India

© 2006 Rose Reis, Courtesy of Photoshare

Nearly one-sixth (17%) of the world's population lives in India, which occupies only 2.4% of the world's area. One-sixth of India's population is in Uttar Pradesh (UP), the most populous and largest Indian state, with an estimated 166 million people. If UP were a country, it would be the 7th largest country in the world.

The urban population of UP is estimated to be about 35 million or 21%. The most populated cities are: Agra, Aligarh, Allahabad, Bareli, Ghaziabad, Kanpur, Lucknow, Meerut, Moradabad and Varanasi. In 2004-2005, about 31% (11.7 million) of the urban dwellers were poor.

UP has the second highest total fertility rate (3.8) in India and experiences about 1,000 births daily among the urban poor. The unmet need for contraceptives is 22%; 9% for spacing and 13% for limiting births. Contraceptive use is closely related to wealth – 50% of people in the lowest quintile do not use contraceptives.

The country program of the Urban Reproductive Health Initiative in India, called Urban Health Initiative (UHI), is being implemented in six cities in UP: Agra, Aligarh, Allahabad, Gorakhpur, Moradabad, and Varanasi. Successful strategies will be scaled up over time. UHI, led by Family Health International, is a 5-year (2009-2014) integrated family planning (FP) project designed to assist the Government of UP in revitalizing the state's family planning program in urban areas.

UHI will focus its efforts on the lowest and second lowest wealth quintiles promoting spacing methods in an effort to significantly increase contraceptive prevalence rate (CPR) by 2014 in selected cities of UP.

This will be accomplished by:

Developing cost-effective interventions for integrating quality FP with post-partum and post-abortion services,
Improving the quality of FP services for the urban poor with emphasis on high volume clinical settings,
Testing innovative private-sector approaches to increase access to and use of FP by the urban poor,
Developing interventions for creating demand for and sustaining use of contraceptives, and
Increasing funding and financial mechanisms and a supportive policy environment for ensuring access to FP supplies and services for the urban poor.

FHI will provide leadership to ensure successful implementation of activities among the five core partners and six Technical Assistance (TA) partners.

UHI-India core partners	UHI-India TA partners
FHI360	Client Outreach NGO Partners
Care India	Clinical Service Partners
Hindustan Latex Limited Family Planning Promotion Trust (HLFPPT)	Communication Agency Partners
Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU•CCP)	Technical and Management Partners
	Evaluation & Research Partners
	Government Partners

Key Indicators

Total fertility rate (TFR): 3.8 children born/woman

Contraceptive prevalence rate (CPR): 46% of married women in large urban settings in UP using a modern method of contraception

CPR: 63% of married women in the highest wealth quintile using a modern method of contraception

CPR: 31% of women in the lowest wealth quintile using a modern method of contraception

Unmet family planning need: 22% (9% spacing & 13% limiting)

Source: 2005-06 National Family Health Survey (NFHS-3)

For more UP health statistics, see results of the National Family Health Survey, 2005-06.

MLE 2011 Updates

• Held meetings with UHI in the 4 intervention cities on using the baseline data from India, focusing on key city-specific indicators

• Held a workshop with UHI, the Population Foundation of India and Futures Institute on using the baseline data from India to inform program design

• Held joint city- and state-level dissemination events of the India baseline data with government and other key stakeholders

• Completed city-level and multi-city reports summarizing baseline data findings from India

• Held a Monitoring and Evaluation workshop for Monitoring Officers and other staff at UHI

• Presented two posters at the 2011 Population Association of America Annual Meeting:

• Presented four posters at the 2011 International Conference on Family Planning in Dakar:

- Does Women’s Autonomy Influence their Contraceptive Use? A Perspective from the Urban Poor in India
- Gender Sensitive Men Influence Family Planning Use: Evidence from Urban India
- Family Planning Use and Missed Opportunities for Service Provision in Urban Uttar Pradesh, India
- Provider Imposed Restriction to Clients’ Access to Family Planning in Uttar Pradesh, India

• Oral presentation at 2011 ICFP in Dakar:

- Using the Theory of Normative Social Behavior (TNSB) to Understand Women’s Use of Modern Contraceptive Methods In Uttar Pradesh, India

• Poster presentation at APHA:

- Investigating the Association between Facility-Level Quality of Family Planning Services & Contraceptive Use in Urban Uttar Pradesh, India

• Developed a Joint Monitoring and Evaluation Strategy plan for India in collaboration with UHI

• Conducted analysis for a paper on men’s gender equitable attitudes and contraceptive use

• Discussed and reviewed a cost inputs system for cost effectiveness measures/studies with UHI

• Held multiple MLE/UHI midline evaluation planning meetings in New Delhi, India and Chapel Hill, NC to identify UHI key programmatic questions and to design a midterm evaluation to answer these questions.

• Undertook intensive preparation activities for the midterm survey. These included:

- Identification of in-country research partner
- Managing the contract and budget finalization for the survey agency
- Submitted renewal paperwork for appropriate in-country and US-based ethic review boards
- Working with the survey agency to establish the midterm timeline and determine the structure of the midterm survey roll-out
- Pre-test and finalization of procedures and tools for tracking of longitudinal respondents in the midterm survey
- Held multiple joint survey instrument review meetings with UHI in preparation for the midterm survey
- Adapted draft midterm tools, consent forms and scripts for the midterm survey for household data collection (HH tool, women’s tool) and SDP data collection (facility audit, client exit interview) to be sure they were adequately capturing the key programmatic question identified by UHI

See all MLE activities in India

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