India needs to significantly increase the budget for the family planning sector, else it may fall short of the commitment to provide the services to 48 million new users in the country by 2020, a new study said today.
The study by Population Foundation of India (PFI) said the country would need to spend about Rs 15,800 crore, if not more, during 2013-2020, to meet its commitment of providing additional family planning services through public funded providers to 48 million people.
At Family Planning 2020 – a global partnership that supports the rights of women and girls to decide for themselves when and how many children they want to have – India had committed to reaching 48 million new users, in addition to the existing 100 million users of family planning services.
“Any delay in doing so or any gap that may result because of paucity of resources would cost the country dear in terms of high maternal and infant mortality, morbidity and poor child health resulting from poorly spaced pregnancies,” PFI said in a statement.
Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand as well as Assam and Himachal Pradesh need greater focus and commitment on the issue, it said.
“Family planning, which is almost fully funded by the Central government, has received very little attention from it as compared to other health programmes. Family Welfare, which includes the budget for family planning constituted only 4 per cent of the 2014-15 Health and Family Welfare budget,” the study said.
The share for family planning within the family welfare budget has been further reduced to around 10-15 per cent with subsequent curtailment in contraceptive procurement and social marketing, it stated.
“The study on resource requirements for India to meet its FP2020 commitments indicates that it would need to spend at least Rs 15,800 crore by 2020 to achieve this goal as well as the Sustainable Development Goals.
“The need of the hour is to work closely with the private sector and civil society to make this promise a reality,” Poonam Muttreja, Executive Director of PFI said.
Noting that the Centre funds family planning activities in states through two channels – the Family Welfare budget and National Health Mission (NHM), PFI said though the allocation for family planning increased by 47 per cent from 2013-14 to 2015-16 under NHM, it still fell short of the required amount.
Fund allocations under the family welfare budget saw a sharp decline of 54 per cent during the same period. As contraceptives, information, education and communication activities are covered by this, the decline is extremely worrying, PFI said.
The study showed that going by the current rate of increase of mCPR (modern contraceptive prevalence rate), India would have about 32.8 million additional users, that is about 15 million short of the committed FP2020 goal.
“Therefore, India will have to do much more to cover the gap in terms of making available contraceptive supplies, outreach services, and trained manpower to address the needs,” it said.
Private players that have been dominating the spacing contraceptive market in the country and their participation is “crucial” to meet the goal, the PFI study said.
“As per the current trend, users covered by the private sector are expected to reach 9.79 million, while the required number should be 21.6 million to meet the goal.
“This implies a gap of 11.8 million users that are unlikely to be covered by the private market unless the government steps in with additional public resources and involves the private sector through social marketing or franchising mechanisms,” it said.
Expressing concern on the allocation of resources, it said the government’s financial documents do not show any evidence of planned progress towards achieving the desired contraceptive method mix with a focus on spacing.
“There continues to exist a significant bias towards limiting methods. About 82 per cent of the NHM flexi pool budget and 71 per cent of total resources are allocated for compensation, mostly to users of limiting methods and incentives to those providing them.
“Also, the changing pattern of the Centre-state allocation formula, where states with their tight resources and low priority to family planning activities, are expected to share 40 per cent of the programme funds from their own resources instead of the earlier 25 per cent. This would greatly hamper the meeting of the goal,” it said.