By Rupesh Dutta

New Delhi, Sep 25 (IANS): As the government continues to push for new methods of contraceptives to boost family planning, West Bengal and Meghalaya have so far witnessed the highest decline in Total Fertility Rate (TFR) and also an increase in adoption of modern contraceptive methods such as oral pills and IUDs against sterilisation, says official data.

The National Family Health Survey (NFHS)-4 (2015-16), released for 16 Indian states, reveals that Meghalaya recorded a TFR of 3 from the 3.80 recorded during NFHS-3, a decade earlier for 2005-06. West Bengal has witnessed a fall in TFR from 2.30 during NFHS-3 to 1.80 in NFHS-4.

TFR is the number of children who would be born to a woman (per 1,000 women) if she/they were to pass through the childbearing years bearing children according to a current schedule of age-specific fertility rates.

Among other states, Maharashtra witnessed a TFR of 1.90 during NFHS-4 from 2.10 during NFHS-3, while Karnataka witnessed a TFR of 1.80 from 2.10 over the decade.

The data also shows that West Bengal and Meghalaya are among the states which have seen the highest adoption of condoms, IUDs and oral pills, and also a welcome decline in sterilisation, a terminating contraception method that is full of complications, including internal bleeding, infection or damage to other organs.

"The results of West Bengal and Meghalaya can set an example and play the role of catalyst for other states. This shows that now people have started moving for spacing methods, which is always convenient. Using the statistics of these two states the Indian government can actually intensify its family planning initiatives," Poonam Muttreja, Executive Director of Population Foundation of India, told IANS.

The NFHS has also reported a sharp decline in numbers of women aged 20-24 years who were married before they were 18.

Meghalaya and West Bengal, besides a few more states, have recorded the highest fall in this category -- from 24.5 per cent to 16.5 per cent and 53.3 per cent to 40.7 per cent respectively, in the last decade.

In the usage of contraceptives, Meghalaya witnessed 7 per cent increase in oral pills usage at 11.70 per cent during NFHS-4 from 5 per cent earlier.

West Bengal witnessed almost 9 per cent increase in usage of oral pills, from 11.70 per cent in NFHS-3 to 20 per cent in the latest data.

However, the increase is absent in some of the bigger states where the government's family planning incentives have been intensified over the years. Tamil Nadu has seen no progress in oral pills usage -- with 0.20 per cent recorded both in NFHS -3 and -4.

Uttarakhand has reported poor response - with the usage of oral pills declining from 4.20 to 3.20 per cent in the current data.

In the usage of condoms, West Bengal has seen a rise - at 5.90 per cent in NHFS-4 from 4.30 during NFHS-3.

States like Bihar have seen a decline in usage of condoms from 2.30 per cent to 1 per cent, while Maharashtra has see a rise from 6.20 per cent in NFHS-3 to 7.10 per cent in the latest data.

M.C.A Mishra, Director AIIMS, told IANS: "It is heartening to witness that in Meghalaya and West Bengal, there is significant increase in use of non-sterilisation methods. But it is worrying to see such a trend missing in states like Bihar and other larger states."

"Focus should be on use of barrier methods and/or contraceptive pills. Among the pills, Saheli (Centchromen) is non-hormonal, indigenously developed. It is effective and low cost," he said.

Sterilisation, which until some decades ago was the most preferred method of contraception, has seen an overall drastic decline almost in all states.

Sterilisation of women in Meghalaya in NFHS-4 was 6.20 per cent from 9.50 per cent in NFHS-3, while the figure for male steriliation is nil in the last one decade from 0.10 per cent in NFHS-3.

In West Bengal, sterilisation among females has fallen from 32.20 per cent to 29.30 per cent in the last decade, while among males it dipped to 0.10 per cent from 0.80 per cent in same period.

Female sterilisation in bigger states like Madhya Pradesh and Karnataka also fell from 44.30 per cent to 42.20 per cent and 57.40 per cent to 48.60 per cent respectively in the last one decade.

Medical science says that fall in female sterilisation is a good sign because if the operation fails, it may increase the risk of ectopic pregnancy (when a fertilised egg implants outside the womb, usually in a fallopian tube).

The sterilisation operation is difficult to reverse. Female sterilisation doesn't protect against sexually transmitted infections (STIs), so doctors recommend condom usage.