1) India has a rapidly growing population that is projected to surpass China's by 2022, becoming the world's most populous country. India currently makes up 17.5% of the global population but only 2.4% of the land area. 2) The National Family Planning Programme was launched in 1952, making India the first country to implement a national family planning program. It aims to promote small family norms and birth spacing through voluntary acceptance of family planning methods. 3) Common family planning methods available in India include natural methods, barrier methods like condoms, intrauterine devices (IUDs), hormonal methods like oral contraceptives and injectables, and permanent surgical methods like vase

1. SREERAJ.V.T
Jr. Health
Inspector
FAMILY PLANNING
;

2. Some Facts…..
 World population 711 Crore
 Indian Population 1,251,695,584 (July 2015
est.)
 Second most populous country
 Will become the first by 2022
 Occupies 17.5% of world population and
2.4% of land area.
 Population growth rate is 1.25%
 Birth rate is 20.22
 Death rate is 7.4

3. S.N
o.
Census Year Population % Change
1 1951 361,088,000 -----
2 1961 439,235,000 21.6
3 1971 548,160,000 24.8
4 1981 683,329,000 24.7
5 1991 846,387,888 23.9
6 2001 1,028,737,436 21.5
7 2011 1,210,726,932 17.7

6. Historical Background
 1952- National Family Planning
Programme
 1977- National Family Welfare
Programme
 1985- Universal Immunization
Programme
 1992- Child Survival And Safe
Motherhood Programme
 1997- RCH (Phase-1)
 2000 National Population Policy

7. The National Family Welfare
Programme was launched in 1952
as National Family Planning
Program.
India was the first one to do so.
It is 100% centrally sponsored
program.

8. EARLY DEVELOPMENT : -
 The second 5 year plan (1956 to 1961)
the “clinic approach” was adopted . Large
no of family planning clinic were opened
.
 In 1960 the NFWP entered a New
technological era with introduction of
the Lippi's loop later replaced by copper
T .

9. Later Development:-
 Target free approach
 IUD insertion at the rate of 20/1000
urban and 10/1000 rural.
 Integration with maternal and child
welfare , immunization , nutrition and non
formal education.
Medical termination of Pregnancy Act
PNDT Act.

10. AIMS & OBJECTIVES OF
FAMILY PLANNING
-To bring down population growth.
- To reduce the maternal & child
mortality rate.
- To control the unwanted birth.
- To prevent from Unsafe abortion.
- To bring out wanted birth.
- To bring interval between pregnancies.

11. 1. Operational goals
2. Demographic goals
1. Operational Goals :-
- To promote the voluntary acceptance of small
family norms .
 Family planning has two main goals :-
- To promote the people to use of spacing between
children &
Child survival.
GOALS OF FAMILY
PLANNING

12. DEMOGRAPHIC GOALS -:
- Stabilizing the population by the
year 2045.
- Reduce the infant mortality rate to
level below 30/1000 live childbirth.
- Reduce the maternal mortality rate
to the level below of 100/100,000
live child birth.

13. RCH Programme
The reproductive and child health program
was formally launched by Gov. of India on
15th Oct 1997. As per recommendation of
International Conference on Population
and development held in Cairo in 1994.

14. COMPONENTS OF RCH
Effective maternal and child health care
Increased access to contraceptive care
Safe management of unwanted pregnancies
Nutritional services to vulnerable groups
Prevention and treatment of RTI/ STD
Reproductive health services for adolescents
Prevention and treatment of gynecological
problems
Screening and treatment of cancers, especially

15. RCH Phase‐IAim
• To bring down the birth rate below 21 per 1000
population,
• To reduce the infant mortality rate below 60 per
1000 live birth and
• To bring down the maternal mortality rate
<400/1,00,000.
• 80% institutional delivery, 100% antenatal
care and 100% immunization of children were
other targeted aims of the RCH programme.

16. RCH Programme- II (2005-2009)
 To reduce Infant Mortality Rate (IMR),
 Maternal Mortality Rate (MMR)
 Total Fertility Rate (TFR)
 To increase Couple Protection Rate
(CPR)
 Immunization coverage, specially in
rural areas.
 The ultimate objective is population
stabilization , through responsible
reproductive behavior.

17. Vertical Programmes Integrated Service Delivery
Camp Oriented Client Oriented
TargetOriented Goal Oriented
Quantity Oriented Quality Oriented

18. FAMILY PLANNING
METHODS

19. METHODS
TEMPORARY
NATURAL MECHANICAL HORMONAL
PERMANEN
T
SURGICAL

20. NATURAL METHODS
a. Calendar Method
b. Basal Body
Temperature
c. Cervical Mucosa
d. Sympto thermal
Method
e. Ovulation awareness
f. Withdrawal Method

21. MECHANICAL
METTHODS
• Female
condom
• Male
Condom
• Diaphragm
• Spermicidal
Creams
• Intra uterine
devices

22. CONDOMS
ADVANTAGES :-
Cheaper & easy to carry.
 No side effect .
Protection against STD & AIDS.
Reduce the incidence of tubal fertility
& Ectopic pregnancy .
DISADVANTAGES :-
Inadequate sexual pleasure .
To discard after one coital act.

23. An IUD is known as Coil is a
small plastic and copper device .
Usually shaped like ‘T’ which is
fitted into uterus by a doctor
using a simple procedure and
provide protection against
pregnancy .
In IUD can stay in place 5 to 10
year .

24. COPPER T :
Copper reduces the fertility of woman so that it is
used for contraceptive.
Advantages :-
-Inexpensive , easy to use and can be inserted in
minimal time.
-Effective contraceptive.
-Fertility can be restored removal of copper T.
-Can be used up to 10 years.
-Disadvantages
-Pain and bleeding.
-Ectopic pregnancy.

25. Postpartum IUDs (PPIUD)
IUD insertion within 48 hrs of
childbirth

26. Intrauterine device (IUD) with
Progestogen

27.  In addition to birth control, hormonal
IUD are used for prevention and
treatment of:
 heavy menstrual periods
 Endometriosis and chronic pelvic
pain
 Adenomyosis and dysmenorrhea
 Anemia
 In some cases, use of a hormonal IUD
may prevent a need for
a hysterectomy

28. HORMONAL METHOD
Hormonal contraceptives are the effective
means of maintaining interval between births.
It includes :-
1. ORAL PILLS
2. Mixed Pills
3. Mini Pills ( Progesterone only pills)
4. Post Coital Pills
5. Non Steroidal weekly oral pills
6. Long acting /Once a month pills
7. Emergency Contraceptive pills ( E – Pills )

29.  Oral contraceptives (the pill) are hormonally
active pills which are usually taken by women
on a daily basis. They contain either two
hormones combined (progestogen and
estrogen) or a single hormone (progestogen).
 Combined oral contraceptives suppress
ovulation. Progestogen-only contraceptives
also suppress ovulation in about half of
women (they are slightly less effective). Both
types cause a thickening of the cervical
mucus, blocking sperm penetration.

30.  Oral contraceptives are 92 - 99% effective
 Pills are taken daily for 21 days and stopped
for 7 days before starting a new package
 Possible side effects include nausea, breast
tenderness, mild headaches, weight gain or
loss.
 The pill does NOT protect against sexually
transmitted infections (STIs, including HIV).

31. NON STEROIDAL WEEKLY ORAL PILLS :-
Ormeloxifene (also known
as Centchroman)
It is best known as a non-hormonal,
non-steroidal oral contraceptive which
is taken once per week
-

32. LONG ACTING /ONCE A MONTH PILLS :-
-Long acting estrogen & short acting Progesterone are
mixed in this tablet.
- This pill is taken only once a month.
- Its harmful effect only rate of failure is very high .
- Advantages :-
- Prevents pregencey
- Shortness period.
- Prevents ovarian and uterine cancer.
- Disadvantages :-
- Headache
- Malaise
- Leg cramps
- Weight gain.
- Sleep disturbance.
- Hypertension

33. CONTRACEPTIVE PILLS (
ECPs or E – PILLS )
 ECPs are used to prevent pregnancy
following an unprotected sexual intercourse
.If taken within 72 hours ECPs are safe for
all women.
 Levonorgestrel is a
manufactured hormone used in this pill.
 The first pills should be taken as soon as
possible but certainly before 72 hrs.

34. Medical Termination of
Pregnancy
MTP Act 1971
Abortions are termed legal only when all the
following conditions are met:
 Termination done by a medical practitioner
approved by the Act
 Termination done at a place approved under the
Act
 Termination done for conditions and within the
gestation prescribed by the Act
 Other requirements of the rules & regulations are
complied with

35. When can pregnancies be terminated?
 Up to 20 weeks gestation
 With the consent of the women. If the women is
below 18 years or is mentally ill, then with consent of
a guardian
 With the opinion of a registered medical practitioner,
formed in good faith, under certain circumstances
 Opinion of two RMPs required for termination of
pregnancy between 12 and 20 weeks

36. MTP Act: Indications
 Continuation of pregnancy constitutes risk to the life or
grave injury to the physical or mental health of woman
 Substantial risk of physical or mental abnormalities in the
fetus as to render it seriously handicapped
 Pregnancy caused by rape (presumed grave injury to
mental health)
 Contraceptive failure in married couple

37. SURGICAL METHOD :-
 VESECTOMY :-
 It is simple operation performed under local
anesthesia .
 In this method both of the vas-difference are cut 1cm
each & clamped or their heads are tied in a manner
that they can not unite again .
 These days more attention in being paid to Non
Scalpel Vasectomy –NSV- to avoid cuts & stitches.

38. NO-SCALPEL VASECTOMY

39. VASECTOMY
Small incision in the scrotum under LA
 A piece of vas at least 1cm removed after clamping
Cut ends are ligated & folded upon themselves
Sutured so that cut ends face away from each other
oSterility not immediate (at least 30 ejaculations)
oSperms are stored in reproductive tract upto 3 months
oSperms destroyed intra luminally by phagocytosis
o2 semen analysis- no sperm –man declared sterile

40. ADVANTAGES OF NSV
 No incision, no stitch
 Minimal dissection using only 3 instruments
 Chance of complications reduced from 2% th
0.3%
 Safer, convenient, acceptable method
 Cheaper compared to tubectomy

41. Non Scalpel Vasectomy
Local Anaesthesia is
given
Vas deferens fixed by a
ring forceps so that
only minimal amount
of tissue is present in
the ring

42. Skin directly overlying
the vas in the ring
forceps is punctured
Puncturing hole is
enlarged to about
twice the diameter of
vas deferens

43. Delivering the vas
out of the puncture
hole

44. Ligaturing the ends
of vas & excising a
small segment
Tied ends are pushed
back into scrotum
Opposite vas is also
manipulated

45. POST OPERATIVE CARE
 Wear a T bandage for 15days
 Avoid bathing 24hrs after the operation
• Keep the site clean & dry
 Avoid cycling or lifting heavy weights for 15
days
 Use contraceptives until aspermia has been
established
 Have stitches removed on 5th day after
operation

46. COMPLICATIONS OF
VASECTOMY
 Local pain, skin discolouration, bleeding
 Infection, trauma to artery ,gangrene
 Ab formation, autoimmune disease
 Failure rate
 Granuloma formation
 Spontaneous recanalization
 Spermatocele formation
 Haematoma

47. DISADVANTAGES OF NSV
 Haematoma formation
 Sepsis
 Recanalization

48. TUBECTOMY :-
1. Traditional method
This method is known as the abdominal
tubectomy in which under Spinal or
General anesthesia.
2. Mini lap :-
This is minor from abdominal tubectomy in
which under local anesthesia .
3. Laparoscopy :-
In this technique using a laparoscope through
the abdomen .

49.  Local infection.
 Some women complain of bleeding.
 Irregulatingr of cycle.
DISADVANTAGES
 This method is almost 100% safe against
pregencey .
 Minimal complication .
 Comparatively less expensive .
ADVANTAGES

50. Our Roll…..