Indian need to focus on meeting family planning goals

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Last Updated25/05/2022

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

India’s family planning programme has improved access to contraceptives.
This has led to a reduction in TFR from 3.4 in 1990-92 to 2.0 in 2019-21, according to National Family Health Survey (NFHS).
There are two themes that need further attention.
- Rise in adolescent childbearing: It was flagged by NFHS-5 and 2022 report by UNPopulation Fund.
  - It is prevalent in some states such as Tripura and Meghalaya.
- Choices about sexual and reproductive health: COVID-19 has impacted economic resources and access to education, thereby influencing these choices among women and youth.
To meet the SDG of Family Planning by 2030, India needs to focus on improving access to family planning services for both the adult population and youth.

Frontline health workers have contributed significantly in implementing Mission Parivar Vikas.
- Aim: to accelerate access to high-quality family planning choices, to successfully increase the modern Contraceptive Prevalence Rate (mCPR), especially among female non-users from vulnerable communities.
It was done by delivering contraceptives at homes and offering wide alternatives such as injectable contraceptives.
Still many districts in India have low mCPR, with large proportion of them being the youth.
There is need to strengthen capacity of health workers in using Family Planning Logistics Management Information System.
- It is a dedicated software to ensure smooth forecasting, procurement and distribution of family planning commodities across all the levels of health facilities.
- To ensure the availability of and access to contraceptives by marginalised communities.
Family planning interventions should take care of a diversity of contexts, health needs, and populations for whom the intervention is to be implemented.

Break down data by key characteristics to reach specific groups of people in order to have the greatest impact.
When addressing younger populations, holistic health awareness programmes on the right age for marriage, safe sexual behaviour, contraception, reproductive health, and diet diversity are paramount.
By working holistically on overall health goals and addressing social determinants we can ensure equitable family planning services for both adults and young people.

We have still not involved men as much as we can in the family planning programme.
Certain gender transformative approaches have shown promising results in various places.
- The Men in Maternity (MiM) study demonstrated the effectiveness of teaching young couples about contraceptives and promoting joint decision-making in choosing family planning methods.
- Other examples: PRACHAR project in Bihar, Yaari Dosti programme in Mumbai, and GEMS project in Goa.
Many programmes in public health have started leveraging the capabilities of the private sector to improve service delivery.
- Eg: Leveraging India Post and partnering with a third-party logistics partner through the Informed Push Model showcases how the private sector can be effectively engaged to provide family planning products at health facilities and make them available when the community needs them.
Private sector can offer innovative solutions in family planning, and improve community’s access to services.

India needs to develop an equitable model that meets the needs of the youth and adolescents.
Building capacity among health workers, addressing intersectionality, engaging men in the discourse of family planning, and drafting innovative solutions through effective public and private partnerships can greatly improve access to family planning services and overall health of our younger population.

Prelims take away