Transforming Family Planning for a Healthier Tomorrow

Family planning programs play a crucial role in women’s health by providing widespread access to sexual and reproductive health services and counseling information. These programs offer cost-effective solutions for achieving gender equality, empowering women to make informed decisions about contraception and childbirth. Addressing aspects like Healthy Timing and Spacing, fertility awareness, and providing guidance to young couples enables them to make well-informed choices regarding family planning. Access to contraceptives contributes to delaying, spacing, and limiting pregnancies, reducing healthcare costs, and ensuring greater educational attainment for girls, thus promoting gender parity in the workplace.

India’s family planning program has historically overlooked younger age groups, particularly newly married couples and those with only one child. This oversight is attributed to various factors, including prevalent child marriages in places like Bihar, especially in rural areas. Social and traditional norms often pressure young brides to have a child, preferably a male child, shortly after marriage. Limited dialogue between couples regarding family planning decisions, coupled with predominant decision-making by husbands and mothers-in-law, poses challenges in fully addressing the sexual and reproductive needs of young people who require accurate information and support.

Bihar, constituting 8.58% of the country’s total population (Census 2011) and being the third most populous state in India, faces significant challenges. A considerable percentage of women in the state marry before the legal age of 18, and the average age for the first contraceptive use is 25 years, with 90% of family planning relying on permanent methods (National Family Health Survey or, NFHS 5, 2019-20). Despite commitments from the Government of Bihar (GoB), deeply entrenched cultural practices hinder the ability to bring about lasting change. Barriers such as poor service quality, insufficient availability and skills of health workers and facility staff, limited access to family planning services, inaccurate data, and inadequate public health infrastructure persist.

Recognizing the need for increased investments in family planning, particularly to empower young and newly married couples, it is crucial to improve outcomes related to family planning, maternal health, child health, immunization, education, and other development indicators. Shifting from a one-size-fits-all approach, there is a need for a more accountable mechanism involving couples, health workers, communities, and local administration.