Repositioning of the Family Planning Programme in India

Family planning is a prerequisite for the universal access to sexual and reproductive health components of the Sustainable Development Goals (SDGs) and an essential indicator for tracking progress on improving maternal health (Dockalova et al 2016). In developing countries, about 818 million sexually active women of reproductive age (15–49 years) want to avoid pregnancy or delay childbearing for at least two years or want to stop pregnancy and limit their family size. About 140 million (17%) of these women are not using any method of family planning, while 75 million (9%) are using less effective traditional methods (Darroch et al 2011). In Southern, Central, and Southeast Asia, the use of modern contraceptives are less than the global average with only 47% of married women, aged 15–49 years, using modern contraceptives, although higher proportions want to prevent pregnancy (Najafi-Sharjabad et al 2013; United Nations Population Fund 2009). That is why SDG target 3.7 focuses on ensuring universal access to sexual and reproductive healthcare services, including family planning, information and education, and the integration of reproductive health into national strategies and programmes by 2030 (Dockalova et al 2016).

The estimates of contraceptive prevalence among currently married women, aged 15–49 years, in 2015–16 revealed that 48% women in India were using some modern method of contraception. This has reduced from 49% in 2005–06. Unmet need of contraception (National Family and Health Survey [NFHS-4]) was reported by 13%, marginally reduced from 14% of women who reported the same a decade back. This stagnation in family planning in India has been followed by two episodes of slowdown. First, in 1977, in the post-Emergency recoil and recovery of the programme in the country. Second, after the International Conference on Population and Development (ICPD) 1994, when the Government of India was one of the signatories of the ICPD Programme of Action (PoA). Hence, it promptly adopted the reproductive and child health (RCH) approach, where acceptor-based family planning targets were abolished in April 1995. Against this backdrop, this paper aims to highlight the changing scenario of the family planning programmes (FPP) in India, and issues and strategies emerging from the evidence generated from the recently conducted NFHS-4, which may be vital for the repositioning of the FPPs in India.