India’s family planning progress

Anita is a 20-year-old woman who lives in the Gonda district of Uttar Pradesh, India, with her husband, in-laws and two sisters’ in law. Anita is in the third trimester of her pregnancy and will be delivering soon. She has already registered herself at the local Community Health Centre. She has been getting regular check-ups done by the Auxillary Nurse Midwife (ANM). The ANM has told her that the child and she are both healthy and she is likely to have a normal delivery. The ANM has also counselled her about the Post Partum Contraception. Anita is interested in Post Partum Intra Uterine Contraceptive Device (PPIUCD), a contraceptive method that can be inserted immediately after delivery but is a little scared. The ANM takes Anita to meet the staff nurse who has been inserting PPIUCDs at the facility. She tells Anita that there is nothing to be scared of, it is a very safe procedure and Anita will be free from tension about getting pregnant for a while, in case she gets the IUCD inserted. Anita agrees and gets the IUCD inserted immediately after a normal delivery of a healthy baby boy. Now Anita is very happy and relaxed. She can go about her daily chores without any anxiety. This is good both for her and her child and also her larger family.

Many other women like Anita want to space their pregnancies but lack the required information and access to these services.  It is imperative that a vast and diverse country such as India focuses its attention on reaching these women with unmet need, to improve health outcomes.

India made a commitment to include family planning as a central element of its efforts to achieve Universal Health Coverage at the London Summit on Family Planning in July 2012. The cornerstone of the new, evolved national family planning strategy addresses equity, ensuring quality, including adolescents and integration into the continuum of care through the largest public health program in the world, the National Health Mission. The center-piece of the strategy is a shift of focus from limiting to spacing methods, and an expansion of choice of methods, especially IUDs (Intrauterine devices).

Today’s FP2020 report launch shows some heartening progress towards realizing this vision.

Family planning is one of the most cost-effective and high-yield interventions to improve health outcomes, primarily in reproductive, maternal and child health. Putting current family planning knowledge into practice can help:

Save women’s lives: Effective family planning reduces maternal mortality rates. In India, the lifetime risk of maternal death stands at 1 in 170 today, a far cry from levels observed in developed nations, where the lifetime risk is pegged at 1 in 7300. These odds can be significantly improved with family planning interventions.

Save children’s lives: To reduce health risks in infants, a woman should wait at least 3 years after a live birth to have her next baby. Research has shown that babies born less than 2 years after the previous child are more than twice as likely to die in the first year as those born after an interval of 3 years. Access to family planning methods for spacing empowers women to raise healthier children.

Save adolescent lives: Early marriage and child bearing have serious health implications on young girls. Maternal death rates for young women aged 15 to 19 are twice as high as for older women, and young women who give birth before the age of 20 have a double risk of pre-term delivery, compared to women who are over 20. Providing access to contraception for such girls would help save precious lives and provide multiple social and economic benefits.

Address unmet need: The unmet need for family planning in India among women in the post partum period comprises 40% of all unmet need. It is also especially high in groups such as adolescents, migrants and urban slum dwellers. Expanding access to these vulnerable sections of the population is a social imperative that India can ill-afford to ignore.

At the Bill & Melinda Gates Foundation we are committed to supporting the Government of India in building upon the progress achieved so far, to further address this unmet need and save lives.

Published in collaboration with Impatient Optimists

Author: Jyoti Vajpayee oversees The Bill and Melinda Gates Foundation’s family planning work in India, especially the realization of the FP2020 strategy and execution for ICO

Image: A school girl from Brahimpur village in Chapra district of the eastern Indian state of Bihar. REUTERS/Adnan Abidi