Demography introduction, IMPORTANCE OF DEMOGRAPHY,COMMON SOURCES & INDICATORS OF DEMOGRAPHY, Demography cycle,Family planning,objectives,Efforts made in the past,individuals and organisations took initiative to propagate the need for birth control,Contraceptive methods,Various birth control methods like Behavioural methods, Natural methods, Chemical methods, Mechanical methods, Hormonal methods, Terminal methods, Post-conceptional methods,Role Pharmacist of family planning.

1. PREVENTIVE HEALTHCARE
Presented By
Ms. Monika P. Maske
Assistant Professor
M. Pharm
(Pharmaceutical Chemistry)

2. DEMOGRAPHY INTRODUCTION
o The study of human population, their composition, distribution, size, causes and
consequences of any change in these characteristics is known as demography.
o It also defined as the statistical study of populations which involves studying the
structure, size and distribution of populations.
o The temporal or spatial changes according to birth, aging, death or migration are
also studied in demography.

3. o Its common science applied to any type of dynamic population which is
changes with time or space.
o Demography includes :
1. Population distribution in spaces
2. Change in the population size
3. Population composition

4. o Four demographic process are fertility, mortality, marriage and social
mobility.
o This regularly work within a population to determine its size, composition
and distribution.
o Education, religion, ethnicity and nationality are the parameters involved
in demographic analysis.

5. IMPORTANCE OF DEMOGRAPHY
• Control the population growth by adding any modus.
• The demography define the health status of any population or community and
provided the regular health services.
• After demographic study, we can fulfill the nutritional supplement, regular medicine
and also fulfill the population needs.
• Improve the education level of any nation or state by providing the
usable/accessory study materials and equipment's.

6. COMMON SOURCES & INDICATORS OF
DEMOGRAPHY
• Birth rate : Birth rate is the statistic or rational expression about the, number of
live births in a given area during a given time per 1000 population.
• Death rate : Death rate is the statistic or rational expression about the, number
of deaths in a given area during a given time per 1000.
• Infant mortality rate : Number of death of babies before the age of one year
per 1000 live births.

7. • Age – Age structure of the population refers to the proportion of persons in different
age groups relative to the total population.
• Sex ratio— Sex ratio refers to the number of females per 1000 males in a given area
at a specified time period.
• Maternal mortality rate—Number of women who die in child birth per 1, 00,000 live
birth.

8. • Fertility rate : The fertility rate refers to the number of live per births per 1000 women in the
child bearing age group, usually taken to be 15 to 49 years.
• Migration rate : Due to the migration of people, it indicates the demographical
changes in the population and affect the rational presentation. It is effect by two ways,
Emigration - is the process of relocation, in which people replace our
residential place by another place.
Immigration - is also the process of relocation, in which people comes from
their residential area and live another developed or suitable area.

9. DEMOGRAPHY CYCLE
o The population growth of any nation takes place according to cycle.
o Stages of Demography cycle are:
1. High Stationary Stage :- High birth and high death rates are the characteristic
feature of this stage.
- The birth and death rates act with respect to each other in a specific position, so the
population remains stable.

10. 2. Early Expanding Stage :- The death rate begins to fall while the birth rate
continues at or near to the maximum, resulting in increase in population.
3. Late Expanding Stage :- The birth rate begins to decline, but the population
continues to grow because the because the birth rate is still higher than the death
rate.
4. Low Stationary Storage :- The population again become stationary with low
birth and low death rate i.e. overall population remains constant.
5. Declining Stage :- The population declines because death rate exceeds the birth
rate.

11. STAGES OF DEMOGRAPHIC CYCLE

12. FAMILY PLANNING
In 1971, WHO defined family planning is “a way of thinking and
living adopted voluntarily on the basis of knowledge, attitudes and
responsible decision by individuals and couples, in order to promote health and
welfare of the family group and thus contribute effectively to the social
development of a country”.

13. OBJECTIVES
o To avoid unwanted birth.
o To bring about wanted births.
o To regulate the intervals between each pregnancy.
o To control the time at which birth occur in relation to the parents age.
o To determine the number of children in a family.

14. EFFORTS MADE IN THE PAST
o In ancient India, people preferred large families due to certain social and
religious obligations.
o The Rigveda says “A man with many children succumbs to miseries”.
o Beginning of 20th century, Professor R.D. Karve started birth control clinic and
contraceptive centre at Bombay.

15. INDIVIDUALS AND ORGANISATIONS TOOK
INITIATIVE TO PROPAGATE THE NEED FOR BIRTH
CONTROL
o 1922- Indian birth control society formed in Delhi by Gopalji Ahluwalia.
o 1923- Birth Control League started in Bombay by N.S. Phadke.
o 1929- Dr. A.P. Pillay founded wives clinic in Sholapur.
o 1930- Birth Control Clinic at Mysore and Banglore.
o 1949- Family Planning Association of India.

16. CONTRACEPTIVE METHODS
o The scientifically tested and reliable contraception methods are available.
o It helps a couple to avoid unwanted pregnancies.
o The individual or only they can decide best and acceptable for them.
o The family planning or contraceptive methods prevents the sperm to fuse with
the ova released and avoid pregnancy.

17. VARIOUS BIRTH CONTROL METHODS
o Behavioural methods
o Natural methods
o Chemical methods
o Mechanical methods
o Hormonal methods
o Terminal methods
o Post-conceptional methods

18. 1. BEHAVIOURAL METHODS
A. Abstinence :-
- This method is 100% effective.
- The amount to suppression of natural physiological instinct.
- Which may cause unpredictable changes and nervous breakdown.
- This method is not suitable for common people.

19. B. Coitus Interruptus :-
- Its oldest method of voluntary fertility control.
- The male withdraws before ejaculation.
- This prevent deposition into the vagina.
- This method is limited appeal and practically.

20. C. Safe Period or Calendar Method :-
- This method based on ovulation occurs from 12-16 days before menstruation
begins.
- The couple should avoid intercourse from 10th to 18th day of menstrual cycle
counting from the 1st day of menstrual period.
- This method is not reliable because the menstrual cycle may vary.
- Only educated and responsible couples having high motivation and cooperation can
use this method effectively.

21. 1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28
Safe & Risky Periods for Family Planning by Calendar Method
(for 28 days regular Menstrual Cycle)
• Days 1-5 the menstruation days.
• Days 6-9 the safe periods in which conception cannot occur.
• Days 10-18 the unsafe period in which conception can occur.
• Days 19-28 the safe periods in which conception cannot occur.

22. 2. NATURAL FAMILY PLANNING METHODS
• This method depends on some physiological sign and symptoms in the women
which they should recognise.
• These symptoms are correlated with ovulation, the beginning of fertile period,
during which couple should avoid sexual intercourse can be determined.
• Natural family planning methods are,

23. A. Basal Body Temperature Method :-
• At the time of ovulation, the basal body temperature increases by 0.3 – 0.5 degree
C.
• This because of the production of progesterone is increases at this time.
• It measure at morning before getting out of bed.
• This method is effective if intercourse is avoided in the post-ovulatory infertile period
which begins 3 days after.

24. • The increase in ovulatory temperature and continues till beginning of menstrual cycle.
• Total abstinence is recommended during the entire pre-ovulatory period.
2. Symptothermic Method :-
The physiological symptoms develops when basal temperature
rises, the mucus characteristics and estimation of safe period are combined and women
double check her interpretation of the infertile period.

25. C. Cervical Mucus Method :-
• The beginning of ovulation the cervical mucus become watery, clear like the raw beg
white, smooth, slippery and profuse.
• After ovulation it becomes thick and quantity decreases.
• The women should wipe the inside of vagina using a tissue paper to evaluate the mucus
characteristic.
• This method is effective only when used by intelligent and motivated women who can
differentiate the different mucus type.

27. 3. CHEMICAL METHODS
• In this method chemical contraceptive is used in which incorporated spermicide is
present.
• The surface active agents are the commonly used spermicide.
• These agents come in contact with sperms inhibit their ability of oxygen uptake and
kill them.
• The spermicide should introduce in vagina 15 min. before intercourse.
• The chemical methods of family planning involves are,

28. A. Foam Tablets :
• These tablets are inserted by the women into vagina before intercourse.
• The tablet produced foam after insertion, this foam forms a protective coat to
whole area.
• Kill the sperms released in the vagina during intercourse and prevents
pregnancy.

29. B. Spermicidal Jellies/Creams/Pastes :
• These applied in vagina with the help of an applicator.
• They destroy the sperm in vaginal canal.
• These effective only when used along with diaphragm or condom.
Drawbacks :
• High rate of failure.
• Difficulty to used.
• causes burning or irritation.
• Not fully effective with another barrier.

30. 4. MECHANICAL METHOD
• These method aim is to prevent meet of sperm and ovum.
• These method does not produced any side effects, protected against sexually
transmitted diseases, inflammatory disease and also protect from of cervical
cancer.
• These method is most popular.

31. A. Condom or Nirodh :
• Its very thin rubber sheath used by males.
• The Indian Government introduced 3 brands of Nirodh,
1. Dry Nirodh
2. Deluxe Nirodh ( a lubricated condom)
3. Super-Delux Nirodh ( thiner 0.03-0.04mm), lubricated, coloured.

32. • The condoms used to cover the penis in the male, just before intercourse so that the
ejaculated semen would not enter into the female reproductive tract.
• It also prevented the STDs.
Drawbacks :
• Male or female are sensitive to rubber.
• They may tear or slip during intercourse.
• Some couples feels rubber sheath interferes with their sexual sensation.

33. Advantages :
• Simplest, more effective, easily available and easy to use.
• Do not produce any side effects.
• Protect against STD.
• Light, compact and disposable.
• Withdraw when couple desire to have child.

34. B. Diaphragm or Dutch Cap :
• Its made of rubber that are inserted into the female reproductive tract to
cover the cervix during coitus.
Advantages :
• No side effects.
• Reversible non-invasive method.

35. Drawback :
• May sensitive to rubber.
• Failure rate is high so it should be used properly.
• After used it should be removed and washed.
• A high standard of hygiene should be maintained while storing otherwise may
causes infections.
Dutch Cap or Cervical Cup

36. C. Intra-Uterine Device (IUDs) :
• The most effective and popular method are inserted by doctors or experts nurses
in the uterus through vagina.
• Its made up of polyethylene.
• Types of IUDs are used,
1. Non-mediated IUDs - Example- Lippes loop.
2. Copper releasing IUDs - Example- CuT, Cu7, Multiload 375.
3. Hormone releasing IUDs - Example- Progestasert, LNG-20.

37. • Implants and injection - Progestogens alone or in combination with estrogen
can also be used by female as injections or implants under the skin. Their
effective period are much longer.
Advantages :
• Simple device which is insert by women at home and reversible method.
• No side effects, high acceptability and continuation rate.

38. Drawback :
• In some cases heavy bleeding, abdominal cramps for few weeks or days.
• Does not delay first pregnancy.
• Device expelled automatically.

39. 5. HORMONAL METHODS
• Pregnancy is 100% prevented by Combined Oral Contraceptive Pills
(COPs).
• These method is best ensure a desired gap between each pregnancy.
Oestrogen-Progestin Combination (Combined Oral Contraceptive Pill) :
• Combine synthetic pill contain oestrogen (30-35microgram) and progestrogen
(0.1-1.0mg).

40. • Pills starting from 5th day of menstrual cycle.
• If bleeding does not occur the women should continue the next course for a week.
• It does not given to already pregnant lady, age is more than 35 years, diabetic
patients, suffered from jaundice, cancer patients and lactating mother.

41. Progestogen-Only Pill (Mini Pill) :
• Norethisterone, levonorgestrel or ethynodiol drugs incorporated in this pill.
• The pill increases viscosity of cervical mucus and thin endometrium so it
prevents meeting of sperm with ova.

42. 6. TERMINAL OR SURGICAL METHOD
• This perform in both male and female. Surgical method is also called
sterilization method which blocks gamete transport and thereby prevent
conception.
• Three methods are used,

43. 1. Tubectomy - In tubectomy, a small part of the fallopian tube removed or tied up
through a small incision in the abdomen or through vagina.
2. Vasectomy - In vasectomy, a small part of the vas deferens is removed or tied up
through a small incision on the srotum.
Tubectomy Vasectomy

44. 3. Laparoscopy – In laparoscopy a small cut is made in the abdominal of
female and inflated with air or gas when fallopian tube is visible they block by
clips.
• It provide permeant protection against unwanted pregnancies.
• No side effects
• No complications.
Laparoscopy

45. 7. POST – CONCEPTIONAL METHOD
• Levonorgestrel alone or with combination should taken orally within 72 hrs. of
unprotect intercourse and repeated after 12 hrs.
• Three regimens of emergency contraception are,
1. Levonorgestrel (0.5 mg) + Ethinylestradiol (0.1 mg) regimen name is Yuzpe
method.
2. Levonorgestrel (0.75 mg) it is 2-3 times more effective.
3. Mifepristone (600 mg) with no side effects.

46. Sequential Pills or Sequential Oestrogen-Progeston Preparations :
• This recommended for women taking combine HRT (Hormone Replacement
Therapy).
• Experience menopausal symptoms but still have menstruation.
1. Monthly HRT : It is recommended for women with regular periods.
2. Three-Monthly HRT : It is recommended for women with irregular periods.

47. ROLE PHARMACIST OF FAMILY PLANNING
• The family planning posters in hospitals and drug stores.
• Counselling people about the importance of family planning , gap years
between children.
• Handing out pamphlets of family planning.
• Educating about oral contraceptives and family planning methods.
• Addressing family planning centres.

48. • Monitoring the raising population through advising the people and educating
programmes that focus on the issues of high population.
• Instructing and convincing people about the small families.
• Organising discussions, seminars and certification.
• Providing social facilities.

49. THANK YOU