India has made substantial progress in the last eight years according to a recent report published by organisation Family Planning 2020, which found that now more than 139 million Indian women and girls used modern contraceptives.
“Access to [family planning] is fundamental to the success of the [Sustainable Development Goals],” FP2020 – “a global partnership to empower women and girls by investing in rights-based family planning” – tweeted. As the United Nations outlines
“Target 3.7 of the Sustainable Development Goals (SDGs) calls on countries “by 2030, to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes”. Living up to the commitment of the international community to achieve universal access to reproductive health by 2030 requires the monitoring of key family planning indicators.”
In India, family planning is an issue of great importance – both in the context of its population and of gender-related issues. The country has a well-documented plethora of problems when it comes to discrimination along the lines of sex and gender. Family planning ranks among them.
In 2019, Prime Minister Narendra Modi drew attention to the need for family planning. “Population explosion will cause many problems for our future generations,” he said. “We have to be concerned about population explosion. The centre as well as state governments should launch schemes to tackle it.” Of those who practise responsible family planning, he described them as “a vigilant section of public which stops to think before bringing a child into the world, whether they can do justice to the child, give them all that she or he wants. They deserve respect. What they are doing is an act of patriotism. Let us learn from them.”
In terms of women’s empowerment and contraceptive use, a 2019 study noted
“Status of women in India has improved in different dimensions, yet the patriarchal norms influence the decision of using contraception. The current women-centric bottom-top approach in implementation of family planning programme should focus at the women’s right to decision on their own life and health. Such efforts should hinge at strengthening inter personal counseling and capacity building sessions by outreach workers, which may empower women with enhanced knowledge about their health and bodily rights.”
India has indeed made overtures towards enhancing family planning with women’s empowerment at the core. In 2017, it pledged a US$7 billion investment into modern family planning; to increase the prevalence of modern contraceptives to married women from 53.1 percent to 54.3 percent by 2020; and ensure 74 percent of demand for contraceptives was met. These objectives have been realised.
Of investment, the report notes “India continues to be one of the countries with the highest levels of domestic government expenditure, reflecting the governments’ commitment to its family planning programmes.” In fact, India is one of just five countries out of 54 accounting for almost US$1.6 billion of spending on family planning programmes.
Union Health Minister Dr Harsh Vardhan celebrated the outcome of the report, stating “improving the quality of contraceptives, augmenting contraceptive demand through comprehensive IEC [information, education, and communication] campaigns, and focused interventions in high fertility districts through Mission Parivar Vikas, have been few of the country’s notable achievements.
“As a result, we have witnessed an impressive decline in fertility and maternal mortality in the last few years. We continue to strive to substantially reduce the unmet need for contraception by 2030.”
Yet there remains a gender divide, progress notwithstanding. As a Scroll.in report published last year noted, “India’s family planning campaigns, run by both its public health systems and civil society programmes…are focussed almost entirely on women, found a recent study by International Center for Research on Women. The result is that women have greater awareness about contraception and bear its entire burden while men, who actually control decision-making in most homes, remain ill-informed and resentful about family planning practices, said the study.”
Gender balance as it pertains to family planning must be struck. It is undoubtedly positive that more women are using modern contraceptives and awareness is higher. The Government’s commitment to expanding family planning is admirable. But for a robust system of family planning, gender parity must be incorporated into the strategy.
“India faces several major challenges in family planning, the first of which is the prominence of female sterilisation as the most used contraceptive method and one promoted by the government,” Professor Amy O. Tsui told me in an interview in 2019. “Although other methods are available (condoms, pills, IUDs [intrauterine devices, or the coil] and recently injectables), female sterilisation accounts for three quarters of contraceptive use. As a result, a second challenge is expanding contraceptive method choice, including vasectomy.
“Even though India has a history of providing the latter in the late 1970s, today while slightly over one third of married women are using female sterilisation, fewer than 0.5 percent report their spouses having a vasectomy. Other than condoms, there is relatively little use of other methods, especially for spacing births. A third family planning challenge for India is ensuring equity in couples having informed choice for all family planning decisions, whether to prevent unintended pregnancies or to achieve desired ones. Presently the more privileged segments of society enjoy access to such information and means.”
Equity is the need of the hour – across the stratas of class and of gender. As Professor Tsui concluded in our interview, “nearly one in every five women on this planet is Indian (seventeen percent). Each of them deserves to be born a wanted daughter, be educated, live a healthy productive life and be a contributing member of society. India should not squander this human resource, which can potentially help accelerate the country’s future economic growth.” Family planning – including the use of modern contraceptives and expanding women’s opportunities and choice when it comes to their bodily rights – is imperative. The progress India has made is positive – but there is much to do and much to build upon.