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#India – Government shifts focus from birth control to spacing

New strategy free from taboos and coercion, and moves away from a camp-based approach, says health official
Nikita Mehta , Mint
According to UN Millennium Development Goals, India is likely to miss its target for reducing the maternity mortality rate. Photo: Priyanka Parashar/Mint<br />
According to UN Millennium Development Goals, India is likely to miss its target for reducing the maternity mortality rate. Photo: Priyanka Parashar/Mint
New DelhiThe health ministry has shifted its family planning focus to spacing from birth control, emphasizing that the exercise is aimed more at the well-being of women rather than controlling population.
The move is aimed at the 4 million adolescent pregnancies that occur in annually. These contribute to 16% of all births in and 9% of all maternal deaths, according to the National Family Health Survey III.
According to the United Nations Millennium Development Goals (MDGs), India is likely to miss its target for reducing the maternity mortality rate (MMR). India’s MMR is 212 per 100,000 live births, whereas the target is 109 by 2015.
“The thrust of the government family planning strategies is on spacing of pregnancies,” said Anuradha Gupta, mission director, National Rural Health Mission (NRHM).
India’s population has almost doubled since 1980, when it stood at 698.96 million. In 2011, India’s population was recorded at 1.24 billion. Current projections show that India has a good chance of overtaking China as the most populated country in the world within the next half century.
“We have repositioned the strategy as a issue. While we made impressive gains in controlling maternal mortality, achieving the MDG targets will require accelerated intervention in the area,” said Gupta, also additional secretary in the health ministry and member of the committee behind the strategy.
“We want to categorically state that the new strategy is completely free of taboos and coercion. We have also moved from a camp-based approach where our health works had a target to achieve. Instead, we now have fixed-day services for women in clinics. We cannot reduce maternal deaths unless we focus on family planning,” she added.
The previous family planning focus led to excesses such as forced sterilizations in the 1970s. Activist groups are sceptical about whether the policy shift will have any effect on the ground.
“We would welcome the policy by the government, but my personal experience shows the government still concentrates on target numbers more than the quality of services,” said Jasodhara Dasgupta, convenor, National Alliance for Maternal Health and Human Rights (NAMHHR). “The family planning strategies are also very gendered in their approach as only women need to bear the burden of birth control and in many cases they suffer as violation of rights and camp sterilizations are still rampant,” Dasgupta added.
The health ministry is no longer closely focused on population.
“Maternal and child mortality are the major issues faced by India and not population growth. The days of high fertility rate are over,” said S.K. Sikdar, deputy commissioner and head of the family planning division. India’s fertility rate has dropped since 2001, according to United Nations figures.
Two million mothers in India are less than 14 years old and while the overall rate of contraceptive use is nearly 50%, only 7% of 15-19 year olds use them.
“Educated and healthy girls have the opportunity to reach their full potential and claim their human rights,” said Frederika Meijer, United Nations Population Fund (UNFPA) representative for India and Bhutan. “They are also more likely to marry later, delay childbearing, have healthier children, and earn higher incomes,” she said.
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