Adolescent pregnancies: Focus on contraceptive use among young in India

With adolescent pregnancy the focus of this year's UN World Population Day, India aims to reach out to its young population and push spacing as a measure for family planning to achieve the total fertility rate of 2.1 in all states.

As part of its family planning programme, the Ministry of Health and Family Welfare for the first time has started providing post partum intra-uterine contraceptive device (IUCD) to women who deliver children in government set-ups.

Post partum IUCD is a measure of spacing children and is administered to women within 48 hours of delivery.

Of the total 2.6 crore deliveries across the country, 1.25 crore take place in government set-ups.

As per the National Family Health Survey 3, 47% girls in India get married before the age of 18 years and early marriage leads of early child bearing.

With only 7 per cent of 15-19 year-old using contraceptive as per the NFHS 3, the unmet need for family planning is higher among among 15-19 year-olds at 27% compared to 13% unmet need across all age groups.

"We have already started providing IUCDs where the rush of deliveries is more. There are 16000 such delivery points in public sector where substantial number of deliveries take place that will be covered under the programme. Currently such facilities are being provided at government medical colleges and subsequently the district hospitals and other sub-centres will be targeted," said NRHM mission director and additional secretary in the Health Ministry Anuradha Gupta.

She said to reduce the total fertility rate, the emphasis is on spacing and young mothers are being encouraged to do so.

The Health Ministry, under its flagship National Health Scheme, is taking the help of counsellors who will encourage young women to use contraceptives and space their children.

So far, a total of 1,333 counsellors on contractual basis have been employed at such high-case delivery points and more will be appointed soon.

To target adolescents for providing sex education to them along with awareness on nutrition, government also aims to develop peer educators.

Of the 16.4 million married adolescent pregnancies across the world, four million are in India alone. Teenage pregnancies account for almost 16% of the total pregnancies in India and almost 9% of total maternal deaths.

UNFPA representative for India and Bhutan Frederika Meijer said, "The greatest returns on investment come from investing in adolescent girls. Educated and healthy girls have the opportunity to reach their full potential and claim their human rights. They are also more likely to marry later, delay childbearing, have healthier children, and earn higher incomes. They will be a force for change in their communities and generations to come."

India has launched a RMNCD+A strategy that seeks to address reproductive, maternal, neo-natal, child health plus adolescent health need, delivering health services in homes and communities, along with public health facilities of 26 crore targeted adolescents aims to focus on 184 priority districts.

The UNFPA has said that the unwanted, unplanned pregnancies increase the chances of unsafe abortions that risk the life of young women and adolescent pregancies face a higher risk of maternal mortality.

Gupta said data available suggests that 45% maternal deaths occur in 15-25 age group while in 40% pregancies, there is no appropriate spacing among children.

She said 21 states and union territories which account for 44% population have already achieved Total Fertility Rate of 2.1.

With focus on spacing of children, doorstep delivery of contraceptives by ASHA workers has also started in 233 districts and later will be done across the country.