Our gender gap in contraception needs public policy intervention

This brings to the fore a clear gender divide in the methods of contraception used in India. Partition can mean two things. First, it may indicate the greater bodily autonomy exercised by women today; In charge of their own lives and bodies, women can make their own contraceptive choices, determining when and how they want to plan their children and careers. Alternatively, this division may also point to the deeply rooted patriarchy that exploits and subjugates women. To evaluate which of the two is working, we need to look carefully at our data.

According to the NFHS-4 conducted during 2015-16, only 8% of women were found to make an independent decision on the use of contraception, while for almost every tenth woman, it was the husband who decided to use contraception. The irony is that while the husband decides the law, the real burden falls on the women. In fact, with more than a third of India’s sexually active population, female sterilization remains the most widespread method, despite the low cost and safe procedure of vasectomy. Interestingly, based on the NFHS-3 and NFHS-4 data, we also see that a higher proportion of women with a college or higher level of education are on female sterilization (17.2%) using either male or female reversible methods of contraception ( 33.7%). , All these facts bolster the ‘subordination’ explanation of the partition on the ‘physical autonomy’ hypothesis mentioned above.

These observations are also highlighted in a recent study published by OP Jindal Global University as a working paper in 2021 titled Gender Gap in Contraceptive Use: Evidence from India. This study provides evidence that the role of women’s education in the choice of contraception is important. The Bihar model is a classic example of this, in which Niranjan Sagurati, Director of the Population Council of India, said, “The most important [factor] In Bihar’s case there is an increase in education – which has translated into increased use of contraception and increased family planning.”

Therefore, apart from educating children, it is imperative to impart knowledge about the uses and benefits of various methods of contraception to the community at large. It is paramount to target such awareness campaigns at both men and women. Special emphasis should be placed on convincing men about the relevance of family planning, and therefore, the use of several male contraceptive methods that are safer, cheaper and procedurally simpler than female sterilization. This can be done using the country’s existing network of community health workers, such as ASHA workers or Anganwadi workers or auxiliary nurse midwives. However, currently, most of these frontline workers who have the right to disseminate information on family planning are women. Additional male workers may also be deployed to facilitate direct communication with men.

Additionally, India does not explicitly have a law on contraception that makes access to sound sexual health our legal right, although it is one of the key indicator variables of the United Nations Sustainable Development Goals (SDG Indicator 3.7. Is. Including sexual welfare as our legal right within the ambit of the law can ensure that there are no unnecessary restrictions on the advertising and promotion of contraceptives, thus making it easier for people to access information and knowledge on them . In addition, such legislation could also be used to facilitate the availability and accessibility of contraception by enrolling the services of primary health centres, particularly in small towns, peri-urban and rural areas to improve access. For.

The government has taken a step in the right direction by introducing a bill to amend the Child Marriage Restraint Act, 2006 to raise the legal age of marriage for girls from 18 to 21 years. There exists literature that suggests that increasing women’s age at marriage decreases women’s overall fertility (Maitra, 2004). While this would be a relatively direct result of the higher age at marriage, as it shortens the reproductive years of married women, a possible indirect consequence of the move could be improved women’s bargaining power, as it reduces the age gap. could. between husband and wife.

In addition, extraordinary pandemic measures such as lockdowns and urgency of essential supplies have disrupted the contraceptive supply chain. According to the World Health Organization (WHO), family planning has been severely affected during this period, affecting seven out of ten countries. According to the United Nations Population Fund, more than 47 million women in 114 low/middle income countries were unable to use contraceptives. According to the report Resilience, Adaptation and Action: MSI’s response to COVID-19, India alone saw 650,000 unwanted pregnancies during the COVID pandemic.

Therefore, it is the need of the hour to prioritize sexual and reproductive health at the policy level. Promoting better informed and healthy reproductive behavior among the people of the country is a long-term endeavor which should not stop due to health emergency.

Sonal Dua, Aditi Singhal and Divya Gupta are assistant professors, OP Jindal Global University