Family planning programmes & National Commitments FP2020

It includes the family planning programmes, national commitments and the role of community health nurse in family welfare services.

1. Family Planning Programmes and 2020 Made by – Chetna Bhatt IVth year Roll No. 38 about history scope aspects couples elements

2. history scope aspects couples elements According to the World Health Organization (WHO) Family planning is defined as “ the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births . It is achieved through use of contraceptive methods and the treatment of involuntary infertility” (2018) about

3. history scope aspects couples elements about An expert committee defined an described family planning as follows : Family planning refers to practices that help individual or couples to attain certain objectives : To avoid unwanted births To bring about wanted births To regulate the intervals between pregnancies To control the time at which birth occurs in relation to the ages of the parent To determine the number of children in the family

4. history scope aspects couples elements The Ministry of Health and Family Welfare is the government unit responsible for formulating and executing family planning in India. An Inverted Red Triangle is the symbol for family planning health and contraception services in India. about

5. history scope aspects couples elements In 2017, Ministry of Health and Family Welfare launched Mission Pariwar Vikas , a central family planning initiative. The key strategic focus of this initiative is on improving access to contraceptives through delivering assured services ensuring commodity security accelerating access to high quality family planning services. It’s Overall Goal is to reduce India's overall fertility rate to 2.1 by the year 2025 The two contraceptive pills to be made freely available to all government hospitals : MPA ( Medroxyprogesterone acetate) under Antara program Chaya (earlier marketed as Saheli )   about

6. history scope aspects couples elements about Family planning program benefits not only parents and children but also to society and nation, by being able to keep the number of new births under control allows for less population growth. With less population growth this will allow for more resources towards those already existing in the Indian population, with more resources comes longer life expectancy and better health.

7. about history scope aspects couples elements about 1951 THE DRAFT OUTLINE OF FIRST FIVE YEAR PLAN RECOGNISED “POPULATION POLICY 1952 LAUNCHING OF THE FIRST NATIONAL FAMILY PLANNING PROGRAMME IN INDIA 1961-1966 EXTENSION EDUCATION APPROACH INTRODUCTION OF IUD INTEGRATED APPROACH WAS ADOPTED IN 1966 1969 SOCIAL MARKETING FOR CONDOMS WAS INTRODUCED LIPPES LOOP WAS INTRODUCED T I M E L I N E

8. about history scope aspects couple elements about 1969-74 FAMILY PLANNING SERVICES UNDER PHC ALL INDIA HOSPITAL POSTPARTUM PROGRAM MTP ACT , 1971 1975-80 FAMILY PLANNING TO FAMILY WELFARE PROGRAMME COMMUNITY INVOLVEMENT CHILD MARRIAGE RESISTANT ACT 1978 1980-85 STRENGTHENING OF MATERNAL AND CHILD HEALTH STRENGTHENING FAMILY WELFARE 1985-90 FURTHER INCLUSION OF VARIOUS PROGRAMS UNDER MCH. T I M E L I N E

9. about history scope aspects couples elements about 1992-97 REVIEW OF SAFE MOTHERHOOD COMPONENT OF CSSM CHILD SURVIVAL AND SAFE MOTHERHOOD PROGRAMME 1997-2002 REPRODUCTIVE AND CHILD HEALTH (RCH) 2002-07 RCH WAS LAUNCHED WITH FEW MODIFICATION AFTER EVALUATING RCH 1 2007-12 ELEVENTH PLAN T I M E L I N E

10. about history scope aspects couples elements The proper spacing and limitation of birth Advice on sterility Education for parenthood Sex education Screening for pathological condition related to reproductive system Genetic counseling Premarital consultation and examination Carrying out pregnancy test Marriage counseling The preparation of couple for the arrival of their first child Provide services for unmarried mothers Teaching home economies & nutrition Providing adoption services Family planning is not synonymous with birth control ; it is more than mere birth control . A WHO expert committee (1970) has stated that family planning include in its preview

11. about history scope aspects couples elements 01 02 Women Health Maternal Mortality Morbidity of women of childbearing age Nutritional status (weight changes, Hb level etc) Preventable complications of pregnancy and abortion Fetal Health Foetal mortality (early and late foetal death) Abnormal development Infant and Child Health Neonatal, infant and preschool mortality Health of the infant at the birth (birth weight) Vulnerability to disease Health Aspects Of Family Planning 03

12. history scope aspects couples element elements unmeet In order to pin point the couples who are a priority group with in the board definition of eligible couples the term targeted couple was coined. Targeted couples Eligible couples Refers to a currently married couple wherein the wife is in the reproductive age , which is generally assumed to lie between the ages of 15-45 The term target couple was applied to couples who have had 2-3 living children , and family planning was largely directed to such couples .

13. scope aspects couples elements unmeet elements methods Elements of success in family planning programme

14. aspects couples elements unmeet methods elements system It was first explored in 1960s when data from surveys of contraceptive knowledge attitude and practices (KAP) showed a gap between some women's reproductive intention and their contraceptive behavior . Many women who are sexually active would prefer to avoid becoming pregnant , but nevertheless are not using any method of contraception The concept is usually apply to married women. Unmeet need for family planning

15. aspects couples elements unmeet methods elements system Reasons : inconvenient or unsatisfactory services Lack of information Fears about contraceptive side-effects Opposition from husband or relatives Unmeet needs for family planning is higher in rural areas than in urban areas. It also varies by women's education and religion ( Hindu and Christian women have a lower unmeet need than Muslim women)

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20. elements unmeet methods system evaluation elements hum do Delivery System

21. elements unmeet methods system evaluation elements hum do At The Center Level The union ministry of health and family welfare consist of three department which includes : 1) Department of health 2)Department of family and welfare 3)Department of indigenous systems of medicine and Homeopathy. The department of family welfare deals with family welfare matters. The secretary to the Govt. of India in the ministry of health and family welfare is the overall In charge of the department of family welfare

22. elements unmeet methods system evaluation elements hum do 1)The national institute of health and family welfare – An apex level technical institute which serve the following functions to provide health and family welfare in the country. Education and Training Research Evaluation There are national level institution which provided technical help and guidance for promoting health and family welfare program. These are – 2) Central family welfare council : This council is formed of state health Minister. It reviews the implementation of the health and FWP.

23. elements unmeet methods system evaluation elements hum do 4)Cabinet sub-committee – This committee is headed the prime minister and reviews the program of family welfare programme periodically. 3 ) Population advisory council- The council is headed by union health Minister. Members of parliament and person from the field of population control are the members .It was setup in 1982 .Its major function is to analyze the implementation of the programme and advise the government accordingly.

24. elements unmeet methods system evaluation elements hum do At the state level The state governments are responsible for the administration and implementation of the family welfare programme . The organizational setup at the state level consists of a state family welfare bureau , which is part of the state health and family welfare directorate . At present , 25 state family welfare bureau are functioning in the country

25. elements unmeet methods system evaluation elements hum do The set-up consists of a District Family Welfare Bureau consisting of 3 divisions – An administrative division headed by the District Family Welfare Officer Mass education and media division , in charge of District Mass Education And Media Officer An evaluation division , in charge of a Statistical Officer 10-25K Population 25-50k Population >50,000 Population At the district level

26. elements unmeet methods system evaluation elements hum do At the community health CHC is established and maintained by the state governments. Presently it is manned by four medical specialists i.e. Surgeon, physician , gynecologist ,pediatrician , supported by 21 paramedical and other staff . 30 indoor beds with one OT X-ray Labour room Laboratory facilities

27. elements unmeet methods system evaluation elements hum do At the primary heath centre A rural Family Welfare Centre with a medical officer and supporting staff forms integral part of the Primary Health Centre. Each Centre is supported by subcentres. When fully staffed (by 3 medical officers including one lady doctor and supporting personnel) the PHC is expected to provide fairly comprehensive “essential health care” including family planning care. The medical officers are usually trained to provide MTP and sterilization services.

28. elements unmeet methods system evaluation elements hum do At the village level Schemes are being implemented at the village level to improve the outreach of services and increase local participation . The Village Health Guides : are made responsible for spreading knowledge and providing them with supplies of Nirodh and Oral Pills Trained Dais : they conduct safe delivers in rural areas . They act as family planning , counselor an motivators . ASHA : the VHG , TD and ASHAs are the lynchpins of the planning delivery system in India

29. unmeet methods system evaluation hum do Evaluation of Family Planning Evaluation is defined as a “process of making judgments about selected objectives and events by comparing them with specified value standards for the purpose of deciding alternative course of action”. The purpose of evaluation is to improve the design an d delivery of planning services . Five types if evaluation have been defied by a WHO expert committee :

30. unmeet methods system evaluation hum do PERFORMANCE PLANS 2 NEED 1 EVALUATION OF e THAT IS, HEALTH , DEMOGRAPHIC AND SOCIO-ECONOMIC NEEDS FOR FAMILY PLANNING . AN ASSESMENT OF THE FEASIBILITY AND ADEQUACY OF PRAGRAMME PLANS SERVICES RESPONSE COST ANALYSIS OTHER ACTIVITIES

31. unmeet methods system evaluation hum do EVALUATION OF IMPACT 5 EFFECTS 4 CHANGES IN THE KNOWLEDGE , ATTITUDES , MOTIVATION AND BEHAVIOUR. INDICES : FAMILY SIZE B) DESIRED NO. OF ADDITIONAL CHILDREN BIRTH ORDER NO. OF ABORTIONS

32. methods system evaluation hum do  Multiple Indian states have adopted a limited two-child policy. The policies are implemented by prohibiting persons with more than two children from serving in government. The most recent policy to be implemented was by Assam in 2017. Some states have repealed policies; Chhattisgarh introduced a policy in 2001 and repealed it in 2005.A criticism of these policies is that it decreases the number of women in government positions, and encourages sex-selective abortions. As of 2014, there were 11 Indian states that implemented the two-child policy, in hopes to reduce the number of children per family. TWO- Child Policy

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34. FAMILY PLANNING 2020 FP

35. India is one of the principal protagonists in the global FP2020 action plan formulated in 2012. Placed in the context of Government of India’s RMNCH+A (Reproductive, Maternal, Newborn and Child Health and Adolescents) programme, the initiative has been structured to allow for focused intensified efforts to achieve the following FP2020 national commitments through decentralized actions at the state and district levels. FP 2020 INDIA COMMITEMENTS

36. Inclusion of family planning as a central element of our efforts to achieve universal health coverage Increasing financial commitment of Family Planning to more than 2 billion USD (from 2012-2020) Sustaining the coverage of over 100 million women currently suing contraceptives Reducing the unmet need by improved access to voluntary family planning services, supplies and information Expanding the basket of choices and scaling up usage of current methods available

37. Provision of services to all beneficiaries, including adolescents through an integrated RMNCH+A approach Increasing access to contraceptives through community health workers Ensuring healthy birth spacing Strengthening sterilization services through quality service delivery Ensuring quality FP services through updating existing and formulating new standard operating protocols – leading to skilled enhancement of providers and better counseling and monitoring

38. Ensuring availability of free commodities, through strengthened commodity supply system in public health facilities for all eligible couples and adolescents seeking contraceptive services Addressing equity in access to quality services and supply for the poorest and most vulnerable Fostering partnerships with non-government sector for improved service delivery Raising global awareness on the positive impact of Family Planning

39. ROLE OF CHN IN Family Welfare Services

40. Community health nurse has a vast role to play in family welfare services.   Survey work   Collecting demographic facts. Making list of homes and finding out housing location. Collecting information about pregnant mothers, eligible couples, infants and children below the school going

41. Educational Functions And Motivation   Explaining the importance and necessity of family planning to masses. Using various techniques of teaching and communication to propagate the message of family planning to common man. Motivating the eligible couple to use contraceptives and educating them about its uses. Motivating people for family planning operation or permanent contraception.

42. MANEGERIAL FUNCTIONS   1. Conducting Clinics Deciding the date and place of clinics. Arranging equipments and other resources at clinics. Arrangements and distribution of contraceptives. Insertion and removal of IUDS 2. Liaison work Soliciting the co-operation of NGOs/voluntary organization

43.   3. Organizing Family Planning Camps Using various techniques of teaching and communication to propagate the message of family planning to common man. Motivating eligible couples and preparing them for the operation. 4. Maintaining the records Keeping the eligible couple register update. Maintaining the register of sterilization cases, contraceptives users and pregnant mothers. Maintaining other records related to family planning

44. Thank you