family-planning-programme for nursing students.ppt

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Review of Family Planning
Programme
Dr. Kiran Ambwani, DC (Family Planning)
10/10/24 1NRHM Review Meeting, Bhopal

TFR in Different States(SRS 2008)
TFR 3.1 & above
1 Uttar Pradesh 3.9
3 Bihar 3.9
2 Meghalaya 3.8
4 Nagaland 3.74 (2005-06)
5 D&N Haveli 3.5 (1999)
6 Rajasthan 3.4
7 MP 3.4
8 Jharkhand 3.2
9 Chhattisgarh 3.1
TFR- 2.6 – 3.0
1 Arunachal 3.03 (2005-06)
2 Lakshadweep 2.8 (1999)
3 Manipur 2.8 (2005-06)
4 Assam 2.7
5 Gujarat 2.6
6 Haryana 2.6
7 Uttarkhand  2.6
TFR – 2.2 – 2.5
1 Daman & Diu 2.5 (1995)
2 Orissa 2.4
3 J&K 2.3
4 Tripura  2.22 (2005-06)
TFR – 2.1 & below
1 Chandigarh 2.1 (2000)
2 Karnataka 2.1
3 Sikkim 2.02 (2005-06)
4 Maharashtra 2
5 Punjab 2
6 Delhi 2
7Andhra Pradesh 1.9
8 H.P. 1.9
9 West Bengal 1.9
10 A& N 1.9 (1999)
11 Goa  1.8 (2005-06)
12 Puducherry 1.8 (1999)
13 Tamil Nadu 1.6
14 Kerala 1.7
10/10/24 2
NRHM Review Meeting, Bhopal

Sl.No. States
TFR (SRS)
Average
Reduction
in TFR
(04-08)
20042005200620072008
ALL INDIA 2.9 2.9 2.8 2.7 2.6 -0.075
1 Bihar 4.3 4.3 4.2 3.9 3.9 -0.10
2 Uttar Pradesh 4.4 4.2 4.2 3.9 3.8 -0.15
3 Rajasthan 3.7 3.7 3.5 3.4 3.3 -0.10
4 Madhya Pradesh 3.7 3.6 3.5 3.4 3.3 -0.10
5 Jharkhand 3.5 3.5 3.4 3.2 3.2 -0.08
6 Chhatisgarh 3.3 3.4 3.3 3.1 3.0 -0.08
7 Orissa 2.7 2.6 2.5 2.4 2.4 -0.08
AVERAGE PER ANNUM REDUCTION IN TFR IN LAST 4 YEARS -0.10
TFR - Declining Trend

While some states have achieved replacement
level fertility, others will take many more years
Source: Registrar General of India, 2006 (Population Projections for India and States 2001 – 2026
11
th
FYP Goal
Total Fertility Rate
2.1 by year 2012
10/10/24
4
NRHM Review Meeting, Bhopal

Source: DLHS-3 (2007-08)
Spacing
methods
8%
Limiting
method
13.5%
Total Unmet Need
Total unmet need
21.5%
Unmet Need
Current use of Family Planning
Methods
10/10/24 5NRHM Review Meeting, Bhopal

Trends in Modern Contraceptive
Prevalence-Overall
6
65.3
61.1
60.9
60.9
57.657.553.9
53.052.9
47.0
37.7
35.7
30.8
28.2
28.1
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
DLHS-III DLHS-II
10/10/24 NRHM Review Meeting, Bhopal

Unmet Need for Family Planning-Total
7
8.5
11.6
15.8
15.9
16.8
17.9
19.3
19.419.8
20.9
24.0
27.0
33.8
34.7
37.2
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
50.0
DLHS-III DLHS-II
Meeting unmet need of FP will avert nearly35,000 Maternal and
12 lakhs infant deaths.
10/10/24 NRHM Review Meeting, Bhopal

Source: DLHS – 3, 2007-08
In most states, In most states,
approximately approximately
1/3 of all births 1/3 of all births
are occurring are occurring
less than two less than two
years years apartapart
Spacing between Children
10/10/24
8
NRHM Review Meeting, Bhopal

Source: DLHS-3 (2007-08), IIPS Mumbai
Delaying Age at Marriage reduces population momentum
Early Age at marriage – A Challenge in HF States
10/10/24
9
NRHM Review Meeting, Bhopal

Source: DLHS-III
Percentage of teenage girls in India who are pregnant or already mothers
Teenage Pregnancies pose a higher risk of maternal and infant
mortality and morbidity.
Age at First Child birth
10/10/24 10NRHM Review Meeting, Bhopal

Gap between ELA & Performance in Sterilization
10/10/24 11NRHM Review Meeting, Bhopal

Name of the
State/UT
Estimated Couples
exposed to Higher Birth
Order of 3 & 3+ (in
000's)
Sterilisation per 10,000
unsterilised couples
exposed to higher order of
birth 3 & 3+
(March 2009- April 2010)
Bihar 6,632 469
Uttar Pradesh 14,822 319
Madhya Pradesh 3,165 1,296
Rajasthan 3,636 946
Jharkhand 2,054 551
Chhattisgarh 1,083 1,587
Orissa 1,600 728
Uttarakhand 416 586
Tamil Nadu 1,096 3,187
Andhra Pradesh 1,111 10,292
•Averting 50% of higher order births will bring down Birth Rate by
about 4 points.
•This will also help in reducing MMR and IMR.
Higher Order Births(3&3+) – 40% of total births in India
10/10/24
12
NRHM Review Meeting, Bhopal

Strategies
1.District level action plans to achieve ELA
(appoint nodal officer for FP for planning implementing,
monitoring, supervision and evaluating)
2.Fixed Day Static Services till PHC Level: (PRIORITIZE as per
DELIVERY LOAD)
 One Minilap/One NSV Provider at each PHC
 One trained IUCD provider at each Sub centre

3.Postpartum Centers at all facilities, where deliveries are
conducted (Counselor / Trained Minilap Service Provider)
4.Promote minilap over lap. sterilsiation as the preferred
mode
5.Encouraging Male Participation by concerted IEC for NSV
10/10/24 NRHM Review Meeting, Bhopal 13

Strategies Contd…
5. Accreditation of Private Providers: (to increase the
pool of service providers)
6.Promoting IUCD 380 A: as a safe, effective and long
term spacing method
7.Rational Training and Placement plan for Service
Providers
8.Demand generation
(IEC/BCC) activities: communication Strategy focusing
on specific issues like delaying age at marriage, age at
first child, spacing, male participation
9.Monthly Review of FP performance with CMOs
10. Rank and Reward districts
NRHM Review Meeting, Bhopal 14

World Population Day (11
th
July) – 2010
•Slogan
•Population Stabilisation Week (11
th
to 17
th
July)
•Family Health Mela : 2 days’
–In each district/ each parliamentary constituency
–Inauguration by/Presence of local MPs/MLAs/other
elected representatives
–Stalls for Exhibition of FP methods, counseling etc.
10/10/24 NRHM Review Meeting, Bhopal 15
Chhota Parivar : Samagra Vikas
(small family: overall development)

State level activities
•Detailed instructions to District
Magistrates
•Allocate fund at approved rate to
districts/ blocks (from IEC head of RCH
flexipool)
•Broad implementation plan for state/
district level
•Instruction to district CMOs
•Orientation of district CMOs, DMOs, DPMs
10/10/24 NRHM Review Meeting, Bhopal 16

District level activities
•Mobilisation of eligible couples to participate in
the mela
•Identification of district/ block level centres for
services by name
•Deputation of service providers’ team by name
to designated centres for the whole week
•Communication of district/ block ELAs
•Enlisting of clients by ASHAs and ANMs
•District media plan (suited to local situation)
•Beat of mobile vans to reach every village
•Utilising the local NGOs, where available
10/10/24 NRHM Review Meeting, Bhopal 17

Thank you
10/10/24 NRHM Review Meeting, Bhopal 18