World Population Day: Bringing back the ‘choice, voice debate’ on family planning during COVID-19

By Puja Gupta

New Delhi, July 11  Family planning is central to gender equality and womens empowerment, and it is a key factor in reducing poverty. Millions of girls and women in India can transform their lives if needs for family planning – to delay, space and limit the number of children that women have – are met.

Beyond health, there are many far-reaching, transformational and inter-generational effects of women being able to use contraception and take control of their fertility. At the household level, families are able to invest more of their scarce resources in the health and education of their children.

Girls from smaller families are more likely to complete their education and women with fewer children are more able to seek employment, increasing household income and assets, points out Madhu Joshi, Sr. Advisor, Gender Equity and Governance, Centre for Catalyzing Change.

Some progress has been made towards improving gender equity so that women have greater involvement in decision-making processes and positions in government.

Increasing educational opportunities for girls protects them from premature marriage and childbearing and helps address gender inequalities in economic participation. Family planning empowers women to take charge of their lives whilst also enhancing their contributions to family wellbeing and overall national development, Joshi says.

Efforts are underway to mitigate the impact of COVID-19 on family planning access and service delivery. Measures have been taken to reach out with non-invasive methods to communities in conjunction with tracking and tracing of people who are at risk of COVID-19.

She points out: “The estimates done by FRHS in the month of April 2020 presented three case scenarios based on timings of complete restoration of FP services. In the best case scenario with FP services restoration in the month of May 2020 in full capacity across the nation, it was estimated that as a result of the pandemic, 24.55 million couples would not be able to access contraceptives in 2020. Method wise the loss is estimated at 530,737 sterilizations, 709,088 Inter Uterine Contraceptive Devices (IUCDs), 509,360 doses Injectable contraceptives (IC), 20 million cycles of OCPs, 827,332 ECPs and 342.11 million condoms.

“This is likely to result in an additional 1.94 million unintended pregnancies, 555,833 live births, 1.18 million abortions (including 681,883 unsafe abortions) and 1,425 maternal deaths. What is important is that we do not allow the pandemic to reverse the hard earned gains of past decade for increased family planning uptake.”

Adding: “It becomes imperative for all stakeholders to examine the opportunity loss as a result of COVID�19 pandemic and put Family Planning back on track as we deal with the pandemic through strategic engagement; amongst the top priorities is to reach out to most vulnerable populations who may not be able to articulate latent need for contraception � mostly women dealing with loss of livelihoods, facing violence and discrimination; young couples who would not be able to access because of barriers of information and social pressure.”

We need to undertake concerted efforts to ensure that opportunity loss is reversed and couples who desire contraception can access it free from discrimination and with quality, and are to be able to reverse losses and ensure that decadal gains are not reversed. That multi-pronged efforts are being undertaken by government at all levels to bring FP service delivery on track. On World Population Day, Joshi recommends that “we reinforce, the need to keep listening to voices and support women and men in Choices they make for family planning”.

Community based distribution of non-invasive contraception be promoted through channels beyond frontline functionaries of the health system.

Modifying delivery mechanisms along the lifecycle continuum of care for women and girls and including self-care across the spectrum of services offered, can increase access to care during calm times and crises.

Bringing focus on spacing contraception which is non-invasive (condoms, daily and weekly pill) and minimally invasive (injectable) not just to promote choice also to reduce pressure on a burdened health system dealing with rising COVID�19 numbers.

Amplify voices of key constituents on promoting Choice and Voice narrative for Family Planning.