World Population Day (11th July 2023)

“On the occasion of Azadi ka Amrit Mahotsav, let us take a pledge to adopt family planning as a choice for happiness and prosperity”

Vincent Belho

Total fertility rate (TFR) refers to a statistical measure used to estimate the average number of children that would be born to a woman over her lifetime in a given population. It is an important demographic indicator used by demographers and policymakers to assess population growth, replacement levels, and overall fertility patterns.

TFR is influenced by various factors, including cultural norms, socioeconomic conditions, education levels, availability of contraception, government policies, and women's empowerment. Understanding TFR is crucial for policymakers in making informed decisions related to healthcare, education, family planning, and social programs to manage population dynamics effectively.

India was the first country in the world to launch a national program for family planning way back in 1952. Today India has achieved replacement level fertility, with as many as 31 states/UTs having TFR of 2.1 or less as per the National Family Health Survey 2019-20 (NFHS-5) the fifth in the NFHS series. Nagaland TFR is at 2.0 in the rural and 1.2 in the urban. While the unmet needs for family planning is 9.1 from 22.3 of NFHS-4 (2015-16) 

This World Population Day comes at a crucial moment in history wherein the importance of reaching each and every potential beneficiary in order to realize India’s dream of population stabilization needs to be underlined and red flag complacency while continuing with efficiency and consistency the good services to the beneficiaries. Any increase in unwanted pregnancies due to unavailability of services will have significant impact on maternal mortality and morbidity as well as health care costs besides negative impact on new born health. The essential Reproductive Health services focus primarily on provision of modern short and long-acting reversible contraceptives, permanent methods, information, counseling and services including emergency contraception. Education and awareness and easy accessibility to family planning services becomes key to masses both in urban and rural settings. 

“On the occasion of Azadi ka Amrit Mahotsav, let us take a pledge to adopt family planning as a choice for happiness and prosperity.” The theme is appropriate in the sense that what has been achieved so far must continue because family planning offers several benefits that positively impact individuals, families, and society as a whole. 

Some key benefits of family planning include: -

1.    Empowering individuals: Family planning gives individuals, especially women, the ability to make informed choices about their reproductive health and the timing and spacing of their pregnancies. It empowers them to take control of their bodies, education, and careers, leading to increased gender equality and women's empowerment.

2.    Improving maternal and child health: Family planning helps reduce maternal and infant mortality rates by enabling women to plan and space their pregnancies. Adequate spacing between pregnancies allows women to recover fully and reduces the risk of complications during pregnancy and childbirth. It also leads to healthier babies, as women can optimize their health and seek appropriate prenatal care.

3.    Enhancing economic well-being: Family planning contributes to economic development. When individuals and couples can plan their families, they are better able to invest in their education, careers, and economic opportunities. Smaller family sizes allow families to allocate their resources more effectively, resulting in improved economic stability and poverty reduction.

4.    Promoting education: Access to family planning enables young people, particularly girls, to delay pregnancies and continue their education. When girls are able to complete their education, they are more likely to have better employment prospects, contribute to economic growth, and make informed decisions about their lives.

5.    Reducing population growth: Family planning plays a crucial role in managing population growth. By enabling individuals to plan their families, it helps slow down population growth rates, which can alleviate pressures on resources, infrastructure, and the environment. It supports sustainable development and promotes the well-being of future generations.

6.    Preventing unintended pregnancies and unsafe abortions: Family planning services and methods help prevent unintended pregnancies, which can reduce the need for unsafe abortions. Access to contraceptives and reproductive health services can significantly reduce maternal deaths and complications related to unsafe abortions.

7.    Protecting the environment: Family planning contributes to environmental sustainability. Slower population growth resulting from family planning can ease the strain on natural resources, mitigate deforestation, reduce carbon emissions, and support conservation efforts.

Overall, family planning provides individuals and couples with the means to make choices that positively impact their health, well-being, and quality of life. It promotes sustainable development, gender equality, and population stability while contributing to improved maternal and child health, education, and economic prosperity.

Improving family planning services and access in rural areas requires new direction and comprehensive approach that addresses the unique challenges faced by rural communities. Here are some suggestive measures to enhance family planning in rural areas:

1.    Increase awareness and education: Implement community-based education programs to raise awareness about family planning, reproductive health, and the benefits of contraception. Conduct workshops, outreach sessions, and awareness campaigns targeting rural communities. Provide accurate and culturally appropriate information in local languages, utilizing community health workers, local leaders, and trusted sources to disseminate information effectively.

2.    Expand access to family planning services: Establish and strengthen healthcare infrastructure in rural areas, including clinics, mobile clinics, and outreach services, to provide comprehensive family planning services. Ensure the availability of a range of contraceptive methods and trained healthcare providers. Encourage public-private partnerships to leverage resources and extend service delivery in underserved areas.

3.    Overcome logistical challenges: Address logistical barriers that hinder access to family planning services in rural areas. This may involve improving transportation options, ensuring a reliable supply chain for contraceptives, and adapting service delivery models to reach remote communities. Mobile clinics, telemedicine, and community-based distribution programs can be effective strategies in reaching rural populations.

4.    Train and support healthcare providers: Provide training and support for healthcare providers in rural areas to deliver high-quality family planning services. This includes training on counseling techniques, contraceptive methods, managing side effects, and addressing cultural and religious beliefs. Continuous professional development programs and supportive supervision can help maintain provider competency and motivation.

5.    Tailor services to local needs and cultural context: Recognize and respect cultural norms and beliefs related to family planning in rural areas. Engage with local communities to understand their specific needs and adapt services accordingly. Involving community leaders, religious institutions, and local influencers can help overcome resistance and promote acceptance of family planning.

6.    Address cost barriers: Make family planning services and contraceptives affordable and accessible to rural populations. Explore subsidy programs, health insurance coverage, and public financing mechanisms to reduce out-of-pocket expenses. Collaborate with non-governmental organizations, donors, and philanthropic organizations to provide financial support and resources for rural family planning initiatives.

7.    Foster partnerships and collaborations: Establish partnerships between government agencies, non-governmental organizations, community-based organizations, and local stakeholders to collectively address the challenges of family planning in rural areas. Collaboration can leverage resources, share best practices, and ensure coordinated efforts to reach underserved populations effectively.

8.    Emphasize male involvement: Engage men in discussions and decision-making around family planning. Encourage male partners to participate in counseling sessions, community meetings, and educational programs to promote shared responsibility for family planning and reproductive health.

9.    Monitor and evaluate programs: Implement robust monitoring and evaluation systems to assess the effectiveness and impact of family planning programs in rural areas. Regularly collect and analyze data on service uptake, contraceptive prevalence rates, and client satisfaction to inform program adjustments and improvements.

By combining these measures and adapting them to the specific needs and contexts of rural areas, it is possible to improve family planning services, empower individuals and families, and enhance reproductive health outcomes in rural communities.

A society needs to make choices between numerical size or quality population, factors such as education, skills, health, productivity and socio-economic status are indicators to quality population where development and progress are emphasized and becomes the characteristics, attributes and qualities of individuals within the population. 

The writer is General Manager, FPA India, Nagaland Branch – Kohima. 

(Compiled & Issued in Public Interest)