The sterilization program in India is a long standing debate. The government runs an incentive based scheme for the rural poor (72% Indians) where at every level-from the health worker to the doctors, nurses and to even the one who undergoes the procedure, there is cash against participation. Since most of these women are uneducated and have little or no knowledge about surgical care or their rights, doctors usually perform the procedure on mass scale, with some severe laxity, like using the same gloves and equipment. In 2014, about 11 women died in a mass laparoscopic tubectomy that was conducted on over 80 women at the same time, and several others were left critically ill, Guardian reported. The prescribed limit is 30 operations for a surgeon.
The World Health Organization recommends the use of these injectables. Our current health program has been a disaster and to put a patch on the huge leakage in the health system, the government needs to show some long standing impediment cleared. Introducing injectable methods for public access is just that, a method that has been tossing around tables since 1995, when the Drug Technical Advisory Board allowed private use but wasn’t in support of offering it at government clinics.Its decision came in light of the fact that “it has long been known that Depo-Provera causes bone loss, it has recently been discovered that the osteoporotic effects of the injection grow worse, the longer Depo-Provera is administered and may remain long after the injections are stopped, and may be irreversible”.
In 2015, a lot of women’s organizations and public health workers came together to revolt against the government’s decisions.
Reuters reports that 85% of the Family Planning Budget is spent on promoting and conducting sterilization on women. With the world’s third highest sterilization rate, it is surprising to see how anything even remotely related to a woman’s sexuality is owned and controlled by society, mostly against her will. About Rs. 510 million has been spent on paying compensations to all the surgeries that went wrong in the past 3 years.
There is no appropriate infrastructure to support monitoring of side-effects and conduct damage control. It is unfair that the women, already weakened by early marriage and childbirth, have to put themselves through another agonizing procedure. And the pressure to go through this is not even natural, merely social.