Population control and related population control programme

1. PRESENTED BY-
PINKI BARMAN
M.SC (N) 1ST YEAR
AIN/M.SC/2020/007
6

2. INTRODUCTION
India was the first major nation in the world to
adopt policies to control the growth of its
enormous population in 1952. However, the Indian
population has kept on growing much more
rapidly than the rest of the world after the
population control policies have been
implemented for more than six decades. According
to the United Nations, the Indian percentage of the
world total population increased from about 14.9%
in 1950 to 17.8% in 2010.

3. POPULATION- A population is the number of
organisms of the same species that live in a
particular geographic area at the same time,
with the capability of interbreeding.
CONTROL-The power to influence or direct
people's behavior or the course of events.
HUMAN POPULATION CONTROL- Human
population control is the practice of artificially
altering the rate of growth of a human
population.

4. The two main factors influencing population
increases. These are-
1.Decrease death rate-
-control epidemics
-urbanization of population
- more medical facilities
-spread of education
-late marriage
- balance diet

5. -Decline in social evil
-Change habit
-Better sanitation and community health schemes.
-Improvement in agriculture
-Better living standards.
2. High birth rate
 Universal and early marriages
 Poverty and illiteracy
 Preference of male child
 Inadequate supply of family services.
 Effect of religion
 Agriculture occupation
 Dependency of women

6.  Agriculture, economic and urbanization
 Food and Nutrition
 Literacy and education
 Labour force and employment
 Clothing and Housing
 Health care services
 Water supply and Environment

7. 1. Social Policies and Social Change.
 Child marriage restraint Act 1978
 Compulsory elementary education for all.
1. Involuntary Approaches to Fertility control
 Temporary sterilization which is reversible
 Compulsory sterilization
 Restriction of marriage to those couples who can
support family.
 Infanticide especially female infanticide.

8. 3. Family planning approaches to fertility
control-
 In India, family planning has been adopted as a
National Programme from the 1st Five-Year
Plan in 1952.
 India has adopted the goal of “Two Child
Family Norms”
 Jansankhya sthirta kosh was set up-
1. Prerna strategy
2. Santusti strategy

9. 1. National Population Policy 2000
2. National Family Welfare Programme
3. Special Family Welfare Services in Urban-
 The post partum programme
 PAP smear test facility programme
 Sterilization Bed scheme
 Urban Revamping Scheme

10. 4. Legislation for population stabilization-
 The prenatal diagnostic techniques ( regulation
and prevention act)1994
 Medical termination of pregnancy act 1971

11. INTRODUCTION
India is the second most populous country in the
world, sustaining 16.7 per cent of the world
population on 2.4 per cent of the world’s surface
area. Realising that high population growth is
inevitable during the initial phases of demographic
transition and the urgent need to accelerate the
pace of the transition, India became the first
country to formulate a National Family Planning
Programme in 1952. The objective of the policy
was “reducing birth rate to the extent necessary to
stabilise the population at a level consistent with
requirement of national economy”

12.  1923- First Family Planning Clinic in Pune
(Maharashtra)
 1951- National Family Planning Programme launched.
 1951-56- Inclusion of the Family Planning subject in medical
and nursing education.
 1961-66-Creation of Department of Family Planning in Ministry
of health, spread of small family norm.
 1966-67: Time bound and target oriented FP programme about
vasectomy and tubectomy.
 1971-: Integration of maternal child health and family planning
 1972-Post-Partum programme, MTP act 1971.
 1975-77: Mass Campaign for male sterilization-vasectomy
(Emergency period).
 1977- Rename the FP programme as National Family Welfare
Programme (NFWP)

13.  1980-85: Strengthening of maternal and child health
 1983 : National Health Policy.
 1992: Child Survival and Safe Motherhood (CSSM)
programme.
 1996 : Target Free Approach
 1997: Community Need Assessment Approach
(CNAA)
 1997-02: Reproductive and Child Health (RCH-1)
 2000 : National Population Policy
 2002: National Health Policy
 2005 : National Rural Health Mission (NRHM), RCH-II
 2013: Reproductive - Maternal Neonatal - Child +
Adolescent Health (RMNCH + A)
 2013: National Health Mission (NHM)-National Urban
Health Mission (NUHM)
 2017: National Health Policy
 2018: National Population Policy (Under process)

14.  Contraceptive method under NFWP(basket of
choices)
1. Spacing method.
2. Permanent method.
 Fix day static (FDS)services
 Emphasis on spacing methods and postpartum
family planning.
 Promotional schemes
 Involvement of ASHA
 Incentive to ASHA for ensuring spacing
 Pregnancy testing kits- Nishchay

15.  Compensation schemes for Acceptors of
sterilization
Fig- Compensation scheme in public health
facililities (in Rs)

16.  National family planning Indemnity Scheme

17.  New initiatives
 Appointing RMNCH+A counsellors at high case
load health centres (The posts of 1585 RMNCH+A
counsellors were approved across the country in
FY 2016-17).
 Mission Parivar Vikas for increasing the access to
FP services in high fertility districts (145 districts of
7 states with TFR of 3 and above).Expansion of
Basket of Choice .
 Free supply scheme: Under this contraceptives
condoms, OCPs, Mala N. IUCDs, Tubal rings,
Pregnancy Test Kits (PTKs) are procured and
supplied to the states.
 Set-up of Central Medical Services Society (CMSS)
to ensure uninterrupted supplies of commodities
in the states

18.  Supply of centchroman-chhaya (weekly oral
Contraceptive non-steroidal pill, previously
known as Saheli and Novex) through social
marketing scheme.
 Quality Assurance in Family Planning: -
 creation of a panel for preparing guidelines for
conducting sterilization procedure
 uniform proforma for obtaining consent.
 uniform Insurance policy for acceptors of
sterilization procedure

19. 1. The services should be accessible and affordable.
There should be a variety of delivery channels to
make the contraceptives available to all the clients.
Both private and public sectors should be active so
that those client who can pay, may avail from
private sector and those who cannot pay may avail
the services from the government sector.
2. Clients' needs and preferences should be
considered while planning and providing services
to them.
3. Communication and motivation of clients are very
important to make choices and as desired.

20. 4. Services delivery guidelines, tools, etc. should be
based on research findings, i.e. evidence-based.
5. Ensure the availability of all the contraceptives by
having their effective logistics system.
6. A good co-ordination system must be there among
government, voluntary and private agencies to
streamline their efforts to prevent duplication.
7. Build the morals of staff by creating good up
work-environment matching skills with job,
boosting and rewarding the good job done.
8. Make decisions based on feedback received while
monitoring and evaluation and also on research.
9. Good and effective leadership in management of
services.
10. Effective integration of health and family
programme etc. and effective referral services
should be there.

21. 1. At central level
2. At state level
3. At district level
4. At block level

22.  Demographic challenges
 Service delivery challeges-
 Unavailability of regular sterilization service
 Poor postpartum contraceptive services.
 Lack of train medical/nursing staff.
 Lack of regular contraceptive updates.
 Poor community based family planning
services.

23. 1. The post partum programme
 The Post Partum Programme - a maternity-centred
hospital based approach to family welfare - was
initiated in 1966 with the aim of motivating
women within the reproductive age group (15-44
years) and their husbands for adoption of small
family norm through education and motivation,
particularly during pre-natal and post-natal period
 The specific objectives of the programme are-
(a) to provide an integrated package of maternal and
child health (MCH) and family planning services,

24. (b) to conduct skill based training programmes
for medical and para-medical personnel, and
(c) to provide outreach services in the allotted
areas.
 At present, only 550 post-partum centres are
functioning in the medical institutions
including 100 medical colleges and 2 post-
graduate institutions at the national, state The
success of the programme at the district level
encouraged the Government of India to extend
the post partum programme to sub-divisional,
taluka level hospitals as well. At present, 1012
sub-district level post-partum centres are
functioning under the programme.

25. In order to strengthen the facilities for detection
of cervical cancer and pre-cancerous lesions
among women acceptors and non-acceptors of
family planning methods, the Programme
provides financial assistance for running PAP
Smear Test facilities at the medical colleges.

26.  This Scheme was introduced during 1964 by the
reservation of sterilisation beds in
government/voluntary organisations and local
body institutions.
 The purpose of introducing this scheme was to
provide facilities for tubectomy operation, as the
beds for such cases were not readily available in
hospitals. Under this Scheme, a total of 3217 beds
are functioning at present (as on 1" April, 2000).
 A recurring amount of 4500 per bed per annum is
admissible for the maintenance of the sterilisation
beds to local bodies/voluntary organisation on the
achievement of 60 tubectomies per bed per annum.

27.  The Urban Revamping Scheme was initiated in the
year 1993-94.
 This scheme has been introduced with a view to
providing improved services, delivery outreach
services of primary health care, family welfare and
maternity services in urban areas, particularly in
slum areas.
 The state governments have established 871 health
posts (details mentioned earlier) and 10 city family
welfare bureaus. The city family bureaus are
entrusted with the responsibility of coordination,
monitoring, supervision, etc. of the family welfare
services provided by various institutions in the
city.

28. 1. The prenatal diagnostic techniques ( regulation
and prevention act)1994
 The Act and the rules framed there upon have
come into force from 1 January 1996. The Act
prescribes the conditions under which the prenatal
diagnostic techniques an be used to diagnose foetal
abnormalities. Disclosure of Sex of the Foetus is
Prohibited. Punishments are prescribed for the
violation of the law.
 The Prenatal Diagnostic Techniques (Regulation
and Prevention of Misuse) Act is a progressive
piece of legislation aimed at eliminating the social
evil of female foeticide, which often follows
prenatal sex determination.

29.  Regulation of Genetic Counselling Centres,
Genetic Laboratories and Genetic Clinics.- On
and from the commencement of this Act,—
1. no Genetic Counselling Centre, Genetic
Laboratory or Genetic Clinic unless registered
under this Act, shall conduct or associate with,
or help in, conducting activities relating to
prenatal diagnostic techniques;
2. no Genetic Counselling Centre or Genetic
Laboratory or Genetic Clinic shall employ or
cause to be employed or take services of any
person, whether on honorary basis or on
payment who does not possess qualifications
as may be prescribed;

30.  Prohibition of sex-selection- No person, including
a specialist or a team of specialists in the field of
infertility, shall conduct or cause to be conducted
or aid in conducting by himself or by any other
person, sex selection on a woman or a man or on
both or on any tissue, embryo, conceptus, fluid or
gametes derived from either or both of them.
 Prohibition on sale of ultrasound machines, etc., to
persons, laboratories, clinics, etc. not registered
under the Act.- No person shall sell any ultrasound
machine or imaging machine or scanner or any
other equipment capable of detecting sex of foetus
to any Genetic Counselling Centre, Genetic
Laboratory, Genetic Clinic or any other person not
registered under the Act.

31.  Offences and penalties.-
Any medical geneticist, gynaecologist, registered
medical practitioner or any person who owns a
Genetic Counselling Centre, a Genetic Laboratory
or a Genetic Clinic or is employed in such a Centre,
Laboratory or Clinic and renders his professional
or technical services to or at such a Centre,
Laboratory or Clinic, whether on an honorary basis
or otherwise, and who contravenes any of the
provisions of this Act or rules made there under
shall be punishable with imprisonment for a term
which may extend to three years and with fine
which may extend to ten thousand rupees and on
any subsequent conviction, with imprisonment
which may extend to five years and with fine
which may extend to fifty thousand rupees.

32.  The Medical Termination of Pregnancy Act, 1971
was enacted to improve the accessibility and
availability of scientifically approved services and
facilities for the termination of pregnancy in
properly screened cases and thereby reducing the
number of illegally induced abortions and made
amendment in it, in 1975 and in 2003 to legalize the
abortion.
 Conditions for MTP- Medical Ground- when the
continuation of pregnancy means risking mother’s
life or her physical and mental health is likely to be
harmed
seriously.

33.  Humanitarian ground- where rape is the cause
of pregnancy.
 Eugenic ground- where the child is likely to
have serious congenital disorders or
abnormalities.
 Socio-economic ground- where the life of
mother is threatened by social and of economic
conditions.
 Failure of contraceptives- where cause
pregnancy is the failure of contraceptive
devices or resources and the mother is hurt
mentally.

34.  Person authorized for MTP:
 A gynecologist or a registered medical practitioner
can terminate a pregnancy that is 12 weeks old,
while for a pregnancy that is 20 weeks old , two
registered medical practitioners are required.
 Place of MTP and consent-
 MTP can be conducted in government or private
hospitals but certification from chief medical
officer of the district is essential for it.
 Women should be an adult and she should sign
the letter of consent.
 Written consent from her parents/guardians is
necessary.

35. 1. She herself identifies eligible couples, registers them,
motivates them, guides and helps them select
appropriated methods, supplies the contraceptives
regularly and thus helps them to follow small family
norms.
2. Supervises and guides health workers (F&M) in the
motivation of couples for small family norms and in
supply of contraceptives of their choice.
3. Tries to achieve the community needs being assessed.
4. Identifies infertile couples and gives them supportive
care and guidance to consult the gynaecologist.
5. Identifies full range of family welfare needs of families,
plans and provides need-based comprehensive services
by working in a health team.

36. 6. Plans and provides health education on various
aspects of healthful living, MCH and family
welfare, health prevention and protection, etc.
7. Motivates and helps women to improve their
status by education and by becoming self
dependant socially and economically.
8. Creates awareness among families and people at
large about the various social welfare schemes and
utilizes them to improve their socio economic
status.
9. Tries to organize community by involving various
leaders from different sectors including women to
do need assessment, plan, organize and implement
health and welfare activities. and develop position
attitude towards family welfare and fertility
control.