Graduate Journal of Asia-Pacific Studies

6:2 (2008), 10-32

SEEKING ZERO GROWTH: POPULATION POLICY IN

CHINA and INDIA
PhyllisEWSTOLC
FloridaAtlanticUniversity,USA

THERATE 1 ofincreaseintheworldpopulationhasacceleratedremarkablyoverthe

lastcentury.Ittooktheworldpopulationmillionsofyearstoreachthefirstbillion,
then123yearstogettothesecond,33yearstothethird,14tothefourth,13tothe
fifth billion. 2 In 1999, the world passed six billion after only 12 years and, in 2008,
afterjust9years,thepopulationisfewerthan300millionfromthenextbillion. 3 As
population continues to grow, it will become increasingly important to understand
what affects population growth, what effectspopulation growthcan have andhow
governments can control their populations, if necessary. This discussion will be
limitedtothemajorpopulationcontrolpoliciesofChinaandIndiaandcomparethe
methods and effectiveness thereof. These nations were selected because of their
politicaldifferencesandtheirdistinctiveapproachestothepopulationquestion.The
purposeofthisarticleisnottoextolordecrypoliciesdirectedatbirthratereduction,
oreventoanalyzewhetherfertilityhasanyeffectondevelopment,buttodistinguish
thepoliciesthathaveprovensuccessfulandtodiscusstheireffectsoncitizens.Itwill
address the inherently feminine nature of the reproduction question, the effects
populationpolicieshaveonwomenslivesandhowconsideringwomensneedscan
influencetheeffectivenessofpopulationpolicyinreturn.Thegoalofthisarticleisto
demonstrateaneffectivemodelforjustandsuccessfulpopulationcontrolpolicyand
considerwhethersuchaconceptionispossible.

Population growth in Asia

The study of population growth began with Malthus An Essay on the Principal of
Population which proposed that population growth threatens the food supply, the
economy and development. 4 The subject of the relationship between food supply
and population growth became popular in the 1960s when the food supply was
threatened with shortages, inspiring governments to institute population control
programs. 5 Expandingonthisinternationaldiscourse,PaulEhrlichsThePopulation
BombandGarrettHardinsTheTragedyoftheCommonsdiscussedtheimpending
disasterthatunstoppablepopulationgrowthwouldbringtoanovergrazedworld. 6
GaryBeckersupportedMalthusdefinitionofthefamilyasasingledecisionmaking
unit. Yet, he disagreed that prosperity leads to population reduction, proposing
insteadthatprosperityresultsinpopulationgrowth. 7
Thedevelopment,between1930and1960,ofnewhormonalandnonhormonal
methodsofcontraceptionsuchasoralcontraceptives,theintrauterinedevice(IUD)
and improved sterilization techniquesprovided effective means for reducing

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fertility. 8 Studiesinthe1960sdemonstratedthateconomicdifficulties, amongother

factors,madewomenwanttolimitfamilysizeorspacebirths,butfoundthatwomen
did not utilize contraception to assist themselves. 9 As concern over the potential
economic consequences of unchecked population growth increased, these studies
that showed citizen interest in population reduction freed governments to institute
familyplanningprograms. 10
China
Government Policy
BeforethefoundingofthePeoplesRepublicofChina(PRC),Chinaspopulationhad
ahighbirthrate(38per1000in1936)andahighmortalityrate(28per1000in1936),
resulting in a low natural growth rate (10 per 1000 in 1936). Between 1840 and the
founding, the population increased from more than 410 million to more than 540
millionwithanaverageannualincreaseof1.19millionagrowthrateofamere2.5.
Thesocialistideologyofthenewgovernmentviewedrapidpopulationgrowthasa
sign of development and prosperity and restricted abortion and sterilization. The
social and economic improvements the government was able to institute after the
transitionreducedthemortalityrate.Combinedwithproscriptionsonbirthcontrols,
thesepoliciesresultedinarapidpopulationgrowth. 11
Thefirstcountrytoopenly,systematically,andactivelyrestrictreproductive
behavior, 12 Chinadevelopedthesepoliciesonlyafterpartyofficialsbegantoseethat
priorinterestinalargepopulationwasunwise.ThePRCsbirthcontrolpolicieshave
continually evolved through four major phases of population policy: 19491952,
when population development was unplanned; 19531965, when planned control
overpopulation growth slowly began to be implemented; 19661971, when
populationplanningceasedduringtheCulturalRevolution;and1971present,when
population growth has been strictly controlled. 13 By the early 1950s, Zhou Enlai
(Premier 19491976) acknowledged that the population could not continue to grow
without severe consequences. His response was to institute programs to improve
educationandhealthandtoprotectwomenandchildren.Heinstitutedconstraintsto
supportthequalityofthepopulationbyoutlawingmarriagebetweenclosekinand
those with congenital and genetic diseases. 14 The first relevant policy was the
Contraceptive and Induced Abortion Procedures of 1953, which loosened many
conditionsforabortions,butonlyforcoupleswithfourtosixchildren.Thisactwas
expandedtoallfamiliesin1957.However,thebirthratedidnotbegintodeclineuntil
after1963,whenitpeakedat43.6. 15
The Cultural Revolution ended in 1971 and, with it, the 1970 fertility rate of
16
5.75. The nation began to reemphasize population control. Within the next six
years, more than thirty million male and female sterilizations were performed. 17
Abortionbegantobeutilized,and1971sawjustmorethanhalfofwomenhavinga
single abortion (rate of .6 per woman). 18 The government attempted to control the
population by redefining reproductive ideology. The new preference was not
developmentthroughpurebirthrate,ratheraprincipleembodiedinthewan,xi,shao
(later,longer,fewer)campaign.Thisideologicalshiftemphasizeddelayedmarriage,
long birth spacing and limits on births. At first vague, this limit on births was
elucidated by Premier EnlaiOne is not too few, two are ideal, and three are too

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11

manystressing the importance of two births per family, a replacement or zero

growthrateasthetwoparentsarereplacedbytwochildren. 19
However, zerogrowth will not reduce a population; in 1978, the government
introducedthenowwellknownonechildpolicy. 20 June1979,PremierHuarevealed
the goal of reducing the natural growth rate to 5 by 1985. This ambitious goal
required state action rather than awaiting cultural shift toward preference for one
child families. In August 1979, the State Councils Birth Planning Commission,
headed by Vice Premier Chen, announced a strict program of incentives and
disincentives to enforce and expand the onechild policy. The incentive programs
rewarded couples for maintaining onechild families and attempted to counteract
worries about elder care. Couples in cities received a certificate verifying onechild
status, guaranteeing extended paid maternity leave and a fixed monthly stipend
untilthechildsfourteenthbirthday.Thecertificateensuredthecouplehousingspace
equal to that given to twochild families or preferential treatment in the housing
applicationprocess.Also,thissinglechildwasgivenpriorityschooladmissionand
employment. Finally, the couple would be entitled to increased pensions after
retirement. Onechild families in rural areas were to receive additional pay credits
untilthechildsfourteenthbirthday.Thechildwasentitledtoanadultsgrainration.
Regardlessoffamilysize,allcouplesreceivedthesamesizeprivateplotoflandand
housing.Ifaruralcouplesonechildwaskilledorbecamedisabled,theywouldbe
permitted another child without penalty. Also, in some areas the onlychild could
receivefreeschoolingthroughkindergartenandhavecostsforbooks,materialsand
food waived through primary and middle school when his parents agreed to
sterilization. The government designed social insurance plans for elderly couples
who had no children. The disincentive program instituted pay deductions for
familieswithmultiparitybirthsuntilthatchildsfourteenthbirthday,andadditional
higherparitybirthswouldincreasethedeductions.Aonechildfamilywhichhada
second child would forfeit certification and was required to repay any received
benefits. 21 The goal of these policies was to keep the population within 1.2 billion
through2000.Bytheendof1979,thebirthratehadfallento17.9. 22
The policies instituted in the late 1970s completely reordered traditions
associated with family and reproduction and irreparably changed the fertility
practicesofthepopulation. 23 TheMarriageLawof1980furtherchallengedtradition
by encouraging onlychild grooms to settle with their wives families, instead of
wivesjoiningtotheirhusbandsfamilies.Thispracticeimprovestheculturalviewof
a daughter, as her marriage gains the family a son instead of costing them the
investment in their daughter. Also in 1980, party officials emphasized family
obligationinmaintainingsinglechildfamiliestoreducethepopulationforthegood
of the nation while never outlawing higher parity births. 24 The government
reinforced the necessity of birth control by legalizing all methods of contraception
andrestatingtheobligationofbothhusbandandwifetopracticeresponsiblefamily
planning. 25 By the end of 1980, Chinas population neared one billionthen 22
percent of the worlds population. 26 The abortion rate in 1971 had been .6 per
woman. 27 By1979,postCulturalRevolutionpolicieshadledtoapproximatelyforty
seven million abortions. 28 The abortion rate per woman in 1982 was 1.6. 29 The
utilizationofabortionhadmorethandoubled.By1982,twothirdsofthepopulation
of China had been born after the founding of the PRC. 30 This population was

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fundamentallydifferentfromtheireldersinideologyandfamilystructure.Butthese
policies were working to reduce the population growth. By 1991, the birthrate
droppedto20from28in1979. 31 By1992,thefertilityratehaddroppedfrom1970s
rate of 5.75 to 2.0. 32 By 1996, Chinas birthrate had fallen below replacementlevel
fertility. 33
ThegoalsoftheeleventhFiveYearPlan,putforthin2006,aretoincreasethe
income of urban and rural citizens, reduce poverty, expand compulsory education
andincreaseaverageeducationto9years,improvepublichealthandsocialsecurity,
increase coverage of basic pension to 233 million and of rural cooperative medical
care to 80%, and reduce the expense of healthcare. The plan also intends to raise
urbanization to 47% and to reduce standard of living and public service inequality
betweenurbanandruralresidents. 34 InFebruary2008,ZhaoBaige,ViceMinisterof
the National Population and Family Planning Commission, reported the
commissions intention to gradually loosen fertility restrictions to ease labor
shortages. 35 Because of agedependency pressures, the capital of Guangdong
Province has begun to encourage families to have a second child. 36 Nationwide,
individuals who were onlychildrenare being permittedtwochildrenoftheir own.
Though officials recognize the need for an increase in births to meet immediate
worker shortages, they do not want to encourage a large increase in population
growth. While loosening restrictions, officials have also been promising tighter
enforcement among wealthier citizens who have been paying fines to circumvent
fertility limits. 37 2008 also brought specific allowances for earthquake victims
including for parents of killed or seriously injured onlychildren to have another
childortoreceivealifelong600yuansubsidyiftheyareover50.Thosewhoadopt
orphanswillbeexemptfromonechildrestrictionsandfamilieswhoseunregistered
additionalchildrenwerekilledwillnolongerbefined. 38 Overall,thepolicygoalsare
for consistency in fertility controls and balance in social and economic
development. 39 Whether local policy reflects these goals and the intended
improvements in social factors like education and healthcare result in increased
publicwellbeingremainstobeseen.

India
Government Policy
Fertility policy in India has followed a cultural dialogue informed by the caste
system, religious philosophies and international influence from population control
advocates and foreign bodies. In 1940, before independence, the National Planning
CommitteeofIndiasCongressPartycommissionedareportthataddressedconcern
that undesirables in societythe lower castes, the diseased and the mentally ill
were reproducing at rates that threatened the welfare of normal citizens. The
Committee, then led by later Prime Minister Jawaharlal Nehru, discussed the
potential of birth control as a method of economic development but acknowledged
that population measures alone would not be successful. The report recommended
measures to increase uppercaste reproduction, such as the removal of barriers to
intermarriagebetweenuppercastesandpoliciesthatwouldreducethefertilityofthe
unfit,includingcompulsorysterilizationandbirthcontrolpropaganda. 40 Thismixof
economicgoals,racialqualityissuesandthepursuitofreducingpopulationgrowth
wouldcontinuetodefineIndiaspopulationparadigm.

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At the 1952 Third International Conference of the International Planned

Parenthood Federation, local officials demonstrated interest in family planning
programs and even demanded programs with more eugenic basis to prevent the
unfit from reproducing. A presentation by philosopher Dr. Sarvepalli
Radhakrishnan,thenVicePresidentandlaterPresidentofIndia,arguedthatplanned
fertility was a vital method of improving human rights and health for women and
children, and, more importantly, was consistent with cultural norms of selfcontrol
andusingthoughtandskilltopromotenationalwelfare.TheWorld Bankgaveits
first grant for population studies to Ansley J. Coale and Edgar M. Hoover for their
Population Growth and Economic Development in LowIncome Countries. This
study demonstrated that providing nutrition, shelter and education to a growing
population would demonstrate an insurmountable opportunity cost against
economicdevelopmentandgreatlyimpactedIndiansentimentregardingpopulation
policy. 41 Indian interest in fertility control was not invented through contact with
international organizations, but was educated by it. Understanding international
involvementisimportanttocomprehendingtheIndianpolicies. 42
The lack of an authoritarian government, like Chinas, led to a different
approach to Indias population programs. Rarely were contraceptive services
compulsory. That is nottosay thatprogramswerewithoutincidentordesignedto
respect individual rights. The government instead concentrated on two aspects of
contraceptive services: legalization and availability of contraceptive methods and
incentive programs. Despite these efforts, there are some problematic features in
Indias implementation of population control policies. The programs have
concentratedonIUDandsterilizationuse,whileoralcontraceptivesaccountforless
than 8 percent of total method use. 43 Further, while abortion has been legal, safe
abortions have been hard to obtain and many women were required to seek
clandestine abortions due to traditional condemnation. 44 Incentive programs were
first utilized in India when men were compensated for expenses associated with
sterilization. Incentives and disincentives have taken many forms: payments to
acceptors, including: monthly stipend to women who do not become pregnant;
commission to providers; commission to recruiters; payments or services to
communities with high acceptance; cancellation of benefits for couples who exceed
theparitylimit;andpenaltiesforchildrenbornaboveparitylimits. 45
Indias first postindependence census was conducted in 1951. The census
commissioner found the population of 356 million, in spite of a decade of war and
famine, excessive and recommended mass sterilization to reduce the birthrate to 2.
This recommendation was restated more mildly the following year in Indias first
FiveYear Plan, which began the worlds first nationwide family planning program
andcalledforfertilitylimitsandfreecontraceptives. 46 Inadditiontothese,theplan
initiatedthecollectionofdemographicdataincludingpopulationnumber,sexratios,
age ratios and physical and mental health. The Planning Commission struggled to
putfertilitycontrollanguageintotheFiveYearPlan.Itmetwithoppositionfromthe
Ministry of Health headed during the 1950s and 1960s by two disciples of Gandhi,
RajkumariAmritKaurandSushilaNayar,whosharedtheirmentorsdisapprovalof
birth control. In addition to divisions over policy at the national level, the
organization of Indian federalism prevented national agencies from enforcing state
implementation.Theseissuesallowedforsignificantinnovationinpolicyandneglect

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ofnationalgoalsaswellasincreasedagencyforNGOsintheIndiandialogue. 47
The first FiveYear Plan recommended that the programs be implemented
underthepublichealthsystemandprovidefamilyplanningadvicetopatients.The
planincludedanannualbudgetof6.5millionRupees(then$480,000).Thiswasnot
enough to promise implementation; worse, the government only spent around 1.5
millionRupeesperyearthroughouttheplan.Allocatedfundswereoftennotspent,
as implementation depended on the state discretion. However, through the
designatedgoalsandthebudgetsoftheNGOcenters(farexceedingthegovernment
coffers), proponents saw developments that prioritized family planning as a
necessary economic solution and would establish the foundation for goaloriented
policies. 48
The second FiveYear Plan, introduced in 1956, founded the Central Family
PlanningBoard.Thenewdirectoroffamilyplanning,LieutenantColonelB.L.Raina
fromtheArmyMedicalCorpsandhiscontraceptiveadvisorSheldonSegalfromthe
PopulationCouncilwerebudgeted10millionRupeesandworkedforagreaterfund
utilization.Thissecondplansought2500additionalfamilyplanningclinicstosupply
free contraceptives to lowincome clients. By 1959, the program formed 473 rural
clinics and 202 urban clinics and launched a nationwide promotional campaign.
However, these gains amounted to a single clinician each hired at existing rural
health clinics, already serving 82 percent of the population and 66,000 people each.
Due to these conditions, clinicians were often underqualified and overwhelmed.
Limitationscausedofficialstoseethepermanenceofsterilizationastheonlyefficient
goal. 49 R. Gopalaswami, the chief secretary of Madras instituted the first incentive
program in 1956: medical practitioners were paid 25 Rupees (then $5 USD) per
vasectomy on lowincome men. 50 In 1959, the program was expanded to pay
acceptors30Rupees(then$6.30)andmotivators1015Rupeesforeachacceptor.The
per capita annual GNP at the time being less than $70 USD, these incentives
representedsignificantpayments. 51 Thenationalprogramadoptedincentives,hiring
staffandallocatingfundstoenable3,000hospitalsandmaternityhomestoprovide
free sterilization and compensation for expenses for lowincome acceptors.
Governmentemployeeswhoacceptedsterilizationweregrantedaweekofvacation
time. 52
Nineteensixty saw the prioritization of family planning. The third FiveYear
Planresultedinhugebudgetincreasesandlargerclinicincreasetargetsandincluded
the first nationwide incentive of 4000 Rupees (then $800) to local leaders to
encourage lowfertility norms. This policy had a monumental incarnation in a five
week campaign in Maharashtra where sterilization camps sought to maximize
acceptancethroughsocialpressureandsucceededinmorethan10,000vasectomies.
Malesterilizationwaspreferredforthiscampaignbecauseoftherelativeeaseofthe
procedure, which could be performed in less than half an hour utilizing local
anesthetic.However,thefastrateandlowcostsatwhichtheseproceduresweredone
challengedtheconstraintsofeventhisrelativelysimpleprocedure,resultinginpoor
cleanlinessand cursory medical screening. Mass sterilization efforts continued and,
in 1962, 158,000 Indians (more than 70 percent of them males) were sterilized in
mobileclinicstheMinistryofHealthcommissionedtoaddressreproductionamong
thoseinstitutionalizedforchronicmedicalandmentalillness. 53
The third FiveYear Plan also contained a concrete target of a 40 percent

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reduction in birthrate by 1972. The plan called for the training of 49,000 nurse
midwives and numerous other necessary staff by 1967, but hiring and training so
many proved unfeasible. In many states, physicians received only two days of
trainingbeforeperformingvasectomies.Bytheendofthethirdplanin1966,42,000
people had received training in family planning including 7000 physicians, still far
short of what was needed and many areas still wanted for professional staff. This
issuewascomplicatedbycontinued failuretoproperly institute training programs.
Further,thenationalstaffwasnearlyunchangeddespitebudgetincreasesin1966to
three hundred times larger than the 1957 budget, which prevented them from
properlyoverseeingtheprograms. 54
TheintroductionoftheIUDbroughtnewfocustopolicyinIndia.Insteadof
relying on vasectomy, programs now had a longterm, inexpensive solution for
womens fertility with low risk of user error. However, the same problems that
plagued sterilization affected IUDs: poor training of clinicians; poor medical
screeningsofpatients;limitedinformationprovidedtopatientsaboutrisksandpoor
followup, even with serious complications. Despite concerns, Alan Guttmacher,
then head of the Population Councils medical committee, was able to convince
Nayar to support the IUD and she included it in family planning programs,
cancelingMinistryofHealthstudiesoneffects.Shereducedinsertionandtreatment
training to minimum standards and implemented mobile insertion teams. The
Ministry also implemented both specific targetsto prevent 40 million births over
the next ten yearsand financial rewards for staff who met quotas. The Planning
Commissionanticipatedthat19.7millionwomenwouldbeusingIUDsby19701971.
No doubt influenced by international experts who insisted on separating family
planning programs from the health apparatus in order to prevent the misuse of
funds on health services and allow concentration on birth control targets, the
commission intended to push IUD acceptance ahead of advances in general rural
health services. In 1965, the Population Council provided India with one million
IUDsand20,000inserters.IUDinsertionstotaled60,000byDecember1965inPunjab
alone. 55
IndiraGandhisinaugurationin1966metagrowingfoodcrisis.However,her
interestinfamilyplanningensuredthattheprogramsdidnotfallinthefaceofmore
pressing economic issues. She renamed the Ministry of Health to the Ministry of
HealthandFamilyPlanning,denotingherdedication.Justastheadministrationwas
working to increase acceptance of IUDs with acceptor incentives, higher than
expectedcomplicationratesfromlaxstandardsbegantoslowacceptance.Insteadof
addressing concerns, such as funding contraindicated infection treatment, the
Ministryrequiredclinicstopayforrelatedcarewiththe3Rupeesperacceptorthey
received. Monthly insertion rates fell from 120,000 to 60,000 by March of 1966. In
October,therewerefewerthan50,000insertions,andtheMinistryofHealthagreed
to pay incentives to acceptors. The Ministry provided 11 Rupees per IUD, 30 per
vasectomyand40pertuballigationtothestateswiththediscretiontopaywhatever
provednecessarytoacceptors,motivatorsorstafftobestensureacceptance.Punjab
hadbeenpayingIUDacceptorsandachieved277percentofitstargetfor19651966.
Madrashadbeenpayingforsterilizationacceptorsandmotivatorsandhadthebest
acceptanceratesnationwide.Compoundingtheloomingfamine,1966broughtlittle
monsoonrainandover100millionpeoplewereatriskofstarvation.Thepercapita

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income the next year reached just 112 Rupees, increasing the impact of incentives
amonglowincomefamiliesandacceptancegrewsharply.Bihar,inthethirdyearof
drought,sawacceptancejumpfrom2,355sterilizationsand12,677IUDinsertionsin
1965to97,409totalacceptorsin1966and185,605in1967.Thefaminesresultedin1.8
millionacceptorsnationwidebetween1966and1967. 56
Despite shortterm increases in certain states, it became indisputable that the
generalpopulationwashesitanttoacceptthechosenbirthcontrolmethods.Officials
respondedbyincreasingincentives including land and fertilizer. The complications
duetopoorlytrainedphysiciansgrewworse.Insomestates,developmentprograms
fell to fund population control. In Maharashtra, some field worker and educator
positions were eliminated to free funds for incentive payments. 1967 brought
punitivemeasuresagainstphysiciansfornotmeetingquotas,statescallingforhigher
incentivepaymentsanddenialofmaternityleaveandotherbenefitstogovernment
employeeswhosurpassedfertilitylimits.Bytheendof1967,ratesweredownover
most of thecountry. The national government considered but declined compulsory
sterilizationprograms. 57
Incentive programs persisted through 19711972 when program expenditures
exceeded funding but sterilizations increased by 70 percent. The following year,
19721973, 3.1 million sterilizations occurred and the budget was again surpassed.
The budget for the following year was cut, and the concentration shifted from
sterilization to health care. 58 However, in 1975, incentives for sterilization were
raised. 59 Thefollowingyear,thegovernmentdraftedtheNationalPopulationPolicy
Act with the intent of reducing the birthrate from 41 to 2025. 1976 also brought
declaration of emergency because of the high birthrate, leading some states to
institute compulsory sterilization programs. 60 In some rural regions in the north,
sterilization camps were again used to meet targets. Disincentives were again
instituted to ensure compliance, particularly among government workers.
Sterilizationsincreasedfrom1.4millionin19741975to2.7millionin19751976and
to 8.3 million in 19761977. The camps worsened the reaction of the citizens to the
programs and acceptance and effectiveness suffered. 61 The government succeeding
IndiraGandhiin1977canceledcompulsorysterilizationprograms,declaringthatall
family planning programs would be voluntary. Sterilization numbers promptly
decreased to fewer than one million. When Indira Gandhi returned in 1980, she
distancedherselffromcompulsoryprograms. 62
By 1981, the population had reached 683,810,051. The growth rate between
1971 and 1981 at 24.75 percent dropped little from 24.80 percent between 1961 and
1971. 63 ThesterilizationcampsreopenedinFebruary1982withrewardsequaling$22
USD to female acceptors and $15 USD to males. 64 It became apparent that the
culturalpreferenceforsonswascausingaseriousreproductiveproblem.Whenfaced
withincentivesforreducinghigherparitybirths,familieswereelectingtoterminate
femalefetusesorkilltheirfemaleinfantssotheycouldtryagainforason.Thesex
ratioforbirthshaddroppedto934femalesper1000malesandfurtherdecreasedin
by1992to927femalesper1000males.Thepopulationreached846,302,688andthe
growth rate improved with development including new irrigation and urban
expansion. 65

Asof1997,45percentofmarriedcouplesusedcontraceptionwith72percent
of acceptors choosing sterilization. The historical problems with large sterilization

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numbers continued, and overtaxed medical staff still failed to offer less permanent
methodslikeoralcontraception. 66 In2006,theFinanceCommissionrecommendeda
disincentive plan designed to tax couples with more than two children, but Prime
Minister Singh disapproved of the policy as it did nothing to ensure reproductive
health or improve the socioeconomic status or health of women or their children. 67
Thegreatestchallengefacedbycurrentpolicyisbirthratepressureamongthepoor.
FiftysixpercentofthepoorinIndialiveinthefivestatesofBihar,MadhyaPradesh,
Uttar Pradesh, Orissa and Rajasthan, home to 45 percent of the whole population.
Withintwentyyearsthesefivestatesalonewillbehometomorethan50percentof
thepopulationand75percentofthepoor. 68
TheEleventhFiveYearPlan,adoptedin2007,statesnumerousrelevantgoals.
Itdescribeswomenasagentsofeconomicandsocialgrowth 69 andstatesthegoals
ofeconomicempowerment,provisionofbasic necessities,protectionfromviolence,
political participation and infrastructure to promote effective policy and
involvement. It also lists goals for reducing death, disease and overwork among
children.Theenumeratedtargetsfor2012areasfollows:raisesexratioforages06to
935, 33 percent of government aid directly or indirectly to female citizens, reduce
infant mortality to 28, reduce malnutrition for ages 03 and female anemia by half,
reduce primary and secondary school dropout rates by 10 percent, reduce fertility
rateto2.1.Theplanalsoincludeshousingforruralhomeless,wateraccessforurban
women and clean water for all citizens by 2009, guaranteed employment for job
seekers, increasing access to health insurance programs, decentralization of health
program planning and an incentive program for certain areas whereby families
wouldberewardedforbenchmarkactionsforfemalechildrenlikebirthregistration,
immunization, school enrolment and delayed marriage until age 18. The focus in
India appears to have shifted to health and wellbeing, but specific fertility targets
remain, along with language regarding fertility programs. The Eleventh Plan still
cites unmet need while discussing the low incidence of methods requiring male
responsibilityandthedisproportionatedependenceonfemalesterilization.ThePlan
emphasizes the protection of citizen decision making and choices 70 while stating
the intention to continue utilizing mass media campaigns for behavioral change. 71
Also,despitecomplaintsregardingthedependenceonsterilization,thePlanpraises
a pilot program in Tamil Nadu which trains doctors in these procedures and
proposesexpandingsuchlocalinitiatives.

Cultural Difficulties
PriortoBritishcolonization,Hindutraditionextolledhighfertilityencouragingmen
oncetheymarriedtoprocreateextensively.However,thisvaluemust beviewedin
thecontextofhighchildmortalityratesandlowlifeexpectancy.Between1911and
1921, up to 75 percent of children died by age five. 72 In the same period, life
expectancyonlyreachedagetwenty. 73 Thoughstilloneofthehighestintheworld,
theinfantmortalityrateinIndiawasmuchimprovedby1997at80. 74 Indiaranked
fiftyfifth in the world in 2006 with a rate of 54.63, nine times that of the United
States.In2008,Indiaranksseventyfifthforinfantmortalityat32.31,stillmorethan
five times the rate in the United States. The current life expectancy in India is just
morethansixtynineyears. 75 Thisdeclineinmortalityrates,combinedwithasteady
birthrate,ledtothemassivepopulationgrowthinIndia.Yet,becauseofthehistorical

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reality of high infant mortality rates, planning services aimed at smaller families
havenotbeenverywellaccepted.Therearenoreligiousproscriptionsagainstbirth
control, only a scriptural condemnation of abortion. Nonetheless, the culture has
beendefinedgreatlybythefearforsurvivalbroughtonbytheterrifyingmortalityof
the early twentieth century. 76 Further, much of India is still agrarian and values
childrenasworkersandcontributorstofamilywelfare.Inagrariansocieties,children
areproducers,ratherthanconsumers,andlargerfamiliesaresupportiveratherthan
costlyastheyareseenintheneomalthusianparadigm. 77 Thiscomplicatesthenotion
of population control and requires a change in how government addresses these
communities.
There is also a great disparity in Indian society in the way that men and
womenareviewed.Menarevaluableasbreadwinnersandsonsarenecessarytocare
fortheirparentsinoldage.Theyarealsonecessaryforreligioustraditionincluding
certain ceremonies at a fathers funeral service. 78 Sons are even described in some
texts as ensuring immortality and power to a paternal line and saving their fathers
from hell. 79 A woman only receives favorable treatment as a pregnant young wife.
Heronlyreligiousactivitiesareritualscarriedoutforthewelfareofherhusbandand
children, as babies are her godgiven purpose. Even a young woman knows that if
she is widowed, only her childrenand particularly her sonswill care for her. 80
The disparity of the value of women and their role in the family complicates the
applicationofcontraceptiveprograms.Bothmembersofthecouplemustbeincluded
in the discussion of reproductive health, and the method chosen must be one that
botharecomfortablewith.Alsoimportant,womenmustbeassuredtheireconomic
statuswillnotbecompromisedbythedecisiontolimitbirths.
Indiaspopulationcontroleffortshaveenjoyedlimitedsuccess,butsomestates
anddistrictshavedemonstratedveryimportantinnovations.Clearly,thequestionof
reproduction is one requiring both cultural sensitivity and cultural reformation.
ThereareindividualstatesinIndiathathavedemonstratedgreatsuccesswiththeir
populationcontrolpolicies.Wouldthesepoliciesworkwhengeneralizedacrossthe
whole and disparate population of India? Of note is the distinction of the poor
agrarianfamiliesandthecontinuedrelevanceofculturalpreferenceforlargefamilies
in that environment. While the urbanizing populations may be more readily
persuaded of the reduced need for multiple children, children in poor agrarian
families are vital contributors to the economic viability of the family. 81 To be
successful, population control policies applied to these areas must address the
concernsoffamilieswhofearthelossofincomefromamissingchild.Theagrarian
economicrealityisbasedondedicatedlaborinwhichmorehandsmeansincreased
security.Itisnotsufficienttogiveasmallrewardinreturnforcontraceptiveuse,asit
maybeinaworkingurbanfamily.Thepoliciesusedtoaddresspopulationgrowth
inruralareasmustensurelongtermeconomicsecuritytofamilieswhofearlosingit
bycooperatingwithcontraceptiveprograms.
BecauseofthedecisionsoftheIndiangovernmenttocomplywithdemocratic
principles and generally preserve the voluntary nature of their population control
policies, 82 the responsiveness of the government to citizen opinion must be flexible
and quick. Enforcing policies that reduce the attractiveness of contraceptive
cooperation will only result in failed policy. Because of the vast differences among
theIndianpopulation,thepoliciesmayneedtobedesignedtomeetdistinctneedsin

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19

each community. To some extent, this has occurred by default as a result of the
federalstructureandthediscretionallottedstatesinIndia. 83 However,whilepolicies
may be tailored to provide accommodations that may be more helpful in one
community than another, any program benefits must be available equitably across
the nation, in order to provide equal opportunities for assistance. Further, policies
must be formulated to be beneficial, and even persuasive, but great care must be
takentoavoidcoerciveregulation.Theaimofbirthcontrolassistancesshouldbeto
enablefamiliestomoreeasilyplantheirreproduction,nottostrongarmpeopleinto
changing their personal desires to meet targets. The famine and hardship
experiencedin19661967isanunfortunateexample. 84 Policiesthattakeadvantageof
desperate people and force them to make permanent choices for immediate and
temporarysurvivalratherthanassistingthemtowardenduringsecurityareneither
appropriate nor successful in the longterm. The Indian people have repeatedly
demonstratedtheirdeterminationtoresistunjustcontraceptivepoliciesinthesharp
decline of acceptance rates following the discontinuation of the most coercive
policies,suchasmasssterilizationcamps. 85 Failuretoensurejustapplicationoflaw
willproducenothingbutfurtherresistance.

Current Analysis
Forapopulationprogramtobejust,itmustrecognizeandsupporthumanandcivil
rights equitably as established within a given nation. For the program to be
successful,itmustpromoteandachieveasustainablelevelofpopulationgrowththat
neitherstressessocialprogramsnordeprivestheeconomyofworkers.Theliterature
presentedinthisarticleestablishesthatthemethodmostlikelytoachievethesegoals
istoinstitutepoliciesdesignedprimarilytoencouragesocialandeconomicwelfare
including the development of improved rights recognition and agency. Following,
the reader will find sections dedicated to particular segments of public policy that
will promote these goals and will contribute to population growth interests while
maintainingajustsociety.Thesepolicyoptionsshouldbeviewedinthelightofthe
successesandfailurespresentedinthehistoriographiesabove.
The Importance of Education
Educationisthecornerstoneofdevelopmentandadvancement.Becausepopulation
growthisintertwinedwithdevelopment,itisalsointertwinedwitheducation.Any
educationsystemwillbestretchedbyarapidlygrowingpopulationandcanbethe
firstplacetocombatsuchgrowth.Educationalachievementisamajordeterminantin
reproductive behavior worldwide and encouraging secondary and postsecondary
educationcanbeapowerfultoolforimprovingtheeffectivenessoffamilyplanning
programs. Moreover, the education system may be utilized for instructing the
population as a whole on how their reproductive behavior creates national
populationgrowthandhowthataffectsqualityoflifeforfamilies,communities,the
nation and the world. Through education, citizens are empowered to make
responsiblereproductivechoices. 86
Any population program concentrating on improving education in general
and sexual and reproductive health in particularis inherently more just. By
entrustingcitizenswiththeknowledgetotakeresponsibilityoftheirownlivesand
their contributions to society, a government can improve acceptance of behaviors

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which will reduce population growth without risking attitudinal regression

associated with such policies as compulsory sterilization. Improvement or the
institution of a standardized national education system should be part of any
comprehensivepopulationcontrolprogram.
Thewriterproposesthatqualityfullspectrumeducationshouldbeaprimary
focusofanypolicyprogramintendingtoreducepopulationgrowth.Accessibleand
affordableif not freepublic academic instruction at the primary and secondary
levelsprovidescitizensbasicknowledgerequiredforproductivecivicandeconomic
involvement. Comprehensive health education for both public school students and
the public at large empowers individuals to take responsibility for their wellbeing
andisavitalpartofapreventivehealthcareprogram.Aprograminstitutingbothof
these would reduce mortality pressures and enable informed reproductive choice
while improving economic and social mobility and political empowerment. All of
theseeffectswillcontributetoaneffectiveandjustpopulationpolicy.

The Fine Line of Coercion

Incentives have historically been instituted to encourage immediate positive action
on the part of individuals. These programs take two manifestations, the first being
smallincrementalremunerationswhichassumethatafamilywantstocontroltheir
fertility and assist them in doing so, rewarding them for each month or year they
successfully prevent new births. Incremental incentives are empowering,
encouraging families to seek and utilize the contraceptive methods they are most
comfortable with. The second manifestation consists of large, onetime payments
giventothosewhomaywantalargerfamilytomeeteconomicneeds.Thesechange
theimmediatecostbenefitdynamictofavorsmallerfamiliesandaregenerallyused
toencouragepermanentmethodsofcontraceptionsuchassterilization,changingthe
decisionsanindividualwouldotherwisemakeaboutreproduction.
The idea behind disincentives is that society will benefit so greatly from a
reduction in population growth that the government has a vested interest in
intervening in personal decisions to prevent excessive fertility for the good of the
population.Thus,minor,shortterminfringementofpersonalrightsandprivacyare
viewed as excusable. Disincentives, as discussed previously, include penalties for
highparity births, failure to accept contraceptive programs and similar
noncompliance. Incentives can be compatible with human rights by creating the
positive effect of population control on longterm quality of life and by the
immediate benefit of financial rewards. Likewise, disincentives can be justified if
properlyinstitutedbycomparingtheimmediatecostagainstrightstothelongterm
improvement in human rights, which can come with a reduced population. Yet,
these methods can be abused when highly organized by governments that fail to
provide sufficient oversight. 87 It is tempting to view disincentives as a tax on the
choice to procreate beyond the governmentpreferred parity. A cursory viewing
would show incentives to be the more just method of encouraging cooperation,
rather than punishing noncompliance. Incentives, however, often lead to coerced
acceptanceofsterilizationandlongtermmethodsofcontraceptionduetoimmediate
economicneedwhichmaylaterbeoutweighedbytheneedforachild.Thecoercive
power of incentives is demonstrated in that incentivedriven acceptance of

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impermanentmethodsgenerallyproduceslowratesofreacceptanceandreductions
inacceptanceonceimmediateeconomiccriseshavebeenalleviated. 88
Disincentives,unlikeincentives,canreinforcedevelopinglowbirthratenorms
without forcing acceptance of permanent contraception such as sterilization. These
strategies are more successful in societies with full legal access to all methods of
contraception and no increased hardship on higherparity children. Disincentives
allowtheacceptorstodecidewhenandhowtoreducefertilityinsteadofhavingto
accept the particular method with the highest financial reward. 89 While they might
manifest in a higher immediate cost for those who choose to have additional
children, disincentives better protect human rights because of the increased
likelihood of coercion toward positive action associated with some incentive
programs. Therefore, incentive programs should only be instituted with great care
and oversight and only in conjunction with more protective disincentives. Any
disincentive program should be marked by an economic structure that permits
additionalchild(ren)tocontributetothefamilyincomethroughwork,thoughhisor
herbirthmaycostthefamilyexceptionalsocialbenefits.However,anysocialwelfare
program which provides basic necessities should never be restricted based on
fertility.TheChinesepolicyofgivingthesamesizelandallowanceforruralfamilies,
thus, may be acceptable, though the similar program of increased grain rations for
smaller families is likely not. Likewise, historical Indian policies which reduced job
opportunities or political agency for large families were unjust. Other justifiable
disincentivesmaybeeliminationoffreepostsecondarytuitionforhigherbirthorder
children, while elimination of free education for all the children in a family or
eliminationofprimaryorsecondaryeducationforanyofthechildrenwouldnotbe.
The first of these is unjust because it punishes children for the decisions of their
parents,and,ratherthanhavingtheaddedcostoftheextranormativechildren,allof
thechildrenbecomeanopportunitycost.Thisandthesecondareunhelpfulbecause
they reduce educational opportunities to all the children in the family and of basic
education to the higherorder children, which would compromise the necessity of
educationtodevelopmenteffortswhichhaveahigherchanceofsuccessfullylimiting
birthsthandisincentiveprograms. 90
Incentive programs in China have been more successful than those of India.
The writer proposes that the increased achievement results from comprehensive
incentiveplans,whichprovideforthelifelongeconomiclossthatcanbesufferedby
those of agrarian or other lowincome families that would otherwise depend on
multiple children to augment their income. The incentive programs in India have
comprised mostly onetime awards for acceptance of longterm birth control
methodsthatdonotcovertheeconomicimpactthatanadditionalchildcouldhave
had in a familys life. Thus, any incentive program should include comprehensive
careprogramsproviding,attheminimum,apensionforcooperatingcouples.When
developing incentivedisincentive programs, governments must be dedicated to
analyzing the local role of children in families and seek to shift the costbenefit
balancethatplayssogreataroleinthedecisiontoreproduce.Theincentivesmustbe
appropriate to repay the couple for sacrificing their right to reproduce rather than
convincingthemtosubmittogovernmentauthority.Theremustbeacommitmentto
comprehensive oversight in order to ensure that these programs remain wholly
voluntary and that incentives and disincentives reinforce efforts without being

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coerciveorsuccumbingtounofficialabuses.Aidinginthis,reinforcementprograms
must be built upon unrestricted and affordable access to whatever variety of
contraceptivemethodanindividualmightpreferregardlessofageormaritalstatus.
Any restriction of access creates an underserved population subject to unwanted
pregnancyandunintendedpopulationgrowth.

Women Change Everything

Awomansstatus,andwithitherabilitytosafeguardherownhealthandthatof
herfamily,dependsnotjustonherrighttodecideonthenumberandspacingof
herchildren;herstatusalsodependsonherrighttoactasanindependentadult
(herlegalcapacity),toparticipateasacitizeninhercommunity,toearnaliving,
to own and control property and to be free from discrimination on the basis of
gender,race,andclass. 91

Son preferenceisproblematic in both China and India despite thedifferences

in their approaches to population control. As of 1991, the gender disparity in India
was927womenper1000men.Estimatesputmissinggirlsbetweenagezeroandsix
at1.4million. 92 Chinas2000censusshowedagenderdisparityof100femalesto117
males. 93 Asaresultofthisdisparity,estimatesplacemissingbridesatfortymillionin
China. 94 Thenaturaldisparitybetweenfemaleandmalebirthsis100to103110. 95
The source of preference for male children originates with the socioeconomic
history of valuing the work that men have traditionally contributed to society over
theinputofwomeninbothnations.Indiansocietyhasreligioustraditionsupporting
malechildpreference.However,therearemanyreligioustextsthatdescribestrong
and socially valuable women. By increasing the attention paid to these texts, and
improvinggendereducationingeneral,theIndiangovernmentcouldseektocombat
therisinggenderdisparityandeventhepopulationgrowthitself.Therealsolution
to Indias population problem lies in [...] systematic and steady (not sporadic)
valuingandeducationofgirlsandwomen.Ifwomenareperceivedascontributorsto
thefinancesofthehome,theirbirthswillnotbefearedandprevented. 96
The Chinesegovernmenthasalready institutedseveral policiesto combat the
genderdisparity. 97 Thepartydraftedaresolutiontorevisecriminallawtoallowfor
charging those who provide services for the already illegal practice of fetus gender
identification and nonmedical, sexselective abortions. 98 Also, the Chinese have
added three new incentive programs. First, families without sons will receive a
yearly allowance of 600 Yuan once the parents reach sixty years of age, which will
aid greatly the average yearly income of 2000 Yuan. 99 Also, onlydaughters will
receive bonus marks on college entrance examinations and special treatment when
looking for jobs. Finally, daughteronly families will be eligible for preferential
agriculturalassistanceloans. 100
Itisnotonlynecessarytoeducatethepopulationaboutthevalueofwomenin
society; it is vital to educate women in general. When women are educated, they
marry later in life, reducing the number of childbearing years, and thus fertility,
leading to smaller families. Education of women also reduces infant mortality, a
largedeterrenttocontraceptiveparticipationinIndia. 101 Educatingwomenincreases
their agency and empowersthemto theability to act on their own behalftoobtain

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contraceptiveservicestoregulatetheirchildbearing.Also,improvededucationleads
to improved employability, which can reduce the need for children to protect a
woman from poverty in old age. By providing women with economic value,
governmentscanreducetheheavytollthathighfertilitywagesonwomenandalso
enablethemtoreapthebenefitsofhavingsmallerfamilies. 102
Improved gender equity through education can be expected to lower fertility
rates as extensive statistical evidence supports that female education and literacy,
empowerment of women via gainful employment, independent incomes, property
rights,andgeneralsocialstandingimprovementsstarklyreducefertilityrates. 103 By
correctingfemaleilliteracy,lackoffemaleemploymentandeconomicindependence,
by providing family planning education and resources, and by combating religious
and traditional oppression of women, governments can expect to transform the
powerofwomenandthustheincreasetheeffectivenessofpopulationprograms. 104

The Special Case of Kerala

The importance of taking women into account in population control policies is
nowhere better illustrated than in Keralaa state on the southwest coast of India.
Kerala has instituted laws relating to womens rights, education, land reform, food
security and health services as part of their population control program. This state
also has a matrilineal system that values women and their education. The fertility
rate was halved within two generations to 2.2 in 1997. 80 percent of the state
population practices some form of contraception. Life expectancy in Kerala in 1994
was seventy years, surpassing the national expectancy of fiftyseven years. 105 Other
areas with a similar improved status for women like Tamil Nadu and Himachal
Pradeshalsohavegreatlyreducedfertilityrates.AnalysisofChinesepoliciesfurther
attests to the transformative power of female agency. While Chinas sharp fertility
declineisoftenattributedtocoercivepolicies,[...]onecouldhaveexpectedaroughly
similardeclinebecauseofChinasexcellentachievementsinraisingfemaleeducation
and employment. 106 The improvements in the lives of women in Kerala have
developedmuchmorequicklythaninChinaand,likewise,thefertilityinKeralahas
dropped much more precipitously from 3 to 1.8 in the same time that Chinas rate
dropped2.8to2.0between1979and1991.In2001,Keralamaintainedtheirleadon
Chinawithafertilityrateof1.7wellunderChinasrateof1.9. 107
Most important, because the programs in Kerala have been completely
voluntary and coercionfree, the infant mortality rate is much lower than where it
stoodevenwithChinain1979.ThefemaleinfantmortalityrateinKeralaisnowhalf
that of China and there is a reduced gender disparity. 108 Kerala has a much lower
fertility rate than the 4.4 to 5.1 rates common in Uttar Pradesh, Bihar, Madhya
PradeshandRajasthanwhichhavereducedfemaleeducationandhealthcarebutuse
coercion to ensure cooperation with fertility control programs. 109 Female
empowermentismoreeffectiveeventhangeneraleconomicimprovementasseveral
rich districts in Punjab and Haryana have much higher fertility rates than some
poorer communities with higher female literacy and employment. 110 The specific
improvements in these communities clearly show that a commitment to improving
thesocialstatusofwomencanbefundamentalindecreasingbothpopulationgrowth
pressuresandtheconsequencesassociatedwithtraditionalapproachestopopulation
control.

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The Problem of Age-Dependency
While Chinas onechild policy is no longer officially strictly enforced, the
government estimates that the population of those under age thirty is 400 million
fewer than it would have been without the onechild policy. 111 The population
controlshavebeensuccessfulastheoverallgrowthrateinChinahasbeenreducedto
.93percent 112 and,in2000,Shanghai,thecountrysmostpopulouscity,hadafertility
rate of only .96. 113 However, this reduction in population may compromise the
economicstrengthofChinaforthenextthirtytofiftyyears.Whenthefertilityrateis
high,therearealargenumberofchildrendependentonadultworkers;thisispartof
the agedependency effect. When fertility declines, the reduced dependency allows
for economic development. However, reduced fertility results quickly in a large,
unsupported aging population and a smaller workforce. 114 This topheavy age
dependencyeffectwillsoongreatlyimpactChinaasmoreworkersageandthereare
fewer young people to replace them. 115 The workers that will be retiring in China
each year beginning in 2011 will total fifteen million, equal to the number of new
workersthatyear. 116 EverytenChineseworkerswillhavetosupportsevenyounger
or older dependents by 2050. 117 One suggestion to counter this is to raise the
retirementage,butagediscriminationisstronginChinasworkplaces,andworkers
in their forties are having trouble finding jobs because of preference for younger,
moreeducatedworkers. 118
Chinasworkerpopulationhasbeensharplyreduced,butIndiastillhasalarge
potential workforce that is becoming more highly educated. While the rest of the
world is already experiencing population declines and facing a future starved of
skilledworkers,Indiamayhaveachancetopopulatetheworldwiththeireducated
youth. 119 This will create an economic environment in which it will be possible for
India to continue its impressive 8.3 percent growth rate. 120 By supporting
development and further increasing and improving education, India could easily
surpassChinaindevelopment.However,withintwentyfiveyears,thepopulationof
India will likely stabilize, thus dropping the dependency rate and leading to the
same issues of an unsupported aging population within the following twenty
years. 121
These and any other nations interested in sustainable populations must
concentratefirstonsustainableeconomicachievementandgrowth.Improvedpublic
educationemphasizingtransferablebasicskills,accesstotechnicaltrainingprograms
and any grant or taxation incentive programs should be designed to increase entry
into nonvolatile industries, promote entrepreneurship and provide for career
redirectioninthecaseofarapidboomandbustcycleinagivenindustry.Notonly
willtheresultingeconomicimprovementprovidethefertilityreductionscitedinthe
literature, but they will also help cushion a crisis in the agedependency ratio by
increasingtheactiveworkforce.

Conclusion and Recommendations for Continued Success

By implementing programs that resulted in improved education for the general
population and women specifically and some encouragement of womens rights,
along with a strict, active and wellorganized system of regulations, incentives and
disincentives,Chinahasgreatlyreducedtheirpopulationgrowthtowellbelowzero

Stolc/Seeking Zero Growth

25

growth.Indiahasattemptedtokeeptheirfamilyplanningprogramsmorevoluntary,
but, without an emphasis on gender equity and education, the government has
struggledtoreducethegrowthrateasquicklyasChinaandevensomeIndianstates.
Both nations would benefit greatly from an expansion of efforts to educate and
empower women by availing them of improved rights and protections. China has
madespecificeffortstochangetheculturalattitudestowardchildbearing,namely,in
correcting the stigma against small families. They are also beginning to implement
similarculturalattitudechangeswithregardtothedesirefordaughters.Iftheycan
succeedinimprovingsocialopinionofwomentheycanreducethepressuresofson
preference and also improve womens rights in general. When womens lives are
improved,populationgrowthwillreduceevenmore.
To continue to reduce populations and to improve the quality of life for the
citizens of China and India and other nations with similar population problems
throughout the world, the writer recommends a continued reduction in unwanted
pregnanciesbymeansofcontraceptionratherthaninducedabortion.Byencouraging
preemptive methods and sexual education of both adults and adolescents, these
countries can reduce the dangers to womens health associated with unnecessary
abortionsandinfanticide.Manyculturescontainsocialpressuresagainstadolescent
sexualityandthusmanyassumethattheiradolescentsdonotneedsexualeducation
andcontraceptiveavailability.Thiscreatesavulnerablegroup,particularlywiththe
rise in parental AIDS deaths creating more unguided orphans. These nations can
fundamentally change their population dynamics by instituting early sexual
educationplansandmakingincentiveprogramsavailabletounmarriedindividuals.
Further,byinvestingheavilyindevelopmentandeducation,thesegovernmentscan
reduce infant mortality and the economic need for large families contributed to by
lowincome occupations. 122 Finally, by seeking to implement comprehensive
incentivedisincentive programs similar to those in China instead of onetime
sterilization rewards similar to those in India, governments worldwide can
encouragecooperationwithprogramsbyremovingtheneedforadditionalchildren.
This article has assumed the benefits of programs aimed at reducing
populationgrowth,notbecausetheliteraturedescribesincontrovertibleevidencefor
them, but because countries are determined to implement them. In these attempts,
somehavediscoveredveryimportantprinciplesthatmustbeapartofanynations
population controlprogram.However,mostofthesepracticaldiscoveriesandthe
academic literaturestress that the most successful population control policies are
actuallydevelopmentand humanrights policieswhichseem to inherently result in
reducedfertility.Thestarkrealityismanylessdevelopedcountrieshavelargepoor
populations often wholly dependent on government assistance. It is more than
challenging forgovernmentstomeetthese needs. It is understandable why nations
would view population reduction as a quick fix for strained welfare budgets, but
they are not. The aim for governments must be economic and rights development.
However, there is no reason to assume that any population control is inherently
unjust or an unworthy goal. In exploring the successes and failures of previous
attempts, the international community can easily model a program that will be
guaranteedtoreducethepopulationgrowthandimprovethelivesofcitizens.This
modelmustinclude thefollowing: (1)primary, secondary and health education for
all citizens; (2) general economic improvements, including increased economic

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mobility and entrepreneurial opportunity; (3) increased education and social rights
improvements for women, including campaigns designed to raise awareness of
womens issues and the social view of women; (4) policies to encourage womens
activities within the economy; (5) sexual health and contraceptive education for
adults and adolescents; (6) universal and affordable contraceptive availability
regardless of marital status; (7) improved health care to reduce pressures to
reproduce stemming from a high mortality rate; (8) comprehensive incentive and
disincentive programs to encourage citizen participation and assist those who
cooperate,independentofotherdevelopmentefforts;(9)whollyvoluntaryprograms
with strict oversight to prevent abuse; and (10) increased political agency to
empower citizen involvement rather than demonstrate topdown, oppressive
declarations. Nations seeking to implement a population control program will,
naturally, have to tailor this model to their cultural norms. By following these
guidelines,nationscanutilizeprovenmethodstoimprovetheirsocietiesandreduce
theirgrowthrates.
If these steps seem familiar or obvious, it is because they represent a
commitment to economic development and increasing recognition of human and
politicalrights.Yet,thesebasicprincipleshavebeenignoredinthedevelopmentof
population policy, despite demonstrated success. There has long been recognition
among population control advocates that similar measures had the potential to
reduce growth, but preference has been given to more aggressive policies that
provided, if nothing else, a feeling of active problemsolving effort. That
international aid and the very rights and lives of citizens have hinged on these
comparatively unproductive plans is reprehensible. The international community
shouldencouragepoliciesthatinsteadrespecttherecognizedvaluesofhumanrights
and should, if preconditions for aid are unavoidable, make such assistance
dependentonsucheffortsthatwillimprovequalityofliferatherthansimplyseekto
controlreproductivebehavior.

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27


NOTES
Forthepurposesofthisdiscussion,thefollowingtermswillbedefined.
Birthrateisthenumberofbirthsper1000peopleperyear.[43.6(per1000)]
Mortalityrateisthenumberofdeathsper1000peryear.[28(per1000)]
Infantmortalityrateisthenumberofinfantdeathsper1000peryear.[80(per1000)]
Naturalgrowthrateisthebirthratelessmortalityrateper1000peryear.Somesourcesexpressthis
inpercentageterms.[5(per1000)]
Fertilityrateistheaveragenumberofchildrenborntoawomanoverherlifetime.[5.75(births)]
Incentivesaretangibleorintangiblerewardsthattargetcitizensandseektoincreasethelikelihood
ofparticipationindesiredpopulationrelatedbehaviors(David).
Disincentivesarethetangibleorintangiblecostsimposedonatargetpopulationintendedtoreduce
thelikelihoodoffailuretocooperatewithdesiredbehaviors(David).
Paritydenotesthelevelofbirthorder.Asecondchildistheproductofalowparitybirth.Asixthchildwould
beahighparitybirth.
Paritylimitdenotesthemaximumnumberofchildrenpermittedunderapolicyorincentiveprogram.
Acceptorsarepersonsmakingfertilityrelateddecisions(David).
Recruitersormotivatorsseekacceptorsandencouragespecifieddecisions(David).
Providersarethosewhosupplyacontraceptiveproductorservice(David).
Agedependencydescribestherelationshipofthenumberofeldercitizensandchildrentothesizeofthe
workingpopulation.
2AmartyaSen,FertilityandCoercion,TheUniversityofChicagoLawReview,63,3(1996),pp.1035
1061.p.1035.
3USCensusBureau,WorldPopulationInformation:WorldPopulationTrends,online,nd,availableat:
http://www.census.gov/ipc/www/idb/worldpopinfo.html(25June2008).
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at:http://www.gutenberg.org/etext/4239(25June2008).
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(1994),pp.771776;LynnP.FreedmanandStephenL.Isaacs,HumanRightsandReproductiveChoice,
StudiesinFamilyPlanning(SFP),24,1(1993),pp.1830.
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7GaryS.Becker,ATreatiseontheFamily.Cambridge:HarvardUniversityPress,(1981).
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9Bongaarts;SusheelaSingh,DeidreWulfandHeidiJones,HealthProfessionalsPerceptionsAbout
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23,2(1997),pp.5967.
10Bongaarts.
11QianXinzhong,ChinasPopulationPolicy:TheoryandMethods,SFP,14,12(1983),pp.295301.
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13HenryP.David,Incentives,ReproductiveBehaviorandIntegratedCommunityDevelopmentin
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14Xinzhong.
15Tien.
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17Tien.
18ThomasFrejka,InducedAbortionandFertility,FamilyPlanningPerspectives,17,5(1985),pp.230
234.
19Tien,p.442.
20Sen,Fertility;Shen;Xinzhong,
21David;FreedmanandIsaacs;RobertL.WordenandreaMatlesSavadaandRonaldE.Dolan,
editors,China:ACountryStudy,Washington:GPOfortheLibraryofCongress,online,1987,availableat:
http://countrystudies.us/china(25June2008).
1

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David;Tien.
KarenA.LaidlawandEdwardG.Stockwell,FertilityControlProgramsinAsia:AnotherLookat
theData,AsianSurvey(AS),20,8(1980),pp.803811.
24David.
25David;Tien;Xinzhong.
26David.
27Frejka.
28Tien.
29Frejka.
30A.J.Jowett,TheGrowthofChinasPopulation,19491982(WithSpecialReferencetothe
DemographicDisasterof19601961),GJ,150,2(1984),pp.155170.
31Sen,Fertility.
32Shen.
33Sen,Fertility.
34KaiMa,The11thFiveYearPlan:Targets,PathsandPolicyOrientation,NationalDevelopmentand
ReformCommission,online,19March2006,availableat:http://english.gov.cn/2006
03/23/content_234832htm(25September2008).
35TheNewYorkTimes(NYT),ChinatoReconsiderOneChildLimit,29February2008.
36ChinaDaily(CD),Cityeasesonechildpolicy,5July2007.
37NYT,29February2008.
38RadioFreeAsia,QuakeVictimsAllowedExtraChild,27May2008,availableat:
http://www.rfa.org/english/news/china/quake_orphans05272008155530.html(September25,2008).
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