Publication:

Chhaya: a review of India's unique non-hormonal oral contraceptive

Centchroman, which is also marketed as “Chhaya” under the National Family Planning Programme of India. It is the world's only non-steroidal, non-hormonal, once-weekly oral contraceptive. It was first synthesised at the Central Drug Research Institute (CDRI), Lucknow in 1967 and licensed in 1991. Later in April 2016, Chhaya was introduced free of cost into India's national family plaining programme. Despite the safety profile, its uptake remains far below its potential. This review synthesizes the published Indian evidence on the clinical efficacy, safety, acceptability, and programmatic challenges of centchroman as a contraceptive, with an emphasis on the postpartum and post-abortion contexts. A narrative review of peer-reviewed studies, government guidelines, and quality-improvement (QI) initiatives conducted in India was performed. Across the studies, Pearl Index values ranged from 0.2 to 2.0 per hundred woman-years, satisfaction rates reach 77-95%, and delayed or irregular menses is the most consistently reported side effect (8-26%). Access barriers and preference for alternative methods are the leading reasons for discontinuation. QI interventions that emphasize structured counselling and supply-chain strengthening have dramatically increased acceptance rates. Centchroman is a safe, effective, and reversible contraceptive that occupies a unique niche in India's family planning landscape. Programmatic investment in counselling, drug availability, and mHealth support is needed to translate its pharmacological promise into wider use.