As the Reproductive Health Supplies Coalition’s annual meeting gets underway in New Delhi, it seems an opportune moment to consider some of the challenges surrounding access to reproductive health supplies in the world’s second most populous country.
Nearly 40 percent of married women aged 15 to 49 using contraception in India rely on female sterilization.
According to the United Nations Population Division, 12.8 percent of women in India had an unmet need for family planning. In other words, more than 12 percent of women who would like to delay or limit pregnancy lack modern contraception. Compared to many countries in Sub-Saharan Africa, this is not a large percentage. For example, Senegal’s unmet need for family planning hovers around 30 percent. However, it is critical to keep in mind that in absolute numbers, India still has millions of women with a demand for family planning.
The issue of the level of access Indian women have to a robust mix of contraceptive methods is equally important. The vast majority, 71 percent in fact, of contraceptive methods are supplied by the public sector in India. For decades, the most widely promoted method of contraception has been female sterilization. Nearly 40 percent of married women aged 15 to 49 using contraception in India rely on female sterilization. The next most popular method is condoms, with about 5 percent use. Such a picture does not reflect a commitment to ensuring women have access to a range of methods.
Reproductive health is very much a continuum. Over the course of her life, a woman’s contraceptive needs will change. Women seeking to delay their first pregnancy or space their next pregnancy often prefer short-acting reversible methods, like oral contraceptive pills, or long-acting methods like intrauterine devices (IUDs). Women who want to be done with childbearing altogether are more likely to choose long-acting methods (reversible or permanent). But above all else, the woman should be able to choose the method that is right for her. The fundamental goal of any family planning program should be to enable every woman to have a meaningful dialogue with her provider to find the right method…and to then make sure that method is in stock when she needs it.
It is easy to fixate on the piece of this equation that is most easily addressed with money—we focus on procuring the contraceptives themselves. However, it is important not to lose sight of our responsibility to ensure women have a real choice when it comes to their family planning method. One type of contraception should not be prioritized above all others; one method—especially a permanent one—cannot meet the needs of all women.
The RHSC meeting is taking place now with an eye toward ensuring access to affordable, quality reproductive health commodities. Rather than simply being yet another international conference, I hope this meeting of the minds can be a catalytic opportunity. What better place than India to spark a real conservation about choice. Reproductive health supplies present tremendous opportunities and serious challenges, but women around the world deserve access to a range of affordable, quality reproductive health options.