SRHR in India: Progress, Gaps, and the Road Ahead

The International Day of Action for Women’s Health is back again with the theme, “ In Solidarity We Resist: Our Fight, Our Right!”  

In Solidarity We Resist: It reminds that women in India and globally are not alone in their fight against sexual and reproductive health and rights (SRHR) 

Our Fight, Our Right emphasizes access to quality healthcare and the right to make informed health decisions, a basic human right. The struggle for SRHR goes beyond health. It is a fight for justice and equality. Every girl and woman deserves to live with dignity, health, and the freedom to make choices about her own body. 

Progress Achieved

Over the past few decades, awareness among people about using contraception and menstrual hygiene has resulted in reduced maternal mortality rates. 

• Improvements in mental health: India’s mindful steps toward ensuring women lead healthier and more empowered lives have been reflected in a 70% decrease in the maternal mortality rate (MMR) between 2000 and 2020, reaching 97 per 100,000 live births. 

This brings India closer to achieving the Sustainable Development Goal (SDG) target of reducing the maternal mortality rate (MMR) below 70 by 2030.

State-wise Sustainable Development Target

Kerala (20)

Maharashtra (38)

Telangana (45)

Andhra Pradesh (46)

Tamil Nadu (49)

Jharkhand (51)

Gujarat (53)

 and Karnataka (63)

• Increase in Institutional Births: Notably, a 79% to 89% increase in the percentage of women delivering in health facilities between 2015-2016 and 2019-2021 indicates improved access to maternal healthcare services. 

• Fertility Rate Decline: The decline in India's fertility rate to 2.0 between 2019 and 2021 is a positive sign. It indicates better education, access to healthcare, and family planning, especially in urban areas. However, the drop below the replacement level raises concerns due to an aging population and future workforce shortages. Hence, Balanced demographic planning is crucial for long-term sustainability. 

• Introduction of New Contraceptives: Two new methods for birth control were introduced by India- single rod subdermal implant and a subcutaneous injection- in states like Odisha and Rajasthan, offering women more choices in family planning.

Persistent Challenges

India continues to face persistent challenges, such as regional disparities, with states like Bihar and Uttar Pradesh still recording high Total Fertility Rates (TFRs). Additionally, gender inequality, healthcare problems in rural areas, and socio-cultural norms continue to hinder uniform progress. These issues must be addressed to ensure sustainable population health and equitable development across the nation.

• Child Marriage is more common among uneducated women, with 46% married before 18, compared to 3% among those with above secondary level education. Research reveals that 23% of Indian women aged 20 to 24 were married before the legal age of 18. The problem is entirely linked to education levels. Lack of education makes them prone to early marriage, which can act as a powerful tool in safeguarding girls and enabling informed life choices.

• Limited Access to Comprehensive Sexuality Education (CSE): Approximately 15% of young people aged 15–24 have been exposed to sex education in India. Many Indian states still do not approve of sex education, and teachers often avoid the topic due to embarrassment.

• Use of Contraceptives Among Adolescents: Only 10% of 15 to 19-year-olds have used a modern contraceptive method. 

• Gender-Based Violence: Women and girls with disabilities experience up to 10 times more gender-based violence compared to women without disabilities. This is a significant issue. 

The Road Ahead

To bridge the existing gaps in SRHR:

1. Expansion of Comprehensive Sexuality Education: Age-appropriate and culturally sensitive Comprehensive Sexuality Education (CSE) should be implemented across all states. This can empower young girls and boys with knowledge about their sexual and reproductive health. 

2. Strengthened Law Enforcement: Enforce child marriage laws rigorously and establish robust support systems for those affected by child marriage. 

3. Enhance Accessibility to Contraceptives: Adolescents and marginalized communities should be made more aware of diverse contraceptive methods. 

4. Address Gender-Based Violence: Implement targeted interventions to protect vulnerable groups, including women with disabilities, from gender-based violence.

5. Infrastructure Strengthening: Improving healthcare infrastructure is a crucial approach to decreasing maternal mortality rates. Investment in medical facilities and personnel training enhances the quality of maternal healthcare services. Multiple steps have been implemented to strengthen healthcare infrastructure, such as: 

• Comprehensive abortion care services (CACS) are strengthened. 

• Delivery points have been enhanced. 

• First referral units have been established by ensuring access to blood storage facilities, an adequate workforce, and effective referral linkages. 

• Establishment of maternal and child health (MCH) links aims to enhance the quality of care provided to mothers and their children. 

• Obstetric ICU/HDU units are being made operational in high-case-load tertiary care facilities across India to manage complicated pregnancies.

Call to Action!

Government bodies, civil society organizations, educational institutions, and communities must collaborate to achieve comprehensive SRHR in India. This can be done by prioritizing education, healthcare access, and legal protections, ensuring that every individual, regardless of their caste, color, and background, has the right to make informed decisions about their sexual and reproductive health. 

Care from Redcliffe International Day of Action for Women’s Health

Redcliffe Labs has launched several campaigns and services to empower women to prioritize their health. 

• "For The Women, By The Women" Campaign focuses on raising awareness and empowering women to take charge of their health. It comprises over 220 health camps exclusively for women, offering access to essential health screenings and information. 

• Femcliffe Diagnostic Platform: Redcliffe Labs introduced Femcliffe, India's first she-centric diagnostic platform for various life stages. It aims to shift perceptions and encourage women to prioritize timely testing and routine checkups as integral parts of self-care.

• Women's Health Packages: Recognizing the importance of regular health screenings, Redcliffe Labs offers specialized packages tailored to women's health needs. These packages include tests for thyroid function, anemia, arthritis, breast cancer screening, blood pressure monitoring,  sexually transmitted diseases (STDs), and fertility assessments. 

These initiatives align with the broader goals of the International Day of Action for Women's Health, accentuating the need for accessible and comprehensive healthcare services for women.