Sukhi, the oral contraceptive widely used in Bangladesh, has posed a challenge to its Indian counterparts in remote areas of Assam, thereby affecting the birth control strategies.

Thanks to the lack of education among the locals or stigma attached to the use of birth control pills, which are distributed free of cost in government hospitals across Assam. People particularly in the remote areas along the Indo-Bangladesh border in Assam are seen procuring the Sukhi pills at higher than its price than accepting the Indian ones which are distributed free by the government of Assam.

“There is nothing wrong in the composition of Sukhi pills. But people should not use it as it is not certified by our government. Since the pills are smuggled in, it is difficult to ascertain their quality. As Sukhi is not prescribed here, women often use it without any regularity leading to unwanted pregnancies and affecting their health at times,” said Dr. R.K. Talukdar, head of the department of Obstetrics and Gynecology, Gauhati Medical College and Hospital here while speaking at a stakeholders meeting organized by Global Health Strategies, an international advocacy and communication firm, as part of a project in Assam, Bengal, Uttar Pradesh, Bihar, Karnataka and Maharashtra.

“We have Indian certified brand Mala D as oral contraceptive in our hospitals. Those are the safest for our women and distributed free in all the hospitals as well as in primary and community health centres. However, probably due to some kinds of stigma, there is few takes for Mala D,” said Dr. Talukdar.

“We prescribe people to use the contraceptive daily till they want to conceive but the pharmacists ask users to have the Sukhi pills with a seven-day gap which, in many cases, does not serve the purpose and can have an adverse impact on the user's health,” he said.

Unofficial sources, however, claimed that irregular supply of the oral contraceptives in the health centres in remote areas are also a reason for which the people prefers Sukhi, which is sold without any prescription in most of the pharmacies in those areas.

“There is no fixed price for the Sukhi. The pharmacies charge different price from people depending on availability of the smuggled pills,” said a health worker working in Dhubri district of Assam, located along the Indo-Bangla border.

Dr. Takukdar informed that Assam has the highest maternal mortality ratio in the country which is 300 deaths per 100,000 live births compared to the national average of 167 deaths per 100,000 live births. “The modern contraceptive prevalence rate (mCPR) in Assam is only 37 percent compared to 48 percent in India. low contraceptive use leads to higher numbers of unintended pregnancies and unsafe abortions,” he said.

He further said that in Assam the unmet need for family planning is over 14 percent, which indicates that one in seven women who want to space or limit births are not able to do so. “Although men and women are equally responsible, female sterilization remains the preferred method of contraception in Assam at 9.5 percent, while male sterilization is extremely low at 0.1 percent,” he added.