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  • Title: Obsession with targets.
    Author: Anil P.
    Journal: Health Millions; 1994 Jun; 2(3):37-8. PubMed ID: 12345779.
    Abstract:
    Every year from January to March throughout India the entire Family Welfare Department is active to achieve targets for family planning. Experts on population have determined that India needs to achieve a couple protection rate (CPR) of 60% by the year 2000 to reduce the population growth rate and help stabilize the population. CPR is defined as the percentage of eligible couples effectively protected against childbirth by one or the other approved methods of family planning: sterilization, IUD, condom or oral contraceptive (OC) pills. It is estimated that there are 150-180 currently married eligible couples per 1000 population in India where the wife is in the reproductive age. Each state allocates targets: the number of sterilizations to be performed, IUDs to be inserted, and OC pills and condoms to be distributed for each district. The District Medical Officers are allocated targets who direct their subordinates to meet the requirements. The high rate of sterilizations performed as well as coercion and threats are part of target completion. At sterilization camps "motivated acceptors" are sterilized and left alone to bear the side effects. It is estimated that 72 condoms are required by a couple a year. Whether the couple uses the condoms at all is no concern for the target hunters. There have been newspaper reports of large quantities of OC pills and condoms being dumped into ditches. Targets of CPR have been reached with no significant effect on birth rate and growth rate. Deficiencies also exist in relation to the crude birth rate and annual population growth rate. 41.2% of the sterilization acceptors have four or more living children. Their inclusion in the records only boosts the CPR statistics with hardly any impact on the demographic scenario. More attention should be paid to quality rather than quantity and holistic health care especially for women and children.
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