The document discusses India's population trends, challenges, and family welfare programs. It notes that India has the 2nd largest population in the world at over 1.3 billion people as of 2019. Key issues facing India include unemployment, illiteracy, poor healthcare access, and environmental pollution. The government aims to stabilize population growth and improve quality of life through various family welfare initiatives focused on education, health, employment, women's rights, and limiting family size. The document outlines India's national population policies and family planning programs since the 1950s, as well as methods of contraception available.

1. FAMILY WELFARE
PROGRAMME

3. ● Indian population in 2019 is estimated to be
1,366,417,754 (1.36 billion) people at the mid year
according to UN data
● It is 17.71% of the total world population
● The population density in India is 460 per Km square
● India stands at the 2nd place after China in population

4. POPULATION TRENDS & PROBLEMS IN INDIA

5. ● Unemployment
● Illiteracy
● Housing problems
● Health care issue
● Poor sanitation
● Environmental pollution

9. The salient features of population growth are as follows:
1. Approximately 95% of the growth is happening in the
developing countries
2. Currently ⅓ rd of the world’s population is under the
age of 15,& will soon enter the reproductive
bracket,giving more potential for population growth
3. The UNFPA estimates that world population is most
likely to reach 10 billion people by 2050 & 20.7 billion
a century later

10. 4. The expected no. of births per women at current fertility
rates (2008) is; for industrialized countries 1.7,
developing countries 2.7 & for at least developed
countries 4.4.
5. The global fertility rate is 2.5

11. FERTILITY RATE
The no. of live
births per 1000
women in the
reproductive age
group(15-44)
in a given year.

12. THE FAMILY WELFARE
● The concept of family welfare programme is to improve
the quality of life of the people.
● It includes
education,health,nutrition,employment,women’s
welfare & rights,shelter,safe drinking water
● It is a centrally sponsored programme

13. ● Objective of the Family Welfare Programme
(FWP):
1. People should adopt “Small Family Norm” to
stabilise the country’s population at the level of
some 1533 million by the year 2050. The
programme initially adopted 3 child norm.

15. ● 1970 slogan - DO YA TEEN BAS
● 1980 - advocated 2 child norm

16. The current emphasis is on 3 themes:
1. Sons or daughters - two will do
2. Second child after 3 years
3. Universal immunization
● Decline of fertility rate through FWP from 6.4 in 1950
to 2.8 in 2006
● The national target was to achieve a Net Reproduction
Rate of 1 by 2006 by attaining 2 child norm

19. ● India was the first country to launch the family
planning programme & which was initiated in the year
1952.
● Established new clinics, distribution of educational
material,training & research
● During the 3rd five year plan (1961-1966),family
planning was declared as “the very centre of planned
development”
● 1965 - introduction of Lippes Loop

20. ● Formation of Family Planning department in the
Ministry of Health in 1966
● 1970 - initiation of All India Hospital Postpartum
Programme
● 1972 - introduction of Medical Termination of
Pregnancy Act (MTP)

21. NATIONAL POPULATION POLICY 2000
● Population policy in general refers to policies intended
to decrease the birth rate or growth rate
● 1976 - first national population policy
● It was for an increase in the legal minimum age of
marriage from 15 to 18 yrs for females & from 18 to
21 yrs of age for men.
● Modified policy in 1977 by adopting small family norm
& without compulsion & changed the

22. Programme to “FAMILY WELFARE PROGRAMME”
● In 1983 national health policy was approved by
parliament & set the long term goal of achieving a Net
Reproductive Rate of 1 by the year 2000
● National population policy 2000 is the latest
● It reaffirms the commitment of the government
towards target free approach in administering family
planning services.

23. NPP 2000 deals with :
● Decreasing the fertility & mortality rates
● Women education
● Empowering women for improved health & nutrition
● Child survival & health
● Healthcare for the underserved population groups like
urban slums,tribal community,hill area population
● Adolescent health & education
● Increased participation of men in planned parenthood

24. ● Collaboration with NGO
OBJECTIVES OF NPP
1. Bring the TFR to replacement level by 2010
2. To achieve requirements of suitable economic growth,
social development & environment protection.

25. NATIONAL FAMILY WELFARE PROGRAMME
1. Reproductive & Child Health (RCH)
2. Integrated Child Development Scheme (ICDS)
3. Maternal & Child Health (MCH)
4. Safe Motherhood

26. CHILD SURVIVAL & SAFE MOTHERHOOD
PROGRAMME (CSSM)
● RCH phase 1 programme incorporated the
components relating child survival & safe motherhood
& other two components
FAMILY PLANNING CSSM
CLIENT APPROACH
TO HEALTH CARE
PREVENTION &
MANAGEMENT OF
RTI/STD/AIDS

27. ● CSSM incorporated :
1. National Nutritional Anemia Control Programme
2. TT Immunization of pregnant women
3. Dais training programme
4. Family planning
● In 1992 CSSM included all the schemes for the better
compliance.

28. COMPONENTS OF CSSM
1. Early registration of pregnancy
2. To provide minimum of 3 antenatal check ups
3. Universal coverage of all pregnant women with TT
immunization
4. Advice on food,nutrition & rest
5. Detection of high risk pregnancies & prompt referral
6. Clean deliveries by trained personnel
7. Birth spacing

29. 8. Promotion of institutional deliveries

30. CONTRACEPTIVE METHODS

31. ● Contraceptive methods are defined as the preventive
methods to help women avoid unwanted pregnancies
● Broadly classified into 2 - spacing methods & terminal
methods

32. Contraceptive
methods
Spacing methods Terminal methods
BARRIER METHODS
INTRAUTERINE DEVICES
HORMONAL METHODS
POST
CONTRACEPTIONAL
METHODS
MISCELLANEOUS
MALE
STERILIZATION
FEMALE
STERILIZATION

33. BARRIER METHODS
1. PHYSICAL METHODS
a) Condom -NIRODH
b) Diaphragm
c) Vaginal sponge
2. CHEMICAL METHODS
a) Foams - foam tablets,foam aerosols
b) Suppositories - inserted manually

34. c) creams,jellies & pastes - squeezed from tubes
d) soluble films - C-fimm inserted manually
INTRAUTERINE DEVICES
a) Medicated IUDs
b) Non medicated IUDs
● IUDs currently using in India under NFWP - Cu-7-
200B,Cu-T-200B
● First generation IUD - Lippes loop

35. ● Second generation IUD
a) Earlier devices - Cu7,CuT-200
b) Newer devices
1. Variants of T devices - Cu-T-220C, Cu-T-380A or Ag
2. Nova T
3. Multiload devices- ML-Cu-250,ML-Cu-375
● 3rd generation IUDs - Progestasert,LNG -20,
Levonorgestrel

37. ● The ideal IUD candidate according to The Planned
Federation of America is:
1. Who has borne at least one child
2. Has no history of pelvic disease
3. Has normal menstrual cycles
4. Is willing to check the IUD tail
5. Has access to follow up & treatment of potential
problems
6. Is a monogamous relationship

38. ● Timing of insertion is during menstruation or within 10
days
● The follow up objectives are:
1. To provide motivation & emotional support for the
woman
2. To diagnose & treat any side effect or complication

39. ● Side effects & complications
1. Bleeding
2. Pain
3. Pelvic infection
4. Uterine perforation
5. Pregnancy
6. Ectopic pregnancy
7. Expulsion
8. Cancer & teratogenesis
9. mortality

40. HORMONAL CONTRACEPTIVES
1. Oral pills
a) Combined pill
b) Progestogen only pill (POP)
c) Post-coital pill
d) Once a month pill
e) Male pill
2. Depot formulations - injectables, subcutaneous
implants,vaginal rings

41. EMERGENCY CONTRACEPTION

42. ● Emergency contraception (EC) can prevent up
to over 95% of pregnancies when taken within
5 days after intercourse.
● EC can be used in the following situations:
unprotected intercourse, concerns about
possible contraceptive failure, incorrect use of
contraceptives, and sexual assault if without
contraception coverage.

43. ● Emergency contraception refers to methods of
contraception that can be used to prevent
pregnancy after sexual intercourse. These are
recommended for use within 5 days but are
more effective the sooner they are used after
the act of intercourse.

44. METHODS OF EC
● Copper-bearing intrauterine devices (IUDs)
and the emergency contraceptive pills (ECPs).
● A copper-bearing IUD is the most effective
form of emergency contraception available.
● The emergency contraceptive pill regimens
recommended by WHO are ulipristal acetate,
levonorgestrel, or combined oral
contraceptives (COCs) consisting of

45. ethinyl estradiol plus levonorgestrel.
Mode of action
Emergency contraceptive pills prevent
pregnancy by preventing or delaying ovulation
and they do not induce an abortion. The copper-
bearing IUD prevents fertilization by causing a
chemical change in sperm and ovum

46. before they meet. Emergency contraception
cannot interrupt an established pregnancy or
harm a developing embryo.

47. Methods of emergency contraception
The 4 methods of emergency contraception are:
● ECPs containing UPA
● ECPs containing LNG
● combined oral contraceptive pills
● copper-bearing intrauterine devices.

48. LATEST RESEARCH IN CONTRACEPTION
● Promotion of genito urinary clinic
● Provide sex education from adolescent age group
● The National Institute for Healthcare Excellence (NICE)
emphasized the need to promote long acting reversible
contraception
● Extended regimen of combined contraceptive pills for
84 days(Seasonale) is confirmed to be safe
● Metered Dose Transdermal Systems(MDTS),frameless

49. IUDs,SC injections(depo-subQ) & chewable tablets are
being developed for progestogens
● Ongoing research on biodegradable implants.

50. INFERTILITY MANAGEMENT
● The NICE has defined infertility as the failure to
conceive after regular unprotected sexual intercourse
for two years in the absence of known reproductive
pathology.
● Assisted contraceptive techniques -
1. OVUM INDUCTION
2. INTRAUTERINE INSEMINATION
3. IN VITRO FERTILIZATION or EMBRYO TRANSFER

51. 4.INTRACYTOPLASMIC INJECTION
5. GAMETE INTRAFALLOPIAN TRANSFER & ZYGOTE
INTRAFALLOPIAN TRANSFER