Of policy & prejudice in Uttar Pradesh's population control bill

Public health specialists feel Uttar Pradesh’s Population Bill proposing a two-child norm will have a serious impact on women belonging to marginalised communities and their reproductive rights, especially in the absence of basic infrastructure facilities, gender-sensitive labour laws and access to health care services.

Chief Minister Adityanath gives a ‘shagun kit’ to a newly married couple to encourage them to adopt the small family norm, at the launch of a new population policy on World Population Day, in Lucknow on July 11.

Whether the proposed Uttar Pradesh Population (Control, Stabilisation and Welfare) Bill, 2021, is meant to be political rhetoric, an election gimmick or a way to control the sexual rights of communities is open to debate. But there is no doubt that it was formulated, like every other piece of legislation in the past seven years, without consulting the constituency it would impact. While the proposed Bill, which is a part of the State’s 2021-30 Population Policy, has the potential to effect demographic changes among all communities and classes, it will have huge ramifications for marginalised women and their reproductive rights.

Dalit and Adivasi women, relegated to the bottom of the caste, class and gender hierarchies, suffer multiple forms of discrimination by patriarchal structures within their own families and society at large. As such, while the proposed Bill will affect the reproductive rights of all women, the women on the margins of society may bear the brunt of it.

According to Cynthia Stephen, a gender and development policy analyst, the proposed policy is a targeted oppression of the reproductive rights and freedom of Dalit and Adivasi women.

“There is a deep hatred or negation of people belonging to marginalised identities in the culture propagated by [Uttar Pradesh Chief Minister] Adityanath and his brand of politics. Because of that women are excluded from full citizenship and only viewed as somebody’s mother, sister or daughter. Similarly, Dalits and Adivasis are expendable as they exist outside the pale of society,” she told Frontline .

Apart from the Scheduled Castes and the Scheduled Tribes, there exist several small groups such as the nomadic or denotified tribes, numbering a few lakhs in various States, including Uttar Pradesh. In view of extreme marginalisation and low life expectancy among them, these groups tend to have more children. If the population policy is universally applied to every group, sections of nomadic tribes, owing to their socio-economic marginalisation and their inability to access health care services, will get wiped out. Cynthia Stephen said that even before there can be any empowerment of or political mobilisation by these communities, these efforts would be nipped in the bud.

Undermining rights

She said: “The law will not be applied equally across the board. Their Manusmriti-driven agenda privileges some communities over others. But the legislation will not stand if challenged in a court of law. These are intimidatory tactics, and by undermining whatever rights have been garnered over the years, they want to keep people busy with these endless battles. Policies like this differentially affect the rights of women and political aspirations of large sections of populations.” For population to stabilise, the State should instead provide good governance and health care to all, she added.

Echoing Cynthia Stephen’s argument, Dr Sylvia Karpagam, a public health doctor, explained that health was not a stand-alone issue but was based on multiple social determinants. Women who had better education, reproductive health, family support, and a good livelihood and access to health care, a gender-sensitive police force and gender-sensitive labour laws were more likely to assert their reproductive rights. In India, and specifically in Uttar Pradesh, in the absence of these basic requirements, bringing in a two-child norm was “ridiculous”, she told Frontline .

Targeting Doctors

Besides, there was genuine suspicion around any policy introduced by Chief Minister Adityanath in Uttar Pradesh after the State’s COVID management debacle.

Sylvia Karpagam said: “The Uttar Pradesh government’s motives are problematic. If it genuinely cared about the people it would have upgraded public hospitals instead of targeting doctors such as Kafeel Khan, the only reason being he is a Muslim. The government is anti-Muslim overtly and anti-Dalit covertly, so its policies are meant only to target and not to achieve any real development. That is why it does not bother about evidence for its policy.”

She maintained that the Adityanath government should instead first guarantee a better survival rate of children as people tended to have more children out of a genuine fear of child mortality. The government should also improve the Integrated Child Development Services scheme, the public distribution system, reproductive health care services and livelihood options and ensure survival of children through reliable nutritional schemes and improve pregnancy care, she added.

Vulnerable communities have low access to sexual and reproductive health care, including access to family planning, and, therefore, suffer from reproductive health issues. Uttar Pradesh’s dismal health care services, coupled with poor reproductive health education, caste/religious discrimination even in health care education and social security, made people hesitate to access these systems.

Social indicators

Comparing Uttar Pradesh with Tamil Nadu, Sylvia Karpagam said the population of the dominant caste in Uttar Pradesh was large at 46.2 per cent as opposed to 2.2 per cent in Tamil Nadu. “Even dominant castes in Uttar Pradesh have worse social indicators than the Scheduled Castes in Tamil Nadu. S.C. women in Tamil Nadu have more autonomy than the average women in Uttar Pradesh. So maybe it is time the Chief Minister made Uttar Pradesh a State where women had more autonomy. Doing something about heinous crimes such as domestic violence and gang rapes [which are often motivated by caste], even of minors, would be a good place for him to start.” She pointed out that Tamil Nadu had better infrastructure services such as electricity distribution, piped drinking water supply, sanitation facilities and housing, and exposure to family planning messages. The State had fixed the age at first marriage at 18 and had a better total fertility rate compared with Uttar Pradesh.

Sylvia Karpagam said that in Tamil Nadu women had access to and made use of family welfare programmes such as family planning, contraceptives and assisted delivery, and child health schemes to bring down neonatal mortality, infant mortality, and undernutrition. She said: “Tamil Nadu brought in reservation in higher education, which means that a cadre of health care personnel was ready to work at the peripheral settings. Let Chief Minister [Adityanath] first get data on how many women in rural areas have access to education and social security schemes and what the difference is in urban/rural access to social schemes?”

She said the current access to any method of family planning was only 68.7 per cent and female sterilisation was at 57.4 per cent in India.

Sylvia Karpagam said: “Male sterilisation has been consistently 0 for several years and is a stark proof of the patriarchy that operates in society as well as the health care system. Why is a simple method of permanent family planning that requires the man to undergo [simple surgery] not used at all. But if one looks at access to health care, one will understand why women don’t have access. On the one hand, the policies of the government constantly tend to centralise even basic health care, requiring people to spend out of pocket for even basic things. There is a concerted policy level effort to break down the primary health care centre and then say that women did not go to the subcentre or primary health centre in their neighbourhood. The average out-of-pocket expenditure per delivery in a public health facility is Rs.4,954 for the last birth in the five years before the survey in Karnataka, according to the NFHS-5 (2019-20). Around 52 per cent of the births in a private health facility were by Caesarean section as opposed to 22.6 per cent in public facilities. There are so many continuous, systemic, structural caste- and gender-based violence faced by Dalit women. Who will address them? It is easy to pass a population control policy.”

One family, one child

Prof. Kancha Ilaiah, Dalit rights activist, felt that the population policy need not be opposed if it was for future marriages and future childbirths. In his view, India should certainly go for a one family, one child policy like China for a few decades. But this should not be viewed from a Hindu/Muslim/Dalit/Brahmin perspective. It was a reasonably acceptable position to deny incentives to those who were not following the policy, no matter their identity. In fact, the disincentivisation should cover all positions of the State—all elections, jobs and State benefits should be denied to couples who married and had more than two children after the law came into being, he said. But it should be accompanied by a high level of propaganda around family planning and marriage counselling through anganwadi workers and others advocating the two-child policy, otherwise people might not care much about family planning, he added.

Besides, the argument that Dalits tended to have more children was simply untrue and a thing of the past, especially in south India, he said. “Most Dalits now go for two children. In Telangana’s interior villages, where there are 70-75 families, no Dalit family has more than two children. I don’t know much about Uttar Pradesh, but it cannot be much different. Among Muslims, the classical religious view is there that life is given by God and should not be taken away, but with the level of education among middle class Muslim women rising, they are also careful about family planning,” he said.

The population explosion myth is often used as an expedient by some politicians and bureaucrats to shift the blame of India’s development failure. More than 35 Private Members’ Bills have been attempted in the past decades to control population explosion. But data suggest that India’s population is, in fact, in deceleration. According to the 2018-19 Economic Survey, the annual growth rate of the population of India fell to 1.3 per cent between 2011 and 2016 as compared to 2.5 per cent in 1971-81. The NITI Aayog, quoting from the Sample Registration System, showed that the total fertility rate (TFR) of Indian women reduced from 3.2 in 2000 to 2.3 in 2016. The TFR for women in Uttar Pradesh, which was 4.7 in 2000, dropped to 3.1 in 2016. The TFR is a measure of an average number of children born to one woman.

Fertility rates

But if one were to specifically look at fertility rates of the marginalised, as per the National Family Health Survey 2015-16 (NFHS-4), the fertility rates for S.Cs, S.Ts, and other backward classes (OBCs) were slightly higher than that of the upper castes. Prof. Moggallan Bharti, a political scientist who hails from western Uttar Pradesh, said the reason for this was poor access to health and education among the marginalised. He said: “With this new law in place, they are going to be further excluded from the already skewed safety net of the State government. Hence, the S.Cs, S.Ts and other backward communities are at the receiving end of this politically biased law. It must be said here that the government has brought in the Bill to invoke its favourite bogey of Muslims overpopulating, which in reality is the biggest hoax that the Bharatiya Janata Party [BJP]-Rashtriya Swayamsewak Sangh [RSS] brings in to polarise people at the time of elections.”

Terming the draft Bill as ill-conceived and deeply prejudiced, Moggallan Bharti said that while it would impact everybody, it would have far more impact on the marginalised communities, including the S.Cs, S.Ts, backward classes and vast sections of Muslims. “The reason for the marginalised faring badly if this Bill becomes an Act is inherent in the proposed punitive measures that the State will impose if people fail to adhere to the two-child policy. That they will be prohibited from availing themselves of State welfare policies, promotions in jobs, and will not be allowed to even apply for government employment is going to put the marginalised communities in a more serious state of deprivation,” he said.

A group of women’s organisations and health networks wrote to President Ram Nath Kovind expressing concern over the proposed policy. They pointed out that in order to circumvent the disincentive clause, people may not register their marriages, making women and children further vulnerable in situations of domestic violence or abusive relationships wherein they would face hardships in seeking legal recourse for maintenance and support or right to property.

In 2018, the infant mortality rate for Uttar Pradesh was 43 deaths per 1,000 live births and the maternal mortality rate was 197 deaths per 1,00,000 live births. The casual mention of ‘child death’ in the Bill means that there are no provisions in it for improving these indicators and instead the Bill treats them as a reality around which the two-child policy will be implemented. Coercing population control without improving the health conditions of people raises deep concerns, the signatories to the letter said.

Registering its protest against the use of the term “suffer”, the National Platform for the Rights of the Disabled said in a statement: “Sec 15 of the Bill in cludes a terribly pejorative, almost eugenic rationale where it says that if couples have one or two children who ‘suffer’ from disability, they can have more children and will not be seen to contravene the two-child norm. Notwithstanding the other regressive and contentious provisions in the Bill, this Section seeks to invoke an ableist mindset and tends to view the disabled as non-existent and equivalent to being dead. This is atrocious and unacceptable. Disability is a condition and one does not ‘suffer’ from a disability but rather suffers because of it. The Rights of Persons with Disabilities Act, 2016, which the Bill invokes has equality and non-discrimination as its guiding principles. This provision in the Bill is a blatant violation of these principles and reinforces the concept of viewing children with disabilities as a burden, unwanted by families and society.”