Context: India’s family planning programme has improved access to contraceptives. This has led to a reduction in the Total Fertility Rate from 3.4 in 1990-92 to 2.0 in 2019-21, according to the National Family Health Survey (NFHS).

• However, now India needs to focus on improving access to family planning services for not just adults, but also the younger population.

Why India now needs to focus on improving access to family planning services for its youth?

• First, according to NFHS-5 and the 2022 report by the United Nations Population Fund, there is a rise in adolescent childbearing in some States such as Tripura and Meghalaya.
• Second, COVID-19 has had a severe impact on economic resources and access to education, thereby influencing the choices women and the youth make about their sexual and reproductive health.
• Hence, in order to meet the SDG of Family Planning by 2030, India now needs to focus on improving access to family planning services for not just the adult population, but also the youth.

India’s Mission Parivar vikas

• In India, frontline health workers have contributed significantly in implementing Mission Parivar Vikas.
• It aims to accelerate access to high-quality family planning choices, to successfully increase the modern Contraceptive Prevalence Rate (mCPR), especially among female non-users from vulnerable communities.
• They have achieved this by delivering contraceptives at homes and offering a wider basket of alternatives such as injectable contraceptives.

What needs to be done?

• Strengthen the capacity of health workers in using the Family Planning Logistics Management Information System to ensure the availability of and access to contraceptives by marginalised communities.

Family Planning Logistics Management Information System: It is a dedicated software to ensure the smooth forecasting, procurement and distribution of family planning commodities across all the levels of health facilities.

• Family planning interventions need to be structured around the health needs, and populations for whom the intervention is to be implemented. The youth are not a homogenous group.

Key questions need to be answered wrt the sexual reproductive health needs of adolescents with varying profiles such as males and females who are in school, out of school, married, unmarried, and so on. There is a need to break down the data by key characteristics in order to reach specific groups of people in order to have the greatest impact.

• Moreover, when addressing younger populations, holistic health awareness programmes on the right age of marriage, safe sexual behaviour, contraception, reproductive health, and diet diversity are paramount.

Involving men in family planning: The involvement of men in family planning needs to be given equal importance. Certain gender transformative approaches have shown promising results in various places.

• Several examples of involving men in the family planning discourse include the PRACHAR project in Bihar, the Yaari Dosti programme in Mumbai, and the GEMS project in Goa.

Utilising private sector: Many of the programmes in public health have also started using the capabilities of the private sector to improve service delivery. The private sector can offer innovative solutions in family planning, thereby improving the community’s access to services.

Road Ahead

• In several districts, more than one-fifth of the population in the adolescent age group are now entering the reproductive age group. Also, there are still many districts in India that have low mCPR, with a large proportion of them being the youth.
• Hence, it is only by working holistically on overall health goals and addressing social determinants that we can ensure equitable family planning services for both adults and young people.

By: Shubham Tiwari