Family planning in India

indicates family planning products and services in India. Women in India are not being fully educated on contraception usage and what they are putting in their bodies. From 2005 to 2006 data was collected to indicate only 15.6% of women using contraception in India were informed of all their options and what those options actually do. However, the vast majority of married Indians (76% in a 2009 study) reported significant problems in accessing a choice of contraceptive methods. The above table clearly indicates more evidence that the availability of contraceptives is a problem for people in India. In 2009, 48.4% of married women were estimated to use a contraceptive method. It is common to use camps to enforce sterilization. This process can be done with or without consent. Comparative studies have indicated that increased female literacy is correlated strongly with a decline in fertility. Studies have indicated that female literacy levels are an independent strong predictor of the use of contraception, even when women do not otherwise have economic independence. Female literacy levels in India may be the primary factor that help in population stabilisation, but they are improving relatively slowly: a 1990 study estimated that it would take until 2060 for India to achieve universal literacy at the current rate of progress. Higher rates of sterilization are seen among women who hold less education than those with more education. Those with higher education have lower rates due to the delay of getting married and childbirth. The preoccupation with birth limitation by India's family planning programme has meant that it has not been able to successfully reach young married women who are in the process of building their family and enable them to meet their family planning intentions. In 2012, India's modern contraception prevalence rate among all women was 39.2, in 2017 it was 39.57, and in 2020 is predicted to rise to 40.87. ==Family planning programme==

The Ministry of Health and Family Welfare is the government unit responsible for formulating and executing family planning in India. An inverted red triangle is the symbol for family planning health and contraception services in India. In addition to the newly implemented government campaign, improved healthcare facilities, increased education for women, and higher participation among women in the workforce have helped lower fertility rates in many Indian cities. The objectives of the program are positioned towards achieving the goals stated in several policy documents. While India is improving in fertility rates, there are still areas of India that maintain much higher fertility rates. In 2017, Ministry of Health and Family Welfare launched Mission Pariwar Vikas, a central family planning initiative. The key strategic focus of this initiative is on improving access to contraceptives through delivering assured services, ensuring commodity security and accelerating access to high quality family planning services. its overall goal is to reduce India's overall fertility rate to 2.1 by the year 2025. Family planning program benefits not only parents and children but also to society and nation, by being able to keep the number of new births under control allows for less population growth. With less population growth this will allow for more resources towards those already existing in the Indian population, with more resources comes longer life expectancy and better health. ==Fertility rate==

India's current fertility rate as of 2024, is 2.1 births per woman. The fertility rate (average number of children born per woman during her lifetime) in India has been declining and it had reached the average replacement rate in 2019. The average replacement rate is 2.1. (This rate is said to stabilize a population) Replacement rate can be defined as the rate at which the population exactly replaces itself. Factoring in infant mortality, the replacement rate is approximately 2.1 in most industrialised nations and about 2.5 in developing nations (due to higher mortality). The fertility rates in India have dropped rapidly in rural areas, but are dropping at a stable rate in urban and populated areas. Although this seems promising, two-thirds of India's population resides in rural areas, adding to the decreased fertility rate. In 2005 the TFR, (total fertility rate), was listed as 2.9 births per women. Since this time, the country has recorded a steady decline in order to reach the current rate (as of 2024) of 2.1 births per woman. The total fertility rate of India stands at 2.1 as of 2024. Four Indian states have fertility rates above 3.5 - Bihar, Uttar Pradesh, Meghalaya and Nagaland Of these, Bihar has a fertility rate of 4.0 births per woman, the highest of any Indian state. For detailed state figures and rankings, see Indian states ranking by fertility rate. In 2009, India had a lower estimated fertility rate than Pakistan and Bangladesh, but a higher fertility rate than China, Iran, Myanmar and Sri Lanka. According to Jin Rou New and colleagues research and data they were able to compile enough data to create the following table. ==Family in Pronatalist India==

India carries a pronatalist attitude towards fertility, with the large family structure creating an environment for new children to learn and grow in Indian culture. In many parts of India, male children are favored over female children, however efforts are being taken to change this attitude. Males are raised to be assertive and independent figures, while females are raised to put others before themselves, particularly their family. Families tend to encourage childbearing and expect to provide an environment of support for any new members of the family, raising the children based on Indian family practices and beliefs. Children are not encouraged to be independent or assist the family from an early age, rather the family expects to support and provide for the child until they reach adolescence. ==Two-Child Policy==

Multiple Indian states have adopted a limited Two-child policy. The policies are implemented by prohibiting persons with more than two children from serving in government. The most recent policy to be implemented was by Assam in 2017. Some states have repealed policies; Chhattisgarh introduced a policy in 2001 and repealed it in 2005. A criticism of these policies is that it decreases the number of women in government positions, and encourages sex-selective abortions. The policy was geared mainly towards politicians, future and aspiring, to limit their number of children to two or less. Those who held politicians have stricter policies in hopes that they will set an example for the community, if one were to exceed the limit of two children while employed, they would be terminated from the job. Non-politicians may also receive consequences to exceed the two child limit, the government begins to withhold health care, government rights, face jail and, fees. == Modern Initiatives in Reproductive Health ==

Progress on reproductive health and family planning has been limited. As of 2016, India's infant mortality rate is 34.6 per 1000 livebirths, and as of 2015, maternal mortality sits at 174 per 100,000 livebirths. Leading causes of maternal mortality include hemorrhage, sepsis, complications of abortion, and hypertensive disorders, and infection, premature birth, birth asphyxia, pneumonia, and diarrhea for infants. In 2005, the Government of India established the National Rural Health Mission (NRHM) in effort to address some of these issues amongst others. Through the NRHM, special provisions have been made to address concerns for reproductive health, especially for adolescents who are more likely to participate in risky sexual behaviors and less likely to visit health facilities than adults. Ultimately, the NRHM aims to push India towards the Millennium Development Goal targets for reproductive health. ==History of Family Planning Programmes==

Raghunath Dhondo Karve published a Marathi-language magazine Samaj Swasthya (समाज स्वास्थ्य) starting from July 1927 until 1953. In it, he continually discussed issues of society's well-being involving population control through use of contraceptives. He explained the use of contraception would help prevent unwanted pregnancies and induced abortions. Karve proposed that the Indian Government should take up a population control programme, but was met with opposition. Mahatma Gandhi was the main opponent of birth control. His opposition was the result of his belief that self-control is the best contraceptive. However, Periyar's views were strikingly different from that of Gandhi. He saw birth control as a means for women to control their own lives. In 1952, India became the first country in the developing world to create a state-sponsored family planning program, the National Family Planning Program. The program's primary objectives were to lower fertility rates and slow population growth as a means to propel economic development. The program was based on five guiding principles: • "The community must be prepared to feel the need for the services in order that, when provided, these may be accepted • Parents alone must decide the number of children they want and their obligations towards them • People should be approached through the media they respect and their recognized and trusted leaders and without offending their religious and moral values and susceptibilities • Services should be made available to the people as near to their doorsteps as possible • Services have greater relevance and effectiveness if made an integral part of medical and public health services and especially of maternal and child health programs" The program was tied to a series of five year plans (based on the objective of the Gadgil formula which evolved in 1969) aimed at economic growth and restructuring which were carried out over 28 years, from 1952 to 1979. After Emergency the focus of family planning program shifted to women as sterilising men proved to be politically expensive. This is due in part to government intervention which established many clinics as well as the enforcement of fines for those who avoided family planning. Additionally, there was high variance between regions in the use of family planning. However, maternal and infant morbidity and mortality rates remain high along with the number of unsafe abortions, and little is known about the prevalence of sexually transmitted diseases. ==See also==