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Lancet. 1999 Apr 10; 353(9160):1251.In Andhra Pradesh, India, women's groups have formed a Group Against Targeted Sterilization (GATS) to protest the creation of sterilization camps created by government officials in Hyderabad and Secunderabad, where 20,000 people, mostly women, were sterilized to meet a quota deadline. GATS charges that the women were offered incentives to undergo sterilization and that those who resisted were threatened with disconnection of their household utilities. GATS does not oppose family planning or female sterilization but opposes the dehumanizing use of incentives and threats. The impoverished women who are targeted for mass sterilization undergo the procedures in unhygienic settings. Many are anemic, which is a contraindication to any surgical procedure, and they receive no postoperative care. The targeted sterilizations were performed under the banner of the Indian Population Project (IPP), which is funded by the World Bank. GATS fears that the entire IPP will be diverted from the intention of its donor (the World Bank is committed to a target-free approach) and will become subservient to population control efforts.
STUDIES IN FAMILY PLANNING. 1991 Jan-Feb; 22(1):1-18.A study investigative the pros and cons of financial payments for sterilizations to clients, medical personnel, and agents who motivate and refer clients was conducted by the government of Bangladesh in conjunction with the World Bank. Results indicate that Bangladeshi men and women opt to be sterilized both voluntarily and after consideration of the nature and implications of the procedure. Clients were also said to be knowledgeable of alternate methods of controlling fertility. A high degree of client satisfaction was noted overall with, however, 25% regret among those clients with less than 3 children. Money is a contributing factor in a large majority of cases, though dominating as motivation for a small minority. Financial payments to referrers have sparked a proliferation of many unofficial, self-employed agents, especially men recruiting male sterilization. Targeting especially poor potential clients, these agents focus upon sterilization at the expense of other fertility regulating methods, and tend to minimize the cons of the process. Examples of client cases and agents are included in the text along with discussion of implications from study findings.
UNFPA Newsletter. 1980 Jan 1; 6(1):1.A minimum bonus of Rs.100.00 ($6) will now be paid to any employed person voluntarily undergoing sterilization in Sri Lanka. Women will be given 7 days extra leave and men 3 days. The bonus is compensation for out-of-pocket expenses and time for recovery. Many public and private corporations, e.g., the tea industry, pay sterilization bonuses, sometimes in excess of Rs. 100. A bonus of Rs. 500 is awarded women and Rs. 300 is awarded men by rubber, tea, and coconut plantations owned by the state. It is hoped that all adults in Sri Lanka, including the unemployed, will soon be covered by a system of sterilization bonuses. A UNFPA-sponsored project will equip 85 of the country's 117 smaller hospitals and train their staff to perform vasectomies and mini-lap operations under local anesthesia. 7 out of 10 of 370,000 births per year occur in hospital or some other medical facility. Population committees have been set up in several districts with divisional and village committees backing them up. These committees will be used as centers for discussion, motivation, provision of services, and referral. The Ministry for Family Health and the Community Development Services Organization will expand the provision of Depo-Provera, which is increasingly popular in Sri Lanka, especially among Moslem communities.
FPOP Bulletin 9(3): 7. May-April 1977.A new statement which spells out in detail IPPF's belief in the right of the individual to make a voluntary choice has been drawn up by the Central Medical Committee and the Law and Planned Parenthood Committee and approved by the Management and Planning Committee. The 8-point resolution states that sterilization as a method of limiting family size, should be a completely voluntary choice made in full knowledge of alternative methods of contraception and the risks and benefits associated with sterilization. Both male and female methods should be regarded as irreversible; however, at time of sterilziation the method offering greatest hope of reversiblity should be used. Counseling and follow-up should be an integral part of any sterilization program. Incentives should not be discriminatory nor involve withholding of services from families. They also should not be so high as to be unduly influential on the poor. Doctors used by Family Planning Associations should use the best possible techniques and should be remunerated on the basis of quality of care, not the number of cases. In order to keep close watch on use of sterilization, full data should be collected and analyzed.