Mothers wait outside a temporary sterilisation clinic in Rajasthan's Jhunjhunu district, a response to the region's unorthodox push to boost sterilisation numbers.

Mothers wait outside a temporary sterilisation clinic in Rajasthan's Jhunjhunu district, a response to the region's unorthodox push to boost sterilisation numbers. Photo: Ben Doherty

BROADLY translated, the posters read ''Small families are happy families''.

''Especially those that can all fit into their new car,'' the unwritten subtext might read.

In a novel effort at countering India's perennial problem of rampant population growth, every person in Jhunjhunu who gets sterilised in the next three months gets a raffle ticket to win a Tata Nano - billed as the world's cheapest car, about $3000 - or one of a handful of motorbikes, TVs or blenders.

It's not sophisticated, but it's bringing them in. Twenty-eight-year-old Rehka Soni gave birth to her third child, her second son, just six weeks ago.

''I'd already decided with my family to be sterilised after my third child, but I was made aware of this lottery through the newspaper … so it brought my decision forward,'' she said.

Concerned that a target of 21,000 sterilisations for the year was slipping away, Jhunjhunu's chief health and medical officer, Sitaram Sharma, devised the competition, hoping it would attract 6000 new patients. With 1.21 billion people, and half of those under 25, India is likely to overtake China as the world's most populous country within 20 years.

Offering incentives for sterilisation has been tried before. The federal government recently increased its payment to people who volunteered for the free procedure, to 2000 rupees ($A41.85) for women and 2500 rupees for men. ''Motivators'', people who encourage others to have the operation, receive 200 rupees.

Bandit-riddled Shivpuri in Madhya Pradesh faced the dual problems of unlicensed guns and thousands of babies. It came up with the idea of offering licences for illegal weapons if men or their wives were sterilised. While sterilisation is by far the most popular means of contraception in India, it has a chequered history.

During the Emergency period, between 1975 and 1977, India had a policy of compulsory sterilisation for men who had two children.

Sanjay Gandhi, the unelected son of then prime minister Indira Gandhi, distorted the power for his own ends, and thousands of unmarried and childless men were operated on to meet the quotas he set.

Mr Sharma said those who present to a sterilisation camp in 2011 come willingly, and understand the procedure.

Not all agree. Poonam Muttreja, executive director of the Population Foundation of India, told The Saturday Age that offering prizes for sterilisation was coercion by economy and trivialised an important family decision.

''And they should absolutely not have targets for sterilisation. Targets lead to coercion. If there are to be targets it should be for providing family planning, but not for one method, sterilisation.''

Ms Muttreja said the practice of having mobile camps touring villages compromised health care, in particular screening and counselling of women. And overwhelmingly women are those undergoing the procedure. They outnumber men by more than 20 to 1.

''Mainly it is because men fear they will lose their potency. It is not true, but it is a very great fear,'' Mr Sharma said.

Despite sterilisation's invasiveness, less permanent forms of contraception have been slow to take hold in India.

''Sterilisation is permanent, there is no risk of conception. Only a small percentage of people want, and can use, the temporary methods. In the villages in India, literacy is low, education is low, understanding is low. Better to use permanent method,'' Mr Sharma said.

Ms Muttreja says sterilisation remains popular because women are pressured.

''It is the lack of imagination and understanding of the public health system. They want one way to deal with these women who breed. Sterilise them and finish, you've fixed them, you've fixed their wombs.''