Updated: September 26, 2019 10:58:52 am
On World Contraception Day, there is a need to talk about the reproductive health practices and rights of people in India. It is commendable that the government under Prime Minister Narendra Modi has been vocal about the need for a small and healthy family to contribute to India’s socioeconomic growth in the long term.
To achieve this vision, there is a need to highlight the importance of Sexual and Reproductive Health and Rights (SRHR), which are fundamental for family planning and the overall well-being of individuals.
India’s family planning programme dates back to the 1950s and it has made significant progress. The recent emphasis on increasing spacing between children and providing access to the basket of contraceptive choices poses the promise of universal access to reproductive health services.
The National Family Health Survey (NFHS) 4 shows that the use of modern contraceptive methods (mCPR) continues to be around 48 per cent since 2006. In the states which showed mCPR decline, sterilisation contributed to more than 70 per cent of contraceptive use. Further, according to NFHS 4, female sterilisation in India continues to be around 37 per cent since 2006, despite health complications and deaths, highlighting the gender inequality in contraceptive use. This could be because of lack of accessibility or awareness of other contraceptive methods and requires immediate redressal.
India has a vast repository of health and demographic data. But such a repository can also be confusing. For instance, contraceptive use data from large-scale surveys show different levels in selected geographies, making planning challenging. These inaccuracies could be due to errors in data collection.
The errors in data collection impact the quality of data, which compromises the survey findings. The quality of these findings is crucial for policy planning to address reproductive health and maternal and child health issues.
Researchers have pointed out that data quality gets affected due to factors like interviewer bias, which leads to incorrect data entry. This often occurs while collecting female sterilisation data, which is impacted by over-reporting women as non-users and reporting current female non-users as cases of hysterectomy.
The level of the bias has been found to be higher in the states that recorded a decline in mCPR, which reflects that the findings were influenced due to errors in data collection. Also, there is difficulty in distinguishing between methods like sterilisation and hysterectomy for some interviewers, which leads to incorrect reporting.
Research shows that state-level decline in the utilisation of mCPR and decline in sterilisation acceptance could lead to a reduction in the use of mCPR.
There is a need to address data quality issues and introduce technological interventions in data collection, training, and capacity-building of survey officials. The role of the National Data Quality Forum (NDQF), a multi-institutional initiative hosted by Indian Council of Medical Research (ICMR) becomes crucial when it comes to addressing the gaps between data collection and analysis and using that data for advocacy and policymaking.
NDQF aims at improving data quality for better and efficient research, identify discordance and errors, and establish protocols and good practices for improving data quality. NDQF plans to create an integrated platform to share new ideas, develop advanced techniques with the use of Artificial Intelligence (AI) and technology, for improving data quality in health and demographic research for effective policy planning.
There is a need to promote forums like NDQF to reduce the errors in data collection and bring together the brightest minds for developing robust data quality frameworks. Further, the onus should be on making data collection inclusive of people, choice, agency, awareness, and decision-making. It is also crucial to address women’s reproductive rights.
According to NHFS 4.36 per cent females and only 0.3 per cent males underwent sterilisation which showcases the level of the disparity. With male sterilisation on rapid decline, Ministry of Health and Family Welfare released the National Health Policy 2017 which aims uptake of male sterilisation to 30 per cent. Therefore, the focus should be on improving data for identifying the issues in contraceptive use and addressing gender inequality in SRHR in India. The ICMR-NIRRH Mumbai has taken this up as a priority area of research.
This article first appeared in The Indian Express under the headline The Right Count
The writer is director-general, Indian Council of Medical Reseach
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