A new family planning agenda focusing on voluntary acceptance of family planning evolved in the 1980s following the political fallout over the coercive sterilization program of the Emergency. 4 During this era, method acceptance shifted from male sterilization to female sterilization. This shift is largely explained by the development of laparoscopic techniques for female sterilization; misconceptions and concerns about the side effects of vasectomy, such as loss of strength and libido; and the development of women-centered programs, such as the Reproductive and Child Health program. 5 Also driving the change was the 1991 implementation of a centrally sponsored incentive scheme to encourage eligible men and women to accept sterilization. According to this scheme, women undergoing tubectomy were eligible to receive 300 rupees (Rs.) and men undergoing vasectomy were eligible to get Rs. 200. 6 This was revised in 2006, and women opting for sterilization were eligible for Rs. 600 and men undergoing vasectomy were eligible for Rs. of the family planning program, the rhythm method was the only birth control method recommended by the government. Because of the high rates of failure for this method, in 1956 the government began to offer condoms, diaphragms and spermicidal jelly 2 to couples free of charge through hospitals, health centers and birth control clinics, and this "clinic approach" continued until the 1960s. In the 1960s, to further motivate couples to accept family planning, the government adopted an "extension approach," and the IUD and vaginal foam tablets were introduced. This new approach included an educational component designed to bring about changes in the knowledge, attitudes and behavior of people in regard to family planning. Male and female sterilization were introduced in 1966, and the government established method-specific targets for health workers to achieve. 3 To accelerate the pace of fertility decline, the government introduced cash incentives to attract sterilization acceptors in 1967. During the Indian Emergency (1975Emergency ( -1977, in response to the unprecedented population growth of the 1960s documented in the 1971 census report, aggressive sterilization camps were held all over the country and about 8.3 million sterilizations were carried out. However, approximately 75% of the procedures were vascetomies.