Unmet need for reproductive health in India

Using data from the Notional Family Health Survey of 1992-93 and the indivi dual reproductive histories of a cross-section of 70 women from rural Tamil Nadu, this paper exposes the limited extent to which women in India hove b een able to achieve their reproductive intentions and the failure of health services to meet their considerable reproductive health needs. Of the 70 w omen, 69 had been unable to achieve their reproductive intentions, not only non-users of contraception but also ever-users, and all 69 hod on unmet ne ed for reproductive health services. Sterilisation is often the first and o nly method of contraception taken up and only after a series of wonted, mis timed and unwonted pregnancies, miscarriages, induced abortions and neonata l and infant deaths. Women who wanted to have more children than they were able to were also found. Given the paradigm policy shift in India from prom oting fertility reduction only to meeting women's reproductive and sexual h ealth needs, a more useful concept for measuring 'unmet need' for services in programme planning is required, one such cis the HARI index, that would capture the extent to which individual women ore achieving their reproducti ve intentions in good health. Without this, the some problems will only rec ur in younger women.