Despite the range of family planning options made available in India, data from the National Family and Health Survey, NFHS-4, is cause for concern.
The figures released for 14 states shows a fall in the use of contraceptives, compared to the previous NFHS survey done 10 years ago.
With options, awareness, healthcare access and incomes growing, the expectation was that women would exercise more say over their pregnancies, but the data doe not indicate that.
While West Bengal and Meghalaya show an increase in the use of modern contraceptive methods like OCPs and IUDs and a fall in sterilization, the figures for the rest of the state surveyed are not so positive. Over 50% of women prefer female sterilization and there is a decline in the use of contraceptives in some states.
What this means is that a large number of pregnancies continue to be unplanned or unwanted and access to contraceptive methods remains in the hands of a few. In rural areas, women still depend on government health facilities for supply and this is affected by lack of choices, irregular supplies and lack of skilled health providers at the district health centres.
The NFHS data for all the states is as yet not available and therefore a conclusion may be premature. However, the findings from these 14 states, many of which have seen some focused family planning campaigns, is a pointer towards how much more needs to be done.
Ensuring that contraceptive methods are available is a small part of the challenge. Getting women to use them, addressing the myths and empowering them with information about how and when to use these methods is a huge gap which remains unaddressed even in some of the relatively better off states. Tamil Nadu, for instance, shows no change in the use of oral pills. It was 0.20% in NFHS-3 and remains the same in NFHS-4.
Given India’s sizeable youth population and the high prevalence of early marriages, it is critical that resources be invested in making sure that information and access to modern contraceptive methods is made available in rural India.
“There is a need to focus on changing behaviour and the regular, smooth availability of contraceptives”, says Dr Ashok Dyalchand, Director, Institute of Health Management, Pachod. “At the moment, this is lacking”.