COVID-19 lockdown may derail India’s population control measures

The COVID-19 lockdown has jeopardised India's population control measures, triggering fears of a population explosion.  

In an interview with THE WEEK, Poonam Muttreja, executive director of Population Foundation of India (PFI), an organisation that works for the upliftment of underprivileged women in India, speaks about the magnitude of the problem. ''The absence of family planning services, as well as the limited supply of contraceptives, will result in an increased number of unplanned births, abortions, and additional childbirths,'' says Muttreja.

 Muttreja suggests a number of ways to tackle the crisis of population growth.  In states like UP, efforts are already being made to combat the looming crisis which includes the distribution of condoms and contraceptives. 

Excerpts from the interview:  

There are reports that the lockdown could lead to millions of unintended pregnancies across the world. In India, the Family Planning Programme came to a standstill during the lockdown and the lack of access to contraceptives has made matters worse. What is the likely impact of these on India's population control programme?

A recent study by Population Council suggests that going by trends observed for 2019, about 80 lakh condoms and 40 lakh pills are usually distributed per month while, about 15 lakh abortions monthly abortions take place, with March, April, and May being peak seasons. However, in the wake of the lockdown, family planning, and reproductive health services have significantly been scaled down leading to restricted access to services for people.

An India-specific study, which has used supply-side data of clinical Family Planning (FP) services and sales of over the counter contraceptives (OTC) in 2018 and 2019, has estimated that the lockdown will result in an estimated 25.63 million couples not being able to access contraceptives in India. There will be a method wise loss of 693,290 sterilisations, 975,117 Intra-uterine contraceptive devices (IUCDs), 587,035 doses of Injectable Contraception (IC), 23.08 million cycles of Oral Contraceptive Pills (OCPs), 926,871 Emergency Contraceptive Pills (ECPs) and 405.96 million condoms.

How can India tackle the unforeseen population problem that has emerged owing to COVID-19?

UNICEF has estimated that approximately 20 million babies will be born in India between March and December 2020, since COVID-19 was declared a pandemic.

 We are a young country today with a third of our population in the age group of 15-34 years. Ensuring that the reproductive needs of this young population are met at all times is imperative to ensure that the progress made by India’s family planning programmes over the decades is not undone.  For the nation as a whole, unplanned pregnancies during the period of lockdown and pandemic could become a huge responsibility for the country to support in the future. 
 
 The government has included family planning services among essential services to be provided during COVID-19 which is a welcome step. Going forward, the availability of self-care methods like condoms, oral contraceptive pills, emergency contraceptive pills, at the pharmacies, should be ensured. ASHAs and other community-level health workers should be supported to ensure continued access to family planning services. 

The Foundation for Reproductive Health Services recently released a report that throws light on how COVID-19 has led to unintended pregnancies and unsafe abortions. The situation is alarming. How does the Population Foundation of India (PFI) plan to deal with this?
 
PFI is not only doing its bit to support the government in combating the COVID-19 crisis but also generating evidence to assess the impact of COVID-19 on the provision of health services, including family planning.

 PFI, in collaboration with Facebook, has been developing content creatives and messaging around COVID 19 for the Government of India’s MyGov page.  This is to ensure that social media users are equipped with accurate, verified, and updated information on COVID. PFI is also directly working with state governments, the Ministry of Health and Family Welfare, and civil society organizations working at the grass-root level to develop and share information-based material as widely as possible.
 
 As the secretariat for Advocating Reproductive Choices (ARC), a coalition of civil society organizations working in the field of sexual and reproductive health, PFI is coordinating a field study to assess the availability of family planning services in selected districts across Bihar. The assessment will help in strategically engaging with district and state-level officials to address the gaps.
PFI is also assessing the impact of COVID-19 on the availability of services and commodities in public health facilities as well as outreach by frontline workers, through a five-state study (UP, Bihar, Jharkhand, Rajasthan, and Odisha).

In addition, PFI is conducting a telephonic rapid assessment with adolescents and youths in three states (Rajasthan, UP, and Bihar) to understand the level of knowledge, attitude, and practices with regard to COVID-19 and how it is impacting them.