Bhattacharya, Chandraa
(2007)
State-level population policies and family planning service provision in India: Case studies of Madhya Pradesh and West Bengal.
PhD thesis, London School of Economics and Political Science.
Abstract
This thesis investigates the historical origins and the factors leading to the adoption of State-level Population Policies in India, focussing on two case study States, Madhya Pradesh and West Bengal. It analyses the effects of the adoption of such policies on the provision of family planning services in these two States. In examining the socio-economic considerations behind adoption of these policies, the role of state level political leaders and administrators, the function of the central government, the effect of assistance from donor agencies, and the global atmosphere of a 'paradigm shift' created by the 1994 Cairo conference are analysed. The effects of a State-level Population Policy on the services provided by the Family Welfare Programme are examined by focussing on three family planning strategies: contraceptive method mix; involvement of the Panchayati Raj Institutions (community-based institutions); and, discontinuation of demographic targets, incentives and disincentives. The objects of the research, namely, population policies and family planning services were studied in India in New Delhi (the country capital), Bhopal (in Madhya Pradesh) and Calcutta (in West Bengal) and eight districts in two states and two blocks and two health centres in each district over a period of nine months. In-depth semi-structured interviews and documentary research were selected as methods of data collection. The thesis is based on qualitative and quantitative data derived from one hundred and thirty-two in-depth semi-structured interviews, a literature review, family planning performance data and NFHS data. The thesis concludes that Madhya Pradesh policy and the draft policy of West Bengal had their historical origins in national reports, state-specific policy development plans and committees. Demographic trends were considered pressing problems by the Madhya Pradesh policymakers at the time of policy adoption. Commitment and political leadership, effective officials in the Department of Family Welfare at the time and the presence of assistance from the USAID-funded Policy Project led to the adoption of the policy. In contrast, for West Bengal, formulation of the draft was simply a result of following national recommendations without any involvement of external population policy experts. Madhya Pradesh was found to be providing a greater range of contraceptive methods in comparison to West Bengal. In both States, Panchayat representatives were not much involved in the functioning of the Family Welfare Programme. Madhya Pradesh was found to be actively setting demographic targets and was putting pressure on health workers to achieve such targets. Evidence of the disqualification of Panchayat leaders based on a two-child norm was found in Madhya Pradesh. No such evidence was found in West Bengal.
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