Sh. Jagat Prakash Nadda*
New Delhi (The Hawk): On this World Population Day (July 11), we reflect on India's incredible journey in family planning. We celebrate our successes, look forward to a future filled with promise, and reaffirm our commitment to address the challenges that lie ahead.
India's leadership and progress
As endorsed in the United Nations International Conference on Population Development (ICPD) at 30th conference in May 2024, India has not only firmly provided leadership to the ICPD agenda but also has demonstrated tremendous progress on the ground through improved family planning services and dramatically improving health outcomes, especially maternal health and child health.
Responding to demographic changes
Millennial women in India are opting for smaller families, averaging just two children each. This trend reflects a significant shift over the past decade, during which more than half of women (57%) in their reproductive age (15 to 49 years) have actively used modern contraception. This widespread use of contraception highlights the success of India's family planning program. However, family planning is about more than just contraception; it is integral to the health and well-being of women, families, and communities. It empowers women, girls, and youth by providing them with the rights and choices. With 369 million young people aged 10-24, India stands at a transformative demographic shift, poised to realize the dream of a Viksit Bharat.
Moreover, over the decades, the program has evolved significantly, adopting various approaches to family planning, ranging from clinic-based to target-oriented methods, and now to the voluntary adoption of family planning choices. This variation represents the adaptation of policies to meet the changing needs of the population.
The National Population and Health Policies emphasize the necessity of addressing the unmet need for family planning, defined as the percentage of women who do not want to have children or want to delay childbearing but are not using any method of contraception. The program achieved a historic milestone in 2012 with the institutionalization of the Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A) approach, alongside the global emphasis on family planning through Family Planning 2020 and now Family Planning 2030. It has progressively focused on raising awareness, fostering community engagement, improving access to information and services, expanding the range of contraceptive choices, ensuring quality assurance of services delivered up to the last mile, and implementing innovative strategies in high-fertility regions.
Growth and development of a country is linked to population dynamics. The aim is to maintain and achieve replacement levels of fertility both nationally and sub-nationally. India has already achieved replacement level of fertility at National level (TFR 2.0) and 31 States/UTs have already achieved this milestone as per NFHS-5 (2019-21) constituting a success story in its journey.
Alongside Family Planning has also been recognised globally to reduce maternal and child morbidity and mortality and an important component of the program is to focussed on improving maternal and child health which has expanded overall policy objectives in a comprehensive manner.
The demographic diversity of Indian states is unique in the world, and family planning strategies have adapted accordingly. Along with broadening the range of accessible contraceptive options, the strategy also gives significant consideration to social issues such as age at marriage, age at first birth, and girls' educational attainment. These factors are crucial for creating a holistic approach to family planning that addresses the diverse needs of the nation.
Mission Parivar Vikas (MPV): Transforming Family Planning
The Mission Parivar Vikas, one of the key flagship Family Planning Programmes of Government of India was launched in 2016 for increasing access to contraceptives and family planning services in 146 high fertility districts of seven states (Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh, Chhattisgarh, Jharkhand and Assam).
It had a transformative approach to family planning services through extensive campaigns to create awareness using Saarthi Vaahans (Awareness-on wheels), Saas Bahu Sammelens to address social barriers for young women to access contraceptives and providing Nayi Pahel kits to newly married couples to sensitize them about family planning and responsible parenthood practices. At the same time, the health system was geared up to provide quality services and uninterrupted supplies of contraceptives using a robust Family Planning Logistics Management Information system.
The uptake of modern contraceptives improved significantly, faster in the programme districts indicating a positive impact of MPV interventions. These improvements in the uptake of modern contraceptives in the MPV districts led to the Government's decision to scale -up this programme to all districts of the seven states and in six North-Eastern states in 2021.
Expanding the Basket of Choice under the National Family Planning Programme:
To match the changing demographics and needs of the population, the contraceptive basket has been expanded in Financial Year 2016-17. Currently, the National Planning programme offers a variety of reversible modern contraceptives encompassing condoms, Intrauterine Contraceptive devices, oral pills, MPA Injections etc. In 10 states, covering two districts each, subdermal implants and subcutaneous injections (Antara-SC) are in the initial rollout stage, with plans for further extension to pan-India in the coming years.
A Call to Action
As we commemorate World Population Day 2024, themed "Healthy Timing and Spacing of Pregnancy for the Health and Well-being of Mother and Child," we acknowledge the efforts of our state counterparts and the relentless dedication of our health workforce, including ANMs, ASHAs, and other ground-level functionaries who are at the forefront of delivering crucial information and services. A significant proportion of the world's youth, adolescents, women, and children live in our country, giving us the unique gift of a demographic dividend while highlighting the critical need to invest in the health and well-being of our people.
Access to quality healthcare services and a wide range of contraceptives is crucial. The government is committed to overcoming barriers related to access, misconceptions about contraceptive methods, lack of awareness among clients, geographical and economic challenges, and restrictive social and cultural norms. Substantial investments are being made to improve family planning service delivery, including ensuring the availability of both temporary and long-term contraceptive methods, adequate budgetary allocations, and maintaining uninterrupted supplies at health facilities and through community workers. Additionally, family planning services are being extended to the last mile through Ayushman Arogya Mandirs. Given the rapid evolution of the digital world, the government is committed to utilize the opportunity effectively to connect and disseminate our vision, ensuring no one is left behind in terms of access to information and services. Achieving our family planning goals requires collaboration and dedication from all stakeholders. Prioritizing the reproductive health of our youth by expanding the range of contraceptive methods is essential. Furthermore, India's demographic dividend must navigate the complexities of sustainable development, urbanization, and migration. Integrating these factors into our policies ensures that demographic growth translates into a sustainable future and inclusive prosperity for all segments of society.
The reverberating echoes of successful goal interventions must be in tandem with niche strategies, crocheting together loose threads to pave the way for promising growth ahead
On this World Population Day, let us pledge to build a brighter and healthier future for all, with a special focus on marginalized and vulnerable communities across India. Let us strive for a future where our demographic dividend is fully realized, where every citizen has access to quality healthcare, and where the health and well-being of our people are the foundation of our nation's progress and prosperity.
Together, we can make this vision a reality.
*Union Minister, Health and Family Welfare and Chemicals and Fertilizers, Government of India