Incentives and Disincentives in the Indian Family Welfare Program

Abstract

The Indian family welfare program has offered financial incentives since the early 1960s to both family planning motivators and acceptors of sterilization and the IUD. This article reviews the available evidence regarding the impact of incentives on the quality and quantity of family planning services in India. Administrative concerns related to the implementation of incentive programs are discussed, and the current debate on disincentives, as well as the brief period when disincentives were used, is summarized. The studies reviewed, though few in number and varying in quality and methodology, indicate that incentives to acceptors help to increase the level of contraceptive acceptance, especially when they are part of a well designed strategy of service delivery and client motivation. Incentives do not appear to have an adverse effect on quality of services and acceptors, and they do not seem to influence method choice. Disincentives, if they are used, should not impinge on fundamental individual rights of either the parents or the child.

Socioeconomic and Cultural Differentials of Contraceptive Usage in West Bengal

“…In order to stabilize the population size and achieve a net reproductive rate of one, 60 percent of Indian couples would need to practice birth control measures. 11 However, only 34.9 percent of India's reproductive population use some form of birth control. 12 Although Tamil Nadu and Andhra Pradesh are success stories in fertility control and family planning, 13 Uttar Pradesh, by contrast, has by far the highest fertility of any state in India.…”

Incentives for Small Families: Concepts and Issues

“…One-time payments for contraceptive adoption are often used for sterilization (Satia and Maru 1986;Thapa and others 1987), occasionally for the IUD, but infrequently for other methods. This may reflect a combination of more serious financing constraints for sterilization and the IUD, and practical difficulties in monitoring adoption of other methods.…”

“…In India (Satia and Maru 1986), payment levels designated as compensation for lost wages rose from RslO in 1964 to RslOO (US$9.00) in 1983-the latter approximately equivalent to ten to twelve days' wages. An additional Rs4O (men) or Rs7O (women) is designated as compensation for drugs, food, and transport, and many states offer supplementary amounts.…”

“…For example, several Indian states give sterilization acceptors and their families preferred access to health services, education, and loans (Satia and Maru 1986). Where these services are not expanded to meet the extra demand, however, this becomes a disincentive.…”

Factores que influyen en la probabilidad de aceptación del dispositivo intrauterino posparto en cuatro países: La India, Nepal, Sri Lanka y Tanzania

“…En los seis centros de la India que participaron en la iniciativa, los únicos métodos anticonceptivos de larga duración disponibles para el momento inmediatamente posterior al parto eran el DIUPP y la ligadura de trompas bilateral (LTB), y la única alternativa a estos métodos era la píldora de progesterona y el preservativo. Durante muchos años, el gobierno ha venido ofreciendo pequeños incentivos económicos a los profesionales, las mujeres y los trabajadores sanitarios locales para promover la anticoncepción13 . Dado que se recomienda a la mayoría de las mujeres que salgan del hospital con algún tipo de anticonceptivo de larga duración y dado que las opciones son limitadas, el DIUPP se ha convertido en una opción interesante para las mujeres jóvenes con pocos hijos, debido a su reversibilidad.…”