CONTEXT 

• India has entered a demographic sweet spot that will continue for another two to three decades.

• Half of India’s population is under 29 years of age, which means that in this period, a greater proportion of young people will drive India’s economic growth and social progress.
• Hence, this young population must not only be healthy, knowledgeable and skilled but must also be provided with the rights and choices to develop to their fullest potential, including, and especially, sexual and reproductive health and rights (SRHR).

WHAT IS SRHR?

• Sexual and reproductive health and rights (SRHR) is the concept of human rights applied to sexuality and reproduction.
• It encompasses efforts:
  • to eliminate preventable maternal and neonatal mortality and morbidity,
  • to ensure quality sexual and reproductive health services
  • to address sexually transmitted infections (STI) and cervical cancer, violence against women and girls, and sexual and reproductive health needs of adolescents.

Hence, SRHR is a critical aspect of human well being, such that it greatly impacts the psychological, emotional and social well-being of individuals.

INDIA’S PROGRESS

In the last two decades, India has made substantial gains with SRH indicators.

Maternal health:

• • As per Sample Registration System (SRS) data, progressive policies for maternal health have resulted in:

• improved rates of institutional delivery

• • decline in maternal mortality ratio (MMR) from 327 in 1999-2001 to 113 per 100,000 live births in 2016-18.

Family planning:

• There have also been significant shifts in family planning in the past decade,
  • Data from the National Health Family Survey 5 for the year 2019-20 (NFHS-5) shows improved usage of contraceptives in most States.

Population stabilization:

• Also India’s population growth is now stabilising. There has been a decline in the overall fertility rate.
  • The Total Fertility Rate (TFR), presently at 2.2 children, will soon reach replacement level   (2.1).

POOR INDICATORS

Inadequate information and access to SRH services for girls:

Several reports point to inadequate information and access to SRH services for girls in the (15-19) year age group.

• According to Guttmacher Institute (2021), two million adolescent girls (15-19 years) each year had a pregnancy, and of these, nearly 63% were unwanted or unintended.
• According to NFHS-4, girls aged 15-19 years, 22.2% had an unmet need for contraception, according to NFHS-4.

Girls are still marrying too young:

• 26.8% of women aged 20-24 years are married before they turn 18, often having their first child within the first year of marriage.
• Far too many girls and women face gender-based violence and harmful practices that are socially sanctioned.
  • All of these practices are rooted in social norms, beliefs and practices that deny women their bodily autonomy.

Declining performance in bridging gender gap:

India has slipped 28 places to rank 140th among 156 countries, becoming the third-worst performer in South Asia in the World Economic Forum’s (WEF) Global Gender Gap Report (2021).

CHALLENGES

Success is hard-earned and never assured. There are many challenges on the path to 2030, the goalpost for achieving the Sustainable Development Goals (SDGs):

Population growth:

• Despite the decline in overall fertility rate, the population will continue to grow because of the effect of ‘population momentum’.

Uneven progress:

• With little formal education and in the lowest income quintile, TFR among the rural women remains higher than the national average of 2.2 children.

Social norms:

• Social norms such as early marriage, gender-based violence and harmful practices faced by girls and women, are the major challenges that India needs to address.

Weak healthcare system:

• • Further, the COVID-19 pandemic has exposed weaknesses in healthcare systems.
    • It has led to serious gaps and challenges in the provision of information and services on sexual and reproductive health (SRH).
  • Even before the pandemic, universal access to SRHR was hindered by:

• pervasive negative social norms,

• health system barriers

• gender inequality

Need for immediate actions:

• On World Population Day this year, the United Nations Population Fund (UNFPA) India recognised the provision of SRHR cannot wait. Any further delays will curtail the health and well-being of women and girls, the consequences of which can last a lifetime.

WAYFORWARD

Careful approach:

• Time to achieve the ambitious targets of the SDGs is running out. Hence, India must choose its priorities carefully.

Youth centric policies:

• There is a need to place youth, women and girls at the centre of policy making and services, which could trigger a positive ripple effect.
• India will be on a clear path to achieve its goals, if it secures its young people, adolescent girls in particular:
  • access to education,
  • relevant skills,
  • information and services to make healthy choices, including related to SRH,
  • are empowered to exercise their rights,
  • have access to opportunities for employment.

Empower women:

• India’s population stabilisation strategy must be adjusted keeping in mind the rights of women and girls.
  • Instead of using prescriptive or coercive methods (such as one- or two-child norms), women must have a greater say in choosing their family size.
• The current government, with programmes such as Beti Bachao Beti Padhao (BBBP), has made some efforts to challenge existing social norms.
  • Further all sections of society must embrace this call for positive change.
• Research and practical experience show that when women can make informed choices about their sexual and reproductive health, and when they have access to services to support their choices, societies are healthier and more productive.

A woman who has control over her body gains not only in terms of autonomy but also through advances in health, education, income and safety. She is more likely to thrive, and so is her family.

Reference:

1. https://www.thehindu.com/opinion/op-ed/challenging-negative-social-norms/article35203257.ece