India’s fertility rate declined from 2.2 to 2.0 since the last health ministry survey, indicating significant progress in population control measures. Bihar (2.98), Meghalaya (2.91), Uttar Pradesh (2.35), Jharkhand (2.26) and Manipur (2.17), however, still had figures over the replacement-level of fertility of 2.1.
The National Family Health Survey (NFHS-5) published by the ministry said the study also showed knowledge of contraceptives was almost universal, with 99% married women and men aware of at least one modern method of contraception, although only 56.4% used them.
Employed women were more likely to use contraception, with 66.3% women surveyed saying they used a modern contraceptive method, compared with 53.4% unemployed women. “Unmet need for family planning methods” is highest among the lowest wealth quintile (11.4%) and lowest among the highest wealth quintile (8.6%), reflecting contraceptive usage increased with income, the study said . “This data adds to the mountain of evidence that proves that development is the best contraceptive,” Poonam Muttreja, executive director of Population Foundation of India said. “While there is much to celebrate in the NFHS-5 data, our focus should now be to reach the unreached. We must do more for marginalised sections of society, who may be underprivileged on the basis of class, identity or geography,” she said.
Female sterilisation remained the most popular contraception, indicating that the onus of family planning continued to be on women. While 55.2% men said that if a male condom was used correctly, it protected against pregnancy most of the time, about 35.1% men believed that contraception was a ‘woman’s business’ while 19.6% men said that women who use contraceptives ‘may become promiscuous’. Chandigarh has the highest percentage of men (69%) who believe that contraception is women’s business and a man should not have to worry about it while 44.1% of surveyed men in Kerala agreed women who use contraception ‘may become promiscuous’, the report said.
“ We need to increase the number of birth spacing methods in the public health system, given that we have a large young population in the reproductive age group, which contributes to 70% of our population's momentum,” Muttreja said. Considering the huge population size and profound demographic diversity in the country, context-specific policy and programmes will be needed for states, passing through different stages of the demographic transition. “Our experience shows that targeted social and behaviour change communication campaigns can address social norms, harmful practices, and promote male engagement in family planning,” she said.