A prize-winning way to control the population boom

For Devinder and Rekha Kumar, two were enough. After the birth of their second child – a boy – they realised they could not afford any more. The fact that they would receive a cash payment and even be given the chance to win a shiny new car if they actually did something about it only cemented their decision.

So last week, the 24-year-old Ms Kumar found herself among a small group of women and one man in this Rajasthani town who took up the offer of a free sterilisation operation to ensure their families got no larger. On its completion, each was given a coupon for a forthcoming raffle, with prizes including a Tata Nano car, motorbikes and electric food blenders. "I don't want any more children. It would be a burden to raise more children," a dazed Ms Kumar said after she blearily emerged from surgery. "I decided to have this done to make it easier."

India's population is huge and growing. The UN estimates that by 2050, it will have overtaken that of China and risen from its current 1.2 billion to more than 1.5 billion. In a country where there is already intense pressure on resources and opportunities, especially in its densely crowded cities, analysts have warned of the massive challenges this population will present.

But the country's efforts at confronting the issue have had mixed and often deeply controversial results. In the 1970s, Sanjay Gandhi, son of the then-prime minister Indira Gandhi, oversaw a programme enacted during the state of emergency in which unknown numbers of women were forced to be sterilised and men made to have vasectomies. Despite the turmoil and bad publicity created by his programme, today in many communities in India, especially in poorer, rural areas, sterilisation remains the preferred, and often only, form of contraception.

Technically, paying people to undergo the operations is illegal. But the Ministry of Health has established a scheme that pays those who have the procedure for "loss of earnings". A man receives 1,100 rupees (£15) while a woman pockets 600. Anyone who brings willing patients to the clinic – a so-called "motivator" – pockets 200 rupees.

The authorities in the Jhunjhunu district of Rajasthan, about 100 miles north of Jaipur, have long operated a programme of "camps" where men and women are made aware of the potential benefits of family planning and told that free sterilisation procedures are available. But during the monsoon months of July, August and September, officials noticed that the number of participants fell sharply; people were too busy in the fields and they were also concerned about a perceived risk of infection during the damp, humid weather. This year, officials hit upon the idea of persuading people to come forward during these three months, with the chance to win a series of prizes. Although a number of NGOs do not approve of the scheme, officials say they are doing nothing wrong. The prizes have all been donated by a local university.

After Ms Kumar emerged from the recovery area – a plain, windowless room with blankets laid on the floor and no beds – she was helped to stagger to a car waiting to take them back to their village. She explained how she had opted for the operation for purely practical reasons. But she admitted she was excited by the prospect of the raffle. She said: "If I am to win anything, I hope it is the car."