Lok Sabha Question No. 1720 (UNSTARRED), answered on 2017-03-10
Subject: Family Planning
Ministry: HEALTH AND FAMILY WELFARE
Asked by: CHHEDI PASWAN, RADHESHYAM BISWAS

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1720 TO BE ANSWERED ON 10 th MARCH, 2017

## FAMILY PLANNING

## 1720. SHRI CHHEDI PASWAN: SHRI RADHESHYAM BISWAS:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the implementation of National Family Welfare Programme is not satisfactory and if so, the reasons thereof;
- (b) whether the Government propose to formulate any effective fami ly planning policy to check rapidly increasing population of the country;
- (c) if so, the details thereof and if not, the reasons therefor;
- (d) the State - wise  details  of  the  family planning policies currently being implemented by the Government anddetails of impact of our constantly increasing population falling on our law and order  situation,  crime  scenario, employment  opportunities  and  equitable distribution  of resources;
- (e) whether the States have not utilised the funds provided to them and thetarget fixed is not being achieved; and
- (f)  whether  certain  proposals  received from  the  States  including  Assam  under  the said programmes are pending for clearance with the Union Government and if so, the details thereof, State/UT - wise?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE ( SMT. ANUPRIYA PATEL )

- (a): No, the implementation of National Family Welfare Program m e has been satisfactory with the performance in IUCD insertions increasing from 52,75,440 to 55,40,743 and sterilisations increasing from 40,30,409 to 40,70,597 from 2014 - 15 to 2015 - 16 as per HMIS reports available with the Ministry of the Health and Family Welfare.
- (b) & (c): Family Planning has been a key priority area of the Government and it has been vigorously pursued through the National Rural Health Mission launched in the year 2005 in with the policy framework for population stabilization as envisaged in the National Popula Policy, 2000. The main objectives of National Population Policy, 2000 was to address the unmet needs for contraception and achieving a stable population by 2045, at a level consistent w requirements of sustainable economic growth, social development and environmental protecti As a result of the initiatives of the Government , the country's Total Fertility Rate (TFR) has declined from 2.7 in 2006 to 2.2 in 2016 (NFHS -IV). The decadal growth rate has declined from 21.54 % in 1990 - 2000 to 17.64 % during 2001 - 11. The Crude Birth Rate has declined from 23.8 in 2005 to 20.8 (SRS 2015) and 24 states/UTs have already achieved the replacement level T of 2.1 or less out of 3 6 states/UTs.

(d): The  details  of  the  family  planning  interventions  currently  being  implemented  cou wide by the Government is provided at A nnexure1.

As  per  the  available  report  from  the  National  Programme  on  Technology  Enhanced Learning (NPTEL), which is an initiative by seven Indian Institutes of Technology (IIT Bo Delhi,  Guwahati,  Kanpur,  Kharagpur,  Madras  and  Roorkee)  and  Indian  institute  of  sc ience (IISC)  for  creating  course  contents  in  engineering  and  science,  the  problems  resultin overpopulation has been summarised in annexure II.

(e): The States have utilised the funds provided  for   the    Family Planning programm State/UT  wise expenditure  under  the  component  'Family  Planning'  in  2015 - 16  is  placed  at annexure -III .

The Family Planning programme In India  is  target         free and voluntary in na i t is the prerogative of the clients to choose a family planning method best suited to them as per their reproductive right.

(f) No.

## Initiatives under the Family Planning Programe of India:

## New interventions under Family Planning

- Mission Parivar Vikas: The Government has launched MissionParivar Vikasfor substantially increasing the access to contraceptives and family planning services in fertility districts of seven high focus states with TFR of 3 and above. These 146 districts are from  the  seven  high  focus,  high  TFR  states  (Uttar  Pradesh,  Bihar, Rajasthan,  Madhya Pradesh,  Chhattisgarh,  Jharkhand  and  Assam)  that  itself  constitutes  44%  of  the  country's population.
- New Contraceptive Choices: The current basket of choice has been expanded to include th new contraceptives viz. Injectable contraceptive, Centchroman and P rogrsterone O nlyPills (POP).
- Redesigned Contraceptive Packaging: The packaging for Condoms, OCP sand ECPshas now been improved and redesigned so as to influence the demand for these commodities
- New Family Plann ing Media Campaign: A360 degree media campaign has been launched to generate contraceptive demand.
- Enhanced  Compensation  Scheme  for  Sterilization - The  sterilization  compensation  scheme has been enhanced in 11 high focus states (8 EAG, Assam, Gujarat, Haryana)
- A new IUCD (Cu 375) with  5 years effectivity has been introduced in the programme as alternative to the exiting IUCD (Cu 380A with effectivity of 10 years).
- A new method of IUCD insertion i.e. PPIUCD has been introduced.
- Emphasis on Postpartum Family Planning (PPFP) services with PPIUCD and promotion of minilap as the main mode of providing sterilization in the form of post - partum sterilization to capitalize on the huge cases coming in for institutional delivery under JSY.
- Scheme for ensuring drop back services to sterilization clients
- Appointment of dedicated RMNCH+A counsellors at high case load facilities.
- Assured  delivery  of  family  planning  services - In  last  four  years  states  have  shown  their commitment  to  strengthen  fixed  day  family  pla nning  services  for  both  IUCD  and sterilization.
- Scheme for Home delivery of contraceptives by ASHAs at doorstep of beneficiaries.
- Scheme for ASHAs to ensure spacing in births:
- o Under  the  scheme,  services  of  ASHAs  are  being  utilized  for  counselling  newl married couples to ensure delay of 2 years in birth after marriage and couples child to have spacing of 3 years after the birth of 1st child.
- o The scheme is being implemented in 18 states of the country (8 EAG, 8 North Eas Gujarat  and  Haryana).  Additi onally  the  spacing  component  has  been  approved  in West Bengal, Karnataka, Andhra Pradesh, Telangana, Punjab, Maharashtra, Daman Diu and Dadra and Nagar Haveli
- Celebration of World Population Day & fortnight (July 11 -July 24):
- o The World Population Day cel ebration is a step to boost Family Planning efforts al over the country.
- o The  event  is  observed  over  a  month  long  period,  split  into  an  initial  fortn mobilization/sensitization followed by a fortnight of assured family planning s delivery.
- o July  11  to  July  24  'Jansankhya  Sthirtha  Pakhwada'  or  'Population Stabilisation Fortnight'
- o J une  27  to  July  10:  'Dampati  Sampark  Pakhwada'  or  'Mobilisation Fortnight'

## On - going Interventions under Family Planning Programme

- Ensuring  quality  of  care  in Family  Planning  services  by  establishing  Quality  Assurance Committees in all state and districts.
- Increasing male participation and promotion of 'Non Scalpel Vasectomy''.
- Operating the 'National Family Planning Indemnity Scheme' (NFPIS) under which clients are insured in the eventualities of deaths, complications and failures following ste and  the  providers/  accredited  institutions  are  indemnified  against  litigations eventualities.
- Compensation  scheme  for  sterilization  acceptors - under the  scheme  MoHFW  provides compensation for loss of wages to the beneficiaries on account of undergoing sterilisat
- Accreditation  of  more  private/  NGO  facilities  to  increase  the  provider  base  for planning services under PPP.
- Improving contracepti ves supply management up to peripheral facilities
- A rational human resource development plan is in place for provision of IUCD, Minilap NSV to empower the facilities (DH, CHC, PHC, SHC) with at least one provider each f each of the services and Sub Centres with ANMs trained in IUCD insertion
- Emphasis on Minilap Tubectomy services because of its logistical simplicity with less rates.
- Demand generation activities in the form of display of posters, billboards and other au video materials in the various facilities

## STRETAGIES ADOPTED BY JANSANKHYA STHIRATA KOSH/NATIONAL POPULATION STABILIZATION FUND FOR POPULATION CONTROL:

Prerna Strategy: -JSK has launched this strategy for helping to push up the age of marriage of girls and delay in firs t child and spacing in second child birth in the interest of health of mothers and infants. The couple who adopt this strategy awarded suitably. This helps to the mindsets of the community.

Santushti  Strategy : - Under  this  strategy,  Jansankhya Sthirata  Kosh,  invites  private  sector gynaecologists  and  vasectomy  surgeons  to  conduct  sterilization  operations  in  Public  P Partnership mode. The private hospitals/nursing home who achieved target of 10 or more sui tably awarded as per strategy.

National Helpline : - JSK isalso running a call centers for providing free advice on reproduct health, family planning, maternal health and child health etc. Toll free no. is 1800116555

## SUMMARY OF NPTEL REPORT.

Challenges of Rapid Population Growth in India among others are:

- Providing employment to growing population:
- Problem of utilisation of manpower
- Over-strained infrastructure
- Pressure on land and other renewable natural resources
- Increased cost of production
- Inequitable dis tribution of income +

## ANNEXURE II

## ANNEXURE III

| S.No.                    | States                    | Expenditure (2015-16)   |
|--------------------------|---------------------------|-------------------------|
| A. High Focus States     |                           |                         |
| 1                        | Bihar                     | 9795.53                 |
| 2                        | Chattisgarh               | 1952.12                 |
| 3                        | Himachal Pradesh          | 472.51                  |
| 4                        | Jammu &Kashmir            | 257.88                  |
| 5                        | Jharkhand                 | 3497.04                 |
| 6                        | Madhya Pradesh            | 11915.66                |
| 7                        | Orissa                    | 3578.35                 |
| 8                        | Rajasthan                 | 7946.13                 |
| 9                        | Uttar Pradesh             | 6616.58                 |
| 10                       | Uttarakhand Sub Total     | 1045.22                 |
|                          |                           | 47077.02                |
| B. NE States             |                           |                         |
| 11                       | Arunachal Pradesh         | 50.70                   |
| 12                       | Assam                     | 2283.66                 |
| 13                       | Manipur                   | 58.21                   |
| 14                       | Meghalaya                 | 152.12                  |
| 15                       | Mizoram                   | 78.06                   |
| 16                       | Nagaland                  | 106.42                  |
| 17                       | Sikkim                    | 16.21                   |
| 18                       | Tripura                   | 187.36                  |
|                          | Sub Total                 | 2932.74                 |
| C. Non-High Focus States |                           |                         |
| 19                       | Andhra Pradesh            | 3289.53                 |
| 20                       | Goa                       | 53.63                   |
| 21                       | Gujarat                   | 6585.20                 |
| 22                       | Haryana                   | 2050.26                 |
| 23                       | Karnataka                 | 2338.35                 |
| 24                       | Kerala                    | 310.75                  |
| 25                       | Maharashtra               | 3539.06                 |
| 26                       | Punjab                    | 911.62                  |
| 27                       | Tamil Nadu                | 2679.45                 |
| 28                       | Telangana                 | 1086.31                 |
| 29                       | West Bengal               | 3873.14                 |
|                          | Sub Total                 | 26717.29                |
| D. Small States/UTs      |                           |                         |
| 30                       | Andaman & Nicobar Islands | 11.23                   |
| 31                       | Chandigarh                | 19.84                   |
| 32                       | Dadra &Nagar Haveli       | 18.39                   |
| 33                       | Daman &Diu                | 7.16                    |
| 34                       | Delhi                     | 197.38                  |
| 35                       | Lakshadweep               | 0.66                    |
| 36                       | Puducherry                | 76.17                   |
|                          | Sub Total                 | 330.83                  |
|                          | Grand Total               | 77057.88                |