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Reproductive & Child Health II - National Family Welfare Program

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Historical Background/Periodical Development
Maharashtra State is rich in its social & cultured heritage. In the last census, population wise Maharashtra was the third largest State in the country. However, as per latest 2001 census, it stands as second largest State in India. The percentage of 0–6 age group Population has decreased from 17.10 in 1981–91 to 13.63 in 1991–2001.

India was the first country to launch family planning program during 1952. The program was initiated in Maharashtra State during 1957. Initially the program had mainly Hospital based interventions. Later, the program adopted extension approach involving reaching to community for promotion of contraceptive Methods. The program achieved a boost during third year plan, wherein infra–structural inputs were provided. Supportive program like All India post partum program (1971), control of Diarrhoeal Diseases, Community Health Guide (CHG) scheme, Multipurpose Worker (MPW) scheme etc were introduced during subsequent years.

Major paradigm shift in the program was introduced in 1997 when Target Free Approach was initiated. This decentralized; Participary Planning Approach was later renamed as Community Needs Assessment Approach.

Maharashtra Government had taken continuous efforts to control its fast growing population. After reviewing the success and failures of existing strategies in 2000 the State Government introduced its own state population policy:
(Govt. Resolution No. Losandho–2000/Prakra57/00/Kuk–1, Mantralaya, Mumbai–32 Dt.9 May 2000)
&
(Govt .Resolution No. Losandho–2000/Prakra57/00/Kuk–1, Mantralaya, Mumbai–32 Dt.9 June 2000)
Objectives of National Family Welfare Programme

Main objective of the Family planning is to stabilize the population of the state. Fertility & Mortality are the major components of population change. Family planning program mainly regulates the fertility of population by protecting couples in reproductive ages by temporary & permanent methods .These services also help in reducing infant mortality as they increase the interval between two births and reduce the higher order births . Four activities are provided under the family planning program.

  1. Sterilization operation
    1. Male (Vasectomy/Non Scapel Vasectomy).
    2. Female (Abdominal Tubectomy/Laproscopic Tubectomy)
  2. IUD Insertion.
  3. Distribution of oral pills.
  4. Distribution of condoms.
  5. Re–canalization operation.

Main objective of the Family Planning is to stabilize the population of the state. Fertility & Mortality are the major component of Population Stabilization. The component Family Planning deals with fertility part.

Four activities are monitored under Family Planning Programme

  • Sterilization Operations (both Male & Female).
  • I.U.D. Instertions.
  • Distribution of Oral pills and condom.

For ensuring the quality, following steps have been under taken.

  • Eligible couple survey every year.
  • Concurrent evaluation & reliability checks.
  • Monitoring of sterilization deaths at district, regional & state level.

As per National Family Health Survey, II, (1998–99) the couple protection rate (CPR) for Maharashtra is 60.9 %.

Strategy of National Family Welfare Programme

Strategy Levels Strategy Levels

To identify beneficiaries
Health staff enumerates unprotected couples in the respective area at the beginning of the year through Eligible couple survey.

To motivate beneficiaries
After enumeration they list out unprotected Eligible couples, visit them to motivate for accepting family welfare method (Permanent or spacing).

To provide services
Sterilization operations are performed in Health Institutions. For Intra Uterine Device (IUD) insertions, Lady Doctor or Nurse Midwife (NM)/Lady Health Visitor (LHV) are trained.

Oral Pills (O.P.) cycle & Condom (C.C.) pieces distribution is through MPWs & ANMs at the Gross root level and also through all Health Institutes.

Support
Continuous follow–up after accepting family planning Method.

To ensure quality
Concurrent evaluation & reliability checks.
Monitoring of sterilization deaths at district, regional & state level.

To provide counseling to infertile couples

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