Curbing India's booming population, one mobile phone at a time

To promote development in India, the U.S. aid agency is increasingly pushing small-scale and low-cost innovation in the country.

One of these affordable solutions is Project Vikalp, an integrated family planning e-health care model by the U-Respect Foundation that aims to bring about high contraceptive prevalence rates among India’s populous rural communities. Project Vikalp was among the nine winners of this year’s Millennium Alliance Awards, co-funded by the U.S. Agency for International Development.

The inspiration for the project is India’s old family planning program which does little to curb the country’s booming population of almost 1.3 billion, says U-Respect Foundation President Arundhati Char.

“India’s contraceptive prevalence rate today is around 56 percent, of which 38 percent are mostly female sterilization users. Couples are still hesitant to talk about contraceptives or purchase a pack of condoms or a strip of oral contraceptive pills. Women still face many barriers to contraceptive access and use,” Char told Devex. That is why, she added, U-Respect Foundation has set in motion Project Vikalp to usher in vital reforms to the national family planning program.

Here are a few excerpts from our conversation with Char her organization’s award-winning project, named after the Hindi term for “alternative.”

What makes Project Vikalp stand out among other grassroots innovations in India?

Project Vikalp introduces significant innovations to family planning in a way that couples can retain their confidentiality yet get complete information about family planning and contraceptives — and sources of contraceptives and reproductive health services — without feeling intimidated. It leverages on the widespread use of mobile phones in rural communities. It also enables easy tracking of first-time users, switchers between methods or discontinuers of contraceptives, allowing program planners to tweak their strategy in counseling couples towards a more effective family planning program.

The innovation takes a triangulation approach – contraceptives, a toll-free mobile helpline, and local health care providers/on-field community consultants for support functions.

What are some overlooked development problems in India which could benefit from Project Vikalp?

India’s Ministry of Health and Family Welfare has been implementing the same family welfare program since 1952. India has a well-established rural health setup, with a three-tier referral facility of sub-center, primary health center and community health center. Despite intensive family planning programs, however, the prevalence of reversible contraceptive methods remains low. Family planning programs are skewed towards permanent methods like sterilization.

With less than one percent of men adopting a permanent procedure, the onus of family planning continues to rest with women. For the last decade, the government has tried its utmost to increase the use of reversible methods of family planning, yet the latest National Family Health Survey from 2005-2006 recorded less than 10 percent in users of these reversible methods.

Our talks with rural women and men still indicate a lack of information, myths and misconceptions on the usage of contraceptive methods, as well as limited access to family planning services. Health workers also claim to be overloaded with many administrative reporting and routine home visits for monitoring various health indicators in the areas assigned. They say they do not have the time to counsel couples about available methods of contraceptives.

Most of the time, health workers themselves counsel couples to adopt sterilization. They most certainly do not interact with young unmarried boys and girls in the community, especially for sexual health services. By normalizing discussions on these issues, we are attempting to fill up the gaps that exist in communities, both in terms of changing attitudes and complementing them with products and services.

Have the advantages of mobile technology been adequately exploited in India?

Mobile phones are increasingly affordable and accessible even among the poorest, and also the youth. We believe that mobile technology needs to be leveraged more to achieve better healthcare, specifically family planning and reproductive health in this case.

Although the use of mobile technology in the development sector is not new, the current innovation of the use of mobile phones towards raising contraceptive prevalence rates has, to the best of my knowledge, not been tried out in India. We will begin with a toll-free helpline number and plan to move on to a full-fledged interactive voice response system very soon.

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