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Improving reproductive health in India

Mar 08, 2010

Pathfinder International’s working paper A Reproductive Health Communication Model That Helps Improve Young Women’s Reproductive Life and Reduces Population Growth with the help of Bihar's case study shows how community-focused interventions can help to increase age of marriage, provide better access to RH services, and reduce population growth.

A Reproductive Health Communication Model That Helps Improve Young Women’s Reproductive Life and Reduces Population Growth: The Case of PRACHAR from Bihar, India

Publisher: Pathfinder International, January 2010

India, a country with over a billion people and geographically diverse levels of social and economic development, has achieved a medium-low level of fertility. Although fertility has declined remarkably in many states, it remains at a high medium level in others: most notably, the states of Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh (UP), collectively known as BIMARU. Persistent, high fertility in BIMARU, especially Bihar and UP, threatens the progress made to date towards reducing population growth nationally, given that BIMARU is home to over 40% of India’s population.

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Multiple challenges threaten progress made in population and reproductive health. Early childbearing, associated with the practice of early marriage, leads to adverse RH consequences. Short pregnancy intervals contribute to chronic, high infant and child mortality rates. Inequity in the utilization of RH/FP services, particularly in the northern states, keeps contraceptive prevalence low and fertility high. Finally, the population continues to grow due to population momentum brought about by the large population of youth as they reach reproductive age.

This report shows how a RH communication model can help many states in India address the above challenges. The model was developed and tested by Pathfinder International in three districts of Bihar during 2002-2008. The model, known as PRACHAR, provides RH information to adolescents and young couples, their parents, in-laws, and influential community members, creating an enabling social environment conducive to innovative ideas that improve health and quality of life.

(The word “PRACHAR” in Hindi means: “to let people know” or “to disseminate.”) While activities facilitate improved access to RH services, the model does not require direct RH service provision. Details of interventions and evaluation methodology related to PRACHAR are described elsewhere.

The projections show that Bihar state, with a population of 91 million in 2005, can be expected to have a population of about 144 million in 2025 with existing RH/FP programs. However, if the PRACHAR model is implemented, the estimated population would be 121 million in the year 2025—23 million fewer, the equivalent of an Indian state the size of Punjab.

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