A thousand km from the policy makers and multi nationals gathering in New Dehli for the International Family Planning 2020 meeting is Barwani District - a hilly, isolated area of Madhya Pradesh. It is home to 1.3 million people, some of the hardest to reach in India.
The figures reflect the area’s isolation.
In Barwani the average age for girls to be married is 15, and the mean age for first pregnancy is 16, with little spacing between subsequent pregnancies. The literacy rate in Barwani is only 50 per cent – and only 43 per cent for women - compared to 74 per cent for India, and a significant proportion of girls drop out of school after marriage.
Against this backdrop, the Family Planning Association of India – supported by UNFPA – have embarked on a project to address adolescent fertility in Barwani – with the goals of delaying the age of first pregnancies by 1 or 2 years, promoting spacing between pregnancies, as well as improving reproductive care for boys and girls.
The Barwani project is using a range of approaches from communication packs and lively launch events, training for school teachers and health workers to wall painting and hoardings. Key to the project’s impact was the formation of village groups and home visits – which include family elders and in laws – and the use of locally-recruited accredited social health activists (ASHAs) distributing contraceptives. So far the project has reached 87 000 unmarried girls and boys and 23 000 married couples. Midway reports are very promising - contraceptive use has already jumped from 2 to 30 per cent.
This project is one example of the reach of IPPF’s Member Associations - working at the grassroots to provide voluntary family planning services to the most vulnerable populations.
The lack of knowledge and access to services faced by the young people of Barwani is not unusual. Access to sexual and reproductive health remains a distant dream for many of the world’s poor, marginalized and vulnerable women, men and young people.
That’s why IPPF is working towards the FP2020 targets of increasing family planning services to enable 120 million more women and girls to use contraception by 2020. The Federation is increasing its family planning services to save the lives of 54,000 women, averting 46.4 million unintended pregnancies and preventing unsafe abortion and tripling the number of services it provides annually, including 553 million services to adolescents.
So far, IPPF is on track to meet those targets, and in the process it is expanding its range of delivery channels and introducing new contraceptive methodologies to meet the needs of under-served communities like Barwani.