Equitable access will help improve reproductive health

Syllabus: General Studies Paper 2

Context:

The devastating impact of the covid pandemic on essential services, especially family planning and sexual and reproductive health, has worsened access to healthcare, especially for women.

• It has put millions of women at high risk of unintended pregnancies, unsafe abortions, illnesses and even death.

Challenges for family planning measures in India

• High population growth: Phase-1 data from the fifth National Family Health Survey (NFHS-5) shows an impressive decline in the fertility rate in almost all states. 
  • India’s total fertility rate (TFR) is declining. It is now 2.2 per woman, nearing the replacement rate of 2.1, according to the latest government data.
  • TFR indicates the average number of children expected to be born to a woman during her reproductive span of 15-49 years.
  • The replacement level is the number of children needed to replace the parents, after accounting for fatalities, skewed sex ratio, infant mortality, etc. Population starts falling below this level.
  • But overall population growth still appears high because India has a high proportion—about 30%—of young people and adolescents who are either of reproductive age or will soon be. 
  • Therefore the population continues to grow even if its fertility rate is declining. 
  • Some modelling studies project that India will reach a peak population of 1.6 billion by 2048 and it will then decline steeply to 1.12 billion by 2065.
• Lack of access to family planning measures: NFHS-4 showed that in 2015-16, nearly 13% women in the reproductive age group (15-49 years) had an unmet need for family planning, including 6% of women who had an unmet need for spacing methods.
• Contraceptive use is the lowest among women from Schedule Tribes, at 48%, followed by Other Backward Classes, at 54%, and Schedule Castes, at 55%. 
• Inequities in access to family planning have translated into poor health and development outcomes.
• Myths about demographic trends in the country: Many believe that certain religious minorities contribute greatly to India’s population growth, a notion that is not supported by data. 
  • The decadal growth rate decline has been sharper among Muslims than Hindus over the last three decades, at 4.7% and 3.1% respectively between 2001 and 2011 . 
  • The share of Hindus in India’s population reduced marginally, from 80.5% in 2001 to 79.8% in 2011, while the Muslim population registered a slight increase, from 13.4% in 2001 to 14.2%. 
  • Contrary to popular belief, the steepest decline in total fertility rate (TFR) was observed among Muslims (0.8%) followed by Hindus (0.5%), Sikhs (0.4%), and Christians (0.3%), between 2005-06 and 2015-16.

For a large proportion of India’s backward communities, social development programmes remain out of reach. 

Way forward:

• There is an urgent need for universal and equitable access to quality health services, including family planning. 
• Ensuring access to education, social security and health services, especially sexual and reproductive services, is key to improving birth outcomes.
• States like Kerala, which has a high Muslim population, and Tamil Nadu and Andhra Pradesh, have shown us that there is a strong link between development and decline in TFR. 
• Higher levels of female education, greater employment opportunities for women, delayed age at marriage and access to a bigger basket of contraceptive choices have made all the difference.
• Empowering frontline workers to increase women’s access to contraceptives, especially spacing methods, and introducing a wider range of contraceptive methods for women to choose from, based on their personal choice will ensure proper access to family planning.
• Spreading awareness: Engaging religious leaders in family planning and reproductive healthcare advocacy is an important way to encourage public acceptance. Highlighting the gains of family planning measures will also help.
• Behaviour-change communication and development interventions should be geared towards education, with a focus on gender equity. 

Inclusivity and equity are key when it comes to the distribution and delivery of services, information and commodities across communities and geographies. Governments at the national and state levels must ensure that appropriate measures are put in place so that people’s well-being remains at the heart of all policies, including family planning and reproductive health. This is critical to achieve our sustainable development goals, leaving no one behind.

The Live mint Link:

https://www.livemint.com/opinion/online-views/equitable-access-will-help-improve-reproductive-health-11632070021949.html