Population Stabilisation- The Way Ahead: World
Population Day July 11
India’s population as per 2011 census was 1.21 billion,
second only to China in the world. India accounts for 2.4% of the world’s
surface area yet it supports more than 17.5% of the world’s population.
Population Stabilization has always been one of the
priority agenda and Family Planning as one of the key intervention for the
Government. In 1952, India was the first country in the world to launch a
national programme, emphasizing family planning to the extent necessary for
reducing birth rates “to stabilize the population at a level consistent with
the requirement of national economy”. The program has come a long way and
currently Family Planning Program is being repositioned to not only achieve
population stabilization but also to reduce maternal mortality and infant and
child mortality.
National Population Policy, 2000
The National Population Policy, 2000 (NPP 2000) provides
a policy framework for advancing goals and prioritizing strategies to meet the
reproductive and child health needs of the people of India, and to achieve net
replacement levels of fertility (i.e. TFR 2.1) by 2010. National
Socio-Demographic Goals formulated to achieve the objectives of NPP, envisaged
to –
· Address the unmet needs for basic
reproductive and child health services, supplies and infrastructure and to
promote vigorously the small family norm to achieve replacement levels of TFR.
· Achieve 80 percent institutional
deliveries and 100 percent deliveries by trained persons.
· Reduce infant mortality rate to below
30 per 1000 live births, maternal mortality ratio to below 100 per 100,000 live
births, 100% registration of all births, deaths and pregnancies and achieve
universal immunization of children against all vaccine preventable diseases.
· Promote delayed marriage for girls,
not earlier than age 18 and preferably after 20 years of age.
· Achieve universal access to
information/counselling, and services for fertility regulation and contraception
with a wide basket of choices.
· Bring about convergence in
implementation of related social sector programs so that family welfare becomes
a people centered programme.
Total Fertility Rate is still 2.6 at National level and
scenario is diverse across states. Nine states are well above the replacement
level fertility (TFR >3); twelve states/UTs are at threshold of achieving
the replacement level of fertility (TFR – 2.1-3) while 11 state and 3 UTs have
already achieved the replacement level of fertility i.e. <2.1.
The States also differ widely in terms of health
indicators, nutritional status and socio-economic situation. Practice of Family
planning is also low in the states where the other indicators are poor.
Therefore, addressing population growth in the states with high fertility
require a comprehensive approach to population stabilization based on social
and economic development and improvements in the quality of life of people.
Renewed Thrust
Currently the Government follows High-focus district
approach (264 such districts have been selected) and support these districts
(and states) for better implementation of Family Planning programmes (and other
programmes as well).
The Government is committed to reduce the Maternal
Mortality Ratio (MMR) to 100/100,000 live births, Infant Mortality Rate (IMR)
to 30/1000 live births and to achieve the replacement level of fertility (Total
Fertility Rate – 2.1) by 2012.
Strategic Options for Population Stabilization
States with TFR >3.0 (U.P. Bihar, M.P., Rajasthan, Jharkhand,
Chhattisgarh, and Meghalaya): These States
will account for almost 50% of the increase in India’s Population in coming
years. In these States, the immediate concern is to address the unmet need and
focus upon socio economic development to reduce the wanted fertility (desire
for more than two children). At the same time the momentum for future
population growth is to be checked by delaying age at marriage and ensuring
adequate spacing between births.
States with TFR between 2.1 to <3 (Uttarakhand, Gujarat,
Haryana, J&K, Orissa): The
immediate concern in these states is to assist the couples to achieve their
fertility goals by strengthening the family planning programme.
For States with TFR <2.1 (Delhi and Himachal Pradesh): The
immediate concern in these States is to check the population momentum by
delaying the age at marriage and ensuring adequate spacing between births.
Key Thrust Areas – 12th Five Year Plan: Family Planning
· Addressing the unmet need in
contraception through introduction of newer contraceptives.
· Strengthening family planning service
delivery, especially Post-Partum Sterilisation in high case load facilities.
· Enlisting private/NGO facilities to
improve the provider base for family planning services.
· Community based distribution of
contraceptives through ASHAs.
· Vigorous advocacy of family planning
at all levels specially at the highest political level.
Strategies to Achieve Thrust Areas:
· Strengthening human resource structures
(for programme management) at all levels (national, state and district).
· Introduction of a dedicated
counsellor for family planning at district hospitals and high case load
facilities.
· Marketing of contraceptives at
households through ASHAs at nominal charges.
· Improving compensation package (both
for providers and acceptors) for sterilisation services.
· Introducing Multi –load IUD (375) as
a short term spacing method to improve IUD acceptance.
· Performance Linked Payment Plan to
ASHAs for improving retention and usage of IUDs.
· Enlisting more number of private
providers/ NGOs for provision of services.
· Ensuring vigorous advocacy.
*Inputs from the Ministry of Health & Family Welfare
**July 11 is celebrated as World Population Day
**July 11 is celebrated as World Population Day
1.
The immediate objective of the NPP 2000 is to address the unmet
needs for contraception, health care infrastructure, and health personnel, and
to provide integrated service delivery forbasic reproductive and child health
care. The medium-term objective is to bring the TFR to replacement levels by
2010, through vigorous implementation of inter-sectoral operational strategies.
The long-term objective is to achieve a stable population by 2045, at a level
consistent with the requirements of sustainable economic growth, social
development, and environmental protection.
2.
In pursuance of these objectives, the following National
Socio-Demographic Goals to be achieved in each case by 2010 are formulated:
Box 2: National Socio-Demographic
Goals for 2010
o Address
the unmet needs for basic reproductive and child health services, supplies and
infrastructure.
o Make
school education up to age 14 free and compulsory, and reduce drop outs at
primary and secondary school levels to below 20 percent for both boys and
girls.
o Reduce
infant mortality rate to below 30 per 1000 live births.
o Reduce
maternal mortality ratio to below 100 per 100,000 live births.
o Achieve
universal immunization of children against all vaccine preventable diseases.
o Promote
delayed marriage for girls, not earlier than age 18 and preferably after 20
years of age.
o Achieve 80
percent institutional deliveries and 100 percent deliveries by trained persons.
o Achieve
universal access to information/counseling, and services for fertility
regulation and contraception with a wide basket of choices.
o Achieve
100 per cent registration of births, deaths, marriage and pregnancy.
o Contain
the spread of Acquired Immunodeficiency Syndrome (AIDS), and promote greater
integration between the management of reproductive tract infections (RTI) and
sexually transmitted infections (STI) and the National AIDS Control
Organisation.
o Prevent
and control communicable diseases.
o Integrate
Indian Systems of Medicine (ISM) in the provision of reproductive and child
health services, and in reaching out to households.
o Promote
vigorously the small family norm to achieve replacement levels of TFR.
o Bring
about convergence in implementation of related social sector programs so that
family welfare becomes a people centred programme.
If the NPP 2000 is fully implemented, we
anticipate a population of 1107 million (110 crores) in 2010, instead of 1162
million (116 crores) projected by the Technical Group on Population
Projections:
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