‘Most adolescents in India have no access to family planning services’

: India needs youth-focused sexual and reproductive health programmes, along with quality education, to unleash its economic potential, Lester Coutinho, deputy director, family planning program, Bill & Melinda Gates Foundation, tells Sanchita Sharma.

How can India slow the rate of population growth further without using coercive measures?

The generation that will transform India has already been born. We’re facing a critical moment in our history that could define our country’s future trajectory: 1.2 billion adolescents are reaching their reproductive years, yet most still don’t have access to family planning information and services.

Realising and unleashing their economic potential in addition to education requires improving access to contraceptives and youth-focused sexual and reproductive health and family planning programmes. Women represent half of this potential. If we do nothing to improve services for these adolescents and young women, an entire generation of women may find themselves trapped in the same cycle of poverty as their mothers.

What prevents women from accessing services?

The two barriers that tend to be more pronounced among adolescents and younger women, irrespective of age, are a critical lack of access to accurate information, especially as they begin their reproductive years, and cultural barriers and attitudes around adolescent and youth sexual activity. When married, they may face the pressure to prove their fertility, and when unmarried, be judged or stigmatised if known to be sexually active. In certain contexts, there are further programmatic restrictions to contraceptive provision on the basis of age and/or marital status.

Are policies on delaying childbirth rather than limiting births more effective?

Both are effective since the objective of empowering women to take charge of their own bodies and their futures is at play here. When adolescents and young women delay their first pregnancy, they are more likely to have higher educational achievement and gain the skills and knowledge needed to be gainfully employed, which brings economic benefits. This kick-starts a virtuous cycle of more healthy newborns, better maternal health and more productive families. For every 10% more girls that go to school, evidence in some countries has shown GDP can increase by as much as 3%.

NEW DELHI

What’s the role of the private sector?

In many developing countries, the private sector plays a crucial role in delivering family planning information and services to women who need them. Countries like India often struggle to meet the health needs of citizens because private providers are mostly under-regulated and under-delivering, while public health systems remain overburdened.

Is there good data available?

Robust data systems are needed to ensure quality family planning services are made accessible to women in need.

With the introduction of more contraceptive choices, there is a focused effort in India too to provide information and services to newly married women and post-partum women, the national adolescent health programme, and an overall emphasis on improving the quality of counselling and follow up care through innovative digital platforms (though not yet at scale) are likely to show significant impact, not just on fertility, but on the health and empowerment of women, as well as their children

and families.