The government of Assam wants to put a limit on family size to try to slow the state’s population growth. But mistrust of contraception could make it impossible to convince people about the benefits of family planning.

DOMORDALANG, India – If its population continues growing at the current rate, India will surpass China as the world’s most populous country by 2024, according to the United Nations’ latest World Population Prospects report.

In an attempt to do its part in slowing down India’s population boom, the government of the northeastern state of Assam – which has a population of about 32 million – proposed a two-child policy in March. At the time, local health minister Himanta Biswa Sarma said the increase in the state’s population by almost 10 million over the past 16 years was “unacceptable.”

The draft policy includes a slew of measures to discourage people from having bigger families. Anyone with more than two children will be ineligible to work for the government and could be barred from contesting civic as well as village council elections.

Flouting the legal age of marriage would also be a disqualification for government jobs, which are coveted in much of India. Village councils that are able to ensure adherence to the two-child policy could receive more funding from the government.

A draft of the policy says the idea is to “optimise family size,” allowing families “the freedom to aspire for [a] higher standard of living.”

“One of the goals of this policy is women’s education and their empowerment,” says Dr. Ilias Ali, professor of surgery at Assam’s Gauhati Medical College and Hospital and a member of the committee that drafted the proposed policy. He says this will allow them to make more informed decisions about family planning: “If we educate our women up to the higher-secondary level, we don’t need [the government to promote] contraceptives.”

The fine print of the policy is expected later this year, after it is presented to the state legislature. But critics of the proposal are calling it anti-minority and anti-poor, voicing concerns that it might further skew the state’s child-sex ratio of 962 females per 1,000 males in children under 6. If families are limited to two children, they say, abortion and female infanticide rates could rise as parents try to ensure they have sons.

“Population-control focused approaches are likely to have a negative impact on the child sex ratio, due to a deep-rooted culture of son preference in India. This would lead to further gender imbalance,” says Diego Palacios, the India representative for the United Nations Population Fund.

“It’s not a good policy. We need more children to run a household.”

It’s not just experts and activists who are against the policy. In rural Assam, where about 86 percent of the state’s population lives, the government’s proposal is coming up against deeply held social attitudes about family planning.

“I don’t know much about contraception,” says Sanjana Purti, 24, a resident of Domordalang village in Assam’s Dibrugarh district and a mother of one daughter. “I have heard they do some surgery for not having children,” she adds, referring to sterilization.

Purti’s formal education ended in the eighth grade, because her parents could not afford to pay for schooling for all of their seven children. Still, she doesn’t see the benefits of having a small family.

“It’s not a good policy. We need more children to run a household,” she says.

John Topno, 40, a paddy farmer in the village, has two children but wants more. He says he’s not aware of the concept of family planning.

“At least three children are good,” he says. “What if something happens to a child or they move out of the house? In my old age [I need] at least one of them to stay with me.”

Topno’s neighbors, Needan Purti, 35, and his wife, Leena, 26, are expecting their second child, and are undecided about a third one. They say they never used birth control between Leena’s first and second pregnancies. Their first-born is seven years old.

“I have heard of condoms, but haven’t used them,” Purti says.

To spread the word about family planning, and make birth control more accessible, the Indian government launched a program in 2005 that promises each village an Accredited Social Health Activist, popularly known as an ASHA worker.

These community-based health workers are expected to raise awareness about the government’s healthcare schemes, and their mandate includes distributing free contraceptives.

“Women feel shy and are scared that by taking the pill something may happen to them.”

Sibirna Topno has been an ASHA worker in Janu Basti village in Assam’s Lakhimpur district for five years. Most families there have at least four children, she says.

The government regularly organizes family planning-awareness programs in the village. Despite that, Topno says, few women come to her for birth control pills. And only two men in the village have been regularly taking condoms from her.

“Women feel shy and are scared that by taking the pill something [bad] may happen to them,” she says.

And women who do decide to use birth control often have to do it in secret or face suspicion from their male partners. “The men feel that something is stopping their women from having sex with them,” Topno says.

While the younger generation in Domordalang is largely uninformed about the potential benefits of family planning, some older villagers seem more in sync with the government’s advocacy for smaller families.

Ajar Topno, 56, makes about 5,000 rupees ($77) a month from his yield of tea and paddy. “It is more economical if we have a smaller family,” he says. “It is easier to pay for the education of fewer children.” His son and daughter are both high-school graduates.

Ajar Topno learned about family planning in the late ’80s, when he attended a four-day community workshop held by a faith-based organization in a neighboring district.

“They told us that two children were good. They explained the importance of having certain age gap between our children and how that was important for a woman’s health,” he says.

“The problem with young couples in this village is that they don’t feel the need for contraception.”

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