targets versus extension family planning

7/26/2019 Targets Versus Extension Family Planning

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Targets versus Extension Education: the Family

Planning Programme in Uttar Pradesh, India

R O B E R T E.E L D E R , JR.

INTRODUCTION

indeveloping countries, face the difficult task ofbringing ab out needed social

in a

relatively sho rt time . Those governm ents which claim

to

be dem ocratic are faced

ofbringing abo ut such change in a manner consistent with the

s proclaimed values.Inthese societies, tensions have frequently resulted because ad-

a

quantifiable am oun t of change should take

aspecified period , as well as requiring inform ation on the reasons for change to be

This paper utilizes data from the family planning programme

in

U ttar Pradesh, Ind ia,

in

to take precedence over the extension-education aspect of anadministrative pro-

atthe rate of approximately two per cent per year, swallowing up a

or po rtion of economic gains when the Indian government early in 1963 initiated a program me

in

materializing and U ttar Pradesh , being one

of

the least developed Indian

lagged far behind most others in early efforts.*

During 1964 and 1965, several new concepts were introduced into the p rogram me s metho-

^ The data presented

in

the paper which follows result from

a

multi-phase study of the U ttar Pradesh Family

to

114 block extension educa tors, 100 health assistants and 56 block dev elopment officers.

a 60 per cent response.

a

check on the validity

of

statements made by the family p lanning and development staff

anassessment of the demographic characteristics of 1,606

ectomy cases from seven districts in Utta r P rade sh; a on e-district, 22 village survey of villagers attitude s towa rd

a survey of the attitudes of 42 members of the legislative assembly from 28 districts in Uttar

samples were intentionally overlapped in order to include attitudes from as many of U ttar Prad esh s

districts as possible and ultimately every district was included in some phase of this study. Fo r further informa-

inregard todata collection including the q uestionnaires as they were admin istered, see R obe rt E.Elder,

a

N orth Indian State, (unpublished Ph .D . dissertatio n. Du ke U niversity, 1971X

s I-V III, pp. 355-439. Hereafter this will be cited as Elderop

cit

^ Government of Ind ia, Departm ent of Family Planning D irective No./40/63FP ,Family Planning Programme

(New Delhi,4October 1963).

^ Uttar P radesh, Departm ent of Family Planning Directive N o. FP/4057/E12/65 from S. L. Talvar to all District


2/14

250 ROBERT E. ELDfiR, JR .

than a family planning worker, who motivated the case to come for the operation.^ In 19

following the approval of the Lippes loop as a safe and effective method of female contracept

by the Indian Council of Medical Research, the Centre approved and requested the States

institute a similar scheme with slightly smaller incentives for the intra-uterine contracep

device.^

Closely connected with the creation of these two programmes was the introduction of

'target' concept. Beginning in 1965, each State was given and encouraged to achieve a tar

based on its population of couples eligible for family planning. States with the best achieveme

received awards and publicity, thus encouraging a spirit of healthy competition.

In 1966, one additional achievement technique, the 'drive' or 'family planning fortni

was introduced. These were two-week periods in which the staffs of various departments as w

as family planning p ersonnel were given targets and encourag ed to m ake special efforts to achi

them. Beginning in 1966, the number of declared fortnights national, state, and local, w

increased each year, until in1968,from August until January, with the exception of two two-w

periods in October and Nov ember, the family p lanning program me in U ttar P radesh was occup

in one continual drive.

The introduction of these new methods risked pushing family planning workers in

direction of a quantity-oriented approach to family planning, but also raised a number of ad

tional problems. What would be the effect of multi-agency fortnights on relationships betw

different categories of block level workers and on family planning staff morale Would it

possible for revenue and development workers who were totally untrained in family planni

to bring properly motivated, demographically valid cases to family planning camps The inc

tive of ten rupees represented a large sum of money for an Indian peasant, approximately f

times his daily wage. Would this be extension education, or bribery? Would a high-press

programme encourage voluntary change or engender negative feelings on the part of the tar

population Finally, in a programme the future support of which would depend on a popula

elected legislature, how would negative popular reactions to the programme affect legislat

attitudes of support for family planning The remainder of this paper has been devoted to exp

ing the issues raised above and reporting negative ramifications of the programme methodol

outlined above.

ADMINISTRATIVE METHODOLOGY AND THE FAMILY PLANNING WORKER

According to the Raina Report, extension educators were to be the key to family plann

extension edu cation in the block. W hat was the effect of targets, drives and incentives on the w

^ Utta r P radesh, De partmen t of Fam ily Planning Directives No. F P/l 104/XVI

1-49/64 Intensification

of St

zation

under

the Family

Planning

Scheme (Lueknow, 18 April 1964), p. 1. The incentive fee to be given to the

being motivated was increased shortly after the imp lementation of the program me from ten to 15 rupees.

^ Utta r P radesh, D epartme nt of Family Planning D irective No. nil, Intra-uterine Contraceptive Device

Programme

from

i

5-/7-65

(Lueknow, June 1965), p. 1.

Information in regard to the continuous-drive situation became known to this author because of relation

established with different training centres throughout the State. Training centres were unable to procure suffic

trainees from the field because of the reluctance of superior officers to release them for training during the d

periods.

^ The Raina Report refers to B. L. Raina,Family Planning ProgrammeReport for1962 63(New De lhi: G

ment Press, April 1963). In consultation with the block medical officer and f emale surgeon the extension educ

was required to plan and organize extension services in collaboration with other block

staff

foster and main

co-operative and productive relationships with both formal and informal leaders in the block, organize meet


3/14

TARGETS VS EXTENSION EDUCATION

251

which they perceived and attempted to implement their role? In the spring of 1968, a survey

sconducted involving 114 block extension educators in which an attempt was made to answer

question.^ To summarize briefly, the study discovered that although family planning workers

receiving training in extension education techniques, once they went into the field they

perceived that it wasthe number of cases rather than their quality that wasmost important

their superior officers. The 114 respondents, when asked whether their superior officers were

interested in extension education techniques than the fulfilment oftargets gave the answers

in Table 1.

TABL E 1.Block extension

educators'

composite ssessmentofsuperior

officers'

commitmenttoqu lit tivevs. qu ntit tive progr mme

Number

97

106

107

106

104

Officer

Block Medical Officer

District Family Planning Officer

Block Development Officer

Sub-Divisional Magistrates

TASOS*

*

Total average

Quanti-

tative

5 8

74

8 4

9 3

7 7

superior officer score.

Quali-

tative

4 2

2 6

16

7

2 3

Significance

Not signif.

001

001

001

001

Source:

Elderop. cit. Block Extension Educator Administered Questionnaire , p. 189.

Superior

officers were tending to punish subordinates who proved unable to fulfil their

on a regular basis. The method most frequently utilized was dismissal or the threat of

Dismissal

however, was not the only method utilized to punish the worker. His pay could

stopped, his touring allowance (expense account) might be cut off, or he might receive a

that if his record did not improve he would be

dismissed.

^

Thatinsecurity of tenure and role ambiguity contributed to lowered morale on the part of

planning workers was indicated by the low job satisfaction scores given them by their

officers presented in Table 2 below.

TABLE 2. Job diss tisf ction of block extensioneduc torsasviewedby district

f mily pl nning officersandblock development officers

Number

34

56

Officer

District Family Planning Officer

Block Development Worker

Block extension.educator

Satisfied Not satisfied

16

25

84

75

Significance

001

001

Source:

Elderop .cit. Mailed District Family Planning Officer Questionnaire and Adminis-

tered Block Development Officer Questionnaire, pp. 357, 409.

For a brief explanation of the manner in which various parts of this study were carried out see footnote 1.

The author was unable to ascertain the exact number of dismissals each year, but a fairly accurate estimate was

le. 34 district family planning officers who responded to a written mailed questionnaire involving their job

There were 510 blocks represented in the 34 districts. This would appear to indicate a termination level


4/14

252 ROBERT E. ELD ER, JR.

Block extension education reflected a dissatisfaction rate still higher than the estimates

their superio rs. Only two out of 18 interviewees were satisfied with their job . Mo st seemed aw

tha t their perform ance was less than satisfactory, bu t generally attribu ted job difficulties to fac

beyond their control: low status, lack of power, and the constant threat of dismissal. A bl

extension educator from Allahabad District accurately reflected the feelings of block extens

educators interviewed when he said:

M y mo rale is very mu ch dow n. There is n o reward even if I do the best w ork. As the jo

only temporary, the threat of dismissal always hangs over my mind. Because of this, I have

give more time to flattery an d acting as a yes-man to the oflicers and less time to my actual wo

Otherwise, these people m ay repo rt against me and I ll be turned out the next day. Here we

getting m ore than Rs. 300 ifwecan get even 200; with self respect and security of

job,

we wo

resign this next

REL ATIO NSH IPS BETWEEN DIFFEREN T CATEGORIES OF WORK ERS AND MU LTI-

A G E N C Y F O R T N I G H T C O N C E P T

An increasingly large pa rt o fthe family p lanning w orke rs inability to procure cases was due to

fact that multi-agency fortnights forced them to compete for targets with members of ot

agencies. Each of th e stafl s with w hom the family plan ning w orkers w ere being forced to comp

possessed suflicient power to command favours and/or obedience from villagers. The blo

development staff controlled seeds, fertilizers, and the granting of loans. Members of the hea

st ff such as the sanitary engineer, administered food adulteration statutes and thus had c

siderable control over the merchant castes, and revenue workers dealt with tax collection a

land redistribution. Even basic health workers brought medicines to the villages and so posses

some power.

All these categories of workers had been of some assistance to family planning workers

making con tacts with villagers prior to the institution of multi-agency family plann ing fortnights

However, at the point where they became involved in the family planning programme th

also became subject to targets and the threat of

dismissal.

^

In competition with more powerful revenue and development staffs, family planning work

were not able to compete on an equal basis. Table 3 indicates comparative achievement statist

for family planning, revenue and planning staffs in seven districts of Uttar Pradesh during a t

month period in 1968-1969.

When revenue and development workers were forced to achieve targets, co-operation w

family planning workers virtually ceased and competition became intense. Two examples giv

by family planning worker interviewees show the sort of competitive situation which existed.

Case I: Taken at the Cam p

A., a health assistant from Jaunpur District, had worked two days in Kyothali Villa

preparing two cases for a family planning vasectomy camp which was to be held near the blo

dismissal rate reported by block extension educators was comparable to that given by the district family plann

officers, it is easy to see that the overall discipline rate w as considerably higher. E lder,

op . cit..

Part 3, Block Ext

sion E ducators A dministered Questionnaire , p. 369.

^ Block Extension Edu cator, A llahabad D istrict, Oral Com munication, Jan uary 1969.


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TARGETS VS EXTENSION EDUCA TION 253

namasthe

(hello, greetings). Before he could greet them, B., a

lekhpal

(revenue worker)

bighasof

C , a health assistant from M athu ra D istrict, motivated two cases for vasectomy. The village

Because there was no officer in the block with sufficient interest in the cause of the family

behalf,

the lot of the health assistants and block extension

^

T A B L E 3 . Vasectomy cases brought by family planning. revenue and planning

staffs

in

first ten mon ths of

1968 69

Divisions

Lucknow Division A

Meerut Division A

Lucknow Division B

Lucknow Division C

Agra Division A

Nainital Division A

Meerut Division B

Planning

414(28%)

157(28%)

168(32%)

405(51%)

1,270(27 )

979 (40%)

608 (32%)

4,001 (32%)

Revenue

518(35%)

111(20%)

152(2900)

109(14%)

3,061 (65%)

683 (28%)

448 (24%)

5,082(41 )

Family

planning

*500(34%)

*192(35o)

115(22^)

277 (35/)

347(17%)

494 (20 0)

514(27%)

2,439(20 )

* This figure includes cases brought by both Health and Famil>

Others

34(2 / )

92(17%)

88(17O

0(0%)

26 (Po )

318(13%)

335 (18%)

893(7%)

' Planning

Total

1,466

552

523

791

4,704

2,474

1,905

12,415

Staff.

Source : These figures were collected from statistics available at seven district planning bureau s

visited during the month of December 1968.

WO STUDIES OF CASE QUALITY

SINGH PRAI ST UDY, 1 96 6

above, family planning

The result, according to extension educator interviewees and newspaper coverage of the

rogramme, was that the cases that were brought were having little impact on efforts to lower the

individuals who were sick, or too young, as well as a large number of untouchables.'^

'* Health Assistant Jau npu r District, Oral Com mu nication, Novem ber 1969,

'* Health Assistant Math ura District, Oral Comm unication, October 1968.


6/14

254 ROBERT E . ELDER , JR.

Although research in this area has been extremely limited, such studies as have been car

out tend to support these findings. Prior to January 1969, only two studies on vasectomy

been undertaken in Uttar Pradesh.

One of these carried ou t by the State Family Planning De partm ent in 1965, indicated tha

least 30 per cent of all cases operated on for vasectomy were over age. A more intensive st

undertaken early in 1966 analysed 1,000 persons motivated for vasectomy in the Baraba

District. Investigators looked at records at the primary health clinics where the operations

been carried out and questioned each patient on his age, marital status, and number of childr

living and deceased. The essence of the findings are presented in Tables 4 and 5 blow.

T A B L E

4 . ge of vasectomy respondents as recorded and

verified

Age

Below 30 years

30-39

40-44

45-49

50 and above

Official records

1

23

29

33

14

On the spot verification

3

17

14

17

49

Source: Ranbir Singh, 'A Study of Sterilization Cases in a District of Uttar

Pradesh', Research Section, Rural Health Division, Planning Research

Action Institute (Lucknow: 1966, unpublished, mimeographed, 20 pp.), p. 13.

T A B L E 5.

Types of persons vasectomized

Types

Having wives 45 or older

Unmarried

Widower or separated

With wives below 45 years of age

(1) Having one or no child

(2) Having two female children

(3) Ha ving two c hildren excluding (2) above with the

youngest child not exceeding five years

Total

Per cent

35-5

6 0

21 0

1-7

0 4

2 4

67 0

Source: Ranbir Singh, 'A Study of Sterilization Cases', p. 15.

As is evident from these tables, substantial discrepancies existed between the ages record

in ofiicial records and the actual ages as verified by this investigation team. 67 per cent of

cases examined did not meet government requirements for a valid vasectomy.

E L DE R S T U D Y , 1 9 6 8

In December 1968, the author attempted to discover whether variations in the quality of ca

brought by different agencies might be a major factor contributing to the rising number

Vasectom y', 3 July 1967, p. 3 ; 'Seventy-two Year O ld M an U ndergoes Vasectomy', 3 May 1968, p. 7; 'For


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T RGETS

VS

EXTENSION EDUC TION

255

T A B L E

6. Percentage of husb nds45 years of age or over brought in for

vasectomy by

different gencies

H u s b a n d s

Dist r ict

Aligarh

Almorah

Barabanki

H ar do i

Lucknow

Meerut

Muzzafarnagar

Naini tal

Si tapur

Base

Mean Percentage

over 45

Total by

district

167

19 1

2 0 4

118

291

14 2

2 7 4

17 2

4 7

1606

Family

planning

2 0 %

3 1 %

26//

27/o

3 7%

9 %

13%

35/o

25//

28/o

Revenue

4 7 %

46/o

43//

22/o

43/o

2 3 %

4 9 %

44/o

3 5 %

39%

Percentage

Planning

43//

4 1 %

35/o

1 1 %

38/o

4 6 %

28/o

33/o

17%

33/o

of total

Heal th

80/o

0 %

55/o

60/o

9 o

I3/o

1 0 %

2 0

3 3 %

3 1 %

Other

0

0

13/

0

0

0

2 7 %

0

0

4 %

Sou rce: Inform ation for Tab le 6 was procured from a selected sam ple of vasectom y patien ts

from the distr icts me ntioned abo ve, 10 Dece mb er 1968 - 14 Jan ua ry 1969.

T A B L E 7.

Husbands with

wives

aged 38 or over by agency

District

Al igarh

A l m or ah

Barabanki

H ar do i

Lucknow

Meerut

Muzzagarnagar

Naini tal

Si tapur

Base

Mean Percentage

Total by

district

165

185

198

118

2 92

14 7

2 72

157

4 7

1581

Family

planning

1 6 %

2 3 %

2 6 %

2 2 %

20/o

17%

23/o

2 1 %

0 %

19%

Revenue

4 6 %

54/o

2 4 %

52/o

49/o

37/o

52/o

3 1 %

50 %

4 4

Planning

6 9%

2 0 %

73/o

17%

4 9 %

4 6 %

30/o

1 1 %

4 1 %

4 0 %

Heal th

6 0 %

20//

5 2 %

50/o

4 6 %

2 8 %

18%

0 %

67/o

3 8 %

O t h e r

0

2 5 %

33/o

67/o

2'o

0 %

37/o

2 0 %

O^^o

2 0 %

Source: Information for Table 7 was obtained from a selected sample of vasectomy patients

from the districts mentioned a bov e, 10 Dec emb er 1968 - 4 Janu ary 1969.

As was indicated in Tables 6 and 7 above, revenue staff workers were bringing in larger


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256 ROBERT E. ELDER, JR.

As

regards proportions of patients who did not meet vasectomy criteria, results were alm

asdiscouraging as the Singh Study cited above. Table 8 presented below indicates that 62 p

centof the men in the sample tested had wives aged 38 or over, five or more children, or both.

Itmight be argued that for a relatively recent programme involving the type ofsocialchan

required, the family planning programme was making substantial progress. Elderly people,

thosewho had large families, were making some demographic contribution to the programm

In

addition, a nucleus of family planning acceptors was being created in each village which wo

make vasectomy appear less and less anti-social for those who still remained to be motivate

If this was the government s intention, then the present policy may in some cases have be

successful.

TAB L E 8. Number of men in the sample with wives aged 38 or over five or

mor

children

or both

District

Aligarh

Almorah

Barabanki

Hardoi

Lueknow

Meerut

Muzzafarnagar

Nainital

Sitapur

Total number

t Total number

Total

number

cases

165

185

198

118

292

147

157

47

1,581

of cases

of cases

Number of

of men with

Number of Five or

casesf

wife 38 or over

92

60

98

45

128

51

81

28

21

in which data on

in which data on

163

205

203

107

301

147

261

170

47

1,604

wives were

number of

more

children

84

87

47

51

128

61

121

78

67

available.

children were

Number

with

both

129

122

75

201

11

151

96

28

available.

Source:

Information for Table 8 was obtained from a selected sample of vasectomy cases

from the districts mentioned above, 10 December 1968 to 14 January 1969.

Yet the government was making frequent pronouncements about the number of birt

preventedby vasectomies performed each year. Until the autumn of 1968 it had made no eff

tocollect the age breakdown of patients undergoing vasectomy and may have been misleadi

itselfas to the number of births it was in fact preventing. Furthermore, the distortions wh

occurred

daily as a result of the pressure to achieve targets were having as great a negative

and a woman aged 38 approximately 24

years.

45 and 38 years and over were selected as cut-off ages for males

females respectively, not only because it was reasonable to assume that a man or woman will have achieved m

of his or her family by this time, but also because of the distortion of agefiguresdiscussed in the early PRAI stu

Age is very diflficult to ascertain at the village level and in a programme where popular acceptance is not equa

the targets which must be achieved it is likely that age distortion continued to occur at approximately the s

frequency as was ascertained in the PRAI study. District Family Planning Officers interviewed, with one except

gave estimates of invalidity ranging from 50 per cent to 75 per cent and agreed that statistics given in case c

and vasectomy registers were, generally speaking, understated. For this reason the relatively high percentage

marginal cases which appeared in this sample gave some cause for alarm. If all case ages were increased by

five years, between 40 and 45 per cent of the cases in the sample selected would be invalid on the basis of age alo

^ Although it is fairly easy to understand why the bringing in of wives over age is no positive contribution

lowering of the birth rate, the category of five or more children presented in Table 8 deserves explanation. Si

the programme is attempting to limit families to two or three children, vasectomizing family heads who have


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T RGETS

VS

EXTENSION EDUC TION

2 5 7

w s just as likely that programme policies

ER TTITUDES TOW RD F MILY PL NNING

T A B L E 9 . Programmeorg niz tion andimplement tionas perceived by villagers

multipleresponse

Affirmative Per

Base 335 responses cent

The workers rarely visit the villages, no systematic education programme is

conducted.

Workers only talk of loop or vasectomy; they do not talk of anything else

W orkers are scolded by people wherever they go. People even chase them ou t

of the village. They do this because they talk only of vasectomy.

People are only forced to become acceptors but the follow-up of the case

after vasectomy does not happen.

Workers come and collect data about family members. People get scared.

The wrong type of people are forced to take vasectomy simply to inflate the

numbers.

People are given allurements and false promises are made. Sugar, blankets,

and even land are promised, bu t these promises are not often kept.

Pradhans

(village leaders) are used to pu t pressure on prospective acceptors.

Workers come and make night halts, properly educate people, do not force

people to accept exhibitions, cinema shows are organized. Sometimes,

meetings are also organize d by them . 31 9-3

We have had little contact with the programme or its personnel and could

not give an answer in regard to programme organization or implementa-

tion. 103 30 7

Source: Elder, op. cit., Village Level Qu estionnaire, p. 415.

81

55

8

9

49

9

30

4

24-2

164

2-4

2-7

146

2-7

9 0

1-2

T A B L E 10 .

Whether

Base 335

It should be continued to run as it

It needs revisions and changes

Do not know

the

progr mme

is

organizationneeds

any revision

Frequency

43

132

160

Per

cent

12-8

39-4

47-8

Source: Elder, op. cit.. Question 1 1, Village Level Qu estionn aire, p. 415.

Village respondents were asked three questions in regard to the attitudes which they held

toward family planning workers and the programme as it was currently being administered:

he manner in which the family planning programme was organized (Table 9), whether they


10/14

258 ROBERT E. ELDE R, JR .

long-range goals of family planning, and yet were periodically confronted with the nega

results of a target-oriented, time-bound programme which left a number of acceptors dissatisf

At best, their reactions were to suggest that changes must take place before the program

would gain acceptance. Moreover, a substantial percentage of the sample studied (49 per ce

who were willing to make suggestions in regard to the programme, would have abolished

altogether.

T A B L E 1 1 .

Suggested modifications of programm e m ade b y respondents who

felt that modifications should take place - multipleresponse

Per-

Base 132 Frequency cent

More emphasis on education, efforts to be more concentrated on females -

more frequent visits by workers - efforts and demonstration of recanaliza-

tion of vasectomy.

Vasectomy operation should be performed only on eligible couples.

More emphasis should be on mass publicity and group meetings.

There should be extensive follow-up of acceptors.

More efforts should be on making female acceptors for IUCD, tubectomy,

etc. - as they can effectively prevent pregnancies more than men. Muslims

should also be asked to accept family planning.

Treatment of sterile couples.

There should be efforts to popu larize simple me thods. Associated problem s

such as sepsis, bleeding, etc. should be minimized by providing medicines. 10 7-6

Workers should not manipulate or make false promises or force acceptance.

Prom ises should be fulfilled. 5 3-8

Workers and government officials should accept family planning first.

Legislation in supp ort of the progra mm e should also be passed. 3 2 3

Lands should be given as incentive for vasectomy. Programme should be run

through acceptors. Marriage age should be raised to 28 for males and 22

for females. 4 3-0

Family planning should be eliminated altogether. It is against religion.

Vasectomy leads only to impotence and causes both physical and mo ral 64 48-5

deterioration.

14

12

11

10

8

7

106

9 1

8-3

7-6

6 1

5-3

Source: Elder,

op. cit.

Village Level Qu estion naire, p. 415.

ttitudesof ElectedRepresentatives

In a dem ocratic contex t popu lar d issatisfaction will be mirrored in the attitude s of elected offici

and, in a democratic state, administrators operate and implement programmes only at the d

cretion of popu larly elected officials. The section w hich follows p resents results of an examinat

of the attitudes of a selected sample of Uttar Pradesh legislators in an effort to ascertain t

extent to which such a reaction had already occurred.^^

One area of legislator opinion which was examined concerned the manner in which

programme was being implemented and whether or not they felt that their constituents w

favourably inclined toward it. Respondents were asked to estimate what percentage of

patients in their district brought in for family planning were demographically invalid and w

percentage they thought were brought in by non-extension education as opposed to extensi

education techniques. Respondents answers are presented in Tables 12 and 13.


11/14

TARGETS VS EXTENSION EDUCA TION 259

T A B L E 12.

How many of the cases being brought in for vasectomy and loop

in yourconstituency are valid?

Responses -

invalid

90 and over

70-89

50-69

25-50

0-25

r e q u e n y

28

3

4

5

2

r

e n t

67

7

2

5

Source: Elder, op. cit. 'M.L .A. Qu estionnaire,' p. 438.

29

7

3

2

69

7

7

5

2

T A B L E 13. What percentage

of th e

cases being brought

i nfrom your

constituency

havebeenproduced bynon extension education techniques

Responses - Per

non-educational Frequency cent

90 and above

70-89

50-69

25-50

0-25

No answer

Source: Elder,

op. cit.

'M.L.A. Questionnaire', p. 438.

ssure to achieve was particularly strong, many people who could make little or no con tribution

When questioned on the opinions of their constituents concerning family planning, the

T A B L E 14. What percentageof yourconstituency wouldyou say i sfavourableto

t h e family

planning programme

as it is currently being

administered ?

Per

Unfavourable Frequency cent

90 and above

70-80

50-69

25-49

0-25

Source: Elder,

op. cit.

'M.L.A. Questionnaire,' p. 438.

It is evident from responses presented in Tables 12 to 14 that legislators had concluded that

34

6

2

8

4

5


12/14

26o

ROBERT E . ELDER , JR.

Responses presented above indicated that a significant majority of Uttar Pradesh legisla

in mid-1969 felt that the programme as administered was neither popular nor effective. On

basis of these feelings, they were unwilling to grant additional funds for the present programm

53 per cent of the sample studied suggested that funds be cut. In terms of development, fam

planning was clearly at the bottom of their lists.

Unless a popular base of support for the programme is created, the central governm

will have to sup port it indefinitely. Such a con sensus w ill be difficult to create w ithou t the hel

elected representatives, the majority of whom in 1969 were hostile to the programme. They

T A B L E

15 . Rankthefive activities listed belowin terms oftheir

importance to India sdevelopment

Activities Frequency

Agriculture 181

Education 147

Ru ral industries 127

Ru ral health 110

Fam ily planningf 71

* First ranks in priority were given five points, last ranks one and totals

for 42 respondents added for each development area in order to obtain

figures presented above.

t The Governm ent of India had given family planning num ber two

priority in the Fourth Five Year Plan, In light of this, the fact that family

planning was given such a low priority by Uttar Pradesh legislators is

especially significant.

Source: Elder, op. eit., M ,L,A. Questionnaire, p, 438,

T A B L E 16, Shouldallocations in regardtofamily planning be raised or lowered

or remain the same

Responses Frequency Per

cent

Should receive less

Raised without qualification

Raised if properly utilized

Remain the same*

Stopped completely

* This could be seen as a negative statement because at this time most of the money for the

financing of family planning programmes is being given to the State by the Centre,

Source: Elder, op. eit., M ,L.A . Qu estionnaire, p, 434,

that family planning was already being given far greater priority than it deserved. It is like

that a major reason for both pop ular and legislative hostility tow ards the program me was cau

by the distortions which had occurred as a result of the changes in programme methodolo

begun in 1965.

8

5

6

9

14

19

12

14

21

33


13/14

TARGETS VS EXTENSION EDU CATION 26 I

The large-camp, large-incentive approach assembles as many as 100 doctors in mobile

The theory behind this approach is that when large numbers of people from a given area

The large-camp approach has seemingly solved the problem of target achievement, but what

Case quality figures at the Gorakhpur camp have not yet been

Another disturbing factor concerns the quality and quantity of case follow-up. Because of

es they have no t even b rought in themselves

Sepsis in even a small number of cases may further

Further, the emphasis of the large incentive fee approach represents a rejection of the exten-

on education appro ach. E xtension edu cator s mo rale, which was already low, may have

^^ Oral comm unication w ith Professors George and Ruth Simm ons, Popu lation Planning Staff University of

ld also be app ropriate at this time to express appreciation to Eric Brown, my student assistant, for providing


14/14

targets versus extension family planning

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