Monday, 15 August 2011

Resultant demographic scenario and its implications for India (Part III)

Slow progress towards women empowerment:
In spite of a significant jump in female literacy from 53.7% in 2001 to 65.5% in 2011, its impact has not been seen in the meaningful improvement in women’s autonomy measured in terms of decision-making roles within the family and community. Women’s autonomy can have a significant impact on the health seeking behavior of women by altering their relative control over fertility and contraceptive use, and by influencing their attitudes and abilities. To measure women’s autonomy and empowerment more directly, the National Family Health Survey-3 (IIPS 2007)[1], asked about women’s participation in household decision-making, their freedom of movement, and access to money that they could spend as they wished. Married women were asked who makes decisions on their own health care, making large household purchases, making household purchases for daily household needs, and visiting their own family or relatives. Only 37 percent of currently married women participate in making all four of these decisions. Further, only one-third of women are allowed to go by themselves to the market, to a health facility, and to places outside their own community. Further, a comparison with other States of India indicates that Four Large North India (FLNI) States have a consistently poor record on all the indicators of decision-making.  In this connection, one should note that these States recorded the highest level of unwanted fertility in the country, as revealed by the latest NFHS (IIPS 2007:109).

While India’s population continues to grow by 16-17 million people annually, 15 million women, mostly belonging to the “bottom of the pyramid” especially in the FLNI States, seek to postpone childbearing, space births, or stop having children, but are not using a modern method of contraception. This is also known as the "unmet need" for contraception. Often, these women travel far from their communities to reach a health facility, only to return home “empty handed” due to shortages, stock outs, and/or non availability of doctors and paramedical staff. When women are thus turned away, they are unable to protect themselves from unwanted/unplanned pregnancies and sexually transmitted infections, including HIV/AIDSs. And this type of incomplete control over the reproductive process leads to relatively high levels of unwanted childbearing. Around 26 million children are born in India every year and out of this about 5.5 million births have been classified as unplanned. Further, as per the NFHS-3 (IIPS 2007) about 30 per cent (around 218 million persons) of the total population in the young age group 0-35 years in India was the product of unwanted childbearing. The level of unwanted fertility in the country has increased from 23 per cent in 1992-93 to 30 percent in 2005-06, as shown in Table1.

                Table 1 India:  Level of unplanned /unwanted fertility, 1992-2006

Unplanned  pregnancies
Per cent of unplanned births
·         Unplanned Births (in million)
Unwanted fertility
Per cent of unwanted  fertility
·         Persons in age 0-35 resulting from  unwanted fertility (in million)
Based on data obtained from National Family Health Survey 1, 2 & 3 and Sample Registration Bulletins.

The consequences of unintended pregnancy are serious, imposing significant burden on women and families, and in turn slowing down the process of women’s empowerment. Unintended pregnancy breeds powerlessness and powerlessness breeds subordination (quality of obedient submissiveness) and subordination breeds unintended pregnancy.  And women find themselves in a vicious circle, as shown below[2]:

Can all the impending challenges be solved? Probably note. What is possible, however, is to make these more manageable. One area where urgent attention is required is to decelerate growth of population significantly, especially in the Four Large North Indian States. And the next blog aims in this direction.

[1] IIPS.  2007.  India: National Family Health Survey, 2005-06. Mumbai:  International Institute for Population Sciences.

[2] For details, see: Kothari, Devendra. 2010.  “Empowering women in India through better reproductive healthcare”, FPA Working Paper No 5, Jaipur: Forum for Population Action.

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