Andrea M. Wojnar, UNFPA India Representative and Country Director Bhutan

Message from Andrea M. Wojnar

We present the United Nations Population Fund (UNFPA) India Annual Report 2023–24 with a deep sense of satisfaction having successfully rolled out the first year of our Tenth Country Programme (CP10) in partnership with the Government of India (GoI). As the world’s most populous country, we wholeheartedly support India’s flagship initiatives towards building a future propelled by the boundless capabilities of its youth and women—a future where men stand as allies, the elderly age with dignity, bodily autonomy is an inherent right, the task of addressing climate change is championed by the resourcefulness of girls and women, and technology serves as a powerful catalyst for unlocking gender equality.

Our deepest gratitude to the Government of India, state governments, esteemed donors, private sector, NGOs/CSOs, think tanks and the communities for the opportunity to partner in the country’s development journey. With a renewed sense of purpose and anticipation, we at UNFPA in India, look forward to continuing this collaboration to realize our shared vision of a more equitable and sustainable future for all.

UNFPA in India

UNFPA focus is in the four programme states of Bihar, Madhya Pradesh, Odisha and Rajasthan. The first year of the CP10 brought new direction, impetus and approach to UNFPA’s initiatives through innovative partnerships with the Government and the private sector, technology-led programming, policy communication, large scale social media advocacy, flagship publications and engagement with youth.

PROGRESS IN 2023

Powered by a rights-based approach and supported by data and evidence, UNFPA’s initiatives are systematically and surely translating to choices for all across the four thematic areas mentioned below. From midwives–‘women in pink’ ensuring safe delivery, to women having more control over their health, young and adolescent people having safe and reliable health information at their fingertips, empowering young girls and women with digital and financial literacy and skills, and encouraging men and young boys to be allies towards a gender equal world.

2023 Highlights

Health of Youth, Wealth of Nation

A G-20 co-branded event that UNFPA co-led with the Ministry of Health and Family Welfare

Health of Youth, Wealth of Nation

India Ageing Report 2023

Published by UNFPA India and the International Institute for Population Sciences (IIPS) to outline elder care challenges and solutions

India Ageing Report 2023

State of the World Population Report 2023

This demographic dynamism positions India as a key player in shaping the future trajectory of global population trends

State of the World Population Report 2023

SDG Financing Gap

UNFPA forged 11 diverse partnerships spanning civil society, Government, academia, and the private sector in India, aiming to advance the ICPD mandate, resulting in the mobilization of 6.4 million USD to enhance sexual and reproductive health, gender equality, and adolescent development across sectors

SDG Financing Gap

Sexual and Reproductive Health and Rights

In 2023, UNFPA supported initiatives to enhance the reach of SRH services, expand the choice of contraceptives, capacitate national midwifery technical institutions and meet the unmet need for family planning in select states.

During the year, UNFPA supported the introduction of two new contraceptives—a subdermal implant and a subcutaneous injection—in the country with technical assistance (TA) to deliver services in two states, Odisha and Rajasthan. This was aimed to offer greater agency to women, especially younger women who can now choose reversible contraception according to their circumstances and preference. Furthermore, in the spirit of the South-South Triangular Cooperation, UNFPA facilitated inter-country visits to Indonesia and Kenya for officials from the MoHFW and four state health departments to understand the nuances of programme management and service delivery of these contraceptives.

To achieve long-term goals for reproductive health, UNFPA supported Odisha and Rajasthan in preparing their Family Planning 2030 roadmaps and facilitated the planning, implementation and review of family planning programmes in all four focus states.

Competent midwives specialising in evidence-based recommended practices can play a significant role in accelerating India’s progress towards the 2030 goal of zero preventable maternal deaths. A well-trained midwife can assist the mother efficiently and respectfully through the birthing process and alleviate the burden on doctors- allowing them to dedicate their expertise to high-risk cases. The two National Midwifery Training Institutes (NMTIs) supported by UNFPA, have developed 23 midwifery trainers ready to operationalise the State Training Institutes. Reliable and accessible SRH services are a core need for the communities and people left behind, especially in the focus states. In these states, UNFPA has, in partnership with respective health departments and donors, undertaken initiatives to transform existing facilities.

Results

Results Recommendations

2

new contraceptives introduced in 2023

Results Recommendations

88%

of health facilities have at least 5 reversible contraceptives available

Results Recommendations

43%

of health facilities offer comprehensive SRH services

Results Recommendations

2

National Midwifery Training Institutes operationalized

Gender and Human Rights

Securing gender and human rights are a priority for UNFPA. The agency works with lawmakers to end harmful practices against girls and women in India and to ensure there are strong legal and remedial responses. Building capacity for gender-sensitive media reporting to create a committed cohort of media allies, and creating ‘Girl-Friendly Gram Panchayats’ to localise SDG-5 (Gender Equality) at the village level are multi-approaches towards gender equality.

UNFPA’s advocacy and capacity building efforts in Rajasthan have prioritized the strengthening of the health sector response to GBV and harmful practices. UNFPA’s efforts elicited a policy commitment from the Government of Rajasthan, which specifically allocated funds (USD 500,000) to improve GBV response. The gender cell established at the Rajasthan Police Academy with UNFPA’s support not only sensitised personnel but also led to better coordination with the Department of Women and Child Development, Panchayati Raj Department and other allied departments.

Even more difficult to track than GBV can be gender-biased sex selection at birth, since the practice takes place in the shadows, often bypassing procedures laid down by law. Over 100 participants from all 33 States and Union Territories were trained on the effective implementation of the Pre- Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 or the PCPNDT Act in a national capacity building workshop in partnership with the MoHFW.

UNFPA’s advocacy in this area has received an encouraging response from the Ministry of Panchayati Raj (MoPR) as well. As a positive outcome at the sub-district and village level, ‘costed response to GBV and harmful practices’ has been included as a parameter to assess the performance of Panchayats’ across the country.

Engaging with the PRIs to create Girl-Friendly Gram Panchayats’ is a scalable intervention that piloted in 2023. The success of this initiative led to its replication across all districts of Rajasthan, which will further expand to Madhya Pradesh in 2024.

Results

Results Recommendations

Project successfully piloted

in Rajasthan’s Sawai Madhopur district

Results Recommendations

128

master trainers to impart digital, financial, and SRH literacy

Results Recommendations

6 million

women in SHGs

Results Recommendations

2,640

PRIs engaged to raise public awareness against exclusionary practices towards girls and women

Bringing Youth Front and Centre

Youth and adolescents are India’s strength; but, to fully realise this advantage, accessible and quality health and information, education and life skills is necessary.

UNFPA underscores its support for national flagship programmes such as the School Health & Wellness Programme and National Adolescent Health Programme, which are dedicated to enhancing the health and well-being of young people. UNFPA plays a crucial role in designing and testing innovative models for Adolescent Friendly Health Services (AFHS), specifically tailored to address the sexual and reproductive health needs of vulnerable groups. Additionally, UNFPA is committed to developing curricula and training modules aimed at building the capacity of young people and key stakeholders. Through evidence-based advocacy and strategic partnerships, UNFPA advocates for increased investment in youth health, recognizing its fundamental significance for sustainable development.

Results

Results Recommendations

769

AFHCs supported to strengthen SRH services in Bihar, Madhya Pradesh, Odisha, and Rajasthan

Results Recommendations

7.8 million

adolescents enabled through LSE, including use of contraceptives, gender equitable norms, and improved mental health

Results Recommendations

1.1 million

adolescents counseled

Results Recommendations

40,000

school teachers trained as Health and Wellness Ambassadors

Results Recommendations

Roadmap outlined

to harmonize curriculum with International Technical Guideline on Comprehensive Sexuality Education (CSE)

Results Recommendations

Just Ask! Chatbot

27.5M views, 2.5M interactions, 2.1M likes, 287.7K shares 287.5K downloads, 23,000 users

Research and Advocacy in Population Dynamics

UNFPA research on population dynamics in India helps in identifying emerging areas of concern for the Government to plan ahead. Apart from supporting several research assignments in population dynamics, UNFPA also directly analysed the data from the National Family Health Survey Round 5 (NFHS-5) 2019–20212 and prepared a series of analytical papers on relevant topics. UNFPA advocated and added to the questionnaire for the ongoing field study for NFHS-6.

The evaluation of the 9th country programme (CP9), 2018-2022, proposed establishing a clearer path from research to policy in the medium run. As a response, the concept of Research for Impact (R4I) Review was recommended in the 10th Country Programme 2023-27. The R4I Review Meetings are designed to help UNFPA engage with eminent scholars, academicians, and researchers from multidisciplinary fields to gain a comprehensive understanding of political and policy processes in India. The review meetings are organized bi-annually and seek advice from experts on various research work in its planning stage as well as share findings in the subsequent meetings.

Results

  • Caring for Our Elders Institutional Responses India Ageing Report 2023

    UNFPA launched the IAR 2023 on 27 September 2023. The comprehensive report, prepared and published in collaboration with the IIPS, reviewed the living conditions and welfare of older individuals in India. The data analyses from the Longitudinal Ageing Survey in India (LASI) of 2017–18, Census of India, Population Projections by the GoI (2011–2036) and World Population Prospects 2022 of United Nations Department of Economic and Social Affairs (UNDESA) offers evidence-based decision support for policy makers. The report covers the challenges, opportunities and institutional responses surrounding elder care in India, as India navigates a demographic shift towards an ageing population.

    Read more

Driving Innovation and Technology

Innovation is essential for UNFPA to deliver at the scale and pace needed to realize the ICPD Programme of Action and achieve the Three Transformative Results by 2030. To enable UNFPA to be fit-for-challenge to achieve the outputs in complex development contexts, UNFPA harnesses innovation to meet the demands of tomorrow and boost its impact, especially for those furthest behind, and leverage opportunities, social capital, funding and technology.

UNFPA prioritizes a rights-based, gender-equitable, and inclusive approach in innovation, engaging the furthest left behind populations and ensuring new solutions address the deepest inequalities and inequities across all contexts. The innovation to address challenges go beyond technology, focusing also on social norms, behavior change, and systems-level innovation for lasting social impact. The developmental issues that UNFPA deals with are often complex and deep rooted in nature. In this context, conventional means of outreach can fall short while fusion of behavior change strategies coupled with digital technologies do better at overcoming hurdles and limitations.

JustAsk! Khulke Poocho! AI Chatbot

JustAsk! Khulke Poocho! AI Chatbot

A safe, personalized and non-judgemental digital engagement platform created using human-centred design (HCD) approach and AI, proved to address the needs of adolescents and young adults to demystify myths and misconceptions around sexual and reproductive health and rights (SRHR) in India. It reached 23,000 users in Madhya Pradesh within four months in July 2023, and holds the potential to scale across the country.

Empowering SHG Women

Empowering SHG Women

600,000 Digi Shaktis in Odisha — through building capacities in digital and financial literacy with its integration in SRHR and gender rights. These Digi Shaktis will reach over 6 million members of their groups in the state giving a true demonstration of what innovative women-led development looks like.

Strengthening Clinical Skills of Midwifery Educators and Midwives

Strengthening Clinical Skills of Midwifery Educators and Midwives

on labour and complication management through state-of-art virtual reality (VR) based simulation training program at National and State Midwifery Training Institutes of India in Rajasthan and Punjab. VR simulation training is integrating clinical protocols and practices aligned to DAKSHATA* Operational Guidelines guidelines of MoHFW, to help midwives develop cognitive skills and prepare them for clinical practice such as labour management.

Enhancing the response to Violence against Women (VAW)

Enhancing the response to Violence against Women (VAW)

with the Department of Women and Child Development (WCD) Odisha. Through implementing a multi-institutional coordination system (built on blockchain technology) between 30 One Stop Centres (OSCs) and 68 Shelter homes for survivors of gender violence. The system capability will enable the institutions to provide systematic and hassle-free services to GBV survivors and has the capability to link other institutions such as police and judiciary in the future.

FINANCIAL UTILIZATION - 2023

Resources Mobilized in 2023

US$ 6.4 million

With thanks to our Donors

  • Bihar State Madrasa Education Board, Government of Bihar

  • Department of Mission Shakti, Government of Odisha

  • Patna Municipal Corporation, Government of Bihar

  • The Norwegian Ministry of Foreign Affairs

  • Bayer AG

  • Bill & Melinda Gates Foundation

  • World Health Organization (WHO)

In-kind support

  • Amazon Web Services (AWS)

  • Laerdal Medical India

  • VerSe Innovation

Download the report