Jaipur, One of the globally
acclaimed universities and renowned research institutions, IIHMR University,
Jaipur, has been implementing project PMA 2020 in Rajasthan. Performance
Monitoring and Accountability or PMA 2020 involves India as one of the program
countries out of the other 10 countries which include, Ghana, Ethiopia, Kenya,
Burkina Faso, Indonesia, Nigeria, Uganda, and Democratic Republic of Congo. The
project is implemented by IIHMR University, Jaipur in collaboration with Bill & Melinda Gates Institute for Population and
Reproductive Health
at the Johns Hopkins Bloomberg School ofPublic Health and International institute for
Population Sciences and Ministry of Health & Family Welfare. .Project is funded bythe
Bill and Melinda Gates Foundation. .
According to Dr. Anoop Khanna, Principal Investigator, Rajasthan
for PMA 2020 and Professor at IIHMR University “Performance Monitoring and
Accountability 2020 (PMA2020) uses innovative mobile technology to
routinely gather rapid-turnaround, cost-effective population data on family
planning and water, sanitation and hygiene.” He added, “PMA 2020 is a
project that focuses
on important indicators that monitor family planning. The project has recently
concluded round one and will provide information every 6 month till 2017 and
once a year from 2018. Round one included 4874 households and 297 health
facilities which were surveyed from June-September, 2016 on reproductive health
in the state. It has been observed that in the state of Rajasthan the overall
family planning has been given more importance in the recent years.”
According
to the project findings, more than ½ of married women are using modern
contraceptive methods, where the use of birth
control pill is up from 5% in 2005-06 to 7% in 2016 and the use of injectable
has increased. Male condoms are used by 10% of married women which is up from
6% in 2005-06. Although Female
sterilization is the most common form of contraception, it has decreased over
the last decade.
According
to the project findings in round one Dr. Anoop Khanna further added, “The
current level of unmet need for family planning in Rajasthan is 15% which is
slightly below the level 10 years ago which shows that the overall demand for family
planning is increasing. The unmet need for limiting (i.e those who do not want
another child) has increased while the unmet need for spacing (i.e those who
wish to have another child) has slightly declined. This presents an opportunity
to expand access to long-acting methods, especially reversible methods, to
enable women to meet their reproductive goals. Thus, the total unmet need for
family planning in married women in Rajasthan between 15-49 years is 15% where
10% is for limiting and 6% is for spacing.”
Inequitiesare
not just a part of the income being distributed but these inequities are also
found at the family planning level wherethe report findings specify that poor
women have more unintended pregnancies than wealthy women. Among women in the
poorest wealth quintile, 22% reported that their last pregnancy was unintended,
compared to 12% in the wealthiest quintile. Increased access to contraception,
and especially highly effective long-acting methods like IUDs and implants, may
help prevent unintended pregnancies, particularly among poorer women.
Even
though multiple healthcare facilities offer contraceptive facilities, for many
women other more effective reversible methods remain out of reach. More than
three-fourths of public facilities offer at least 3 modern contraceptive
methods. Among public facilities, 77% offer at least 3 modern contraceptive
methods and 38% offer 5 or more modern contraceptive methods. About 96% of
Community Health Centers (CHCs) and 87% of Primary Health Centers (PHCs) offer
3 or more methods, while approximately 92% of public hospitals offer 5 or more
methods.
The
findings of the project on Adolescent Reproductive health specifies that Young
women start to use family planning several years after they become sexually
active and, often, after they have already given birth. The median age when
women first start using contraception is 22.2 years. However, the median age at
first sex is 18.3 years and the median age at first birth is 21.0 years. The
pattern is even more pronounced when looking specifically at women living in
urban areas who have their first birth at age 21.0, but do not start using
family planning until almost three years later, at age 23.1. By that time,
women in urban areas have, on average, 2.1 children. This suggests that unmet
need for young, urban women may be especially high, and presents an opportunity
to expand family planning offerings and increase contraceptive coverage for
this group.
In
Rajasthan, data collection is led by the Indian Institute of Health Management
Research (IIHMR) University in Jaipur. A sample of 147 enumeration areas (EAs)
was drawn by the International Institute for Population Sciences from a master
sampling frame. In each EA households and private health facilities were listed
and mapped, with 35 households randomly selected in each EA. Households were
surveyed and occupants enumerated. All eligible females ages 15 to 49 were
contacted and consented for interviews. The final completed sample included
4,874 households (97.2% response rate), 5,262 females (96.0% response rate) and
297 health facilities (96.1% response rate). The first round of data collection
was conducted between June and September 2016.
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