The Khanna study.
This field study of India's population problem was located in 11 villages in Punjab state, 10-25 miles from Ludhiana city. Headquarters were in the town of Khanna. In the region in 1951 the population was 70% rural, clustered in villages of 150 to 3000 persons. Marriages followed the caste system and almost all women married. All couples of childbearing age, nearly 1000, were visited monthly by field workers. Preliminary stages of the study with training of staff lasted 3 years; the study itself continued 4 more years. The test population was 8000. Adjacent villages without the program provided 4000 controls. For 15 months 5 contraceptive methods were offered; vaginal foam tablets were most frequently preferred. (Condoms were not offered and the study was designed before oral contraceptives or intrauterine devices were developed). This intensive effort resulted in no definite change in the crude birth rate during the 4 years of observation. Half of those visited never reported practicing contraception and a fourth reported using contraception less than 1 year. A majority had no strong objection to contraception and about 15% reported using some form before the study. The birth rate of 38 per 1000 population suggested some form of restricting births. Long breast feeding for birth spacing purposes was common. With a large out-migration the yearly increase in population was only 1.1% instead of the expected 2.1%. To reduce the birth rate people must understand and appreciate why a lower rate is to their benefit. Reduction in death rate of young children, delayed marriages, and efficient methods of birth control are also needed. Curtailment of the rate of proliferation should be done willingly and without coercion.