Family Planning in India
Family Planning in India is a part of Family Welfare Programme to tackle the population problem in India. The family planning programs are run by the “Ministry of Health and Family Welfare”.
The Indian Government has taken massive efforts for family planning. There has been an increase in usage of contraceptives in the past few decades. Still, considering the present population, the rate of surge in population is a national issue.
Increasing population in India is a problem. By 1981, India’s population had doubled itself since 1947. Since then, it is increasing by about 150 lakh/ per year. By 2012, India’s population touched over 1.22 billion.
Such a rapid increase in population has very serious repercussions on the socio-economic development of the country. Varying social customs and beliefs favor large family which impedes the process of change which could accelerate with the adoption of modern methods of contraception. A universal desire to have at least one or two male children and the ‘mean age’ of marriage of women at 18 years could also become contributory factors to large families.
In India, family planning of having one or two child in not mandatory by law. It is promoted by the Government by highlighting the benefits of using birth-control methods to control population. In keeping with the democratic traditions of the country, the Family Welfare Programme seeks to promote on a voluntary basis, responsible and planned parenthood with two-child norm, male, female or both, through independent choice of family welfare methods best spited to the acceptors.
Family welfare services are offered through the total health-care delivery system. People’s participation is sought through all institutions, voluntary agencies, opinion leaders, people’s representatives, government functionaries and various other structures and influential groups. Imaginative use of the mass media and inter-personal communication is resorted to for explaining the various methods of contraception and removing socio-cultural barriers wherever they exist. As a result of this approach, the number of acceptors of various methods of family welfare has started to register progressive increase over the years.
The Family Welfare Programme which began as a people’s movement continues to be implemented on a voluntary basis. Maternal and child healthcare, family welfare, women’s rights and nutrition are integral to it. The strategy being followed is constantly tailored to cater to the needs of the changing society.
The programmes are implemented through the state governments for which Central assistance is provided. In rural areas, the programme is being further extended through a network of primary health centers and sub-centers.
Maternal and child health-care and expanded programme of immunization are also a part of the family welfare programme.
The Central Family Council advises on family welfare programmes at the national level. A number of Central committees like the Research Coordination Committee have been set up to study the progress of research programmes.
Nirodh, is provided under the social marketing programme which is being operated through a network of retail outlets of leading consumer goods and pharmaceutical and oil companies. Under the free distribution scheme besides Nirodh, Jelly cream tubes are also distributed.
The oral pill programme under free scheme was extended to all the urban centers, including those run by local bodies and voluntary organizations. Besides this, social marketing of oral pill has also been undertaken with the help of four pharmaceutical companies on zonal basis. Oral pills are being sold under the social marketing programme under the brand name `Mala-D’.
It is estimated that 39.8 per cent of 13.57 crore eligible couples whose wives are in the reproductive age group of 15-44, were protected by one or another of the approved methods of family welfare as on 31 March 1988. As a result, 953 lakh births had been averted.
The programme of medical termination of pregnancy through well- trained doctors in well-equipped approved hospitals is essentially a health-care measure. But in a way, it supplements the family welfare programme as it provides for legalized abortion in cases of contraceptive failures also. A good proportion of the acceptors of abortion go in for some form of contraception like sterilization, IUD, etc. The Medical Termination of Pregnancy Act, 1971 is in operation since April 1972.
Care of mothers and children and vulnerable groups of the society plays a pivotal role in family welfare programmes. The Maternity and Child Health Programmes (MCH) are directed towards effective ante-natal care, ensuring safe and aseptic delivery and appropriate post-natal care, initiation and maintenance of breast-feeding, timely immunization against common infectious diseases, control of diarrhea, attention to growth and provision of basic medical care, etc.
Infrastructure of health is being extended and manpower being trained to achieve these objectives of MCH cares. To provide specialized pediatric care, pediatric units in districts, sub-divisional hospitals and newly set-up units of district hospitals have been and are being equipped. A sum of Rs. 33 crore had been provided during 1987-88 for procurement of vaccines and MCH drugs for immunizing children and mothers against diseases and preventing nutritional anemia. An amount of Rs.5 crore had been provided for the programme of control of diarrheal diseases among children through one rehydration therapy during 1987-88. This programme had been initiated during 1986-87 and there was a provision of Rs.25 crore for this new programme during the Seventh Plan.
The question of more effective coverage of population and coordinative working was considered by the Executive Committee of Central Family Planning Council in 1972, which led to formation of a package of health and family welfare services at the peripheral level by multi-purpose health workers. Under this scheme, the state-level health administrators were trained at the National Institute of Health and Family Welfare in the concept and philosophy of the multi-purpose workers’ scheme. The district level medical officers and key-trainers of health and family welfare training centers were trained at Central training institutes.
The post-partum programme is a maternity centered hospital based approach to family welfare programme and now, covers medical institutions at national, state and district levels. These include medical colleges and post-graduate institutions. Besides, medical colleges are also implementing PAP smear-test facilities programme for early detection of cervical cancer among acceptors of family welfare methods. The purpose of extension of the post-partum programme to sub-district hospitals is to provide the maternal and child health-care services in rural and semi-urban areas so as to bring an overall improvement in the health status of the mother and the infants
The Urban Revamping Scheme has been introduced with a view to providing improved service delivery out-reach system of primary healthcare, family welfare and maternity services in urban areas. No new urban family welfare centers are to be set up but existing urban forces are to be reorganized and new health posts established as per the recommendations of the working group.
Sterilization beds scheme provides immediate facilities for tubectomy operations in the hospitals where such cases could not be admitted due to lack of facilities. Under the scheme, beds are sanctioned to those medical institutions/hospitals which are run by voluntary organizations on the basis of their performance during the previous year. Beds are sanctioned to the voluntary institutions on the recommendations of the state governments and regional director of health and family welfare of the respective states.
As on 2009, the fertility rate of India was 2.7. The family welfare programme in India depends on its voluntary acceptance by the people. To approach a large population of couples in the reproductive age group, living in urban and remote rural areas, a broad-based mass education and motivation programme had been launched. The ultimate objectives of the projects are to improve health and family welfare infrastructure in the area covered and to reduce maternal and child mortality and morbidity.
Bio-medical research in the field of reproductive biology and fertility control is being done in the Indian Council of Medical Research, Central Drug Research Institute, All India Institute of Medical Sciences and National Institute of health and Family Welfare.