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April 22, 1999

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Hillary Clinton adores the way UP-ites do it (with condoms and pills)!

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Sharat Pradhan in Lucknow

Politics permitting, we feel there is a strong case for celebration in Uttar Pradesh.

Rarely does India's most populous state come in for praise. So when it does, and that too from no less a person than United States First Lady Hillary Clinton, it is party time, right?

Hillary was much impressed with UP's population control project, which is funded by -- nope, this didn't have anything to with it! -- the United States Agency for International Development. At a recent conference on population and development at The Hague, the lady commended the State Innovations in Family Planning Services Agency -- a UP government creation under the Rs 10 billion USAID population control programme -- for the substantial improvement it achieved in reproductive and child health services.

In her address, the first lady singled out a few success stories from different parts of the world, among which one from Kanpur found much prominence.

"I have heard and seen around the world, but I want to end with the story of just one Kanpur-based young girl, Kusum Singh, who was married at the age of 13 to an abusive illiterate husband," said Hillary, "At the age of 15, she realised she had no future. She knew if she were to have any hope at all, she had to stand up for herself.

"When selections for community health workers were held, she stood for selection and she won. But to work in the village, she had to take a courageous step, to walk out of her house. She said the biggest challenge in her health care work was to get other women out of their homes and become more active in the life of their community. First two joined, then four, and before your eyes we became a group, she explains. Now she says she has the capacity to mobilise 250 women to walk towards a healthier life."

Hillary also praised the role of non-government organisations in primary health care and family planning services.

Significantly, SIFPSA has taken major strides in bringing down the family size from six to five in most of the 15 districts that it took up barely four years ago.

Says SIFPSA executive director Aradhana Johri, a dynamic Indian Administrative Service officer with long experience in medical, health and family planning sector: "The difference between what we were doing over the past decades in the name of family planning and what we do today is that besides government machinery, NGOs are playing a key role in placing women at the centre of development and linking development with women's rights and population issues."

She continues, "Unlike the traditional family planning programme where the emphasis was only on sterilisation, here the stress is on overall mother and child health care, besides promotion of the use of contraceptives of all different sorts."

Ever since the project was launched in the country's most populous state, SIFPSA has been involved both in improving maternity and child health services in the government and the NGO sector. Besides funding some 80 NGOs in five districts, the organisation funded the state government too, to the tune of Rs 200 million annually.

An evaluation of SIFPSA activities prepared by an independent agency, Macro International, lauds the organisation for promoting contraceptives.

The number of people using temporary family planning methods like oral pills have doubled in the last four years. This is largely due to the impact of the community-based distribution programmes carried out under the programme, the report pointed out.

Macro International carried out the survey with help from AC Nielsen, a US based research agency, which carried out random interviews of 1300 married women in the 13-49 age group in the districts of Allahabad, Meerut, Moradabad, Unnao and Varanasi between January 2 and 22, 1999. The study showed that 7.2 per cent women were using IUDs, oral pills or condoms -- this was double the prevalence rate of 3.7 per cent in 1995, when the project was undertaken.

The study revealed that the number of users in the 15 districts has risen from 238,000 to 463,000 in the last three-and-a-half years. What is even more noteworthy was that of the 225,000 couples who started using spacing methods, as many as 170,000 began to adopt them only as late as from January 1998.

Claims Johri, "This clearly shows the programme has grown quite rapidly over the past one year. There is every reason that it would pick up in the days to come."

SIFPSA's teething troubles are all over now. Its approach is different and much more pragmatic, leaving the option of choosing the spacing method to the users themselves. And that, Johri says, is the reason for its success.

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