India needs to focus on improving access to family planning services for not only adults but also young population
India needs to focus on improving access to family planning services for not only adults but also young population
India’s family planning program has improved access to contraceptives. According to the National Family Health Survey (NFHS), this has reduced the total fertility rate from 3.4 in 1990-92 to 2.0 in 2019-21. However, there are two topics that require further attention. Firstly, according to the NFHS-5 and 2022 reports by the United Nations Population Fund, there has been an increase in the birth of adolescent children in some states such as Tripura and Meghalaya. Second, COVID-19 has had a severe impact on economic resources and access to education, affecting the choices women and youth make about their sexual and reproductive health. To meet the Sustainable Development Goal of family planning by 2030, India now needs to focus on improving access to family planning services not only for the adult population, but also for the youth.
expanding horizons
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 options, to successfully increase the Modern Contraceptive Prevalence Rate (MCPR), particularly among women non-users from vulnerable communities. They have achieved this by offering a wide basket of options such as home delivery of contraceptives and injectable contraceptives. However, there are still many districts in India where mCPR is low, a large proportion of which is youth. We need to strengthen the ability of health workers to use the Family Planning Logistics Management Information System – a dedicated software to ensure smooth forecasting, procurement and delivery of family planning items at all levels of healthcare facilities – and to ensure access. for contraceptives by marginalized communities.
Family planning interventions need to be adapted to the diversity of contexts, health needs and populations for which the intervention is to be implemented. Youth are not a homogeneous group. We need to answer important questions related to the sexual reproductive health needs of adolescents with different profiles, such as in-school, out-of-school, married, unmarried, etc.
These are key considerations in planning and designing programs. Data needs to be broken down by key characteristics in order to reach specific groups of people to have the most impact. Furthermore, when addressing the young population, holistic health awareness programs on correct age of marriage, safe sex practices, contraception, reproductive health and dietary diversity are of paramount importance. Only by working holistically on holistic health goals and addressing social determinants can we ensure equitable family planning services for both adults and youth.
promoting male engagement
We still haven’t included men in the family planning program as much as we could. Some gender transformative approaches have shown promising results in various places. For example, The Men in Maternity (MIM) study conducted 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 involving men in family planning discourse include the promotional project in Bihar, the Yari Dosti program in Mumbai and the GEMS project in Goa.
Many public health programs have also begun to take advantage of the capabilities of the private sector to improve service delivery. For example, leveraging India Post and partnering with third party logistics partners through an informed push model demonstrates how the private sector can provide family planning products at healthcare facilities and make them available to the community when they need them. can be implemented effectively. The private sector can offer innovative solutions in family planning, which will improve the community’s access to services.
India needs to develop a common model that meets the needs of youth and adolescents. In many districts, a fifth of the population in the adolescent age group is now entering the reproductive age group. Thus, building capacity among health workers, addressing interoperability, involving men in the discourse of family planning, and creating innovative solutions through effective public and private partnerships, including access to family planning services and the overall health of our young population. can improve a lot.
Sudhir Maknikar, Director, Family Health, Path