AHMEDABAD: Premila Bhabor of Panchmuva village in Panchamahal is a mother of five. After giving birth to a daughter and a son, she wanted another son. "What if the first one does not survive," was her concern. But that did not happen and she conceived three girls after that. The family lives in extreme poverty. Premila and her husband did not use contraceptives though a health worker had explained how they worked.
This is one story among the hundreds in rural Gujarat where the knowledge of contraception has reached but the message hasn't yet been conveyed.
May 28 is observed as the International Day for Action on Women's Health and the theme set by Women's Global Network for Reproductive Rights (WGNRR) for this year is 'Access to Contraceptives is a Human Right'. In rural Gujarat, while the infant mortality rate and the maternal mortality rate have improved over the years, the use of contraception - both temporary and permanent - is still limited.
However, the awareness of contraceptives is on the rise with an increase in its users, from 65% to 67%. "Non-reversible methods of contraception are preferred to reversible methods with female sterilization being the most prevalent form at 41.5%," says Smita Bajpai, project coordinator, Chetna.
As for the vast number of those who reject contraceptives, Bajpai says: "The primary reason for refusing is the desire for having a male child and the nagging fear that one child might not survive." To tackle this, a project was launched in 2006 which saw several state NGOs and the department of health and family welfare collaborate to bring about a change in the health status of women in these areas. This project mobilized couples by counseling them on permanent and temporary methods of contraception provided by the public health system. Individual as well as joint counseling was done to provide complete information about various methods and the couples then chose the method of their choice.
Reports from 17 districts of Gujarat indicated that a total of 1,833 women accepted the temporary method of spacing children - intra uterine contraceptive device or IUCD. A total of 2,955 women accepted permanent sterilization. Interestingly, the state policy provides more compensation to men, but the report indicates only 129 men accepted this method during 2008-13. Men still find it difficult to accept this method as they confuse it with the concept of masculinity, the findings say.
"Women are overburdened with work. There is no one to look after the children at home and health facilities are far off, making it difficult to seek help," Bajpai says. "Most families in these areas migrate for livelihoods. To track them and to ensure that they receive services at the places they migrate to is a major challenge in these areas."
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