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CONTRACEPTIVE CHOICES AVAILABLE TO INDIAN WOMEN (NAYA VISHWAS NARI KE PASS)

 

So far the Indian Government has focused the whole issue of population control centered on sterilization. All our national programmes gave big emphasis to female sterilization and various incentives, money, forced sterilization have been tried in our country and not succeeded. What is needed today is awareness, education and freedom to choose. The knowledge of various contraceptive and the awareness is sadly lacking even in urban India and this has led to a huge unmet need and poor contraceptive couple protection of just 43%.

We doctors and Govt. agencies and NGO’s are the responsibility to help the population make a contraceptive choice which is appropriate to them and not to thrust a decision and we also have to keep various social, religious and actual factors of the population in mind.

The need for the day is to provide Education and communication to the client population. Good counselling interaction with patients, Listen, Learn and respond, provide information and to respect choice of the client. Mass Media has to come forward to provide Audio Visual information to the mass population.

What are the choices of contraception available today:

(1) Tubectomy—Globally this is the most widely used method. In year 1999-2000 about 42 million tubectomies were done and 97% were in age group 20–22 years. Out of a total of 202 million sterilization 163 million are women and 161 million in developing countries.

A safe reliable permanent method of contraception.

(2) Vasectomy—A very simple, safe, very effective procedure, not very popular because of various social myths and lack of awareness and fears of impotence. Only less than 3% of couples opting for permanent methods choose vasectomy. Non scalpel vasectomy should be popularised in India.

(3) Oral contraceptive Pills—Over 100 million women world wide use oral pills and this is a very good and effective method. In India pill became very unpopular again because of poor compliance due to social reasons (fasting) and also due to myths of weight gain and irregular periods with pill use.

(4) Emergency contraception—In case of unprotected intercourse today the option of emergency contraception is available and FOGSI has initiated a 24 hours free helpline with Reliance for information and counselling Dial 39700111 in your city.

(5) Intrauterine contraception Devices—Highly effective method, there are over 110 million users in the world. In India the health worker was authorised and allowed to inset IUCD’s without proper training and this led to a lot of wrongly inserted IUCD’s and a very good effective method was blamed. Today hormone releasing Mirena IUCD’s are available which are effective for five years but are expensive.

(6) Male involvement—If we want any success in solving our family planning problem, we have to motivate the Indian males to come forward for vasectomy as permanent method and to adopt condoms for spacing methods.

(7) DMPA—Today injectable progesterone only once in 3 months contraceptive is also a good and safe and very effective method specially just after delivery. Women have to be counselled for period irregularities witht his method.

How can we win the loosing battle of Population control ? This is the biggest challenge India is facing, we need strong political will, proper implementation of Govt. programmes, mass media campaign in newspapers and T.V., a sense of responsibility and nationalism towards saving our country from disaster of Population explosion.

Population control programme should have top priority if India wants to be a world leader.

Naya Vishwas Nari Ke Pass

Today in this 21st century every human being has a right for Health, Equality and Decision making. Unfortunately our country India is lacking behind in this basic rights to women and there is a clear gender bias which has led to our women left without possess for making decisions even in controlling their own reproduction, added social pressures & myths have led India to a brim of a big Population explosion.

Though our country is showing good progress and advancements, but these are being diluted by the increasing population. India has worlds 2.4% landarea but 16% world population. Indians still get married at younger age 6.2% get married at 10–14 years and 43% Indian population is married by 15–19 years age and has a very high fertility of too early births and too many births. A single most contributing factor to this is women’s lack of education and empowerment the demographic indicators of health in India are not very good with the Infant mortality rate of 70, a crude death rate of 8.7 and a life expectancy of 62 years average male and 3 years average female. A big factor to our bad health statistics is our contraceptive coverage and according to a survey only 46% of our couples in child bearing age have a effective contraceptive coverage.

India’s population is on the rise and this has brought our resources tender treat pressure and has led to many social evils like shortage, crime and unrest and poor quality of life.

On Population day India had over 1.06 billion people that is more than all Africa and every 6th person on earth is an India (Nothing to be proud about) we are adding 33 babies per minute. This has become a big worry to our Government and the service providers. The people of India have wake up and fight this war of Population explosion otherwise our country will see doom’s day very soon and our children will starve to death.

Our current aim should be to atleast tabilize our population at a level consistent with our National economy and the people of India have to come forward to understand need of family limitations becouse a small family will give you Big opportunity in life.

We have to cater to the huge need of contraception in the age group of 15–45 years. The problem can be solved only if the Government health programmes join hands with the private sector and the mass media.

The huge unmet need of family planning has to be urgently catered too and has to be urgently fullfilled.

There is a need for female sterilizates contom distribution, Pill awareness, IUCD awareness, Male sterilization, Injectable and other method availability and education about Traditional methods.

Today, we need to give our women a choice to accept contraception and a free will to regulate her fertility and give her a Naya Vishwas Nari Ke Pass.

By Dr. Narendra Malhotra
 
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