Greater Access to Rights-Based Family Planning Needed

by August 7, 2018 0 comments

Greater Access to Rights-Based Family Planning NeededIf the Indo-Vietnam strategic partnership on sustainable development is to see the light of day, there must be improved access to quality rights-based family planning services.

Over the last couple of years, India and Vietnam have developed a robust strategic partnership. But burgeoning trade and military alliances are not the only ties that bind the two countries together. They also share another common perception – that population needs to be controlled and this can best be done through the two-child policy. So, is this policy necessary to accelerate the process of population stabilisation? In India, there is no evidence to show that this policy has directly led to decline in fertility rate. On the contrary, ample proof exists of how it has violated women’s reproductive, human and political rights. Since the policy bars anyone with more than two children from participating in elections to local government and from holding any post in the panchayats and urban local bodies, women face negative consequences of implementation of the norm directly (as candidates) as well as indirectly (as spouse of those disqualified) in the form of desertion, forced abortions, neglect and death of female infant or female child being given up for adoption.

In fact, India’s National Family Health Survey 3 (2005-06), indicated most States, including some high fertility ones, had reached replacement level fertility. In other words, a majority of couples did not wish to have more than two children. And yet, some States continue to push the two-child norm, instead of focusing on increasing access to healthcare and family planning services. The case in point here being the draft Bill on the two-child policy introduced in 2017 by the newly elected BJP Government in Assam on grounds that population growth needed to be curbed, particularly among minority communities in the State. It overlooks the fact that the total fertility rate (TFR) in the State (2.2) is just a notch away from India’s replacement level fertility of 2.1.

In Vietnam, the government believes the two-child policy has brought the national population growth rate down to about one per cent in 2016. Its contraceptive rate is also high at 67 per cent.  In 2003, although it stopped taking punitive action against the general public if they had more than two children, Government officials and parliamentarians continued to be at risk of losing their jobs if they had a third child. The policy has still not been discontinued although Vietnam reached a fertility replacement rate (2.09) in 2006. It has maintained that rate for the last decade. However, with some districts being more populous than others, the country is now mulling over whether disincentives for the public be reintroduced to bring down population growth among some of its ethnic communities.

But this policy has not just brought down the number of births, it has adversely influenced fertility decisions. A strong son preference in both countries has led to sex selective abortions to ensure that one of the two children is a boy. Just like in India, the availability of technology to determine the gender of the foetus in Vietnam has provided the opportunity to avoid unwanted female babies leading to thousands of ‘missing girls’ revealed a recent UNFPA report. The number of ‘unwanted girls’ in India may be as high as 25 million because their parents wanted to have sons instead according to the Government’s 2017-18 economic survey.

Consequently, India and Vietnam are struggling with an imbalanced sex ratio at birth skewed in favour of boys. In India, average sex ratio declined from 906 female births per 1,000 male births in 2012-14 to 898 in 2014-16. Although Vietnam showed slight improvement, the number of girls are still less (112 boys to 100 girls). This is despite the fact that both countries have laws banning sex determination and sex selective abortions.

So, are there lessons that these countries can learn from each other? A comparative analysis of human development indicators shows a communist party led-Vietnam is ahead of the world’s largest democracy. Consider these statistics: India is ranked 131 of 188 countries in the 2017 Human Development Report. Vietnam is ranked 115. India spends only 1.3 per cent of its GDP on health compared to 3.9 percent spent by Vietnam. Although India’s maternal mortality rate has come down to 130 per 100,000 live births, it is still much higher than Vietnam’s which stands at 58 in 2016. Even the infant mortality rate in Vietnam is better than India’s (17 per 1,000 live births compared to 34 per 1,000 in India). With 51 percent of women of reproductive age impacted by anaemia, India has the largest number of anaemic women in the world. It is 24 per cent in Vietnam. Clearly, India needs to invest much more on its women.

However, Vietnam stands at crossroads today with its population ageing quickly, thanks to the two-child policy. Considered to have one of the world’s fastest aging populations in the world by the World Health Organization, the number of younger people, (under 15), has been declining for several decades. Today, it stands at 23 per cent   of the population, compared to almost 40 per cent in 1989 increasing its risk of ‘growing old before it grows rich’. On July 11, World Population Day, the Government publicly admitted challenges existed and promised to change the focus of its population policies, from family planning to more comprehensive population and development initiatives within the human rights framework.

India is still a young nation, with the elderly comprising 8.9 percent of the population. By 2030 this is expected to rise to 12.5 per cent. But does it want its two-child policy to make it old before it can get rich? For it to reap its demographic dividends, India must transform its population policies. One way is to increase its contraceptive rate by making contraceptives and services available to all and stop targeting women to meet population goals. Couples need to be persuaded to have small families, not coerced by the two child policy. Unless there is improved access to quality, rights-based family planning services and women have a choice on if, when and how many children to have, neither India nor Vietnam can achieve sustainable development.

Writer: Swapna Majumdar

Courtesy: The Pioneer

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