such programmes through the national governments. This has nevertheless failed to achieve the targets.
In the absence of a concomitant desire to promote the social and economic development and welfare, the poor realise that it is children who provide them the only source of love and economic security in an increasingly hostile world. The increasing population, despite such single-minded coercive programmes for control of their fertility shows how a programme designed by the ‘haves’ to serve their own interests cannot inveigle the poor who devise their own methods for evading what they know goes against their overall welfare.
Forceful implementation, especially against the male during the emergency, even led to the overthrowing of a government. This has resulted in more benign sounding strategies and programmes like IUD, immunization, MTP, Maternal and Child Health, laparoscopic tubectomy, ‘non-scalpel’ vasectomy, Norplant injectable contraceptives and vaccines, combined with crude incentives and disincentives for their acceptance. The change of name of these basically medical solutions for what is essentially a social problem into heavily externally funded ‘Family Planning’ and ‘Family Welfare’ programmes has not only failed to entice the poor to control their fertility but has also affected the Primary Health Care programme through which it is carried out. In the process it has also disrupted the medical and health services which serve the felt needs of the poor.
No amount of mere changing of the names of the programmes or of the projects/activities can convince them that there is a change of heart. This can be achieved only by visible improvement in fields like education, health and rural development.
The close association between poverty, family size and population is observed not only in sub-Saharan countries, as at present, but was also observed in countries like the UK during the early days of the industrial revolution. Over production is nature’s method for ensuring survival of the species. This is also demonstrated in our northern BIMARU states as compared to those of the South. It is also seen within each state between the reproduction rate of the rich and poor, which is concealed by aggregate statistics.
And yet it is our own state of Kerala which most vividly demonstrates that it is not necessary to await affluence as in countries like Germany to achieve a NRI (Net Reproductive Index) of 1, and even below the replacement level, since Kerala has already achieved this with an annual per capita expenditure on health equivalent to US$ 15 as compared with US$ 3000 of Germany.
The intimate connection between education of the female and family size can be achieved at an economic level, which is within the reach of most countries of the world. Education of the female is desirable not only for population control but even more so for its own sake as it initiates a cascade of other social and economic changes. The care of much of the health and medical functions including family size lies within her capacity and can be achieved more cost effectively in an accessible and humane manner.
The depletion and pollution of the natural resources of our planet is far more the result of wasteful utilisation by an affluent few rather than that of the marginalized masses.
Health and medical care can serve only as a vehicle for reaching technology to those who desire to voluntarily limit the size of their family.
The regulation of family size cannot be imposed as a national programme by political fiat. Their role is to create the climate and opportunity for demand and utilization of reproductive technology.
Overall, social and economic development is the prerequisite for the control of population. This is feasible well within our existing resources if these are distributed in a reasonably equitable manner. The prime requirement for this is the political will, which is unfortunately dominated by a select few.