DISASTROUS POLICY OF INJECTABLE CONTRACEPTIVES FOR RURAL INDIA
Shree Mulay
The decision of the Health Ministry of India to support injectable contraceptives in rural India is fraught with serious health risks.
The Union Health Minister Ghulam Nabi Azad announced on November 19, 2010 that injectable contraceptives will be covered by the National Rural Health Mission (NRHM) in India. This is a blow to women health Advocates in India who have long resisted the introduction of injectable contraceptives like Net-En and Depo Provera, and implants like Norplant because many studies demonstrate the harmful effects of these contraceptives.
These effects include adverse effects on the heart, bone density and the liver and more importantly many women stopped ovulating altogether making them infertile. Clinical Acceptability trials conducted by the Indian Council of Medical Research (ICMR) and World Health Organization (WHO) on the Net-En and Depo-Provera, respectively, showed that women stopped using these contraceptives in large numbers within two years (43% and 75%, respectively) because of the serious side effects caused by them.
An important reason for objecting to the injectables and implants by health advocates was that these contraceptives were provider-controlled and women could not discontinue them at will. In the case of Norplant, once the implants are placed in a woman, they cannot be readily removed and they last for five years! The health status of poor women I rural India is already poor therefore the additional risks will make matters worse. These contraceptives should never have been introduced and they should be withdrawn from the public health system altogether.
(Shree Mulay is the Vice-Dean of Community Health and Humanities at Memorial University, Newfoundland, Canada)