Over the last decade, India’s general fertility rate (GFR) has fallen by 20%. The number of children born per 1,000 women in the reproductive age group of 15-49 years is referred to as the GFR. According to experts, decrease in the indicator has positive connotations for India, with an increase in availability and usage of modern contraceptives, and more literacy.
According to the Sample Registration System (SRS) data 2020, the average GFR in India was 86.1 from 2008 to 2010 (three-year period) and has dropped to 68.7 during 2018-20 (average of three years). The SRS data states that the decline has been steeper in rural areas, at 20.2%, compared to 15.6% in urban areas.
Former AIIMS head of obstetrics and gynaecology Dr Suneeta Mittal told the Times of India that the decline in GFR indicated a reduction in population growth, which was a good sign. She pointed out that increased marriage age, higher literacy rate among women, and easy availability of modern contraceptive methods were some of the key factors driving this change.
Positive Changes: Education
The positive advancement indicated by experts also includes the role of literacy in GFR reduction. The SRS report also highlights that there is a difference between the GFRs of illiterate and literate women, with the latter displaying lower levels of GFR at the national level.
Usage of Modern Methods of Contraception
Meanwhile, India has also made advancements in contraceptives. According to a report published in 2021, over 139 million women and girls in India now use modern methods of contraception. The report published by FP2020, a global partnership that supports women’s and girls’ reproductive rights, detailed the progress made in family planning over the last eight years, PTI had reported.
The report had stated that the number of modern contraceptive users in 13 low-income countries has more than doubled since 2012, and over 121 million unintended pregnancies, 21 million unsafe abortions, and 1,25,000 maternal deaths have been avoided in the last year alone.
In the last year alone, contraceptive use prevented more than 54.5 million unintended pregnancies, 1.8 million unsafe abortions, and 23,000 maternal deaths in India.
What India has Planned
In 2017, India updated its FP2020 commitment with two very specific, data-driven pledges: to invest $3 billion of domestic resources in family planning by 2020, and to increase the country’s modern contraceptive prevalence for married women from 53.1 per cent to 54.3 per cent by 2020, with 74 per cent of the demand for modern contraceptives satisfied. Both of those commitments have been fulfilled, the report said. “India continues to be one of the countries with the highest levels of domestic government expenditure, reflecting the governments’ commitment to its family planning programmes,” it stated.
“This year’s data includes estimates for 54 countries amounting to nearly $1.6 billion in spending. Most of that figure is attributable to just five countries: India, Indonesia, Bangladesh, Pakistan, and the Philippines,” it said. In India, over 139 million women and girls now use a modern method of contraception, it further said.
“India continues to be one of the countries with the highest levels of domestic government expenditure, reflecting the governments’ commitment to its family planning programmes,” the report said.
“Improving the quality of contraceptives, augmenting contraceptive demand through comprehensive IEC campaigns, and focused interventions in high fertility districts through Mission Parivar Vikas, have been few of the country’s notable achievements. As a result, we have witnessed an impressive decline in fertility and maternal mortality in the last few years. We continue to strive to substantially reduce the unmet need for contraception by 2030,” then Health Minister Harsh Vardhan had said.
On India’s proposed contribution to the next phase of Family Planning Partnership, Vardhan had stated: “We realize that advancing collaborations, adopting a more focused approach, and addressing the needs of young population will be of prime importance. India remains committed towards this global agenda. The overall aim thus, is to plan and implement this refurbished approach with the vision that every child is wanted, every birth is safe, and every girl and woman is treated with dignity.”
A Look at the Life-changing ‘Saheli’
One of the most notable outcomes of India’s population control policy was the development of Saheli (Centchroman), the world’s first non-steroidal birth control pill, which was introduced in 1995 as part of the National Family Welfare Programme. The pill was the result of two decades of rigorous research at the Central Drugs Research Institute (CDRI) in Lucknow, led by Dr Nitya Anand, a celebrated organic chemist, a report by the Better India said. The report explains how the oral contraceptive drug, which was to be taken once a week, gave many Indian women the freedom to choose.
The first birth control pill was invented in 1951 by Carl Djerassi, an Austrian-born Bulgarian-American pharmaceutical chemist, and his colleagues George Rosenkrantz and Luis Miramontes. It was to be taken daily, and caused steroidal side effects.
In contrast to Djerassi’s pill, the Centchroman was to be taken once a week because it was well absorbed in the body for many hours. The CDRI pill also does not disrupt a woman’s hormonal balance because it does not affect ovulation. The pill works by preventing implantation (the process by which a fertilised egg attaches to a woman’s uterine lining). Furthermore, the pill can be taken after sexual activity. It contains no steroidal component (and thus none of the associated side effects), and if a woman stops using it, she can regain fertility.
It took nearly three decades to complete the entire process, the report mentions, adding that the pill was approved by Indian regulators in 1990. Hindustan Latex Life Care, a PSU, and Ahmedabad-based Torrent Pharmaceuticals were granted licences to manufacture it under the brand name ‘Saheli’ (meaning female friend). The World Health Organization (WHO) also approved the pill, naming it ormeloxifene and selling it as Novex-DS or Sevista around the world.
With inputs from PTI
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