Just to add to the debate:-- Provider perspective
Here's the other side of the story on Non-scalpel and traditional Vasectomy. Some early observations from interviews with providers:
In a research effort that I am working on in a northern State, public health system NSV surgeons do not feel there is enough incentive for them to conduct the NSVs monetary or non-monetary. A payment of Rs. 25 per case was considered disrespectful to their skills and expertise.
They think of sterilization as a thankless job, they did not feel that the clients or the field PHC staff treated them with respect (whereas when they work in the hospital-- for other surgeries they are well respected) many clients and field staff treated them with disrespect in the camps.
If there were any complications they were considered solely responsible and all other staff in the process were not held accountable- considering the responsibility they shoulder for the public health system they felt they did not receive commensurate reward.
Leila Caleb Varkey
Researcher for an NSV Client and Provider Acceptability study 2006-2008 EngendeHealth and FHI.
Incentives or no incentives, the system still can't be made to function. In Bokaro General Hospital women are paying bribes to get sterilised every year. If our organisation wants to book cases for sterilisation of women we are told to bring x number of men for NSV to get appointments for y number of women! The whole sytemn is based on money and agents. That's why BGH has the highest number of NSVs in the country. More money without increasing services will only add to our headache!
On Sun, 30 Sep 2007 Rajesh Sood wrote :
>can u post a copy of the notification..
>now let see to it that the money reaches the beneficiaries ....
>On 9/30/07, jashodhara dasgupta <email@example.com> wrote:
> > These seem to be different ways to push people into accepting methods:
> > incentives so that it doesn't look like coercion!
> > Compensation for family planning hiked
> > NEW DELHI: Concerned over a decline of 4.3 per cent in sterilisation
> > performance in the country, the Union Health and Family Welfare Ministry has
> > further increased the compensation package for the loss of wages to people
> > who adopt family planning methods. The compensation has been nearly doubled
> > for men undergoing vasectomy to boost male participation in family planning.
> > This is the second revision within a year as the compensation package was
> > revised on October 31 last. But despite this, sterilisation saw a further
> > fall of
4.3 per cent during 2006-07 as compared to the previous year.
> > According to the new package, the compensation for vasectomy has been
> > increased to Rs. 1,500 from Rs. 800 and tubectomy to Rs. 1,000 from Rs. 800
> > in public facilities and to Rs. 1,500 for both these interventions in
> > accredited private health facilities to all categories of people in high
> > focus States and those below the poverty line, the Scheduled Castes and the
> > Scheduled Tribes in the non-high focus States.
> > In 2006, the Ministry enhanced the compensation package from Rs. 400 to
> > Rs.800 for people of all categories in the high-focus States and from Rs.
> > 300 to Rs.800 for tubectomy and Rs.200 to Rs.800 for vasectomy in non-high
> > focus states for BPL acceptors only.
> > In the 18 high focus States where the facility is provided in the public
> > institutions, the acceptor (individual) receives Rs. 1,100, motivator Rs.
> > 200 and the remaining is to be kept aside for other expenses accrued. Those
> > going in for tubectomy will get Rs. 600 and the motivator Rs. 150.
> > In the non-high focus 17 States and Union Territories, an individual gets
> > Rs. 1,100 for vasectomy while the BPL, the SC and the ST categories opting
> > for tubectomy will be paid Rs. 600.
> > The motivator in the first case receives Rs. 200 and Rs. 150 in the second
> > category. Amounts of Rs. 50 and Rs. 100 have been kept aside for drugs in
> > the two categories while the surgeon gets Rs. 100 and Rs. 75.
> > Similarly, the compensation for tubectomy for those above poverty line
> > people in non-high focus States has gone up from Rs. 300 to Rs. 650 where
> > the acceptor will now get Rs. 250 in the non-high focus States.