In recent times, there has been a lot of focus on how China’s population will age before the economic dividends of its fertility decline will kick in. There are lessons here for many in India who feel that “controlling” the population is the answer to ensuring that we have more resources to go around. Fortunately, today the rights perspective is very much centre stage in India’s policies. But the rights perspective can be effective only if we view the issue from a gender lens, given the inordinate burden women face in planning the family. It is also equally important to centre stage male responsibility.
However, the whole programme, even today, has not quite gone away from the concept of women being responsible for population stabilisation. In India, it is often men who make decisions on family size. Therefore, any programme which does not involve men enough will not be totally successful. The bulk of workers in the family planning programme are women like Asha workers. In rural and semi-urban areas, it becomes difficult for them to address men on contraception. Therefore, there is a great need to incorporate more trained male workers here.
The National Family Health Survey-5 data shows that India’s total fertility rate (TFR) declined to 2.0 from the previous 2.2, reaching below the replacement level. There are only five states with TFR above 2: Bihar (3), Meghalaya (2.9), Uttar Pradesh (2.4), Jharkhand (2.3) and Manipur (2.2). Adopting modern family planning methods and reducing unmet needs are important factors, but again the focus has been largely on women. The ministry of health and family welfare’s Mission Parivar Vikas (MPV) is aimed at accelerating quality family planning and reducing TFR to the replacement level of 2.1 by the year 2025. This was initially implemented in 146 districts in seven states (Bihar, UP, Assam, Chhattisgarh, MP, Rajasthan and Jharkhand). MPV has now been scaled up in all districts of these states and six northeastern states to ensure the availability of contraceptives. As per a UNFPA report — unmet needs have reduced in MPV districts by a greater number of percentage points vs non-MPV districts, and modern contraceptive use has increased. “But”, says Indira Behara, vice president, Global Health Strategies, “the data is mainly driven by an increase in condom use; use of reversible methods for women is still very low; the more options we give women to decide their pregnancies, the more they will want to start to use a method. A critical component is involving and encouraging men to recognise how important it is that they and their partners use modern contraception and that there are reversible methods that women can use.”
Andrea M Wojnar, UNFPA India Representative says, “Recalibrating family planning through the expansion of reversible and long-acting contraceptive methods, improved counselling, empowering women and engaging men are crucial for harnessing India’s demographic dividend.”
There is a notable link between family planning and broader economic objectives. Nobel laureate Claudia Goldin, in her influential 2002 paper, ‘Power of the Pill: Oral Contraceptives and Women’s Career and Marriage Decisions’, examines the impact of the birth control pill during the 1960s and ’70s by delving into how increased access to reproductive autonomy led to a rise in women pursuing careers.
A growing emphasis has been placed on the use of inclusive language in family planning. Terms like “enabling access to quality contraceptives” are being advocated to ensure service quality for all demographics. The focus should also be on male adolescents whose increased participation could be a game changer. Building capacity among health workers, addressing intersectionality, and implementing innovative solutions through effective public and private partnerships and advocacy initiatives can significantly improve access to family planning services and the overall health of our younger population.
The views expressed are personal
Lalita Panicker leads the opinion section at Hindustan Times. Over a 33-year career, she has specialised in gender issues, reproductive health, child rights, politics and social engineering. ...view detail
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