Family planning schemes in india

Different family planning schemes in India

1. National Family Welfare SCHEMES IN INDIA

2. DR. NIRANJAN CHAVAN MD, FCPS, DGO, MICOG, DICOG, FICOG, DFP, DIPLOMA IN ENDOSCOPY (USA) Professor and Unit Chief, L.T.M.M.C & L.T.M.G.H, Sion Hospital National Co-Ordinator, FOGSI Medical Disorders in Pregnancy Committee (2019-2021) Vice President MOGS (2020-2021), Scientific Secretary, AFG (2021-2022) Chairperson, FOGSI Oncology and TT Committee (2012-2014) Chair & Convener, FOGSI Cell Violence Against Doctors (2015-16) Dean and Chairman, Academia of Global Obstetricians and Gynecologists Chief Editor, AFG Times (2015-16) Course Co-Ordinator of 11 batches of MUHS recognized Certificate Course of B.I.M.I.E at L.T.M.G.H (2010-16) Member, Oncology Committee AOFOG (2013-2015) Member, Managing Committee IAGE (2013-17), (2018-20) Editorial Board, European Journal of Gynaec. Oncology (Italy) Course Co-Ordinator of 3 batches of Advanced Minimal Access Gynaec Surgery (AMAS) at LTMGH (2018-19)

3. National Family Welfare Program Launched as National Family Planning Programme in 1952 100% centrally sponsored program First country in the world to launch such a program Family Planning Dept.- created in 3rd Five Year Plan(1961-66) 4 th FYP - integration of Family Planning services with MCH services(1969-74)

4. MTP Act introduced 1971(4th FYP) Name changed from National family planning to family welfare programme .(5th FYP1974-79)

5. Population Growth- India 2 3 .84 2 5 .2 2 7 .89 25.13 3 1 .86 36.1 43.92 1 3 5. 4 121.01 102.7 84.63 68.33 54.81 1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 2011 2019 Source: Census of India/data in crores

6. Objective “Reducing the birth rate to the extent necessary to stabilize the population at a level consistent with the requirement of the National economy”.

7. FAMILY WELFARE PROGRAM Target free approach Voluntary adoption of Family Planning Methods Based on felt need of the community Children by choice and not chance Policy level More emphasis on spacing methods Assuring Quality of services Expanding Contraceptive choices Service level

8. family Welfare services Supply of c on t r a c ept i v es Pregnancy testing kits at health centers Adolescent r e p r od u c t i v e and sexual health services Family Planning including Post partum services Safe abortion and post abortion services

9. Condoms Oral Contraceptive Pill Intra Uterine Devices (IUD) Focus on Post Partum Contraceptives Tubectomy i) Mini Lap Tubectomy ii) Lapro Tubectomy Vasectomy i) Conventional Vasectomy ii) No-Scalpel Vasectomy T erm i nal Methods FAMILY WELFARE SERVICES

10. Bi r th R a te ( I ndia) 1 9 5 1 1 9 6 1 1 9 7 1 1 9 8 1 1 9 9 1 2 1 2 1 1 2 1 8 Source: planningcommission.nic.in/SRS 4 1 .7 4 1 .2 37.2 3 3 .9 2 9 .5 29 21.8 19 .1

11. De a th R a te (India) 1951 1961 1971 1981 1991 1995 2001 2005 2011 2018 Source: planningcommission.nic.in/ SRS 22.8 19 15 1 2 .5 9.8 10 8 .4 7.6 7.1 7. 2 3

12. 1 st FYP “Clinical approach” 2 nd FYP “Target approach” 3 rd FYP “Extension & Education approach” 4 th FYP Post Partum scheme, reduce CBR to 32 5 th FYP N ational Family Planning Programme replaced by N ational Family Welfare Programme , reduce CBR (Crude Birth Rate) to 30 6 th FYP Net Reproduction Rate (NRR) of 1, family size to 2.3 5 Year Plans ”

13. 7 th FYP Spacing methods, community participation and promotion of MCH care 8 th FYP Stress on the involvement of NGOs to supplement and complement the Government efforts. 9 th FYP Stressed on reduction in population growth 10 th FYP Focused on reduction on IMR (Infant Mortality Rate) , decadal growth rate & increased literacy rate .

14. 11th FYP Targets Reduce IMR to 28 and MMR to 1 per 1000 live births Reduce TFR (Total Fertility Rate) to 2.1 Provide clean drinking water for all by 2009 and ensure that there are no slip- backs Reduce malnutrition among children of age group 0- 3 to half its present level Reduce anaemia among women and girls by 50% by the end of the plan Family planning insurance Scheme Jansankhya Sthirata Kosh

15. Objectives Reducing MMR to 100 Reducing IMR to 28 Reducing TFR to 2.1 Providing clean drinking water for all by 2009 Reducing malnutrition among children of age group 0–3 to half its present level Reducing anaemia among women and girls by 50% Raising the sex ratio for age group 0–6 to 935 by 2011– 12 and 950 by 2016–17.

16. 12 th five year plan The experience of Indonesia and Japan shows that, as compared to limiting methods, emphasis on family spacing methods like IUCD and male condoms has had a better impact in meeting the unmet needs of couples. A recent study has estimated that meeting unmet contraception needs could cut maternal deaths by one-third. There is, therefore, a need for much more attention to spacing methods such as, long term IUCD.

17. IUD insertion on fixed days by ANMs (under supervision of LHV for new ANMs) would be encouraged. Availability of MTP by Manual Vacuum Aspiration (MVA) technique and medical abortions will be ensured at fixed points where Mini-Laparotomy is planned to be provided. Services and contraceptive devices would be made easily accessible. This would be achieved through strategies including social marketing, contracting and engaging private providers.

18. Postpartum contraception methods like insertion of IUD which are popular in countries like China, Mexico, and Egypt and male sterilisation would be promoted while ensuring adherence to internationally accepted safety standards.

19. Dimensions of Quality Services User Accessible Acceptable Equitable Privacy& respect Informed choice Provider Appropriate service environment Technical competence Job satisfaction System Efficient Integration of services

20. At Household/ Village Level Services/ Activities H ousehold visits:By ASHAs,ANMs : Counseling FP services (OCPs, ECPs, Condoms) Follow up of IUCD, sterilization & Postpartum clients Referral Community Mobilization Creating Role Models: “Jan Mangal”couples and “ Prerna ’”Scheme by Jansankhya Sthirikaran Kosh in some districts of Rajasthan •“NSV Champion” in Jharkhand

21. At Sub centre Activities/Services Maintaining Eligible Couple Register Counseling and service provision during ANC, PNC & Immunization visits IUCD insertions Follow up services Referral Services Contraceptive supply Support &Supervision of ASHA & AWW Areas to be strengthened Facility readiness according to IPHS standards Training in IUCD (No – Touch Technique) Provision of IEC Materials Supportive supervision by LHV / MO PHC Strengthening Referral

22. At P rimary H ealth C entre Activities/Services All FP services including Tubal ligation (interval & postpartum)& NSV Follow up services Counseling and appropriate referral for couples having infertility Training and supportive supervision of field level staff like ANMs, MPWs& ASHAs Areas to be strengthened Ensuring availability of 24/7Services as per IPHS Ensuring availability of trained personnel in Minilap /NSV/IUCD insertion Fixed Day Static Services for sterilization Regular supply of drugs, equipments & instruments Referral Services

23. AT COMMUNITY HEALTH CENTRE Activities/Services 24x7 specialist services All FP services including Laparoscopic Sterilization services Follow up services Training and supervision of field level staff Regular supply of drugs Diagnostic Services Areas to be strengthen ed Up gradation as per Strengthening of counseling component Rational posting of specialists Operationalize District Clinical Training Centres Fixed Day Static Services for sterilization Strengthening of RKS Management of couples having infertility

24. SCHEMES UNDER FAMILY WELFARE PROGRAMME

25. Family Planning Insurance scheme To encourage people to adopt permanent method of Family Planning Centrally Sponsored Scheme since 1981 to compensate the acceptors of sterilization for the loss of wages Implemented through ICICI Lombard General insurance Company Compensation: (w.e.f-07.09.07) Compensation in case of adverse event (w.e.f. January 1 st , 2009)

26. Death following Sterilization (inclusive of death during process of sterilization operation) in hospital or within 7 days from the date of discharge from the hospital. - Rs.2Iakh. Death following Sterilization within 8 - 30 days from the date of discharge from the hospital.- Rs. 50,000/- Failure ofSterilisation Rs 30,000/-. Cost of treatment in hospital and upto 60 Actual not days arising out of Complication following exceeding steriliza tion operation (inclusive of complication during process of sterilization operation) from the date of discharge .- Rs 25,000/-. Indemnity Insurance per Doctor/ facility but not more than 4 cases in a year.- Upto Rs. 2 Lakh per claim

27. Janmangal Program Started in 1992 for population stabilization and decreasing IMR and MMR Community program To promote use and meet the unmet need of spacing methods Objective Making contraceptives available in rural areas Supporting RCH services 28

28. Benefits Appropriate gap between birth of two children Preventing early pregnancy Decreasing imbalance in sex ratio Pro m ot i ng c o m m u n i c at i on b e twe e n c o u p l e s regarding family planning Selection of Janmangal Couple Sel e c t ed b y female h e a l th wor k er and finalized at PHC level 200-2000 population – 1 JMC 2000 population plus - 2 JMC Rs. 200/- given to each JMC after meeting 29

29. Jyoti Scheme Launched on April 1, 2011 Applicable for females with no male child & 1-2 female child & have undergone sterilization Give preference in health services, education and employment Objective Promote Females as role model for small families Girl child 30

30. Jansankhya Sthirata Kosh National Population Stabilization Fund -registered as an autonomous Society Combination of government and civil society Working to promote innovations Promote initiatives which leverage the strength of different economic and social sectors To reach out needy population groups

31. Santushti Motivate private gynecologists to perform 100 tubectomy /vasectomy, doctors are paid according to already notified compensation rates (Rs 1500 per case) MOU is signed between the district CMHO and private facilities Funding is provided by JSK through the Collector and CHMO Initiated in Madhya Pradesh, Rajasthan and Orissa 64 MOUs and around 1600 sterilization operations .

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