Use of a Spacing Method Before Sterilization Among Couples in Kerala, India

couples use to control their family size.3 In India, people often equate the term family planning with sterilization, although government policies aim to promote the use of reversible methods.4 Several factors account for sterilization’s widespread use in India. Government incentives offered both to potential users and to providers throughout the late 1960s and the 1970s* undoubtedly contributed to the predominance of permanent methods over temporary methods. In response to the Cairo recommendations and to the results of internal evaluations, and because of reports that the program was administered unscrupulously and that the numbers of acceptors were inflated, the Indian government introduced a target-free approach in April 1996. Under the new target-free philosophy, grassroots health workers are charged with offering family planning services to couples who are interested both in spacing their children and in limiting family size. Nevertheless, use of reversible methods remains comparatively poor. For example, Francis Zavier is doctoral research fellow at the Department of Demography, University of Kerala, Trivandrum, India. Sabu S. Padmadas is doctoral research fellow, Population Research Center, Faculty of Spatial Sciences, University of Groningen, The Netherlands. The authors would like to thank P.S. Nair and Sukumari N. Nair for their helpful comments and encouragement during the course of analysis and writing. Use of a Spacing Method Before Sterilization Among Couples in Kerala, India