Special Correspondent

Strategic programmes to involve communities in population stabilisation needed

‘Panchayati Raj Institutions should play a bigger role in monitoring PHCs’

NEW DELHI: The working group on Population Stabilisation for the Eleventh Five Year Plan (2007-2012) has emphasised the need for expanding the range of choices in contraceptives as well as the quality of services in family planning, both in rural and urban areas. Sterilisation should be the last resort in contraceptive choices as a permanent method may not be preferred when levels of infant and child mortality are high, or because of religious beliefs.

In its report submitted to the Planning Commission, the working group has pointed out that India’s family welfare programme place heavy emphasis on sterilisation whereas many other Asian countries start their family planning programmes with spacing methods and then gradually introduced sterilisation. Providing sterilisation services also requires well-trained medical personnel and facilities. Just increasing the budgetary provision would not yield the desired results unless it was accompanied by strategic reforms and programmes to involve communities in population stabilisation, it said. Despite five decades of promoting family planning methods, a large percentage of couples report unmet need for contraception. Even meeting that could make a significant dent on the birth rate, the report said.

Further suggesting that auxiliary nurse midwives and Accredited Social Health Activists be asked to identify the couples with unmet need in their area and address their concerns, it points out that this would call for expansion of sterilisation services, especially in the large North Indian states.

The percentage of married women using contraception had increased from 10 in the early 1970s to 53 in 2005, which includes both traditional and modern methods. The percentage of female sterilisation is as high as 34.3 per cent while only 0.9 per cent of men go in for vasectomy. Condom is used by 4.8 per cent men, and pills by 3.5 per cent women.

It also states that the health outcomes could be improved if local communities had a greater say in providing basic healthcare. The Panchayati Raj Institutions should play a bigger role in supervision and monitoring of the Primary Health Centres (PHC) that need restructuring.

Concerted efforts are necessary to improve the coverage and quality of registration of births, deaths, marriages and pregnancies. The responsibility of this could be entrusted with the local bodies with clear-cut guidelines.