By Dr. Sujeet Ranjan,
Family planning affects people in myriad ways. Most fundamentally, it advances human rights. Knowledge and use of family planning methods can regulate planning of birth in terms of Birth Interval and Nutritional status of mothers and children, Birth order and Nutritional status of children, Birth interval v/s under 5 mortality (U5MR), Mother’s age during pregnancy v/s under 5 mortality (U5MR), Registration of pregnancies v/s birth order.
From fears on the implications of unchecked population growth just a few years ago, India has come a long way in bringing about many encouraging changes across states with regards to family planning. The latest data from the National Family Health Survey-5 (NFHS-5) showed promising results highlighting improvements in the family planning demands being met and a remarkable decline in the fertility rate across states. With India aiming to become a $5 trillion economy in a few years, the country needs to sustain such levels of progress in family planning as it will lead to an increasing participation of women in the workforce, without which, achieving this economic goal will be a challenge.
Since the progress of women is imperative for the progress of the community and the nation, it becomes even more crucial to ensure that they do not drop out of school or their jobs. A leading reason for such dropouts has been unintended pregnancies. Family planning plays a key role in reducing these dropouts as it advances inclusivity and empowers women to access opportunities that fulfill their educational and professional aspirations. Women’s education and employment enables them to be a part of an economically productive workforce, have fewer and healthier children and contribute to the household and national economy.
Over the years, the government has undertaken various initiatives under the umbrella of the family planning programme to ensure a decline in women dropouts in educational institutions and workplaces due to unintended pregnancies. From promoting the use of modern contraceptives to steadily expanding the basket of contraceptive choices to encouraging birth spacing to initiating contraceptive programmes- efficient measures have been taken across districts to increase their access to family planning services. Family planning focused programmes such as the Mission Parivar Vikas, and the deployment of ASHA workers in rural communities have been instrumental in addressing the unmet need for family planning services, especially in high fertility districts. These efforts have raised awareness, brought behavioral changes, developed community participation and enabled empowerment across districts. Such family planning services have significantly contributed in reducing the fertility rate and stabilising the population across the country.
The NFHS-5 survey results are a testament to these efforts as all of the 17 states analyzed witnessed an increase in the use of modern methods of contraceptives. The proportion of women with unmet needs for family planning who want to stop or delay childbearing but are not using any method of contraception has declined across almost all states. There has also been an increase in users getting information on side effects of current contraceptive methods. The number of districts with a modern contraceptives prevalence rate of over 60% has also increased significantly between the survey rounds. The unmet need for spacing which remained a major issue in India in the past has also significantly reduced in almost all states. This indicates that the population in the country is stabilising, which could bring an end to the fears of a population explosion and the calls for a two-child policy.
The progress witnessed in family planning is also a key contributing factor in achieving the Sustainable Development Goals (SDGs). These include not just the goals which have a direct reference to family planning, but also the more primary ones focused on poverty, hunger, quality education and sustained economic growth. It would be impossible to achieve these goals without ensuring that women have access to quality, rights-based family planning services.
Since the pandemic, The Ministry of Health and Family Welfare has ensured the prioritisation and inclusion of reproductive health services including family planning in essential health services. This is a step in the right direction to signify the importance of maintaining the system and ensuring that women get unrestricted access to family planning services even in the wake of public health emergency.
However, while India has come a long way in enabling family planning measures, there is still work to be done in this regard. The need of the hour is to sustain the growth and acceptance of family planning, and challenge the prevailing regressive social norms related to family and children. The NFHS-5 survey indicated an imbalance in sterilisation which makes it essential to integrate men into the ambit of family planning. This requires male specific family planning campaigns, which can bring about a wider awareness on the role of men in the family planning system and the need for them to take more responsibilities and support their partner to sustain the growth of the system.
The health system’s capacity with respect to infrastructure, accountability, resources and governance needs to be continuously scaled up and strengthened to enhance service quality. There needs to be enhancements in primary care facilities, quality of care and increased focus on areas of unmet need for contraceptives. There also needs to be constant counseling and periodic follow ups, especially in rural areas, to ensure that there is continuous engagement and that misconceptions and health concerns regarding the subject are regularly and adequately addressed. India needs to build on the progress highlighted in the survey and strengthen partner engagement, community involvement and family planning access, which can result in improved health, social and economic outcomes for the country.
(The author is Executive Director of The Coalition for Food and Nutrition Security (CFNS). Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)