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Education remains the most effective contraceptive: experts

Education remains the most effective contraceptive: experts

The country is seeing an increase of teenage pregnancies both among married and unmarried teens

The country is seeing an increase of teenage pregnancies both among married and unmarried teens

Last year, India overtook China as the world’s most populous country.

According to United Nations estimates, India’s population which is currently 1.4 billion, will peak at 1.7 billion or so in 2064 before settling at 1.53 billion in 2100. But even though these numbers are staggering, data indicates that population growth is slowing —the total fertility rate has dipped below the replacement level of 2.1 and is projected to dip further.

With World Population Day (July 11) around the corner, experts say India’s thrust should be on ensuring the sexual and reproductive health of its young people.

A study that referenced the National Family Health Surveys (NFHS) concluded that there is a significant association between years of schooling and total unmet needs for family planning and unmet needs for spacing. The results of the study are contained in the paper ‘Changes in discourse on unmet need for family planning among married women in India: evidence from NFHS-5.’ It was published in the Scientific Reports journal last year. According to the study: “The demand for unmet needs for spacing and limiting was the highest among the women in the age categories 15–19 (17.8%) and 20–24 (17.3%).”

This, says Poonam Muttreja, executive director, Population Foundation of India, is primarily due to two factors: women who get married very young are usually from backward regions and not very educated, and therefore, their agency to negotiate or even talk about family planning is limited. “This is a social norm: even if the young woman does talk to a healthcare worker, the thinking is that once they are married, they must prove their fertility with children before family planning, and therefore there is no room for access to contraception,” she says.

The other issue, Ms. Muttreja says, is that the country is increasingly seeing teenage pregnancies both among married and unmarried teens, and yet, families are unwilling to accept that their unmarried children may be sexually active. “This is compounded by the lack of sex education. Globally, evidence has shown that where sex education is given, the sexual debut of a young person is postponed. It also helps eradicate misconceptions. In India, for a young person to even access condoms or any other form of contraception is culturally and socially against norms,” she adds.

There is an urgent need to focus on young people, both men and women, and on their sexual and reproductive health through culturally sensitive behaviour change communication, and by offering them a basket of contraceptive options to meet their needs. She reiterated that women’s education continues to be the most effective contraception..

Sumana Manohar, senior consultant obstetrician and gynaecologist at Apollo Hospitals, Chennai, also highlights the need for education among older students — those in classes 11 and 12. “They need to be given information about contraception. Doctors could also advise young people, who are in stable relationships, who approach them, on the options available. Our society is fairly conservative, but we need to do justice to young people,” she says. 

Even abortion, points out Dipika Jain, director, Centre for Justice Law and Society, Jindal Global Law School, is a qualified right. “Abortion is largely criminal in India except under the Medical Termination of Pregnancy (MTP) Act, which allows for abortions under certain conditions, and is based on gestational limits and the opinions of doctors. This means that the decisional autonomy of a pregnant person is not respected — abortion services are not provided on request — the person must qualify for the service as per the conditions of the act. Any abortion outside of the Act is criminalised. This makes access to safe and legal abortions difficult for a large section of pregnant people in India,” Prof. Jain says.


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