The document summarizes India's family planning program. It provides population figures for Indian states and shows that Uttar Pradesh has the largest population at 19.96 Cr. The national program aims to stabilize population growth by 2045 through addressing unmet need and lowering the total fertility rate (TFR) to replacement level. It highlights initiatives to increase modern contraceptive usage, address high-risk births, expand contraceptive choices, and promote quality sterilization and IUCD services. The family planning program utilizes schemes like ASHA and compensation for acceptors and providers. It also establishes quality assurance structures like state and district indemnity subcommittees to address issues.

1. FAMILY PLANNING
PROGRAM IN INDIA
Dr. S.K Sikdar
Deputy Commissioner,
In-charge: Family Planning & Aspirational District
Ministry of Health & Family welfare

2. India’s Contribution to World Population

3. Uttar Pradesh
19.96 Cr. (16%)
Maharashtra
11.24 Cr. ( 9%)
Bihar
10.38 Cr. (9%)
West Bengal
9.13 Cr. (8%)
Andhra Pradesh
8.47 Cr. (7%)
Madhya Pradesh
7.26 Cr. (6%)
Tamil Nadu
7.21 Cr. (6%)
Rajasthan,
6.86 Cr. (6%)
Karnataka
6.11 Cr. (5%)
Gujarat
6.04Cr. (5%)
Orissa
4.19 Cr. (3%)
Kerala 3.34 Cr. (3%)
Jharkhand, 3.30 Cr
Assam, 3.12 Cr. (3%)
Punjab, 2.77 Cr.
Chhattisgarh, 2.55 Cr
Haryana, 2.54
Delhi, 1.68 Cr. (1%)
J & K, 1.25 Cr. (1%) Uttarakhand, 1.01 Cr.
(1%) Other states & UTs,
2.61Cr. (2%)
PopulationShare
of States
(InCrore)
Source: Census 2011

4. LONG-TERM
Population stabilisation by 2045
MID-TERM
TFR to replacement level of 2.1 by
2010
IMMEDIATE
Address unmet need
National Population Policy - 2000
Objectives

5. Population & Growth Rate
238
252
251
279
319
361
439
548
683
846
1029
1210
0.56
0.03
1.04
1.33
1.25
1.96
2.20 2.22 2.14
1.97
1.64
0
0.5
1
1.5
2
2.5
0
200
400
600
800
1000
1200
1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 2011
Growth
Rate
Population
(Million)
• Steepest decline in Decadal Growth Rate between 2001 and 2011 from 21.54% to 17.64%
• Growth rate of populous states with high TFR has fallen sharply after decades of stagnation

6. Fertility trend in India (TFR)
6
TFR (NFHS)=2.2
TFR (SRS)= 2.3

7. 55% of country’s
population living in 24
States/UTs has already
achieved replacement level
fertility

8. Contraceptive Usage and Unmet Need
Female
Sterilization, 3
6
Male
Sterilization, 0
.3
IUCD/PPIUCD,
1.5
Pills, 4.1
Condoms, 5.6
Modern Contraceptive Usage (NFHS IV)= 47.8%
(Track 20 estimates) = 54.4%

9. Teenage Fertility
18.8
18.3
13.6
12.2
12
11.8
10.6
10.5
10.3
8.6
8.3
7.8
7.6
7.4
7.3
7.2
6.5
6.3
5.9
5.7
5
4.8
4.7
4.5
3.8
3.5
3
2.9
2.9
2.9
2.8
2.6
2.6
2.3
2.1
TR
WB
AS
BH
JH
AP
TG
AR
DN
MG
MH
KN
OR
MN
MP
MZ
GJ
RJ
HR
NG
TN
CG
AN
DD
UP
PD
KL
GO
JK
UK
SK
HP
PJ
DL
CH
India = 7.9%
Source: NFHS IV

10. Wanted and actual fertility rates
Source: NFHS-4
If unwanted fertility is averted
TFR will reach replacement level.

11. HIGH RISK BIRTHS
Too Close… Too Many… Too
Early…
Too Close
48.1 % of births have birth interval of less than 36
months
Too Many
22.8% are 3rd or more order births
Too Early
7.9% of births are in the age group 15-19 years
Source: NFHS IV, SRS

12. Birth spacing >36 months
3/13/2023 12
Source: SRS 2016

13. Why Family
Planning?

14. Fertility Contribution
52.5% of country’s
fertility is contributed by
age group 15-24 years
1.28 crore births every year
15-24 years women
contribute 46% of
the maternal mortality
Source: SRS

15. 13/03/2023
15
Prevents one in every three maternal deaths
Why FP?
Prevents unintended
pregnancies and unsafe
abortions
Prevents high-risk pregnancies
For every woman who
dies of pregnancy and
childbirth
complications, at least
20 more suffer long-
term illness.
Three times more risk of
child mortality if the
interval is less than 18
months
Prevents infant
deaths

16. Benefits of achieving FP goals Social Sector cost savings
outweigh Family Planning
costs
Education
Rs 28, 305 Cr
Immunization
Rs 23, 985 Cr
MH,
Rs 8, 640 Cr
Water,
Rs 6, 885 Cr
Total Cost of FP, Rs 5,130 Cr
(2007-2015)
Total Savings: Rs 67,815 Cr
(2007-2015)
Source: NFHS II, MDG analysis
Source: Calculation by Health Policy Initiative (USAID Project), Futures Group

17. National Family Planning
Program

18. Key highlights of FP programmes
3/13/2023 18
India was the first country to launch National Family Planning Program
• Target free approach
• Voluntary adoption of Family Planning
Methods
• Based on felt need of the community
• Children by choice and not chance
Policy level
• More emphasis on spacing methods
• Assuring Quality of services
• Expanding Contraceptive choices
Service level

19. Expansion of the
basket of FP
Choices
Augmenting the
demand through
ASHA Schemes
for Family
Planning Promoting quality
sterilization
services
Promoting
quality IUCD
services
Generating
demand and
awareness for FP
services
Addressing global
Commitments
(Family Planning
2020)
KEY FP INITIATIVES/SCHEMES

20. Contraceptive Basket of Choice under National
Family Planning Program
Temporary Methods
• Condoms (Nirodh)
• Oral Contraceptive Pills-
• Combined Oral Contraceptives (Mala N)
• Centchroman (Chhaya)
• Emergency Contraceptive Pills (Ezy Pill)
• IUCD-380A, 375
• Injectable MPA
Permanent Methods
• Male Sterilization (Conventional
Vasectomy/NSV)
• Female Sterilization (Minilap/Laparoscopic)
3/13/2023 Family Planning Division, MoHFW
IUCD
380 A
IUCD
375

21. Expansion of the basket of FP
Choices
Introduction of new contraceptive choices-
 Injectable Contraceptive (Antara Program)
 Centchroman (Chhaya)
 Progesterone only Pills- under pilot
Introduction of new device-
 Cu IUCD 375 (effective for five years) was introduced in program in 2012-13.
Introduction of new method-
 Post partum IUCD was introduced in the program in 2010-11 and has provided
post partum women an effective spacing option.

22. Augmenting the demand through ASHA
Schemes for Family Planning
•Home Delivery of Contraceptives
•Ensuring Spacing at Birth
•Pregnancy Testing Kits-
•Pregnancy Testing Kits are now a part of ASHA kits so as to
ensure early management of pregnancy

23. Promoting quality sterilization services
•Sterilization Compensation Scheme-
• The compensation package has been enhanced in
2014 for 11 high focus high TFR states
• Higher package for post partum sterilization and
male sterilization
• Higher package for MPV districts

24. Sterilization Compensation Scheme
States Acceptor ASHA/ Health Worker Others Total
11 High focus states
(UP, BH, MP, RJ, CG, JH,
OD, UK, AS, HR, GJ)
VAS. 2000 300 400 2700
TUB. 1400 200 400 2000
TUB. (PPS) 2200 300 500 3000
Mission Parivar Vikas
Districts
VAS. 3000 400 600 4000
TUB. 2000 300 500 2800
TUB. (PPS) 3000 400 600 4000
Other High focus states
(NE states, J&K, HP)
VAS. 1100 200 200 1500
TUB. 600 150 250 1000
Non High focus states
VAS. 1100 200 200 1500
TUB.
(BPL + SC/ ST only)
600 150 250 1000

25. Clinical Outreach Teams
• The scheme is applicable for 146 MPV districts in 7 high focus states
• Special package for provision of sterilization services
Female Sterilization Male Sterilization
Client 2000 3000
Motivator 300 400
COT Cost 2200 1600
Total 4500 5000
3/13/2023 25

26. Contd...Promoting quality sterilization services
National Family Planning Indemnity Scheme-
• Clients are indemnified in the unlikely events of deaths, complications and
failures following sterilization
• The providers/ accredited institutions are indemnified against
litigations
• The scheme was revised in 2013 and is now being operated by the state
governments directly with NHM funding.
Claims arising out of Sterilization Operation
Amount
(Rs.)
Additional as per Hon’ble
SC Directives
A Death at hospital/ within seven days of discharge
2,00,000 2,00,000
B
Death following Sterilization (8th – 30th day from
discharge)
50,000 50,000
C Expenses for treatment of Medical Complications
25,000 25,000
D Failure of Sterilization 30,000 30,000
E
Doctors/facilities covered for litigations up to 4 cases
per year including defense cost
2,00,000
(per case)

27. Contd…Promoting quality sterilization
services
•Mobile teams dedicated for FP services-
• Has been introduced in high focus states, in 2014-15, to
provide sterilization services in areas where there is dearth of
service providers.
•Scheme for ensuring drop back services to sterilization clients-
• The scheme was launched in 2015 as per demand from the
states to provide drop back to sterilization clients.

28. Sterilization
Performance
2014-15 2018-19 % Decline
Bihar 517,314 395560 -23.5
Chhattisgarh 48,153 65438 35.9
HP 17,706 10878 -38.6
JK 13,015 10184 -21.8
Jharkhand 114,313 90943 -20.4
MP 373,584 305919 -18.1
Rajasthan 303,436 246065 -18.9
Mizoram 1,545 1391 -10.0
Haryana 69,865 59480 -14.9
Karnataka 322,145 278427 -13.6
Maharashtra 470,682 393443 -16.4
Telangana 156,729 76310 -51.3
Tamil Nadu 311,741 232690 -25.4
West Bengal 197,101 173164 -12.1
Puducherry 8,651 6639 -23.3

29. Promoting quality IUCD services
• Interval IUCD:
• Can be provided in all public health facilities by a trained provider in OPD
• PPIUCD (Post partum IUCD):
• Inserted within 48 hours after delivery in facilities conducting deliveries
• PAIUCD (Post abortion IUCD):
• Inserted within 12 days of abortion in PHC and above facilities
PPIUCD and PAIUCD incentive scheme :
• Trained/Skilled empanelled provider inserting PPIUCD/PAIUCD- Rs 150 per
insertion.
• ASHA accompanying Client- Rs 150/insertion

30. PPIUCD Acceptance
(% acceptance out of total public health
deliveries)

31. Contd… Promoting quality IUCD services
•Increasing provider’s base for providing IUCD services-
• Task shifting was introduced for utilizing the army of doctors
qualified in ISM (Ayurveda, Unani, Siddha and Homeopathy)
for the provision of IUCD services after undergoing a
structured training, at peripheral public health facilities.

32. Generating demand and awareness for FP
services
• Improved counseling through RMNCH Counselors
• Celebration of World Population Day & fortnight (July 11 – July 24)
• Population stabilisation fortnight has helped to break the seasonal trend of sterilization services
in the northern states of India.
• It is being held in all blocks, districts and states of India since 2009 and the event is observed
over a month long period, split into:
• June 27 to July 10: “Dampati Sampark Pakhwada” or “Mobilisation Fortnight”
• July 11 to July 24: or “Jansankhya Sthirtha Pakhwada” or “Population Stabilisation
Fortnight”
• Celebration of Vasectomy fortnight (21st November to 4th December)
• The objective is to improve male participation in Family Planning

33. Quality Structures: Family Planning Indemnity
Subcommittee
Elements State FP Indemnity
Subcommittee (SISC)
District FP Indemnity
Subcommittee (DISC)
Members 5 5
Meeting
frequency
As often as warranted/
minimum half yearly
As often as warranted/
minimum quarterly
Quorum 3 members 3 members
Functions Redress, dispose and
disburse claims/ complaints
received through the DISC,
to the district health society
as per procedure and time
frame laid down in the
manual
Process claims received
from the clients and
complaints/claims lodged
against the surgeons and
accredited facilities, as per
procedure and time frame
laid down in the manual33

34. Composition of SISC
• Mission Director –NRHM (Vice
Chairperson)
• Director Family
Welfare/Director Health
Services/Director Public
Health/Equivalent (Convenor)
• Additional/Joint Director
(FW)/Deputy Director
(FW)/Equivalent, designated by
the state government as the
nodal officer for the Quality
Assurance Cell (Member
Secretary)
• One Empanelled
Gynaecologist (from public
institutions)
Composition of DISC
• District Collector (Chairperson)
• Chief Medical Officer/District
Health Officer (Convener)
• District Family Welfare
Officer/RCHO/ ACMO/
equivalent (Member secretary)
• One empanelled gynaecologist
(from public institutions)
• One empanelled surgeon(from
public institutions)

35. Hon’ble Supreme Court Directives
• Uploading following on state website: List of empaneled sterilization providers, Details
of S/DQAC member, Annual Report
• Availability and usage of Consent form, Medical record checklist and sterilization
certificate. The same to be translated in local language.
• Phase out camp approach for provision of sterilization services.
• Monitor at least 2 Public Health Facilities & 1 Accredited private/NGO Facility per month
• Document the minutes of meeting , Action Points and review in subsequent meeting
• Conduct client exit interviews during each visit (10% clients in each camp/fixed day
facilities)
• Strict adherence to the guidelines and standard operating procedures.

36. New Initiatives under Family Planning
•Mission Parivar Vikas
•Unified Software for FP logistics
•Expansion of Contraceptive basket of choices
•New Contraceptive Packaging
•New FP media campaign

37. Mission Parivar Vikas
• Objective:
To accelerate access to high
quality Family Planning
choices based on information,
reliable services and supplies
within the rights framework.
• Timing/ Phasing:
To implement the mission in
all the 146 districts at one go
and not in phases.
Bihar- 37 districts; RJ- 14
districts; MP- 25 districts; CG-
2 districts; JH- 2 districts)
Delivering assured
services
Dovetailing with new
promotional schemes
Ensuring commodity security
Building capacity (service
providers)
Creating enabling
environment
Close monitoring and
resolving implementation
bottlenecks

38. Unified Software for FP logistics
Aim:
To streamline FP logistics and
supply chain management
• Web based, App based and SMS
based application
• Instant access to stock
information from National level to
ASHA level
• Auto forecasting of contraceptives
• SMS alerts for key indicators
• Auto generated reports for
program review

39. New Communication Campaign
FP
Webpage
52 week
long radio
chat show
Toll free
helpline
number
Print ad
posters
Outdoor
Campaign
Celebrity
wats app
videos
Television
ads

40. Overall Impact of Family Planning Services
Source: Track
20 Estimates
Bihar Chhattisgarh
Himachal Pradesh
Haryana

41. Overall Impact of Family Planning Services
Source: Track
20 Estimates
Jharkhand Jammu and Kashmir
Karnataka Madhya Pradesh

42. Overall Impact of Family Planning Services
Source: Track
20 Estimates
Maharashtra
Puducherry
Mizoram
Rajasthan

43. Overall Impact of Family Planning Services
Source: Track
20 Estimates
Tamil Nadu Telangana

44. Its all about making the right
choice at the right time.
Responsible Us for a
Responsible Future!
Thank You…