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FAMILY WELFARE

PROGRAMME

FAMILY WELFARE PROGRAMME


India launched a nation wide Family Planning
Programmed in 1952.
India is the first country in the world to launch
such a programme.
A separate department of Family Planning was
created in 1966 in the ministry of health.
In 1977, the Janata Government formulated a
new population policy ruling out compulsion.
The acceptance of the programme was made
purely voluntary.
Also the Janata government named the FP dept.
as Department of Family Welfare.
The allocation for these programmes was just 0.1
crore in First Five year plan. It has increased to
3256 crores in the seventh plan.

CONCEPT OF FWP
It is a Centrally sponsored programme.
For this, the states receive 100 per cent
assistance from Central Government.
The current policy is to promote family planning
on the basis of voluntary and informed
acceptance with full community participation.
The emphasis is on a 2 child family.
Also, the emphasis is on spacing methods along
with terminal methods.
The services are taken to every doorstep in order
to motivate families to accept the small family
norm

AIMS OF FWP

Family welfare programme has laid down the


following long term goals to be achieved by
the year 2000 AD:
Reduction of birth rate from 29 per 1000 (in
1992) to 21 by 2000 AD
Reduction of death rate from 10 (in 1992) to
9 per 1000.
Raising couple protection rate from 43.3 (in
1990) to 60 per cent.
Reduction in average family size from 4.2 (in
1990) to 2.3.
Decrease in Infant mortality rate from 79 (in
1992) to less than 60 per 1000 live births.
Reduction of Net Reproduction Rate from
1.48 (in 1981) to 1.

ELIGIBLE COUPLES, TARGET COUPLES AND COUPLE


PROTECTION RATE
Eligible couples:

An eligible couple is a currently married


couple, the wife being in the reproductive age
group i.e. 15 to 45 year.
It is estimated that there are 150 to 180
eligible couples per 1000 population in India.
Presently, there are about 144 million eligible
couples in India. These couples are in need of
family planning services.

Target couples:
They are couples who have had 2 to 3 living children. Family planning
was largely directed to such couples.
The definition of target couple has been gradually enlarged to include
families with one child or even newly married couple.
The aim is to develop acceptance of the idea of family planning from
the earliest possible stage.

Couple protection rate (CPR):


It is defined as the percentage of eligible couples effectively protected
against child birth by one or other methods of family planning.
CPR is an indicator of the prevalence of contraceptive practice in the
community.
The long term demographic goal is to achieve couple protection rate of
60 per cent by the year 2000 AD.

IMPORTANCE OF FWP

Integration with health services: Family welfare


programme (FWP) has been integrated with other health
services instead of being a separate service.

Integration with maternity and child health: FWP


has been integrated with maternity and child health
(MCH). Public are motivated for post delivery sterilization,
abortion and use of contraceptives.

Concentration in rural areas: FWP are concentrated


more in rural areas at the level of subentries and primary
health centers. This is in addition to hospitals at district,
state and central levels.

Literacy: There is a direct correlation between illiteracy

Breast feeding: Breast feeding is encouraged. It is estimated that about


5 million births per annum can be prevented through breast feeding.

Raising the age for marriage: Under the child marriage restraint bill
(1978), the age of marriage has been raised to 21 years for males and 18
years for females. This has some impact on fertility.

Minimum needs programme: It was launched in the Fifth Five Year Plan
with an aim to raise the economical standards. Fertility is low in higher
income groups. So fertility rate can be lowered by increasing economical
standards.

Incentives: Monetary incentives have been given in family planning


programmes, especially for poor classes. But these incentives have not
been very effective. So the programme must be on voluntary basis.

Mass media: Motivation through radio, television, cinemas, news


papers, puppet shows and folk dances is an important aspect of this
programme.

NATIONAL
POPULATION POLICY

WHAT IS A POLICY?
Set

of Ideas or Plans that is used


as a basis for decision making;
Attitude and actions of an
organization regarding a
particular issue;
General Statement of
understanding which guide
decision making.

NATIONAL POPULATION POLICY


What is Population Policy?

A deliberate effort by a national government to


(Driver,1972). influence the demographic variables
like fertility, mortality and migration.

Influence the size, distribution or composition of


human population

FOUR STAGES OF POLICY


PROCESS
Problem

Identification and Issue


Recognition
Policy Formulation
Policy Implementation
Policy Evaluation

OBJECTIVES

to address the unmet needs for contraception.

to provide integrated service infrastructure, and health


personnel delivery for basic reproductive and child health care.

is to achieve a stable population by 2045, at a level consistent


with the requirements of sustainable economic growth, social
development, and environmental protection

Make school and child health services, supplies and


infrastructure. education up to age 14, free and compulsory
and reduce drop outs at primary and secondary school levels to
below 20% for both girls and Reduce infant mortality rate to
below 30 per 1000 live births boys

Reduce maternal mortality ratio to below 100 per 100,000


live,

Achieve universal immunization of children against all


vaccine births. Promote delayed marriage for girls, not earlier
preventable diseases. than age 18and preferably after 20
years of age.

NATIONAL POPULATION POLICY


-MILESTONES
1946-

Bhore Committee Report


1952- Family Planning Programme
1976- Statement of National
Population Policy
1977- Policy Statement of Family
Welfare Programme

CONT
1983-

National Health Policy


emphasized the need
1991- National Development
Council appointed a Committee
1993- Dr. Swaminathan group
prepared a Draft and discussed
by cabinet and then Parliament

CONT..
1991-

Circulated and requested


comments from Central and State
Agencies
1997- Promised to announce this
policy in near future
1999- Another Draft Policy was
finished and finalized it on 19th
Nov.

PROGRAMMES IMPLEMENTED TO
ACHIEVE IMMEDIATE GOAL AND
MEDIUM TERM GOAL
Aims up to 2010
IMR below 30/1,000 live births
MMR below 100/1,00,000 live births
80% institutional deliveries
100% registration of vital events
Medium Term Goal
Total fertility Rate to replacement level

CONT..
Themes to achieve these
Objectives
Decentralized planning and
implementation
Empowering women and
encouraging male involvement

CONT
Meeting

the unmet need for


family Welfare Services
Addressing the needs of
disadvantaged and under- served
population groups
Encouraging public- private
partnership

MATERNAL AND CHILD HEALTH PROGRAM


Maternal and child health refers to promotive,
preventive and curative health care activities for mothers
and children
Objectives of MCH

To reduce maternal, infant and childhood mortality

and morbidity.
To

promote reproductive health

To

promote physical and psychological development of

children and adolescents

POLICY GUIDELINES FOR IMPLEMENTATION OF MCH


PROGRAM:

Effective use should be made of existing resources and


infrastructures available in the community.

The services should be delivered as close to the homes of


beneficiaries as possible.

Services for mothers and children should be delivered in an


integrated manner.

Child survival programs should serve as a sugar coating for delivery


of the family planning programs which in general, are not popular.

Voluntary agencies working in the area should be involved in


providing MCH services.

PACKAGE OF SERVICES RENDERED IN MCH PROGRAMS


The multipurpose health workers form the backbone of this program They
are expected to:

Record occurrence of pregnancy in their work area on the basis of history of


missed periods and

Screen women identified as pregnant for any of the under mentioned Risk
factors

Age less than 145cm

Weight less than 40 kg or more than 70kg

History of stillbirths pregnancy

History of stillbirths

History of cesarean section as indicated by scar in lower mid- abdomen.

Identify women with moderate severe anemia

Administer two doses of tetanus toxoid


Provide iron and folic acid tablets to pregnant women for a period of 180 days.

Antenatal Care

The package of antenatal care for all pregnant women


consists of

Screening for anemia, eclampsia

and pre eclampsia

and multiple pregnancies

Hb estimation, blood pressure and fund height is


measured.

Advised to edt more food than general.

Breast are examined to exclude retracted nipple.

New born care

Regarding spacing of further birth.

Intra natal care

Trained birth attendant

Use aseptic precautions during delivery of infant, severance of cord


and subsequent care of the cord and infant.

Education to mothers regarding

Breast feeding (Exclusive breast feeding)

Immunization

Family planning and

General health

Care of children

Monitoring of growth of children to detect faltering


of weight gain or malnutrition.

Immunization against Vaccine Preventable diseases

Treat of common ailments as per the IMCI


guidelines

Referral of cases to health institutions

Implement national health programs.

Impart

health

community.

and

nutrition

education

to

Implementation of MCH Programs

Medical officer of PHC is the leader of the health team

Services are delivered by staff members of the PHC and sub


centres.

INTEGRATED CHILD DEVELOPMENT SERVICES


PROGRAM(ICDS)

ICDS was launched in 1975 in 33 community development


blocks and now spread to more than 4000 CD blocks.

OBJECTIVES:

To improve the nutritional and health status of


children in the age group of 0 to 6 years.

To lay sound foundation of Psychological , Physical and


social development of child.

To reduce morbidity, mortality, malnutrition and


school drop - out rates.

To impart nutrition and health education to mothers


for making them more competent in looking after
nutrition and health needs of children.

PACKAGE OF SERVICES RENDERED IN ICDS PROGRAM:


The scheme is focused for the benefit of preschool children and
pregnant and lactating women in the reproductive age group (1544 yrs).
The Package of services provided by the ICDS scheme is given
below.

The expectant and lactating women are offered heath check-ups,


immunization

against

tetanus,

nutritional

supplements,

nutrition and health education.

Recently health check-ups of adolescent girls have also been


included in the program.

Children below the age of 36 months, are given health check-up,


immunization and nutrition supplements.

Children between 36 to 72 months also receive non formal


preschool education

Children are also administered

a dose of 20000 international

units of vitamin a every 6 months.

Iron and folic acid provided to pregnant women and nursing


mothers:

Health checkup of children includes record of weight for


identification of mal nourished children, who received special
attention.

Implementation of ICDS program

ICDS work

is administered by child development project officer

(CDPO), the anganwadi workers monthly report to CDPO.

CHILD SURVIVAL AND SAFE MOTHER HOOD PROGRAM


CSSM was initiated in 1992 the different components of
the program are:

Advice on Breast feeding

Care of the newborn infant

Resuscitation of the neonate

Care of low birth weight infant and also services to


pregnant women. Package of services the services under
this program provided to

Pregnant women

Infants and children under 5 years of age

Pregnant women

Essential care for all register by 12-16wks

Antenatal checkup at least 2 times

Immunization with T.T

Give IFA (1 tablet a day for 100 days)

Treat those with clinical anemia (2 tablets a day for 100


days)

Deworm with mebendazole (during 2nd/3rd trimester)

Safe and clean delivery services

Prepare women for exclusive breast feeding and timely


weaning.

Early detection of complications:

Clinical examination to detect

Bleeding indication APH or PPH

Weight gain more than 3kg in a month

Systolic BP of 140mm Hg or more

Fever 39oC and above after delivery or after abortion.

Prolonged or obstructed labor

Emergency care for those who need it

Early identification of obstetric emergencies

Provide initial management and refer to identified


referral units.

Use fastest available mode of transport women in the


reproductive age group:

Counseling on

Optimal timing and spacing of birth

Small family norms

Use and choice of contraceptives

Information on availability of:

MTP services

IUD and sterilization services

Provide family planning services

THANK YOU