Critically evaluate the shift of India's family planning programme from a target-driven to a rights-based approach in the light of persisting gender disparities in sterilisation.

India started its family planning programme in 1952 and for decades ran it on sterilisation targets, which turned coercive during the Emergency. After ICPD Cairo (1994), India adopted the Target-Free Approach (1996) and the National Population Policy 2000, which treat contraception as a matter of choice. The shift has brought demographic gains. But a 36.5% vs 0.5% gap between female and male sterilisation [2] shows that rights on paper have not yet become equal choice in practice.

Gains of the rights-based shift

• Demographic success without coercion: fertility is now below replacement level, and contraceptive use rose from 66.7% (NFHS-5) to 69.1% (NFHS-6) [2].
• Lower unmet need: it fell by 1 percentage point [2].
• Safeguards: in Devika Biswas v. Union of India (2016), the Supreme Court ordered sterilisation camps phased out. The National Family Planning Indemnity Scheme compensates people for death, complications or failure after sterilisation [1].

Limitations seen through a gender lens

• A skewed method mix: about 73 women are sterilised for every man [2]. Norms that make contraception "women's work" and myths that vasectomy saps strength limit what couples actually choose.
• Weak tools for men: the Vasectomy Fortnight (held each November), No Scalpel Vasectomy training, higher compensation and a 360-degree media campaign [1] increase supply. They do not change beliefs, so male sterilisation is still only 0.5%.
• A quality deficit: modern-method use fell from 56.4% to 52.7%, while traditional methods rose 6 points [2]. Unmet need counts only women using no method at all, so it hides this weaker protection. When these methods fail, women carry the pregnancy.
• Risk borne by women: women carry the surgical risk. Indemnity pays after harm is done; it does not prevent it.

Verdict and way forward The shift was right in principle but is incomplete in practice. It removed coercion but not the gender imbalance. What is needed:

• Male counselling all year, built into routine visits to couples.
• Counselling on failure rates of traditional methods, with spacing methods offered instead.
• Preparing now for reversible male contraceptives, for which WHO has set benchmarks for the first time [2].

The move away from targets gave Indians freedom from coercion. The next step is shared responsibility between men and women. More male options and a health system that reaches men, not vasectomy quotas, would make reproductive autonomy under Article 21 real and advance SDG 5.6.