Family planning

Reaching Family Planning Goals – The Hindu

India needs to focus on improving access to family planning services not only for adults but also for the younger population

India needs to focus on improving access to family planning services not only for adults but also for the younger population

India’s family planning program has improved access to contraceptives. This led to a reduction in total fertility rate from 3.4 in 1990-92 to 2.0 in 2019-21, according to the National Family Health Survey (NFHS). However, there are two themes that require more attention. First, according to NFHS-5 and the United Nations Population Fund 2022 report, there is an increase in teenage pregnancies in some states like Tripura and Meghalaya. Second, COVID-19 has had severe impacts on economic resources and access to education, thereby influencing the choices women and young people make about their sexual and reproductive health. In order to achieve the Sustainable Development Goal of family planning by 2030, India must now focus on improving access to family planning services not only for the adult population, but also for the youth.

Broaden the horizon

In India, frontline health workers have contributed significantly to the implementation of Mission Parivar Vikas, which aims to accelerate access to high-quality family planning choices, in order to successfully increase the modern contraceptive prevalence rate (mCPR), especially among non-user women from vulnerable communities. They have achieved this by delivering contraceptives to homes and offering a wider basket of alternatives such as injectable contraceptives. However, there are still many districts in India that have low mCPR, a large portion of them being young people. We need to build the capacity of health workers to use the Family Planning Logistics Management Information System – dedicated software to ensure the smooth forecasting, supply and distribution of family planning commodities to all health facility levels – to ensure availability and access to contraceptives by marginalized communities.

Family planning interventions must be tailored to the diversity of settings, health needs, and populations for which the intervention is to be implemented. Young people are not a homogeneous group. We need to answer key questions about the sexual and reproductive health needs of adolescents with diverse profiles such as men and women who are in school, out of school, married, unmarried, etc.

These are key considerations in program planning and design. It is necessary to disaggregate data by key characteristics in order to reach specific groups of people in order to have the greatest impact. Additionally, when dealing with younger populations, holistic health awareness programs on proper age of marriage, safe sex behavior, contraception, reproductive health, and dietary diversity are paramount. Only by working holistically on broad health goals and addressing social determinants can we ensure equitable family planning services for adults and youth.

Encourage male engagement

We still haven’t involved men as much as possible in the family planning program. Some gender-transformative approaches have shown promising results in various places. For example, The Men in Maternity (MiM) study in Delhi demonstrated the effectiveness of teaching young couples about contraceptives and promoting joint decision-making in choosing family planning methods. Several other examples of male involvement in the family planning discourse include the PRACHAR project in Bihar, the Yaari Dosti program in Mumbai, and the GEMS project in Goa.

Many public health programs have also begun to leverage the capabilities of the private sector to improve service delivery. For example, leveraging India Post and partnering with a third-party logistics partner through the informed push model shows how the private sector can be effectively engaged to deliver family planning commodities to health facilities and make them available when the community needs it. The private sector can provide innovative family planning solutions, improving community access to services.

India needs to develop an equitable model that meets the needs of youth and adolescents. In several districts, more than a fifth of the population in the adolescent age group is now entering the reproductive age group. Thus, building the capacity of health workers, considering intersectionality, engaging men in the family planning discourse, and developing innovative solutions through effective public-private partnerships can greatly improve access to family planning services and the overall health of our younger population.

Sudhir Maknikar is Director, Family Health, PATH