Addressing reproductive health Issues with women-based approach
Surveys have shown that how women having a lack of knowledge on sex, contraception, pregnancy, and abortion has been affecting their reproductive health orientation. - By Ajoy Khandheria
With this year’s World Population Day’s theme being reproductive health and gender equality essential for achieving sustainable development, the focus has once again shifted towards the need for women’s reproductive health. Surveys have shown that how women having lack of knowledge on sex, contraception, pregnancy and abortion has been affecting their reproductive health orientation.
A reproductive health orientation means that people have the ability to reproduce as well as to regulate their fertility; women are able to undergo pregnancy and childbirth safely and that the outcome of pregnancy is successful in terms of both maternal and child health and well-being. Reproductive health is affected by a variety of socio-cultural and biological factors and the quality of the delivery system. A woman-based approach to reproductive health is one which responds to the needs of adult women and adolescent girls.
The current scenario
Even after four decades of the inception of family planning programme, nothing much has been observed in terms of the population growth rate, which continues to grow at over 2 percent per year. Currently, almost 18 million people are added to India's population annually, under which 40 percent of the population comprises children under 14.
Life expectancy has now reached 61 years, up from about 44 in 1960; and the crude death rate has fallen dramatically from 27 per 1000 population at the time of Independence in 1947 to 9.8 per 1000 (1991). In Kerala, which reports the longest life expectancy, there is 67.2 years for males and 72.4 for females Whereas, in Uttar Pradesh, which reports among the lowest life expectancies in the nation, there is a reversal of the gender pattern: while males can expect to live a total of 57.1 years, female life expectancy is only 52.8.
Gender disparity the biggest roadblock
Women's unequal access to resources be it healthcare, education is a reality. Even economically despite being the majority of rural Indian women are active, their work goes largely unrecognised and poorly remunerated. Where women work, they earn lower wages including a lower cash to kind ratio than that awarded to men. When it comes to the household level, women have little decision-making authority and freedom of movement.
Many behavioural norms further reinforce women's lack of freedom of movement, self-confidence and their acceptance of self-denial including in matters relating to health-seeking and food intake. Violence against women and rape and are all part of women's lives. Women's poor reproductive health in India can be attributed to various socio-cultural and biological factors. Thus, efforts to improve women's education are fundamental be it raising enrollment and attendance rates of girls in school, reducing the drop-out rate on the one hand or enhancing women's income autonomy.
Loopholes in the Women Reproductive Programme
The India's Family Welfare Programmes are basically focused on achieving demographic targets by increasing contraceptive prevalence and notably female sterilisation. However, the Indian family planning programme also evolved through a number of stages. It has changed its focus. In the early years, the programme was laid with loads of caution and its impact was hardly felt. Then during 1965- 75, the programme was strengthened by integrating family planning with maternal and child health services was introduced. It was also during that decade, abortion was legalised. Despite, all these India's maternal mortality ratio is estimated at 555 per 100,000 live births, about 50 times higher than that of many industrialised nations and six times as high as that of neighboring Sri Lanka.
The following sub-sections highlight major concerns in the area of reproductive health:
a) Focus to be laid on reproductive morbidity and maternal health
b) Improving access to safe abortion
c) Information on sexually transmitted diseases
d) Improved quality of the reproductive system
Ajoy Khandheria is founder with Gramin Healthcare.