Anita Anand | No ‘outsourcing’ of policy: Don’t target NGOs, try to fight ‘male preference’

Pointing to the decline in India’s female-to-male sex ratio, they implied that it was due to funding by American foundations and INGOs to Indian government agencies and NGOs to encourage sex-determination tests, starting in the 1960s. This is somewhat far-fetched.

The sex-determination test was a by-product of a procedure called amniocentesis discovered in the 1930s to determine birth defects or abnormalities in a foetus of a pregnant woman. India, which clearly has a son-preference culture, welcomed the sex-determination part of the test. Many women’s groups, liberals, and left-leaning individuals perceived the sex determination test as encouraging male preference, contributing to a declining female-male ratio, and endangering women’s lives through repeated abortions of female foetuses.

In the early 1980s, I worked on a series of documentaries examining technology’s effect on women in various countries. In India, initially, the idea was to look at contraception technology and how it has changed women’s lives. The focus was narrowed down to the sex determination test, as at that time, women’s groups in India were calling for a ban on the increasingly popular test.

A well-known Mumbai hospital offering the test and subsequently, abortion services to women after learning the foetus was female, allowed my team to research and interview women and families who came for the test. We spent two weeks at the hospital talking to women and accompanying spouses, mothers, and mothers-in-law.

Repeatedly, women undergoing the test said they didn’t want to have a girl child, exhausted by multiple pregnancies in the hope of a male child. They were anaemic and struggled to make ends meet. When asked if women felt bad about aborting a female foetus, several asked: If I had it, would you raise it? A prominent women activist we interviewed said: “When there is such overwhelming preference for a son, what do you do?” There are no easy answers here, we concluded.

In India discussion on family planning, as it was called in those days, goes back as far as the early 1900s, when Mumbai-based Raghunath Dhondo Karve, professor of mathematics, sex educator, and social reformer, pioneered the discussion around family planning and birth control. He advocated that contraception would help prevent unwanted pregnancies and induced abortions. In 1921, he also started the first birth control clinic in India, the same year when the first birth control clinic opened in London.

Fast-forward to 1952, when India became the first country in the developing world to launch a National Programme for Family Planning. The goal was to lower fertility rates, slow population growth, and boost economic development. It was part of the Five-Year Plans focusing on economic growth and restructuring, carried out from 1952 to 2017. Over this period, the preferred birth control techniques shifted from the rhythm method to sterilisations, birth control pills, intrauterine devices (IUDs), and injectables.

From 1952 till now, the family planning programme has been transformed. It is repositioned not just for population stabilisation but also to promote reproductive health and reduce maternal, infant, and child mortality and morbidity. Additionally, these policies have been influenced by global consensus on the issues. As a United Nations member, India is a signatory and committed to implementing policy recommendations, including the 1994 International Conference on Population and Development (ICPD), the Millennium

Development Goals (MDGs), Sustainable Development Goals (SDGs), the recommendations of the Fourth World Conference on Women, and others -- all which seek to recognise and promote girls and women as active participants in national development.

Women in India want fewer children. According to the 2019-2021 National Family Health Survey (NHFS-5), the wanted fertility rate among women in the reproductive age group of 15 to 49 years is 1.6 children, lower than the current total fertility rate of 2.0. Eighty-six per cent of currently married women and men with two living children wanted no more.

The opinion piece singled out the US-based Rockefeller and Ford Foundation as examples of “outsourcing” policies and programmes in this area. However, to isolate the declining female-male ratio to sex-determination tests, and that too at the influence of international donors and foundations, is an exaggeration.

In the 1900s, coinciding with the Government of India Act of 1919, which decentralised responsibility for public health and medical education to the provinces, the Rockefeller Foundation was invited to give inputs. Similarly, post-Independence the Government of India invited the Ford Foundation to assist in creating and supporting institutions with expertise India did not have. These were to create and support institutes of management, law, design, and technology.

In the early 1950s, population growth was a global concern. The Indian government recognised this and put into place policies to address this growth followed up with the creation of the National Programme for Family Planning.

It is not the “outsourcing” of policies and programmes that must be a concern for policymakers at this moment in India’s history. To suggest that in the early days of Independence policies that have empowered women are not relevant is a mistake. It is also mischief.

India has not “outsourced” its development. As a part of the global economy, India must welcome lessons on policies and programmes from other countries and the United Nations community. Women’s empowerment policies and programmes have given women the agency to opt for smaller families and choose reproductive health technologies available to them.

It’s a travesty that male preference is alive and well. This is what the regressive opinion-makers should be worried about.