Policies need to be supported by action

poonam-muttreja

The last three years have been rather eventful for family planning, not only in India but also globally. The Supreme Court of India’s verdict on the Devika Biswas case prioritised quality of care in a rights-based framework with dignity for women, and three new contraceptives (centchroman, injectables, and progestin-only pills) were introduced into the basket of choice. Around the same time, China rescinded the severe one-child norm that had been a part of their coercive population policy for 35 years. Meanwhile, developing nations across the world were gearing up to meet the commitments made under the aegis of FP2020 and the sustainable development goals.

India’s population policy has also gained momentum in the past year. The Ministry of Health and Family Welfare (MoH&FW) lead the roll out of Mission Parivar Vikas in 146 high fertility districts. The packaging for condoms and oral contraceptive pills (OCP) have also been redesigned to increase demand for these commodities, and social franchising schemes were introduced in Uttar Pradesh and Bihar to boost the private sector’s involvement in family planning. In a welcome move, the ministry, under Rashtriya Kishor Swasthya Karyakram (RKSK), launched the Saathiya Kit that addressed the needs of adolescents on sexual and reproductive health, among other issues concerning their age.

This year, India also made global headlines when the World Population Prospects 2015 said that the country’s population would overtake that of China by 2024. And while the data shows that the total fertility rate (TFR) of the country has reduced from 2.7 to 2.2 in the last ten years, the distribution of fertility rates across the country is disproportionate. The more populous states of Bihar and Uttar Pradesh are burdened with 3.4 and 2.7 TFR respectively; and a huge unmet need for family planning – 21.2 per cent and 18.1 per cent respectively.

The fourth National Family Health Survey (NFHS), released this year, highlights that female sterilisation is still the most preferred method at 36 per cent, followed by condoms at a distant 5.6 per cent and male sterilisation at 0.3 per cent. Some states, like Assam, have also resorted to coercive measures like the two child policy, which is not only anti-women but also undemocratic. And for as long as social norms and traditions are stubbornly rooted in patriarchal norms that are discriminatory, women will continue to take the fall for family planning.

In the coming years, we need to see greater commitment to rights of the
couple, the status and dignity of women and the quality of care. Policies need to be supported by action with and through communities. Behaviour change communication (BCC) and entertainment education can challenge and change regressive norms. Population Foundation of India (PFI) has seen results with Main Kuch Bhi Kar Sakti Hoon, an entertainment-education programme that ran for two seasons on Doordarshan and All India Radio. With an effective communication strategy the burden of family planning can be shifted from women and will encourage male engagement. With BCC we can change behaviour and not only raise awareness about the benefits of family planning, but also make family planning a societal issue, an issue of social justice and human dignity.

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