Population policy and health care

FROM POPULATION CONTROL TO REPRODUCTIVE HEALTH — Malthusian Arithmetic: Mohan Rao; Sage Publications New Delhi.

Even as the women's collectives and the voluntary health groups protest against the National Population Policy, which promotes two-child norm, the recent National Commission on Population categorically endorses drastic fertility reduction.

• Why does concerns about population growth continue to dominate India's development and health policies?
• How did the idea of relating population growth to poverty come about?
• What has been the nature of debates on population control among Indian intellectuals and international donor agencies?
• Can the agenda of reproductive health fulfil the need for primary health care?

Through a critical analysis of India's population and public health policies, this book examines these above questions. The key argument of the book is that India's population policies were and are primarily guided by the neo-Malthusian ideas of population growth combined with the eugenic notions of birth control. Internationally the alliance between the birth controllers, American corporate capital, and the demographers not only led to distorted demographic enquiries into population growth but also strongly brought in the neo-Malthusian understanding that the poor with their large family size are responsible for their poverty. The role of international agencies like the Rockfeller Foundation, the United States Agency for International Development (USAID), Population Council, and the World Bank, the book argues, is significant since they are very keen on thrusting the neo-Malthusian and eugenic ideas on India's official policies and programmes.

Through a critical evaluation of the Family Planning programme in India, the book offers a vivid picture of how neo-Malthusianism pervades the entire Family Planning programme which has led to coercive tactics like forceful sterilisation of men and women, introduction of vasectomy camps, forceful insertions of contraceptives like IUCD and the hormonal implants. It also explains how this programme has, over decades, emerged as one of the largest public health initiatives in the world with the entire primary health care being geared towards the goal of a small family size. In the process, as the author shows, the entire health care system was restructured towards meeting the small family norm by projecting it as necessary for the good health of people.

He shows that the alliance between feminists, the neo-Malthusians, and the environmentalists with the patronage of institutions like the World Bank and the Population Council has brought in the so-called "paradigm shift" in the population programme of developing countries. Throughout the book, the author elicits the politics, networks, alliances of different population control lobbyists like the international donors, environmentalists, demographers, and advocates of reproductive rights and elaborates on how justification for population control was sought from different platforms and ideological moorings.

The book is not only a powerful critique of neo-Malthusianism and neo-liberalism which continue to influence India's population policies and programmes, but also underlines the need for an universal primary health care. This well-researched work is of utmost relevance to academicians, activists and policy-makers interested in health care and population policy. S. Anandhi The Hindu, Tuesday, Aug 30, 2005