New Delhi, India—In its ongoing efforts to reduce maternal and newborn deaths, the Government of India has endorsed the use, nationally, of a Jhpiego-developed family planning learning resource package for health workers.
The learning resource package (LRP), Counseling on Postpartum Family Planning and Postpartum Intrauterine Contraceptive Device, includes a detailed reference manual and trainer’s notebook, along with a counseling kit and flip book for health providers. The package is in both English and Hindi.
The development of the package is part of the government’s decision to reposition family planning as a means to improve maternal and child health and to expand the range of contraceptive methods available to couples in the family planning basket of choices. With more women deciding to give birth in a health facility, the government chose—as one of its strategies—revitalizing postpartum family planning (PPFP) and postpartum intrauterine contraceptive device (PPIUCD) services in the country.
Because family planning services in the postpartum period are a relatively new concept in India, health officials felt a pressing need to provide women with effective PPFP counseling services.
“Effective counseling is a tool that empowers people to seek what is best for them and exercise their right to good family planning care,” says Anuradha Gupta, Joint Secretary, National Rural Health Mission.
The PPFP strategy focused on training facility-based nurses and auxiliary nurse-midwives, as well as appointed counselors, to build their competency to provide quality counseling to women—and their families—who come to health facilities for antenatal care and childbirth.
This initiative was taken to address the high unmet need for PPFP and to capitalize on the opportunity of increased institutional deliveries resulting from the government’s incentive program (Janani Suraksha Yojana). A lack of healthy pregnancy spacing has been a major contributor to maternal and child morbidity and deaths throughout the country. The Indian government has partnered with Jhpiego to provide technical assistance in the revitalization of PPFP—including PPIUCD—across 20 states, with financial support from various donors such as the U.S. Agency for International Development, the Bill & Melinda Gates Foundation and the Norway India Partnership Initiative.
India is committed to achieving Millennium Development Goals 4 (reduce infant and child mortality) and 5 (improve maternal health). In a country of more than 1.2 billion people, the infant mortality rate (IMR) stands at 47 per 1,000 live births; the maternal mortality ratio (MMR) is 212; and the country’s total fertility rate (TFR) is 2.6. The target for 2015, according to the MDGs, is to reduce the ratio of maternal deaths to 109 per 100,000 live births, reduce IMR to 28 and achieve a replacement level of TFR (2.1).[1]
[1] MMR Release, Office of Registrar General, India (7th July 2011)