On this World Population Day, we reflect on India’s journey in family planning and reaffirm our commitment to address the challenges that lie ahead.
As endorsed in the United Nations International Conference on Population Development (ICPD) in May, India has not only provided leadership to the ICPD agenda but has also demonstrated progress through improved family-planning services and improving health outcomes, especially maternal health and child health.
In India, people are opting for smaller families, averaging just two children. This trend reflects a significant shift over the past decade, during which more than half of women (57 per cent) in their reproductive age (15 to 49 years) have actively used modern contraceptives. This widespread use of contraceptives highlights the success of India’s family planning programme. However, family planning is much more; it is integral to the health and well-being of communities and empowering women by providing them with rights and choices. With 369 million young people aged 10-24, India is on the brink of a transformative demographic shift.
Moreover, over the decades, the programme has evolved significantly, adopting various approaches to family planning, ranging from clinic-based to target-oriented methods, and 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 emphasise 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 programme achieved a milestone in 2012 with the introduction of the Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A) approach, alongside the emphasis on family planning through Family Planning 2020 and now Family Planning 2030. It has progressively focussed 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.
The 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 the national level (TFR 2.0) and 31 states/UTs have already achieved this milestone as per NFHS-5 (2019-21).
Family planning has also been recognised globally as reducing maternal and child morbidity and mortality. An important component of the programme is to focus on improving maternal and child health. This shift is necessary because family-planning strategies have to be adapted to India’s demographic diversity. The strategy also gives significant consideration to social issues such as age at marriage, age at first birth, and education. These factors are crucial for a holistic approach to family planning that addresses the diverse needs of the nation.
The Mission Parivar Vikas (MPV), one of the flagship family planning programmes of the government, 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).
The approach uses awareness campaigns such as Saarthi Vaahans (awareness on wheels) and Saas Bahu Sammelens to address social barriers for young women to access contraceptives and providing Nayi Pahel kits to newly married couples to sensitise them about responsible parenthood practices.
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 Northeastern states in 2021.
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 are in the rollout stage, with plans for further extension.
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 services.
The government is committed to overcoming barriers related to access, misconceptions about contraceptive methods, lack of awareness, 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.
India’s demographic dividend must navigate the complexities of sustainable development, urbanisation, and migration. Integrating these factors into our policies ensures that demographic growth translates into a sustainable future and inclusive prosperity. Successful interventions must go hand-in-hand with niche strategies.
On this World Population Day, let us pledge to build a brighter and healthier future for all, with a special focus on marginalised and vulnerable communities across India. Let us strive for a future where our demographic dividend is fully realised, 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.
The writer is Union Minister of Health and Family Welfare and Chemicals and Fertilisers
