Two new contraceptives are set to give the Centre's family planning programme, 'Mission Parivar Vikas', a boost. The new contraceptives include an injectable and a weekly pill, both of which have now been launched for women in ten states—Maharashtra, Uttar Pradesh, Madhya Pradesh, Rajasthan, Karnataka, Haryana, West Bengal, Odisha, Delhi and Goa. Of these, UP, MP and Rajasthan have particularly high fertility rates, and hence, are part of the Centre's seven “high focus” states for the family planning programme.
The injectable contraceptives, also known as DMPA (depot medroxyprogesterone acetate), has had a controversial history. It was approved by the Drug Controller General of India (DCGI) in June 1993 for marketing. However, it was approved for launch in the public health system after more than two decades, in 2015.
The injectible has long been the subject of medical controversy as well as women's groups have pointed out the side effects and high discontinuation rates.
The injectible that goes by the name 'Antara' in the public health system, is a progestogen-only method that has to be given every three months, while the pill is a weekly method. “The contraceptives are safe and highly effective, will help meet the changing needs of couples and help women plan and space their pregnancies,” a statement from the ministry of health and family welfare said.
The DMPA is the fourth most prevalent contraceptive and is widely used as an effective, safe and acceptable method of contraception across the world, according to the Population Foundation of India (PFI).
However, experts such as Poonam Muttreja, director, PFI, feel that quality and access are important issues. “For the injectable roll-out, that has been announced after a delay of several years, it is important that the government focuses on the ground situation. We need proper trained staff on ground to consel the women. They need to be advised on the timing of the injection and its side effects such as a disturbance in their menstrual cycles. Proper counselling will also ensure that the women do end up returning for the injection after three months," said Muttreja.
A public health expert, who did not wish to be named, said adequate supply was also an issue, especially in rural areas where oral pills were often out of stock.
Others such as Vinoj Manning, executive director, Ipas Development Foundation welcomed the Centre's increased focus on provision of spacing methods for women, as it strengthens "their ability to exercise their reproductive rights and choices".
“While limiting methods have been chosen by women extensively in the past, we strongly feel that with the expanded basket of choice for spacing methods, women and men shall have more access to comprehensive contraception. We hope that the Antara programme is also scaled up to be made available across the public health system, as in the case of Chhaya and other spacing contraceptives. These methods offer increased choices for women in post-partum period as well as immediately after abortion,” said Manning.