In 1952, nearly 54 years ago, India launched a national programme for fertility regulation for reducing birth rate to stabilise the population. Much water has flown under the bridges since. Then last, Census report of 2001 however put the Indian population at 1027 million. India it is estimated to constitute nearly 17 per cent of the world population. The various population control steps have already lowered the growth rate from 2.20 in 1971 to 1.93 in 2001.
The Centre, over the years has introduced a number of contraceptive services more so for spacing births. Some of the popular spacing measures include use of contraceptives both indigenous and imported, oral contraceptive pills, intra-uterine devices, IUD insertions and sterilizations. Further, the family welfare wing of the health ministry has established a network of population research centres in the states. These centres help in carrying out research on different subjects of population stabilisation demographic and sociodemographic surveys along with communication aspects of population and family welfare programmes.
The new inroads into the whole programme is likely to be achieved through the introduction of a monthly injectable and a bi-monthly injectable contraceptive.
The Indian Council of Medical Research (ICMR) conducted a study on monthly injectable contraceptive, Cyclofem through its network of Human Reproduction Research centres. A total of 63,754 women attended family planning clinics at 15 HRRCs of the council. They were given a balanced presentation of all the contraceptive methods available in the national programme including Cyclofem (Cafeteria approach). Out of them, 26,856 (42.3%) accepted Tubectomy, 116 (0.2%) couples opted for the Vasectomy, 25% accepted condoms, 15.8% accepted IUD, 14.7% accepted Oral pills while monthly injectable Cyclofem was opted by 1,330 (2.1%).
Reproductive Health, Mumbai, initiated a multicentre study on bi-monthly injectable contraceptive (Norethisrerone Enanthate) on 1,209 women. The study was completed recently. The objectives were to assess user acceptability and continuation rates of this injection, to study side effects and also women’s views and attitudes towards injectable contraceptive. The major emphasis of the study was on counselling by skilled counsellors and quality services to the users. The results were reassuring.
The observation based 17,268 months of injection use showed cumulative continuation rates at the end on 12, 18 and 24 months as 65%, 53.6% and 48.3% respectively. It was interesting to observe that 39% of woman requested to provide them injections beyond study period of two years. Over 79% were satisfied with the method. About 89% said that the injectable should be available in national programme and also 79% of them would recommend this method to their friends and relatives. The method was acceptable to the majority of woman and was found very effective. The cumulative method failure rate was 0.3% at the end of one year. Further there was no adverse effect on general or reproductive health necessitating hospitalisation. About 91% of woman conceived within 12 months and majority (52%) within six months after the discontinuation of injection was over.