targets versus extension family planning
TRANSCRIPT
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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N orth Indian State, (unpublished Ph .D .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
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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
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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
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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.
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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
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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
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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
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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.
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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
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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
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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
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