We are already the second most populous country in the world. The population of India crossed one billion mark last year. While we have made tremendous strides in many fields of development, we have not been able to obtain the desired results in the population stabilization front and if we continue at the present rate, it is expected that we will cross the population of China by 2054 A.D. Although India was the first country in the world to initiate a National Family Welfare Programme in 1951, the programme since the beginning has remained fully voluntary. The main effort of the government has been to provide services on the one hand and to encourage the citizens by information, education and communication on the other, to use such services. The guiding objective of the Family Welfare Programme has remained to stabilize population at a level consistent with the needs of the national development.

With its many notable achievements, the Family Welfare Programme is estimated to have averted about 200 million births upto 1998, but the growth-rate of population has not substantially declined so far.The growth rate of population has not shown substantial decline in the past because even though the birth rate has come down from 41.7 in 1951 to 26 in 1999; the death rate and infant mortality have dropped even more sharply. It is evident that population stabilization strategies will have to meet the diverse needs of different states keeping in view the status of fertility rate, death rate and infant mortality rate by designing policies and programmes to address the particular socio-cultural and economic situation, prevailing in each state. There has to be uniformity in National Population goal but diversity in implemention strategies. A flexible approach is fundamental towards achieving a population policy driven by people’s perceived needs.

Recently, we have seen two very important documents. One published by WHO and the other by the Government of United Kingdom. In the WHO document, healthwise, India has been placed at 112th position. No doubt we object to it, but we must also think, how to improve this as most of the parameters included for classification relate to maternal mortality, infant mortality and quality of health services. The second document published by Government of United Kingdom has a foreword by the Prime Minister of England on alleviating poverty and globalization. In this document, there is a mention that total number of pregnancy-related deaths in India in one week is more than the pregnancy-related deaths in the whole of Europe. Both these publications disturb us and we are thinking about ways of improving it.

With this in view, the National Population Policy 2000 has already been approved. A National Population Commission has been formed under the Chairmanship of the Hon’ble Prime Minister of India. Population Commission has specific action points towards achieving the objectives of National Population Policy. One of the important sub groups constituted by the Population Commission is the group on reducing the unmet needs for contraception. The National Family Health Survey has indicated a huge unmet need for contraception. This indicates that although the women of the country are willing to adopt various methods of contraception, the infrastructure is not in place for them to utilize these, either due to lack of accessibility or availability. Maternal mortality in our country is again very high as compared to the neighbouring countries. The major contributing factor towards maternal mortality is unsafe abortion which is carried out by unqualified health personnel under unhygienic conditions. This indicates that although the women do not want unwanted pregnancy to continue, in the absence of better methods, they have to undergo unsafe abortion. Emergency Contraception which is also called ‘Post-Coital’ or ‘Morning after Contraception’ is an important method available in this context. A woman faced with the prospect of unplanned and unwanted pregnancy can, in many cases, avoid the pregnancy by using Emergency Contraception methods.
In this conference, we are going to decide about who will be the clients for emergency contraception.
Will she be a -

• woman already on pill who has forgotten to take her regular dose,
• woman unwilling to have sex with her husband, but has to succumb to his advances without contraceptive protection,
• woman brutally assaulted by somebody, leading to pregnancy, abortion and death
• young girl, at the height of emotion, succumbing to her boyfriend and then going for an unsafe abortion, or
• those 40-45% women who do not know anything about contraception, but do not want to conceive

We have to decide about the appropriate client.
Second question is how will these clients know about EC. Thus, we have to educate them and simultaneously tell them about regular contraception. Third problem will be how the EC will reach them. You have to think about logistics of supply and then to consider the side-effects and efficacy.

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