This presentation discuss the evolution of India's National Family Planning Program and National Population Policy 2000, significant impact of 1994 Cairo conference on country's Reproductive health approach.

1. Kumaravel Ilangovan
Second sem MPH student

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Reducing numbers of abortions
Prevention of maternal deaths
Improvements in child health
Promotion of gender equality
HIV/AIDS – prevention of motherto-child transmission
Cost-effective

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Major milestones in evolution of India’s FP
programmes
Cairo Conference 1994
Reasons for high population growth
Definition of Reproductive Health
India after 1994 ICPD
National Population Policy 2000 A.D
Summary
Further Discussions in this Topic
Conclusion

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1952 – “urgency of the problems of Family
Planning (FP) & advocated a reduction in the
birth rate
1956 – expansion of FP clinics in both rural &
urban areas and recommended a autonomous
central family planning board, with state level
boards.
1961 – the provision of sterilization facilities in
all health facility centers. Maharashtra organized
“sterilization camps” in rural areas. Extension
education approach, small family norm message.

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1963 – The Director of FP “a shift from the
clinic approach to a community based approach
to be implemented by auxiliary nurse midwives
(1/10,000 population) located in PHC’s.
1965 – Introduction of Intra Uterine Device
(IUD)
1969-74 FP services provided, All India
Hospital post partum program, MTP act1971.
1974-79 during emergency Smt.Indira Gandhi
formulated a population policy, which permitted
states to go for compulsory sterilization.

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1977 – A revised policy formulated by Janata
government. Term FP replaced by “Family
Welfare”. Child marriage restraint act was
passed in 1978.
1983 National Health Policy was established.
1980-85 Strengthening of MCH, FW.
1985-90 Inclusion various programmes under
MCH
1991- Karunakaran committee appointed.
1993- submitted a report to NDC in which it
pleaded for NPP
1992-97 CSSM

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Official name: International Conference on
Population and Development
ICPD was a watershed in the history of
thinking on population issues.
It represented a “quantum leap” approach for
population and development policies as it
involved a shift from the earlier emphasis on
population control & demography to
sustainable development and recognition of the
need for Reproductive Health(RH) and (RR)
Rights addressing the “lifetime approach”

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Root cause of High Fertility
Expand the existing FW programmes beyond
the contraceptive delivery to include a range of
RHS
Broader & more holistic. Earlier Total fertility
rate(TFR) and Contraceptive prevalence rate.
ICPD replaced them with quality of
care, informed choice, Gender factor, Women
empowerment & Accessibility to a whole
gamut of RHS.

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Large size of population in the reproductive
age
Higher fertility due to unmet need for
contraception
High wanted fertility due to high IMR
Male child preference
Over 50% of girls marry below the age of
18, resulting in a typical reproductive pattern
of “too early, too frequent, too many”

10. 1996 – Target free approach, review of Safe
motherhood component of CSSM
 1997-02 Reproductive and Child Health (RCH)
(CSSM plus STI & RTI components)
2000 – National Population Policy
2002 – National Health Policy
2002-07 – Planning for RCH-II
2005 – RCH-II and NRHM
2007to12 – NRHM
2013 to 2017 – NRHM extended
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WHO defines reproductive health within
the frame work of definition of health as
“a state of complete
physical, mental, social well-being and
not merely absence of disease or
infirmity, the RH addresses the
reproductive processes, functions and
systems at all stages of life. It implies that
people are able to have a
responsible, satisfying and safe sex life &
that they have the capability to
reproduce & the freedom to decide

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The GOI had reviewed the NFWP on the basis of
various surveys, reports & studies. Following facts
were found:
Targets & incentives distorted the program
implementation. Targets set at the central& state
levels were never appreciated by the population
and health workers at large;
Significant gaps was existed in infrastructure and
outreach services;
Choice of contraceptive was limited;
Involvement of males was poor;
Quality of service was poor that lead to
complications and generate distrust among users;

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Low budget allocation resulted in gaps in
staffing, facilities, package of services;
Training and reorientation program of staff
was not uniform throughout country.
There was hardly any skill development in
training; and
Overlapping of FP services.

14. Vision Statement:
Aims to improve the quality of lives people lead;
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Provide them with opportunities and choices
with a comprehensive, holistic and multi sectoral
agenda for population stabilization;

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Short Term : fulfill unmet need for
contraception, strengthening the health
infrastructure, integrating the services for
Reproductive and Child Health.
Medium Term :effective implementation of
inter-sector strategies to substantially reduce
the TFR by 2010.
Long Term : to sustain the economic
growth, social development and ecoconservation, stabilize the population by 2045

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Fulfilling the Unmet Need for RCH
Free and compulsory education for children
under-fourteen
Reducing the school dropout between boys and
girls to 20 percent
Bringing IMR < 30
Bringing MMR < 100
Increasing Immunization against VPDs to 100
percent
Encouraging the increase in average age at
marriage of girls
Increasing Institutional Deliveries to 80 percent
> delivery by trained persons to 100 percent
Making contraceptive of choice available to 100
percent population

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Enhancing the IEC coverage for RTI/STI/AIDS
to cent percent population
Integrating allopathy with ISM for betterment
of RCH services
Encouraging the small family norm to
substantially reduce TFR
Coordinating the activities of social sector
development to make family welfare program
public oriented

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Decentralize the Plan and Program
Implementation
Convergence in services at delivery points
Women Empowerment to mitigate
nutrition/health problems of females
Strengthening child survival and child health
Meeting the unmet need for FW
Special services for slums
Attending Adolescents
Increasing Male Participation

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Diverse health care providers
Collaboration with and commitments from
NGO and the private sector
Mainstreaming of Indian systems of Medicine
and Homeopathy
Research on RCH and Contraceptive
technology
Care for older population
Information, Education & Communication

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NPP is Gender sensitive
Primary theme is provision of quality services
and supplies & arrangement of basket of
choices. People must be free and enable to
access quality health care.
Substantial differences are visible between
states in the achievement of basic demographic
indicators.

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It has been a unique event in the history of
Public Health in India that in the year 2000 that
the Population Policies have been released at
the country and state level with the goal of
stabilizing Population in a large subcontinent
which currently constitutes one-seventh of
world’s population. It is now for students of
Public Health to see, how the proposed goals
and objectives have been achieved.