BILASPUR (AFP) - India has defended a state-run programme that offers poor women cash incentives to get sterilised after the deaths of 13 women triggered international condemnation.
Health Minister Jagat Prakash Nadda said it was a "misconception" that India set sterilisation targets for local authorities in an effort to control the growth of its billion-plus population.
"It is a target-free, promotional and a demand-driven programme," a government statement quoting Nadda as saying late Thursday.
Indian authorities have come under criticism from rights groups and the United Nations after a mass sterilisation camp in central Chhattisgarh state led to the deaths of 12 women. Another woman died after a second session, held on Monday.
Dozens more are still in hospital after Saturday's camp, when a single surgeon operated on 83 women in just five hours - spending an average of less than four minutes on each patient.
The doctor, who was detained on Wednesday, has accused the government of making him a scapegoat for the controversial sterilisation scheme, which pays impoverished women 1,400 rupees (S$29.45) to go under the knife.
Human Rights Watch has said health workers in India are coercing women into getting sterilised, under pressure to meet informal targets.
Although India scrapped national sterilisation targets in 1996, the advocacy group said local health workers were still given quotas for the procedure and their jobs were on the line if they failed to meet them.
The United Nations has called for all those responsible for the deaths to be held accountable and said that contraceptive choices should be made "without any forms of incentives".
"Any laws, procedures or protocols that might have allowed or contributed to the deaths and other human rights violations should be reformed or changed to prevent recurrences," it said in a statement on Thursday.
Chhattisgarh's chief minister has sacked the surgeon who conducted the operations and the chief medical officer who supervised them.
The state has launched a judicial enquiry, and is also testing the drugs that the women were given after the surgery.
"The seized drugs have been sent for examination," Chhattisgarh Chief Minister Raman Singh said.
"If there is anything wrong with the drugs, we will act against the companies, manufacturer, purchaser and the medical team," he added.
The state government has banned five drugs used at the camp pending investigations, including an anaesthetic and a pain killer.
The victims had suffered vomiting and a dramatic fall in blood pressure on Monday after undergoing laparoscopic sterilisation, a process in which the fallopian tubes are tied.
Although no cause of death has officially been given, authorities speculated that the women had died of septic shock.
However, R. K. Gupta, the surgeon who performed the sterilisations, has blamed the drugs.
The operations were carried out at a decommissioned hospital on the outskirts of Bilaspur. The actual operating theatre was sealed off on Friday, guarded by about six police officers.
Sterilisation is one of the most popular methods of family planning in India, and many state governments organise mass camps where mainly poor, rural women can undergo the usually straightforward procedure.
In all 336 people have died as a result of sterilisations in India in the three years since 2010, according to national government figures.