Family_welfare_programme.pptx family welfare program

family welfare program

1. FAMILY WELFARE PROGRAM Supriya

2. India, the second most populous country of the world, harbours 17.5% of the world’s population in only 2.4% of the global land mass. Coincidentally it also houses almost 17.3% of the world’s protected couples and 20% of world’s eligible couples with unmet need . India became the first country in the world to initiate the family planning program in 1952 Introduction

3. India launched the National Family Welfare Programme in 1951 with the objective of "reducing the birth rate to the extent necessary to stabilize the population at a level consistent with the requirement of the National economy. Introduction

4. “Family planning means planning by individuals or couples to have only the children they want, when they want them. This is responsible parenthood”. Definition

5. “Family welfare includes not only planning of births ,but they welfare of whole family by means of total family health care. The family welfare programme has high priority in India, because its success depends upon the quality of life of all citizens”. Definition

6. 1951-56: Family Planning Program adopted by Government of India 1St Plan first of its kind in the world. 1961-66: Extension education approach 3rd Plan: Dept. of Family Planning created in Ministry of Health. Created . Target Oriented Approach Lippies loop introduced and Massive effort to promote IUCDs and Condom. 1969-74: Family Planning Services. 4th Plan: Primary Health Centre. All India Hospital posts Partum Program. Medical Termination of Pregnancy Act, 1971 Milestones of Family Welfare program:

7. 1974-79: Campaign for male sterilization 5th Plan: Renaming Family Planning to Family Welfare. Community involvement Child Marriage Restraint Act 1978 1980-85: Strengthening of Maternal and child Health 6th Plan: Strengthening Family Welfare National Health Policy1985-90: Further inclusion of various programs 7th Plan: under MCH 1992- 97: Child survival and safe Motherhood 8th Plan: Program. Milestones of Family Welfare program

8. 1993- 94: National Development Committee Report International conference on population and Development, Cairo, 1994. 1996: Target Free Approach Review of safe Motherhood Component of CSSM 1997-02: Reproductive and child Health RCH 9th Plan: (CSSM Plans STI and RTI Components) 2000: National Population Policy 2002: National Health Policy 2002-07: Planning for RCH- II 10th Plan: 2005: RCH – II Milestones of Family Welfare program

9. To promote the adoption of small family size norm, on the basis of voluntary acceptance. To promote the use of spacing methods. To ensure adequate supply of contraceptives to all eligible couples within easy reach. To arrange for clinical and surgical services so as to achieve the set targets Aims and Objective of family welfare programme

10. Participation of voluntary organizations/local leaders/local self-government, in family welfare programme at various levels Using the means of mass communication and interpersonal communication to overcome the social and cultural hindrances in adopting the programme or extensive use of public health education for family planning. Aims and Objective of family welfare programme

11. The concept of welfare is basically related to quality of life. As such it includes education, nutrition, health, employment, women’s welfare and rights, shelter, safe drinking water-all vital factors associated with the concept of welfare. It is a centrally sponsored programme. For this, the states receive 100 per cent assistance from Central Government. The emphasis is on a child family. CONCEPT OF FAMILY WELFARE PROGRAMME

12. Also , the emphasis is on spacing methods along with terminal methods, The current policy is to promote family planning on the basis of voluntary and informed acceptance with full community participation. The services are taken to every doorstep in order to motivate families to accept the small family norm. CONCEPT OF FAMILY WELFARE PROGRAMME

13. Reduction of birth rate from 29 per 1000 (in 1992) to 21 by 2000 AD Reduction of death rate from 10 (in 1992) to 9 per 1000. Raising couple protection rate from 43.3 (in 1990) to 60 per cent. Reduction in average family size from 4.2 (in 1990) to 2.3. Decrease in Infant mortality rate from 79 (in 1992) to less than 60 per 1000 live births. Reduction of Net Reproduction Rate from 1.48 (in 1981) to 1. G oals of the family welfare programme

14. Nearly 98% of women and 99% of men in the age group of 15 and 49 have a good knowledge about one or more methods of contraception. Adolescents seem to be well aware of the modern methods of contraception. 2. Over 97% of women and 95% of men are knowledgeable about female sterilization, which is the most popular modern permanent method of family planning. While only 79% of women and 80% of men have heard about male sterilization. Impact of family welfare activities

15. 93% of men have awareness about the usage of condoms while only 74% of women are aware of the same. Around 80% of men and women have a fair knowledge about contraceptive pills. Impact of family welfare activities

16. Sterilization Program IUD Programme (Intrauterine Device) Contraceptive Programme Family Planning Insurance Scheme. Janani Surakshya Yojana . Nutrition programme Urban Family welfare programme Urban revamping Scheme Green card Scheme Rural Family Welfare centre Family Welfare programme includes the following activities:

17. Scheme wise activities under FW Directorate:

18. Infant Mortality Rate – 50/1000 Live Births by 2010 Maternal Mortality Ratio – 250/100000 Pregnant Women TFR-2.1 by 2010 (total fertility rate) Full Immunization-100% by 2010 Goal

19. State Family Welfare Bureau: The State Family Welfare Bureau is functioning at State Head quarter as an administrative Unit for implementation of Family Welfare programme in all the districts of the State. District F.W. Bureau (Non-Tribal & Tribal): The District Family Welfare Bureau is one of the key branches functioning in the district health Office under Chief District Medical Officer for implementation of the FW Programme in all districts of the State. A. Central- Plan:

20. Training Of Nurses, Midwives & LHV& Functioning of Sub-Centres: Sub Centres are the base level health institution to implement multiple health activities at the rural and remote areas of the State. Health Worker (Female) and Lady Health Visitors are the accountable Govt. personnel to implement different vertical health programmes. For their training, orientation and time to time improvement, the scheme efficacy in all districts of the State. A. Central- Plan:

21. Revamping Of Urban-slum: In order to provide regular health services. Immunization and other FW activities at urban slums, revamping urban slum scheme is included in the 3 major cities of the state, i.e. Bhubaneswar, Cuttack & Rourkela ( Sundrgarh ). A. Central- Plan:

22. Orientation Training of Medical & Para Medical Staff: Orientation of Basic Health Training programme have been going on RHC, Jagatsinghpur for conducting training of Health Worker (Male) including orientation training programme of Medical Officers and other health functionaries in the State. This scheme is the Centrally Sponsored Plan & 50% Central Assistance is being funded by Govt., of India as Grants-in-Aid. A. Central- Plan:

23. Launched in April 1976 It called for an increase in legal minimum age of marriage from 15-18 for females & From 18-21 for males Policy was modified in 1977 Emphasized on small family norm without compulsion & changed the program title to “Family Welfare Program” Latest is NPP 2000 It deals with women education, empowering women for improved health & nutrition, child survival & health, family welfare services for under-served population, adolescent’s health & education, increased population of men in planned parenthood & environment protection NATIONAL POPULATION POLICY

24. IMR Mission: Due to high IMR in the State, the State Govt. implemented the Infant Mortality Reduction Mission in the State from 15th August 2001 which is functioning effectively in Orissa. The IMRwas91 per 1000 live births in 2001 which has come down to 75 as per 2005 SRS (Sample Registration system). As per the programme of the Mission, referral transport facility was being provided to the pregnant mother for promoting institutional delivery. But after implementation of JSY programme, the mission is providing the mobility support for treatment of puerperal mother and sick infants. This is exclusively a state budgetary programme all districts of the State. B. State-Plan:

25. Navajoti Scheme: The Navajyoti scheme was launched in December 2005 in 14 districts having high IMR. In these selected districts DAIS are being trained to provide safe delivery and home based new born care in home delivery.

26. III . Maternal and Perinatal Death Inquiry – ( MapeDI ): This is a contribution towards reduction of MMR and improvement of maternal health status in Orissa. It also contributes neonatal and perinatal mortality for reduction of child hood deaths, project, but an overarching umbrella integrating all on-going vertical health programmes and addressing issues related to the determinants of health, like sanitation, Nutrition, safe drinking water .

27. To improve availability of and access to quality health care by people especially for those residing in rural areas, the poor, women and children. Stabilize population Make health institutions full functional even at grass root level Reduce IMR to 50/1000 LB by 2010 Reduce MMR to 250/100000 by 2010 Reduce TFR to 2.1 by 2010 Increase institutional delivery Goal of the Mission

28. New Initiatives; under Initiative under NRHM, the components are: ASHA- (Accredited Social Health Activist), Untied Fund at Sub centre level, Upgrading Community Health Centres (CHC) as per Indian Public Health Standard (IPHS), Rogi Kalyana Samiti (RKS), Mobile Medical Unit (MMU), AYUSH( Ayurvedic Yoga Unani Sidha Homeopathy ) Intersectoral Convergence Components under NRHM (National Rural Health Mission):

29. RCH-II is a continuation of RCH-1 programme which is continuing from the year 1997-2005. Objective of the programme is to improve the Reproductive health of men and women and the health of children with the focus to reduce maternal and child mortality and morbidity giving emphasis on rural health care. Goal of the programme is to bring down the IMR to 50/1000 live births by 2010 and MMR to 250/100000 live births by 2010. Activities – Health of Pregnant mother and infant are interrelated. RCH-II – Reproductive & Child Health Programme- II :

30. RCH-II is different from RCH-I in its flexible approach, strengthened management capacity, integrated behaviour change communication, client based quality services, Convergence with other critical sector. Components of RCH-II: Population stabilization Maternal Health New-born care Child Health Adolescent Health RTISTI treatment and control Urban Health; Tribal Health Other priority Areas: Targeting of services, strengthening service delivery, infrastructure and maintenance, supply of drugs and equipment, strengthening of health care providers. RCH-II

31. Maternal Health: Antenatal Care: i. Early Registration of Antenatal cases ii. Fixed Health and Nutrition day iii. Routine Antenatal check-up iv. Malaria Chemoprophylaxis V. Identification of risk factors and timely referral vi. Safe Abortion Services vii. Treatment of Sexual and reproductive Tract Infection RCH-II

32. Intranatal Care: i. Care of Pregnant mother during delivery ii. Janani Suraskhya Yojana (JSY): To promote institutional delivery, pregnant mothers are provided with cash assistance . It involves a co-ordinate care by field workers like ANM, AWW and ASHA . iii. The objective of JSY is to reduce overall maternal mortality ratio, infant mortality rate and to increase institutional delivery in BPL families. RCH-II

33. Under this initiative, eligible pregnant women are entitled to get JSY benefit directly into their bank accounts. Cash entitlement for different categories of mothers is as follows ASHA package of Rs . 600 in rural area& Mother’s package in LPS is Rs 1400 & HPS is Rs . 700 ASHA package of Rs . 400 in urban areas Mother’s package in LPS is Rs 1000 & HPS is Rs . 600 RCH-II

34. iv. VANDE MATARAM SCHEME A voluntary scheme wherein any obstetric & gyneacology Specialist, MBBS doctor can volunteer themselves for providing safe motherhood services SAFE ABORTION SERVICES: •Facilities are provided under RCH phase II •Medical method of abortion •Manual Vacuum Aspiration(MVA)

35. c. Post natal care : As 60% of infant death takes place during 1st month of life, care of mother during and immediately after delivery is vital for safety of mother and as well as infant. The Lady Health Workers, ASHA, are oriented to visit the mother to check up the health of mother and baby, breastfeeding of infant immunization. Birth spacing and Family planning measures, treatment and Reproductive Tract Infections etc. In case some risk factors are identified the mother/infant is referred to public health institution for treatment. There is provision of Rs . 150/- per case as cash assistance for referral of sick neonate under RCH programme . RCH-II

36. Launched in 1992 Integrated all the scheme for better compliance Has following components: Early registration of pregnancy Minimum three ANC check ups Universal coverage of all pregnant women’s with TT immunization Advise on food, nutrition & rest Detection of high risk pregnancies & prompt referral Clean deliveries by trained personnel Birth spacing Promotion of institutional delivery CHILD SURVIVAL AND SAFE MOTHERHOOD PROGRAM

37. The approach was developed by United Nations Children's Fund and the World Health Organization in 1995. It is a systematic approach to children's health which focuses on the whole child & not only focusing on curative care but also on prevention of disease IMNCI

38. Activities – Under IMNCI package: A. Care of new-born and Young Infants (Under 2 months): Three home visits are to be provided by ANM, AWW, and ASHA to every new-born on day 1, 3 and 7. For LBW babies 3 more visits are undertaken. (Low Birth Weight) B . Care of Infants and children (2 months – 5 yrs ): Management of diarrhoea, respiratory tract infection, eye & ear infection, malaria, malnutrition, anaemia and other diseases. Counselling for breast feeding and supplementary feeding Immunization Recognition of risk conditions, management /referrals. IMNCI

39. In this context to address the above problems of Adolescent population specifically to reduce MMR, IMR and Total Fertility Rate (TFR) the Adolescent Reproductive Health is included in RCH-II. Objectives: To increase utilization of Reproductive Health Services by adolescent boys and girls in the state and to develop awareness regarding equity issues in acceptance of available services. Adolescent Reproductive Health

40. Strategies: BCC (Behavioural changes communication): on delayed marriage Care during pregnancy Prevention and treatment of STI Provisos of condoms. Contraceptive Pills, Emergency contraceptive Pills Education on Nutrition Safe abortion services Educate community Self Help Group, PRI ( Panchayatraj institution) members on gender and other RCH issues. To provide easy access to health facilities. Adolescent Reproductive Health

41. Activities: Training of Service Providers, Medical Officers, other health personnel, NCOS. Advocacy at all levels Adolescent Reproductive Health

42. Health problem of Tribal community needs special attention as their unique distinctive culture, habitat isolation and remoteness from the on-going developmental processes of the country has alienated them from the mainstream of health system. 22.3 % of state’s populations belong to Tribal population, which is affected by illiteracy, poverty, superstition, malnutrition, absence of safe drinking water and many other factors. Tribal Health

43. Formation of Village Health Committee, Engagement of ASHA Accredited Social Health Activists) Traditional Birth Attendant to maintain Link between health facility and community. Appointment of 3 Health workers in sub centre having more than 5000 population. Health camps in every Tribal village with population of300, Provision of Mobile Health Units, Provision of Emergency Obstetric Care at block level and Comprehensive Obstetric Care at First Referral Unit level by developing infrastructure and placement of adequate staff. Monthly Swasthya Melas to be conducted by NGOS in every village to address reproductive child health issue. Training and skill development of service providers, Adequate IEC, BCC to empower the tribal women regarding safe reproductive practices . Tribal Health-Activities:

44. Increased no. of child births and lack of spacing between child births have many hazardous effects on the health and nutrition status of mother as well as child. GOI advocates for acceptance of different temporary and permanent FP measures which are easily accepted by educated population like. Family Planning (F.P.):

45. Sterilization : Is the terminal method of family planning. After 2-3 child births one of the parents opt for surgical method of sterilization. Female sterilization is by the main poplar method in the state. This service is provided by MOs in each Govt. hospitals. Intra uterine Device (IUP): Copper T is inserted inside the uterus to prevent pregnancy. The copper T is provided by GOI. The service is provided in sub centre level and in all hospital Family Planning (F.P .):activities

46. Use of Condom: Condom is used as a contraceptive device as well as for protection from HIV / AIDS. Condom vender machines are installed in hospitals and social marketing of condom is promoted Oral Pills: Use of oral pills by women for the purpose of preventing pregnancy. The tablets are provided by GOI and supplied to people at sub centre and all health facilities in free of cost all districts of the State Family Planning (F.P.):activities

47. COMPENSATION package for FP Programme- Sterilization: With a view to encourage people to accept sterilization operation voluntarily, compensation for loss of wages is being paid to the beneficiaries as per pattern fixed by the Govt. of India from time to time. Family Planning (F.P.):activities

48. FP Insurance Scheme: GOI has started an Insurances scheme to cover the death, complication and failure cases of sterilisation as well as indemnity cover of surgeons. An agreement has been signed by GOI and Oriental Insurance Company and the scheme has been implemented from November 2005 in all districts of the State. Revised Insurance package from January 2008: Family Planning (F.P.):activities

49. The state Govt., have introduced Green Card Scheme with effect from 1983 to popularize permanent method of F.R for two children or less. Parents and children under Green Card Scheme are eligible for certain benefits all districts of the State. Green Card Scheme

50. Immunization is one of the most well-known and effective methods of preventing childhood diseases. Universal Immunizations Programme (UIP) is established in India in 1985. Since then morbidity and mortality due to vaccine preventable diseases have declined over the years all districts of the State. Immunization :

51. Objectives: To prevent infant from 6 killer diseases like Diphtheria, T.B. Polio, Whooping Cough, Tetanus, and Measles. Goal: 100 % full immunization by 2010 Immunization:

52. Activities: Special Immunization Week Intensified Pulse Polio Immunization Supply of sufficient Vaccine Use of Immunization Card and Counter Foil : Maintenance of Cold Chain System Use of Auto-Disposable syringes Training to HW (F ): Adverse Effect of Immunisation Survey of Vaccine Preventable Disease

53. 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, New born 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. Family Planning 2020 India Commitments

54.  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

55.  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 counselling and monitoring  Ensuring availability of free commodities, through strengthened commodity supply system in public health facilities for all eligible couples and adolescents seeking contraceptive services

56.  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

57.  Central social Welfare Board, all – India Women’s conference, Bhart seweak samaj , Biswa are some of the national organisations involved in family welfare programmes to improve the health of mother and child.  They are undertaking various projects and organizing seminars on reproductive and child health in order to create awareness among women for sustainable development of the community.  They are also conducting various training program for the workers working in family welfare programmes.  They are providing maternity aid and running maternity home to encourage institutional delivery of women.  They are also providing milk powder to nursery School children, giving instructions to women about family planning and mother craft activities. Role of national family welfare organisations in family Welfare programmes

58.  UNFA, the world’s largest source of population funding, began operations in 1969.  UNFPA is assisting India in supporting the strategy endorsed by the 1994 International Conference on Population and Development (ICPD), which emphasised the inseparability of population and development and focused on meeting individuals’ needs rather than demographic targets.  UNFPA Country Program-V (1997-2001) of US$ 100 million for India is the largest UNFPA programme of assistance worldwide. UNFPA – UNFPA IN INDIA (United Nations Population Fund)

59. The works of UNFPA on population Issues Improving Reproductive Health Linking population and Development Promoting Gender Equality Advancing Human Rights Supporting Adolescents and Youth Making Motherhood Safer Using Culturally Sensitive Approaches Preventing HIV Infection Assisting in Emergencies Securing Essential Supplies Building support/Donations Procurement.

60. The overall goal of the 2008-2012 Country Programme is to advance the fulfillment of the rights of all women and children in India to survival, development, participation and protection by reducing social inequalities based on gender, caste, ethnicity or region. UNICEF’s work is centred on children from neonatal stages to adolescence. In addition to reducing infant mortality rates (IMR), the Reproductive and Child Health programme will also aim to reduce maternal mortality rates (MMR) from 301 to 100 per 100,000 live births. The Country Programme, 2008-2012vUNICEF

61. Direct care provider  Assist doctor in conducting clinics  Assist in IUCD insertions  Assist in ANC/PNC clinics  Distribution/ provision of family planning services  Follow up • Through home visits • Through clinic visits • Maintaining careful record of follow up, findings, date of supplying device, etc.  Referral • Make referrals to various agencies as per need  Maintain Records and report • Record of the people using birth control methods individually, their attitudes, date of acceptance and any problems. Role of nurse

62. Educator/communicator  Communication and health education  Be a good listener  Indirect counselling needs to be offered  Health education through various media  She could involve community leaders to participate in the programme and through them she could carry out family planning work.

63. CHN should impart Knowledge about family planning • Population problem • Nature of family planning • Methods of family planning • Resources available in the community • Government policies CHN should have Knowledge about the person Individual’s needs and awareness Culture, beliefs and attitudes Customs and practices

64. Administrator and manager  Implementation of successful programme  Arrange the facilities, equipment/articles  Manage the work of staffs-ANM/ASHA/AWW/HW

65. Coordinator/collaborator  Coordinate and collaborate the work with different sectors Leader • Lead the programmes and motivate colleagues for implementation of it Guidance and counsellor  Helps beneficiaries to adopt appropriate family planning methods

66. Advocate • Advocacy towards the issues for the individual/family Researcher  To evaluate the program and find out new solutions  Participate in research projects carried out  Conduct new researches.

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68. Thank you