familyplanning- types, advantages dis pptx

family planning

1. Family Planning Presented by: Anushree Bhunia

2. An Expert Committee (1971) of the WHO defined family planning as "a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country“. Definition

3. Another Expert Committee defined and described family planning as follows: "Family planning refers to practices that help individuals 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 births occur in relation to the ages of the parent; To determine the number of children in the family. Cont …

4. The United Nations Conference on Human Rights at Teheran in 1968 recognized family planning as a basic human right. The Bucharest Conference on the World Population held in August 1974 endorsed the same view and stated in its Plan of Action' that "all couples and individuals have the basic human right to decide freely and responsibly the number and spacing of their children and to have the information, education, and means to do so". Basic Human Rights

5. Cont … The World Conference of the International Women's Year in 1975 also declared "the right of women to decide freely and responsibly on the number and spacing of their children and to have access to the information and means to enable them to exercise that right". Thus during the past few decades, family planning has emerged from whispers in private quarters to the focus of international concern as a basic human right, and a component of family health and social welfare.

6. Scope of family planning 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 includes in its purview: Proper spacing and limitation of births, Advice on sterility, Education for parenthood, Sex education, Screening for pathological conditions related to the reproductive system (e.g., Cervical cancer), Genetic counselling. Premarital consultation and examination,

7. Genetic counseling

8. 8) Carrying out pregnancy tests, Marriage Counselling, The preparation of couples for the arrival of their first child, 11) Providing services for unmarried mothers, 12) Teaching home economics and nutrition, and 13) Providing adoption services. These activities vary from country to country according to national objectives and policies with regard to family planning. This is the modern concept of family planning. Cont …

9. Health aspects of family planning Family planning and health have a two-way relationship. The principal health outcomes of family planning were listed and discussed by a WHO Scientific Group on the Health Aspects of Family Planning. These can be summarized under the following headings: W omen's health Foetal health Child health

10. Health aspects of family planning

11. Women's health: Maternal mortality, morbidity of women of child bearing age, nutritional status (weight changes, haemoglobin level, etc.) Preventable complications of pregnancy and abortion. Foetal health: Foetal mortality (early and late foetal death); abnormal development. Infant and child health: Neonatal, infant and pre-school mortality. Health of the infant at birth (birth weight), vulnerability to diseases. Cont …

12. a) Women's health Pregnancy can mean serious problems for many women. It may damage the mother's health or even endanger her life. In developing countries, the risk of dying as a result of pregnancy is much greater than in developed countries. The risk increases as the mother grows older and after she has had 3 or 4 children. Family planning by intervening in the reproductive cycle of women, helps them to control the number, interval and timing of pregnancies and births, and thereby reduces maternal mortality and morbidity and improves health.

13. The health impact of family planning occurs primarily through: The avoidance of unwanted pregnancies; Limiting the number of births and proper spacing, and Timing the births, particularly the first and last, in relation to the age of the mother. It is estimated that guaranteeing access to family planning alone could reduce the number of maternal deaths by 25 per cent, and child mortality by 20 per cent. Cont …

14. The essential aim of family planning is to prevent the unwanted pregnancies. An unwanted pregnancy may lead to an induced abortion. From the point of view of health, abortion outside the medical setting (criminal abortion) is one of the most dangerous consequence of unwanted pregnancy. Unwanted pregnancies:

15. Particular mention must be made of the unmarried mother who faces significantly higher health risks. There is also evidence of higher incidence of mental disturbances among mothers who have had unwanted pregnancies. Cont …

16. Repeated pregnancies increase the risk of maternal mortality and morbidity. These risks rise with each pregnancy beyond the third, and increase significantly with each pregnancy beyond the fifth. ii. Limiting the number of births and proper spacing:

17. The incidence of rupture of the uterus and uterine atony increases with parity as does the incidence of toxaemia, eclampsia and placenta previa . Anaemia is a common problem in mothers with many children and the rate of still-births tends to increase significantly with high parity. Cont …

18. The somatic consequences of repeated pregnancies may also be exemplified in the clear association between the incidence of cancer of the cervix and high parity. Family planning is the only way to limit the size and control the interval between births with a view to improving the health of the mother. Cont …

19. Generally mothers face greater risk of dying below the age of 20 and above the age of 30-35. In many countries, complications of pregnancy and delivery show the same pattern of risk, with the highest rate below 20 and over 35 years of age. iii. Timing of births:

20. (b) Foetal Health A number of congenital anomalies (e.g., Down's syndrome) are associated with advancing maternal age. Such congenital anomalies can be avoided by timing the births in relation to the mother's age. Further, the "quality" of population can be improved only by avoiding completely unwanted births. In the present state of our knowledge, it is very difficult to weigh the overall genetic effects of family planning.

21. (c) Child health Issues relating to family planning are highly relevant to paediatrics. It would seem that family size and birth spacing. if practised by all, will yield substantial child health benefits. These are: Child mortality Child growth, development and nutrition Infectious diseases

22. It is well known that child mortality increases when pregnancies occur in rapid succession. A birth interval of 2 to 3 years is considered desirable to reduce child mortality Family planning is, therefore, an important means of ensuring the survival of all children in a family. a) C hild mortality

23. Birth spacing and family size are important factors in child growth and development. The child is likely to receive his full share of love and care, including nutrition he needs, when the family size is small and births are properly spaced. Family planning, in other words, is effective prevention against malnutrition. b) Child growth, development and nutrition:

24. Children living in large-sized families have an increase in infection, especially infectious gastroenteritis, respiratory and skin infections. c) Infectious diseases:

25. Family planning is associated with numerous misconceptions - one of them is its strong association in the minds of people with sterilization. Others equate it with birth control. The recognition of its welfare concept came only a decade and half after its inception, when it was named Family Welfare Programme. The welfare concept

26. The concept of welfare is very comprehensive and is basically related to quality of life. The Family Welfare Programme aims at achieving a higher end - that is, to improve the quality of life of the people. Cont …

27. Small differences in the family size will make big differences in the birth rate. The difference of only one child per family over a decade will have a tremendous impact on the population growth. Small-family norm

28. The objective of the Family Welfare Programme in India is that people should adopt the "small family norm" to stabilize the country's population at the level of some 1,533 million by the year 2050 AD. Symbolized by the inverted red triangle, the programme initially adopted the model of the 3-child family. Cont …

29. In the 1970s, the slogan was the famous Do Ya Teen Bas. In view of the seriousness of the situation, the 1980s campaign has advocated the 2-child norm. The current emphasis is on three themes: "Sons or Daughters - two will do": "Second child after 3 years", and "Universal Immunization". Cont …

30. Cont … A significant achievement of the Family Welfare Programme in India has been the decline in the fertility rate from 6.4 in the 1950s to 2.3 in 2015. The national target was to achieve a Net Reproduction Rate of '1' by the year 2006, which is equivalent to attaining approximately the 2-child norm. All efforts are being made through mass communication that the concept of small family norm is accepted, adopted and woven into lifestyle of the people.

31. An "eligible couple" 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 and 45, There will be at least 150 to 180 such couples per 1000 population in India. These couples are in need of family planning services. About 20 per cent of eligible couples are found in the age group 15-24 years. Eligible couples

32. On an average 2.5 million couples are joining the reproductive group every year. The "Eligible Couple Register" is a basic document for organizing family planning work. It is regularly updated each functionary of the family planning programme for the area falling within his jurisdiction. Cont …

33. In order to pin-point the couples who are a priority group within the broad definition of "eligible couples", the term "target couple" was coined. Hitherto, the term target couple was applied to couples who have had 2-3 living children, and family planning was largely directed to such couples. Target couples

34. The definition of a target couple has been gradually enlarged to include families with one child or even newly married couples with a view to develop acceptance of the idea of family planning from the earliest possible stage. In effect, the term target couple has lost its original meaning. The term eligible couple is now more widely used and has come to stay. Cont …

35. Couple protection rate (CPR) Couple protection rate (CPR) is an indicator of the prevalence of contraceptive practice in the community. It is defined as the per cent of eligible couples effectively protected against childbirth by one or the other approved methods of family planning, viz. sterilization, IUD, condom or oral pills. Sterilization accounts for over 60 per cent of effectively protected couples. Demographers are of the view that the demographic goal of NRR=1 can be achieved only if the CPR exceeds 60 per cent.

36. Couple protection rate is based on the observation that 50 to 60 per cent of births in a year are of birth order 3 or more. Thus attaining a 60 per cent CPR will be equivalent to cutting off almost all third or higher order births, leaving 2 or less surviving children per couple. Therefore, the previous National Population Policy was to attain a CPR of 42 per cent by 1990 (end of Seventh Five Year Plan), and 60 per cent by the year 2000. In short CPR is a dominant factor in the reduction of net reproduction rate. C ont …

37. Couple protection rate (CPR) During 2014-2015, the total number of family planning acceptors by different methods was as follows. Family planning methods Family planning acceptors Sterilization 4.03 million Vasectomy 0.07 million Tubectomy 3.95 million IUD insertion 5.28 million Condom users 13.81 million Oral pill users 5.6 million

38. However about 45.28 per cent eligible couples are still unprotected against conception. Currently about 54.8 per cent of eligible couples in the reproductive age group 15-44 years were effectively protected against conception by one or the other family planning method. C ont …

39. A state-wise break-up of the figures reported indicates that while some states notably Punjab, Gujarat, Maharashtra, Karnataka, Haryana and Tamil Nadu etc. are forging ahead to cover more than half of their fertility level population by contraception, the other states like Bihar, Uttar Pradesh, Assam, Rajasthan, West Bengal, Jammu and Kashmir etc. are lagging behind with low contraceptive acceptance levels. C ont …

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