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Equitable access will help improve reproductive health

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Imagine a world where you don’t have the right to make decisions about your own health and well-being, where choices about your health depend on someone else’s idea of ​​what is good for you and where access to care is beyond your reach. Sadly, this is the reality for a number of people in India today, especially women (bit.ly/3lu5nak). The devastating impact (bit.ly/3zi4IOd) of the covid pandemic on essential services, especially family planning and sexual and reproductive health, has worsened access to healthcare, exposing millions of women to a high risk of unwanted pregnancies, unsafe abortions, illnesses and even death.

Data from Phase 1 of the Fifth National Family Health Survey (NFHS-5) shows an impressive decline in fertility rates in nearly every state. Despite this, overall population growth still appears high due to a demographic transition: India has a high proportion – around 30% – of young people and adolescents of childbearing age or soon to be. This explains why a population continues to grow even if its fertility rate declines. Some modeling studies (bit.ly/2XAEJVu) project that India will reach a peak population of 1.6 billion by 2048 and then decline sharply to 1.12 billion by 2065.

Data shows that while women may wish for fewer than two children, many cannot access family planning methods that allow them to limit pregnancies. The NFHS-4 showed that in 2015-16, nearly 13% of women of reproductive age (15-49 years) had an unmet need for family planning, including 6% of women who had an unmet need for family planning. spacing methods (bit.ly / 3tNCQjU).

In addition, contraceptive use is lowest (bit.ly/3CnvKFP) among women in annex tribes, at 48%, followed by other backward classes, at 54%, and annex castes. , at 55%. The situation has likely worsened due to the restrictions on covid. These trends indicate that inequalities in access to family planning have translated into poor health and development outcomes.

The widespread myths and misconceptions about the country’s demographic trends, including fertility rates and population growth, are more damaging. Many believe that certain religious minorities are a major contributor to India’s population growth, a notion that is not supported by the data. In fact, the ten-year growth rates among all religious groups are steadily declining. The decline has been more marked among Muslims than among Hindus over the past three decades, at 4.7% and 3.1% respectively between 2001 and 2011 (bit.ly/3nPjLNv). Between 2001 and 2011, a sharp decline was observed in the rate of population growth for Jains (20.5 percentage points), Buddhists (16.7), Sikhs (8.5) and Christians ( 7). The share of Hindus in the Indian population decreased slightly 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%. In absolute numbers, the Hindu population increased by 139 million between 2001 and 2011, while the Muslim population increased by 34 million. Contrary to popular belief, the largest decline in the 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.

These figures refute the preconceived ideas about the dislike of the minority community for family planning. SY Quraishi, in his book The Population Myth, dismantles popular myths around the Muslim fertility rate, tracing the Islamic principles that support family planning and those that encourage small families in religious discourse.

For much of India’s backward communities, social development programs remain elusive. 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 essential to improve birth outcomes.

States like Kerala, which has a large Muslim population, and Tamil Nadu and Andhra Pradesh, have shown us that there is a strong link between the development and decline of the TFR. Indonesia and Bangladesh, two Muslim-majority countries, outperformed India in terms of declining fertility rates. Higher levels of education for women, better employment opportunities for women, an advanced age at marriage, and access to a greater basket of contraceptive choices have made all the difference.

Key steps to ensure more women in India have access to family planning services include highlighting the gains they are contributing to, empowering frontline workers to increase women’s access to contraceptives, especially spacing methods; and the introduction of a wider range of contraceptive methods from which women can choose. , according to their personal choice. Involving religious leaders in advocacy for family planning and reproductive health is an important way to foster public acceptance. This practice has been implemented in many programs in other countries, with great success.

Communication and development interventions for behavior change should focus on education, with an emphasis on gender equity. Inclusiveness and equity are essential when it comes to the distribution and delivery of services, information and commodities across communities and geographic areas. Governments at 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 essential to achieve our sustainability goals, leaving no one behind.

Fauzia Khan is a Member of Parliament from the Nationalist Congress Party

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