Lok Sabha Question No. 4518 (UNSTARRED), answered on 2019-07-19
Subject: Family Planning
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kuldeep Rai Sharma, Supriya Sadanand Sule, Sunil Dattatray Tatkare, Subhash Ramrao Bhamre, Heena Vijaykumar Gavit, Amol Ramsing Kolhe

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

LOK SABHA UNSTARRED QUESTION NO. 4518 TO BE ANSWERED ON 19 TH JULY, 2019

## FAMILY PLANNING

## 4518. SHRI KULDEEP RAI SHARMA:

SHRIMATI SUPRIYA SULE:

SHRI SUNIL DATTATRAY TATKARE:

DR. SUBHASH RAMRAO BHAMRE:

DR. HEENA GAVIT:

DR. AMOL RAMSING KOLHE:

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

- (a)  whether  the  Government  has  failed  to  achieve  the  objective  and  the  target implementing the National Family Welfare Programme, if so, the details thereof and the re therefor;
- (b) whether the Government proposes to formulate any effective family planning policy to rapidly increasing population of  the  country,  if  so,  the  details  thereof  and  if  not,  the  re therefor;
- (c) the details of the family planning policies currently being implemented by the Gove and details of impact of our constantly increasing population on law and order sit uation, crime scenario, employment opportunities and equitable distribution of resources, State/UT - wise;
- (d) the quantum of funds allocated to States/UTs under National Family Welfare Program during each of the last three years and the current year; an d
- (e) whether certain States/UTs have not utilized the funds provided to them and target f not been achieved and if so, the action taken by the Union Government in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY W ELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

- ( a) : As a result of the initiatives taken by the Government under the National Family Welfare Programme, following successes have been achieved:
- The Total Fertility R atehas declined from 2. 9 to 2.2 from 2005 to 201 7 ( SRS )
- 24 out of 36 States/UTs have already achieved the replacement level fertility of less.
- The  decadal  growth  rate  has  declined  from  21.54%  in  1990 - 2000  to  17.64%  during 2001- 11.
- The CrudeBirth R atehas declined from 23.8 to 20.2 from 2005 to 20 17 (SRS)
- The teenage birth rate has halved from 16% (NFHS III)  to 8% (NFHS IV)
- The teenage marriage  has halved from 47.4% (NFHS III)  to 26.8% (NFHS IV) ;

( b)& (c): India adopted a comprehensive and holistic National Population Policy (NPP) in the year 2000, which serves as a policy framework for advancing goals and prioritizing strategi to meet the reproductive and child health needs of the people, to achieve the goal of po stabilization.

Since  2005 , the Government  has  been  i mplementing  the family  planning  programme under the National Rural Health Mission [now National Health Mission(NHM)], in line with the policy framework of population stabilization as envisaged in NPP - 2000, by helping to create a robust  service  delivery and demand  sidemechanism  to  address  the  unmet  need s for  family planning.

The  National  Health  Policy  (NHP)  2017  also  provides  policy  guidance  and  sets  o indicative, quantitative goals and objectives for population stabilization;

Details  of  initiatives  currently  being  implemented  by  the  Government  are  placed Annexure I;

( d) : The quantum of funds allocated to States/UTs under the Family Welfare Program in the last three years is placed in Annexure II;

(e): States/UTs a re allocated funds under NHM in flexible pools so that they can utilize funds  as  per  their  need  and  context.  There  is  an  established  mechanism  to  ensure  t utilization of funds.

The Family Welfare Programme in India is voluntary in nature and follows a target free approach.

## NEW INTERVENTIONS UNDER FAMILY PLANNING

- Mission Parivar Vikas: The focused initiative has been launched for 146 districts wi high  Total  Fertility  Rate  (TFR> 3)  in  7  most  populous  states  (Uttar  Pradesh,  Bihar, Madhya Pradesh, Rajasthan, Chhattisgarh, Jharkhand, Assam). The aim is to increa contraceptive usage and decrease the fertility rates in these 146 TFR districts.
- Introduction of New Contraceptive Choice s: The current basket of choice has been expanded to include new contraceptives viz. Injectable contraceptive and Centchrom
- Redesigned Contraceptive Packaging: The packaging for Condoms, Oral Contraceptive Pills (OCPs) and Emergency Contraceptive Pills (ECPs) has now been improved and redesigned so as to augment the demand for these commodities.
- Family Planning Logistics Management Information System (FP - LMIS): The FPLMIS has been launched to strengthen the supply - chain management system of family plan ning  commodities.  It aims to serve as a decision - making tool for policy makers, program  managers  and  logistics  personnel  to  monitor  and  manage  the  flow  of contraceptive supplies, in order to reduce stock -outs and overstocks, and improve the program's effec tiveness and contraceptive security.
- Clinical Outreach Teams  (COT) Scheme: The scheme has been launched in 146 Mission Parivar Vikas districts for providing Family planning services through mo teams  from  accredited  organizations  in  far - flung,  underser ved  and  geographically difficult areas.
- New  Family  Planning  Media  Campaign: A  360  degree  media  campaign  has  been launched  to  generate  contraceptive  demand.  The  first  phase  of  the  campaign  w launched in 2016 and the second phase (comprising of TVCs, poste rs and hoardings, yearlong Radio show, and a dedicated website on Family Planning) was launched i 2017.
- Enhanced  Compensation  Scheme  for  Sterilization :  The  sterilization  compensation scheme has been enhanced in 11 major high focus states (8 Empowered Acti on Group states, Assam, Gujarat, Haryana) where fertility rates were higher than 2.1.
- Emphasis on Post pregnancy Family Planning services which includes promotion of Post - Partum and Post - Abortion contraception (Post - artum Intra Uterine Contraceptive Devices - PPIUCD, Post Abortion Intra Uterine Contraceptive Devices - PAIUCD)
- Promotion of Intra Uterine Contraceptive Devices (IUCDs) as a spacing method -Introduction  of  Copper  IUCD - 375  (5  years  effectivity)  under  the  Family  Planning Programme.
- Scheme for ensur ing drop back services to sterilization clients.
- Appointment of dedicated Reproductive Maternal Neonatal Child and Adolescent Health (RMNCH+A) counsellors at high case load facilities.
- Assured delivery of family planning services : In the last four years state  have shown their commitment to strengthen fixed day family planning services for sterilizatio
- Scheme for Home delivery of contraceptives by ASHAs at doorstep of beneficiaries.
- Scheme  for  ASHAs  to  Ensure  spacing  in  births: Under  the  scheme,  service s  of ASHAs are being utilized for counselling newly married couples to ensure delay o years in birth after marriage, and couples with 1 child to have spacing of 3 yea the birth of 1st child.

## ON - GOING INTERVENTIONS UNDER FAMILY PLANNING PROGRAMM E

- Ensuring  quality  of  care  in  Family  Planning  services  by  establishing Quality Assurance Committees in all States and Districts.
- Operating the 'National Family Planning Indemnity Scheme' (NFPIS) under which clients  are  indemnified  in  the  unlikely  event  of  death,  complication  or  f following sterilization.
- Compensation  scheme  for  sterilization  acceptors: Under  the  scheme  MoHFW provides  compensation  for  loss  of  wages  to  the  beneficiar ies  on  account  of undergoing sterilization.
- Accreditation  of  more  private/NGO  facilities to  increase  the  provider  base  for family planning services under PPP.
- Demand generation activities in the form of display of posters, billboards and othe audio and v ideo materials in various facilities.
- Observation of World Population Day & fortnight (July 11 -July 24): The month long World Population Day campaign is a step to boost Family Planning efforts over the country. It comprises:
- o June 27 to July 10: 'Dampati Sampark Pakhwada' or 'Mobilisation Fortnight'
- o July 11 to July 24 'Jansankhya Sthirtha Pakhwada' or 'Population Stabilisation Fortnight'
- Observation of  Vasectomy Fortnight (November 21 -December 4) -The vasectomy fortnight is held in an effort to en hance male participation and revitalize the  NSV  programme,  whereby  male  sterilization  services  would  be  provided  to clients at health facilities.  It comprises:
- o 21st Nov -27th Nov: Mobilization phase
- o 28th Nov -4th Dec: Service delivery phase

## State wise FP allocation

| S.No.                    | State                     | FP Allocation (Rs. in lakhs)   | FP Allocation (Rs. in lakhs)   | FP Allocation (Rs. in lakhs)   |
|--------------------------|---------------------------|--------------------------------|--------------------------------|--------------------------------|
|                          |                           | 2016-17                        | 2017-18                        | 2018-19                        |
| A. High Focus States     | A. High Focus States      | A. High Focus States           | A. High Focus States           | A. High Focus States           |
| 1                        | Bihar                     | 24078.5                        | 28396.8                        | 37340.6                        |
| 2                        | Ch hattisgarh             | 8098.0                         | 10017.1                        | 9431.5                         |
| 3                        | Himachal Pradesh          | 2193.6                         | 2704.4                         | 2743.2                         |
| 4                        | Jammu & Kashmir           | 3897.1                         | 3077.3                         | 3893.3                         |
| 5                        | Jharkhand                 | 7441.7                         | 10435.4                        | 11800.1                        |
| 6                        | Madhya Pradesh            | 24262.3                        | 25187.6                        | 28877.5                        |
| 7                        | Orissa                    | 11120.9                        | 12060.2                        | 13532.1                        |
| 8                        | Rajasthan                 | 19418.4                        | 23713.7                        | 22936.1                        |
| 9                        | Uttar Pradesh             | 52519.2                        | 54055.0                        | 53388.4                        |
| 10                       | Uttarakhand               | 2246.3                         | 2465.6                         | 2769.1                         |
| B. NE States             | B. NE States              | B. NE States                   | B. NE States                   | B. NE States                   |
| 11                       | Arunachal Pradesh         | 1380.2                         | 1906.2                         | 1509.4                         |
| 12                       | Assam                     | 10993.9                        | 12629.1                        | 13937.6                        |
| 13                       | Manipur                   | 947.4                          | 1159.0                         | 1033.5                         |
| 14                       | Meghalaya                 | 1737.0                         | 1125.9                         | 1258.6                         |
| 15                       | Mizoram                   | 713.3                          | 751.8                          | 544.2                          |
| 16                       | Nagaland                  | 1064.5                         | 943.5                          | 917.7                          |
| 17                       | Sikkim                    | 249.5                          | 302.2                          | 284.9                          |
| 18                       | Tripura                   | 1245.9                         | 1839.9                         | 1420.5                         |
| C. Non-High Focus States | C. Non-High Focus States  | C. Non-High Focus States       | C. Non-High Focus States       | C. Non-High Focus States       |
| 19                       | Andhra Pradesh            | 9685.4                         | 7914.7                         | 6273.1                         |
| 20                       | Goa                       | 200.2                          | 366.1                          | 321.4                          |
| 21                       | Gujarat                   | 11262.2                        | 11659.9                        | 12512.1                        |
| 22                       | Haryana                   | 4845.0                         | 4998.6                         | 5905.7                         |
| 23                       | Karnataka                 | 12264.0                        | 13268.1                        | 14883.4                        |
| 24                       | Kerala                    | 2284.4                         | 3257.7                         | 5206.6                         |
| 25                       | Maharashtra               | 17537.5                        | 20357.2                        | 19780.2                        |
| 26                       | Punjab                    | 3812.5                         | 3611.7                         | 5509.1                         |
| 27                       | Tamil Nadu                | 9982.8                         | 11019.4                        | 11445.9                        |
| 28                       | Telangana                 | 9399.0                         | 11419.5                        | 6409.4                         |
| 29                       | West Bengal               | 10511.3                        | 17908.9                        | 14810.2                        |
| D. Small States/UTs      | D. Small States/UTs       | D. Small States/UTs            | D. Small States/UTs            | D. Small States/UTs            |
| 30                       | Andaman & Nicobar Islands | 222.4                          | 300.5                          | 262.4                          |
| 31                       | Chandigarh                | 171.3                          | 218.5                          | 139.7                          |
| 32                       | Dadra & Nagar Haveli      | 204.6                          | 202.3                          | 217.1                          |
| 33                       | Daman & Diu               | 96.7                           | 118.4                          | 110.0                          |
| 34                       | Delhi                     | 1983.2                         | 1944.0                         | 1908.9                         |
| 35                       | Lakshadweep               | 52.5                           | 72.6                           | 62.4                           |
| 36                       | Puducherry                | 187.4                          | 252.0                          | 273.6                          |

## Annexure II