On the happy occasion of the Consortium on National Consensus for Emergency Contraception in India, may I have the pleasure to convey my cordial greetings! May this National Consortium be a great success.
Since the International Conference on Population and Development, (ICPD) Cairo, Egypt, 1994, an international consensus on the definition of sexual and reproductive health has been achieved. The ‘paradigm shift’ away from exclusive family planning and population control to a holistic concept of reproductive health could be considered the greatest achievement of ICPD. One good example of this shift is the India’s new Reproductive and Child Health Programme launched by the Indian Government in 1997, with the aim of providing comprehensive, good quality services, planned and monitored in a participatory and decentralized manner. Fertility regulation is still the key component of reproductive healthcare service package, however, fertility regulation must be considered as an integral part of the broader concept of reproductive health.

Inspite of the increase of contraceptive prevalence over the past 30 years in Asia, there are still large segments of the Asian population, including the Indian population, whose fertility regulating needs are not met by the currently available methods and services. The consequences of this unmet contraceptive needs are dramatic in terms of avoidable ill-health and loss of life. The causes of unmet contraceptive needs are multiple and include technology issues (limited or inappropriate choice of available methods and fear, or experience of side-effects); barriers to access to service delivery (cost, distance, legal and regulatory issues); poor quality of services (client-provider interactions, technical competence of providers, inadequate information, poor design and management of service delivery system); and broader social issues (people’s lack of knowledge, socio-cultural, religious and gender barriers, power imbalances within couples and families). We all know that Emergency Contraception methods occupy a uniquely important position in the range of family planning options currently available. They are the only methods couples can use to prevent pregnancy after they have had unprotected sexual intercourse or a contraceptive failure. By making Emergency Contraception more widely available, family planning and reproductive healthcare providers can help reduce unplanned pregnancies, many of which result in unsafe abortions and take a large toll on women’s health. Emergency Contraception also is an essential part of treatment for women who are victims of sexual assault.

At least one important aspect in bringing about significant improvement in sexual and reproductive health will be a better understanding of the complex inter-relationship between society, people, services and technology. The challenge is to use the needs of people as our starting point. Those needs should guide the development of technology and the definition of interventions, including services. The evidence base is important because it enables us to assess what needs to be done, guides us in determining what can be done and permits us to evaluate what has been done in our health systems and health programmes. In a word, we will review and evaluate at this meeting, if there are sufficient evidences indicating Emergency Contraception as appropriate, acceptable, available, accessible and affordable in India. If the answer is ‘Yes’, then decide what we can do for the next step.

As the Area Manager for Asia and the Pacific of our Department, I will do my every effort to promote the collaboration between India and WHO, and I am looking forward to a more constructive and productive co-operation with all of you in the coming years !

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