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Incentives and Disincentives %28Summary%29 |
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"INCENTIVES AND DISINCENTIVES"
ISSUES AND IDEAS:
THE PROBLEM:
With the head-count around 715 million in 1983 and an
annual growth around 2 per cent, the staggering possibility of
India's population soaring to a billion by 2000 A.D. is an
imminent reality. Roughly half of the present population lives
below the poverty line. The critical challenge of reaching mini-
mum needs to this vast deprived segment is each day made
more complex by the further rapid increase of numbers. Pre-
cious progress made by the nation with considerable effort
is lost in the quicksands of this population growth.
Deterioration in the physical quality of life for a vast number
is already visible. The long term, implications for the nation
are even more ominous. For the young generation already
born (40 per cent of India's populapon is below 15 years) is
so much larger in its size than the previous generation, that
even, with fewer children, the absolute numbers of births will
cQ,~tlnue to snowball. The inbuilt momentum for growth in
th\\3situation is therefore another important aspect. Each year's
additi6p to the population pushes higher and higher the level
at which the population figure will eventually stabilise in
the next century. Future generations will therefore pay a still
stiffer price for present inertia.
THE CONTRACEPTIVE CHALLENGE:
Even as, each year the development challenge is madQ
more complex with the growing numbers, so is the contra-
ceptive challenge. Today there are 120 million married couples
of child-bearing age. Because of the high birth rates of the
sixties and seventies, the next two decades will add each year
atleast another 2 million to these numbers. Therefore, as time
passes, more and more persons will have to be convinced to
practice family planning to achieve the same results. In other
words, we will have to run to stand still.
WHAT HAD BEEN DONE AND WHAT NEEDS TO BE
DONE:
India realised her population problem as early as 1947.
But despite starting the first official programme anywhere in
the world, the headway made so far has been inadequate. There
have been considerable achievements in spreading awareness
of the family' planning programme's existence, but the pro-
gramme itself has failed to make the leap towards acceptance
and practice on a wide scale. At present, only 27 per cent or
some 32 million couples in the country stand protected by
modern methods of contraception. To attain the population
goal, adopted by the country, which is to reduce "the birth rate
from 33 per thousand to 21 per thousand by 2000, it is estimated
that a minimum of 60 per cent of the couples of child-bearing
age will have to be convinced to use an effective form
of contraception. this amounts to a more than doubling of
the present levels of contraceptive acceptance. For with the
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gr.eaternumber of couples of child-bearing age in the country
by the year 2000, 60 per cent coverage will entail 90 million
couples, that is a three-fold increase from the present numbers.
NEED FOR A MORE DYNAMIC THRUST:'
With only 17 years le1tto achieve this target, a far more
dynamic population programme is obviously necessary. The
consequences of not acting vigorously and immodiately to
reduce the population growth more effectively than has been
done in the past are a stagnant economy and a greater inequity
in the distribution of wealth. If we hesitate to take firm steps
here and now, more stringent measures may become, necessary
later.
There can be no question but that the steps taken to
influence fertility behaviour must be in complete harmony with
human dignity and basic rights. However, there remains much
that can be done in this context - to reshape economic and
social policies in ways that encourage a small family and make
population stabilisation a major social goal. The question of
linking a system of economic incentives and disincentives with
a strong family planning programme therefore nel~ds,~o be
thoroughly examined. Can such a system help to $P~~d up
acceptance in ways that will still be democratic and hqrnane?
THE CONCEPT OF INCENTIVES AND DISINCE:NTIVES:
Incentives in the context of family planning may be defined
as a tangible or intangible reward to an individual, couple or
other target group given to induce a reduction in fertility. Con-
versely, a disincentive is a tangible or intangible negative
sanction that comes into play when the established norm of
family size is disregarded. Both incentives and disincentives
leave room for voluntary decision making - because there is the
option of rejecting the benefits offered by paying the cost of
foregoing these benefits. It is postulated that a scheme of in-
centives and disincentives mounted by the govemment in
support of the small family norm would have an enormous
educational effect. But for this, incentives would have to go
beyond a one-time cash benefit to touch the daily lives of the
people: so that the behavioural change brought about by the
acceptance of the incentive is perceived to be for the individual's
ultimate good, providing a benefit of permanent value. At the
same time, the disincentive would have to be such that they
do not punish parents for past fertility behaviour, nor cause
undue hardships to the children born in disregard of official
policy.. The incentive and disincentive policy must be pros-
pective in application, providing ample opportunity and suffi-
pient time to parents to change their present attitudos in con-
formity with the community's and nation's interests.
THE ETHICAL A"ID LEGAL ASPECTS:
But can the state, should the state interfere so directly in
an intimate' area of citizens' lives? Is this not an infringement
of the' basic human right to procreative freedom? For this to
be answered the counter question that needs to be posed is:
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can any right be an absolute one, untempered by obligations
and responsibilities ?International forums have stressed "the
right of the couples to decide freely and responsibly the number
and spacing of their children." Freedom to procreate therefore
presupposes that parents have thought about the children for
whom they will be responsible and that they accept such rat-
ponsibility. The human right of the individual t() procreate
must therefore be balanced with a concern for the rights of
others in society not to be burdened by its consequences. And
as much, the right of the child not to be born to a life of degrada-
tion and exploitation.
.
As it has been said:
"True freedom to determine family size can be realised
only if it is like all other human freedoms tempered bYthe
concern of the individual for the rights and interests of
others. The essence of the matter is to protect both society
and individual. In this instance, society needs protec-
tion from the undesirable effect of high fertility and the
individual needs protection fromignoral'lce, coercion and
inequitable access to the technical resources .of society.:'
To get families who claim to benefit from a large numb~r
of children in to the family planning scheme the government
has two options: coercion or incentives. The first is unthink-
able in a democratic humane society. Therefore, incentives,
the payment made by society to a family which has given up
the benefit of a large family by practising contraception, offer
the only ethical path.
A PROCESS OF HUMAN DEVELOPMENT:
Family planning has to be viewed positively as'a process
of human development. It must be a part of the strategy that
ends the economic exploitation of children by parents, through
the use of their labour to augment the family income. After
all the submarginal labour to which the children contfibute can
be performed by the surplus labour available in the community.
A policy of disincentives woudreduce the penefits.and.incrl:lase
the costs to parents having more than two or J~ree chil~rer.
But at the same time it would be necessary to .prQvklesocial
security, old age insurance and other such incentives so that the
parents desire for a larqe family can be effectively curbed; and
also, to provide better h,alth care and nutrition programmes that
would ensure the longevity, as well as the physical quality of
life of tho limited number of children born.
Why should the freedom to procreate not be tempered by
social norms and the common well being of society? The law
intrudes into several other areas of life that are no less intimate:
the right to marry is circumscribed by a minimum age for marriage:
set in the interest of the health of the mother and child; termina-
tion of pregnancy is justified legally and ethically because it is in
the interestof the mother's health. By the same rationale, is it
not necessary to prevent "excess" births that impair the mother's
health and militate against the interest and welfare of children
born in a poor family? Religion emphasise responsibility of.the
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parents for the caring of children. For instance, the Holy Koran
says parents have the mandatory responsibility to ensure the
health, education and training of every child born to them.
Therefore, should not family planning be recognised as a basic
human right? And the child's right not to be born to a life
of degradation, respected?
It has been pointed out that though reproduction and
sexuality are increasingly considered the responsibility of the
couple alone, the consequence of reproduction, that is the
child, is increasingly the responsibility of society. How then
to protect the privacy and autonomy of the adults and at
the same time balance the many rights of the child: to good
education, health, culture, etc. for which the state must invest.
CREATING A "COMPELSUASIVE" ENVIRONMENT:
Lester R. Brown, President, World Watch Institute, says
"as more and more people require space and resources on this
planet, more and more rules are required to supervise individuals'
use of earth's resources. Population-induced scarcity makea
muddling through in a basically laissez-faire socio-economic
system no longer tolerable or possible. Thus, the alternative
to self-discipline in procreation is social control.
As long as the interest of individuals do not synchronise
with that of the state certain inconsistencies in policy would
remain. While legitimising state action it has to be recognised
that human rights per 5e have no meaning without the existence
of the conditions and environment in which such rights have a
purpose and relevance.
The incentives offered should be concise and meaningful
to the lives of the millions, while disincentives should be limited
to those which do not infringe on the fundamental rights.
Under no condition should the child be allowed to suffer because
of the penalty levied on the parents.
In all this family planning has to be seen to be a meansto
an end and not an end in itself. It is vital to remember that the
direct approach to reducing excessive fertility through incentives
must be development-oriented, leading to distributive justice.
Development projects and programmes which improve the
physical quality of life and simultaneously lead to a demand for a
small family are what are being visualised to create a
"eompelsuasive" environment for family planning as a natural
and logical need.
COMMUNICATION BASE:
A prerequisite for any scheme of incentives and disincentives
is widespread information and education about the action pro-
posed by the state to limit the family size over a time frame. The
options too should be clearly spelt out for the people to choose
from. An open atmosphere and continuing dialogue on the
implementation effort would preclude misuse. Effective me-
thods of communication therefore, would need to be deployed:
in the first place, to tell the people how family planning is bene-
ficial, what facilities are available and where, and in the second,
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to acquaint them with the benefits offered by the state to
those that opt for a small family.
THE EXAMPLE OF OTHER ASIAN COUNTRIES:
By accepting social and economic incentives and dis-
incentives to control its population, India would be joining a
host of Asian countries already doing so. The most notable
example is China. China has embarked on a one-child per
family policy. To couples who accept the one child concept a
host of privileges are available. These range from cash bene-
fits, better housing, more private land to farm, better housing
for the parents to preferential access for the only child to health,
education and social facilities. These facilities are withdrawn
and even penalties imposed on the birth of a second child. The
birth of a third child is simply not permitted. Though not
as wide and comprehensive in scale elsewhere, there are other
examples in Asia - such as Singapore, where a systematic
attempt to influence the acceptance of family planning is being
made. Korea, Thailand, Indonesia, Philipines, Sri Lanka have
some schemes in this direction, though not as comprehensively
structured.
INCENTIVES AND DISINCENTIVES IN IN DIA:
Incentives and disincentives are not a new idea for India
either. However, in the past incentives have been mostly
cash-based one-time offers and the disincentives applied to
government workers who were unable to bring in the requisite
number of family planning cases. This does not represent the
carefully and comprehensively thought-out policy now being
advocated. It is also suggested that to work out. a scheme of
incentives and disincentives in relation to individual families
government publicise a family size policy on the following lines:
Incentives Zone
Tolerance Zone
Disincentives Zone
Restricted to 2
children
Government to
announce
a
scheme of incen-
tives
Individual fami-
lies restricting to
2 children get
incentives
Restricted to 3 children
Government appeals to
people not to exceed
three in national in-
terest. Reduced ih-
centives are offered
Individual
families
who do not comply
face disincentives
4 children and
above
Government with-
draws incentives
,applicable to the
first two children
and applies dis-
incentives
Further, it is important to remember that the incentive scheme
would be successful only within the framework of credible family
planning services. Towards this end, contraceptive supplies
and services should be included in the basic minimum needs of
the people. Incentives and disincentives for family planning
are not a replacement of the effort for providing good services,
only a supplement to motivate their use.
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FPF TASK FORCE MAKES SUGGESTIONS:
A multi-disciplinary Expert Task Force recently helped the
Family Planning Foundation to examine the issues involved
in setting up incentives and disincentives and concluded this to
be a feasible proposition. Four categories of target groups for
incentives were identified:
i) Ptivate households or individual acceptors;
ii) Communities or groups which attain a certain level
of acceptance;
iii) Change agents-motivators from the public or private
sector;
iv) Intermediaries, that is stockists, distributors of contra-
ceptives and service providers.
The importance of the community incentives approach was
particularly underlined. It would be a means of not only securing
community participation in the programme, but would also pre-
pare the ground for community level population planning, which
is the ultimate answer. But for the community incentive scheme
to succeed, as also for the solution of the population problem
itself, the Task Force has emphasi!>ed the importance of the
involvement of all developmental Ministries, so that a conver-
gence of their schemes could -be brought upon a single area,
with suitable incentives for population planning built into their
implementation pattern. It is a matter worth considering that
if the incentive schemes succeed in preventing even the fourth
and higher order births only, the total births taking place in the
country would be reduced by a third.
SOME SUGGESTIONS:
An exhaustive exercise of the incentives and disincentives
the state should offer can only be made through internal reviews
of the schemes available in each Ministry or other developmental
agencies/bodies working with the people. However, a number
of suggestions have been offered to illustrate what could be
done:
For sterilisation acceptors a one-time cash gift of Rs. 500
for those with two children, Rs. 300 for those with three
children, offered only to the three income lowest decHes of
population; for ot~ers it should' be linked to the
social security scheme announced in the 1982-83 budget.
For regular employees who undergo' sterilisation after two
children alternative types of monetary incentives in lieu of
lumpsum. payment, such as, advance increment in salary,
ten percent increase in pension, educational allowance
for two children, lower interest rate on housing and trans-
port loan, longer maternity leave with pay for the working
mother.
Deferred incentives schemes for those who prefer spacing
methods - such as the UPASI scheme whereby a certain
sum of money is deposited in an account in the name of
the beneficiary to be cashed only at the age of 45 - liable
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to forfeiture in total if a fourth child is born and by fifty
percent in the case of a third child.
Non-monetary incentives such as educational bonds to
parents who limit themselves to two children; preference
for 50 percent of seats in all educational institutions to the
one and two child family; preference in allotment in public
housing; preference in loans for establishing small scale
industries in rural areas.
A Green Card to entitle the two child family to preferential
treatment in hospital, in provision of electricity, water
connection etc., so that the possession of the Green Card
could become a status symbol entitling a range of benefits
on a preferential basis.
A range of incentives to be offered to communities of people
- at the panchayat, urban ward or workers' colony level -
if they can succeed in bringing 35 percent of the eligible
couples in their area to accept one form or another of
contraception or reduce the number of births to 25 per
1,000 population. Each· Ministry is expected to work
out the incentives it could offer to the community, as
also the individual.
Ministry of Agricultul"9
priority improvement of marketing infrastructure, water
resources, animal husbandry extension services, coopera-
tive banking faq,ilities, subsidised biogas plants
Ministry of Education
Educational bonds, preferential admission, establishment
of one-teacher schools
;.
- Ministry of Finance
. A cash reward or Community DevelopmE;lnt Fund to be
administered by acceptors for creating income-generating
workin thearea; concessions on Social Security certificates ...
Ministry of Healt'"
Green card for preferential health care; location of sub-
centres on a priority basis, provision of doctor's services
and free supplies of contraceptives to voluntary organisa-
tions promoting family planning effectively in an area...•
Ministry of Labour
Expansion of women preferred industries; organisation
of food-for-work programmes for local asset building
.
Ministry of Works and Housing
Reservation of 50 percent of houses in public sector hous-
ing, preferential treatment in accommodation allotment,
priority in construction of rural links r~ads which connect
good family planning areas with main roads ...•
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Illustrations of the type of disincentives that could be
applied;
i) for regular employees no maternitY leave benefits for
the third or subsequent child,
ii) low priority in admission of third and subsequent
children in educational institutions,
iii) cancellation of educational bond given to the first
two children if the parent has a fourth child,
iv) a graded increase in accouchment fee charged in
maternity hospitals depending on family size (beyond
two) and family income,
v) low priority in housing in public housing projects for
parents with more than three children,
vi) low priority in grant of loans by banks for any purpose
if the applicant has more than three children,
vii) for public servants, low priority in allotment of resi-
dential accommodation for parents having more than
three children,
viii) for public servants, restriction of free medical attention
or medical reimbursement to the first three children.