Lok Sabha Question No. 4336 (UNSTARRED), answered on 2019-12-13
Subject: High Reproduction Rate
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kanakmal Katara

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

## LOK SABHA UNSTARRED QUESTION NO. 4336 TO BE ANSWERED ON 13 TH DECEMBER, 2019

## HIGH REPRODUCTION RA TE

## 4336. SHRI KANAKMAL KATARA:

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

(a) whether the Government is aware that India has a high reproduction rate as compared to global standards;

(b) if so, the details thereof, State/UTwise long th the reasons therefor;

(c) whether there is a variation in reproduction rate in urban and rural areas, if so, the details of such variation, State/UT - wise/urban/rural area -wise;

(d) the amount of funds allocated for family planning during the last three years, State/UT wise; and

(e) the action taken by the Government with regard to family planning during the last three years, State/UT -wise ?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a) &  (b): As perWorld Population Prospects 2019 Report, Global Total Fertility Rate ( TFR) is 2.47(2015 -20), and according to SRS 2017, India's TFR is 2.2 which is lower than the global TFR.

Details of Total Fertility Rate State/ UT - wise/ are placed in Annexure I. Reasons for high fertility arel ow literacy levels, Unmet need for family planning and i nadequate birth spacing .

- ( c) : Variation in TFR urban/ rural area - wise as per SRS - 2017 is placed in Annexure II.
- ( d): Details  of  funds  allocated  for  family pl nning  under  National  Health  Mission (NHM) during last three years, State/ UT -wise is placed in Annexure III.
- ( e) : The Government provides all contraceptive methods free of cost in all public he facilities across the country. Details of Initiatives are placed in Annexure IV.

ANNEXURE I STATE / UT- WISE TOTAL FERTILITY RATE (TFR)

| S.No.     | State / UT        | TFR   |
|-----------|-------------------|-------|
| 1.        | Bihar             | 3.2   |
| 2.        | Meghalaya         | 3.0   |
| 3.        | Uttar Pradesh     | 3.0   |
| 4.        | Nagaland          | 2.7   |
| 5.        | Madhya Pradesh    | 2.7   |
| 6.        | Manipur           | 2.6   |
| 7.        | Rajasthan         | 2.6   |
| 8.        | Jharkhand         | 2.5   |
| 9.        | Chhattisgarh      | 2.4   |
| 10.       | Assam             | 2.3   |
| 11.       | Mizoram           | 2.3   |
| 12.       | D&N Haveli        | 2.3   |
| All India | All India         | 2.2   |
| 13.       | Gujarat           | 2. 2  |
| 14.       | Haryana           | 2.1   |
| 15.       | Arunachal Pradesh | 2.1   |
| 16.       | Odisha            | 1.9   |
| 17.       | Uttarakhand       | 1.9   |
| 18.       | Lakshadweep       | 1.8   |
| 19.       | Goa               | 1.7   |
| 20.       | Tripura           | 1.7   |
| 21.       | Puducherry        | 1.7   |
| 22.       | Kerala            | 1.7   |
| 23.       | Maharashtra       | 1.7   |
| 24.       | Karnataka         | 1.7   |
| 25.       | Daman & Diu       | 1.7   |
| 26.       | Telangana         | 1.7   |
| 27.       | Tamil Nadu        | 1.6   |
| 28.       | W. Bengal         | 1.6   |
| 29.       | Himachal Pradesh  | 1.6   |
| 30.       | Punjab            | 1.6   |
| 31.       | Chandigarh        | 1.6   |
| 32.       | Andhra Pradesh    | 1.6   |
| 33.       | J & K             | 1.6   |
| 34.       | Delhi             | 1.5   |
| 35.       | A&N Islands       | 1.4   |
| 36.       | Sikkim            | 1.2   |

Source: SRS 2017 & NFHSIV (2015 - 16)

ANNEXURE I I Variation in TFR U rban/R ural area

## - wise

| TOTAL FERTILITY RATE (TFR, SRS 2017)   | TOTAL FERTILITY RATE (TFR, SRS 2017)   | TOTAL FERTILITY RATE (TFR, SRS 2017)   | TOTAL FERTILITY RATE (TFR, SRS 2017)   | TOTAL FERTILITY RATE (TFR, SRS 2017)   |
|----------------------------------------|----------------------------------------|----------------------------------------|----------------------------------------|----------------------------------------|
| State/ UT                              | TOTAL                                  | RURAL                                  | URBAN                                  | Rural- Urban difference                |
| India                                  | 2.2                                    | 2.4                                    | 1.7                                    | 0.7                                    |
| Andhra Pradesh                         | 1.6                                    | 1.7                                    | 1.5                                    | 0.2                                    |
| Assam                                  | 2.3                                    | 2.4                                    | 1.6                                    | 0.8                                    |
| Bihar                                  | 3.2                                    | 3.3                                    | 2.4                                    | 0.9                                    |
| Chhat tisgarh                          | 2.4                                    | 2.6                                    | 1.8                                    | 0.8                                    |
| Delhi                                  | 1.5                                    | 1.6                                    | 1.5                                    | 0.1                                    |
| Gujarat                                | 2.2                                    | 2.4                                    | 1.8                                    | 0.6                                    |
| Haryana                                | 2.2                                    | 2.4                                    | 1.9                                    | 0.5                                    |
| Himachal Pradesh                       | 1.6                                    | 1.7                                    | 1.1                                    | 0.6                                    |
| Jammu & Kashmir                        | 1.6                                    | 1.8                                    | 1.2                                    | 0.6                                    |
| Jharkhand                              | 2.5                                    | 2.7                                    | 1.9                                    | 0.8                                    |
| Karnataka                              | 1.7                                    | 1.8                                    | 1.6                                    | 0.2                                    |
| Kerala                                 | 1.7                                    | 1.7                                    | 1.7                                    | 0.0                                    |
| Madhya Pradesh                         | 2.7                                    | 3.0                                    | 2.1                                    | 0.9                                    |
| Maharashtra                            | 1.7                                    | 1.8                                    | 1.5                                    | 0.3                                    |
| Odisha                                 | 1.9                                    | 2.0                                    | 1.3                                    | 0.7                                    |
| Punjab                                 | 1.6                                    | 1.7                                    | 1.5                                    | 0.2                                    |
| Rajasthan                              | 2.6                                    | 2.7                                    | 2.2                                    | 0.5                                    |
| Tamil Nadu                             | 1.6                                    | 1.6                                    | 1.6                                    | 0.0                                    |
| Telangana                              | 1.7                                    | 1.7                                    | 1.6                                    | 0.1                                    |
| Uttar Pradesh                          | 3.0                                    | 3.2                                    | 2.4                                    | 0.8                                    |
| Uttarakhand                            | 1.9                                    | 1.9                                    | 1.8                                    | 0.1                                    |
| West Bengal                            | 1.6                                    | 1.7                                    | 1.3                                    | 0.4                                    |

ANNEXURE II I State/UT wise approval for Family Planning activities from year 2015 -16 to 2018

(Rs. in lakh)

| S.No.                     | State                     | Approval                  |
|---------------------------|---------------------------|---------------------------|
| A. High Focus States      | A. High Focus States      | A. High Focus States      |
| 1                         | Bihar                     | 112695.2                  |
| 2                         | Chhattisgarh              | 34738.4                   |
| 3                         | HimachalPradesh           | 10219.1                   |
| 4                         | Jammu & Kashmir           | 13794.8                   |
| 5                         | Jharkhand                 | 39571                     |
| 6                         | Madhya Pradesh            | 96805.6                   |
| 7                         | Orissa                    | 46236.1                   |
| 8                         | Rajasthan                 | 87547.3                   |
| 9                         | Uttar Pradesh             | 208722.1                  |
| 10                        | Uttarakhand               | 10035.9                   |
| B. NE States              | B. NE States              | B. NE States              |
| 11                        | Arunachal Pradesh         | 8627.9                    |
| 12                        | Assam                     | 49369.3                   |
| 13                        | Manipur                   | 4176.1                    |
| 14                        | Meghalaya                 | 4778.5                    |
| 15                        | Mizoram                   | 2715.3                    |
| 16                        | Nagaland                  | 3569.2                    |
| 17                        | Sikkim                    | 1349                      |
| 18                        | Tripura                   | 10251.9                   |
| C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States |
| 19                        | Andhra Pradesh            | 35080.4                   |
| 20                        | Goa                       | 1578.7                    |
| 21                        | Gujarat                   | 46722.2                   |
| 22                        | Haryana                   | 21018.8                   |
| 23                        | Karnataka                 | 52541.6                   |
| 24                        | Kerala                    | 13943.3                   |
| 25                        | Maharashtra               | 79673.9                   |
| 26                        | Punjab                    | 19691.3                   |
| 27                        | Tamil Nadu                | 47512                     |
| 28                        | Telangana                 | 59621.7                   |
| 29                        | West Bengal               | 54734.3                   |
| D. Small States/UTs       | D. Small States/UTs       | D. Small States/UTs       |
| 30                        | Andaman & Nicobar Islands | 949.8                     |
| 31                        | Chandigarh                | 1349.4                    |
| 32                        | Dadra & Nagar Haveli      | 790.6                     |
| 33                        | Daman & Diu               | 421.8                     |
| 34                        | Delhi                     | 7492.6                    |
| 35                        | Lakshadweep               | 72911.8                   |
| 36                        | Puducherry                | 831.6                     |

## - 19

## ANNEXURE I V

## Family Planning Schemes implemented by the Government:

1. Mission  Parivar  Vikas -The  Government  has  launched MissionParivar Vikason  10 th November 2016 for substantially increasing access to ontraceptives and family planning services in146 high fertility districts with Total Fertility Rate (TFR) of 3 and seven high focus states. These districts are from the states of Uttar Pradesh (57) , Bihar (37) , Rajasthan (14) , Madhya Pradesh (25 ) , Chhattisgarh (2) , Jharkhand (9)and Assam (2) that itself constitutes 44% of the country's population.
2. Compensation  scheme  for  sterilization  acceptors -U nder  the  scheme  MoHFW provides  compensation  for  loss  of  wages  to  the  beneficiary  and  also  to  the  s ervice provider (& team) for conducting sterilizations. The packagewas enhanced in November 2014 for 11 high focus high TFR states (8 EAG, Assam, Gujarat, Haryana) , and further increased in November 2016 under Mission Parivar Vikas.
3. Clinical  Outreach  Teams  (COT)  Scheme The  scheme  has  been  launched  in  146 Mission  Parivar  Vikas  districts wef  December  2017 for  providing f amily  planning services  through  mobile  teams  from  accredited  organizations in  far - flung,  underserved and geographica lly difficult areas.
4. New Contraceptive Choices -New contraceptives viz. Injectable contraceptive (Antara program)and Centchroman(Chhaya)have been added to the existing basket of choices in 2015- 16.
5. Redesigned Contraceptive Packaging -The packaging for Condoms, OCPs and ECPs has been improved and redesigned since 2015 in order to increase the demand for these commodities.
6. Scheme for Home delivery of contraceptives by ASHAs at doorstep of beneficiaries launched in August 2011 .
7. A  new  method  of  IUCD  inserti on  immediately  after  delivery  i.e. post - partum  IUCD (PPIUCD) has been introduced in 2010 .PPIUCD incentive scheme has been operational wef 01.01.2014.
8. Scheme  for ASHAs  to  Ensure  spacing  in  births launched  on  16 th May 2012- The scheme is being implemented in 18 states of the country (8 EAG, 8 North East, Guj and Haryana). Additionally the spacing component has been approved in West Bengal Karnataka, AndhraPradesh, Telangana, Punjab, Maharashtra, Daman Diu and Dadra and N agar Haveli .
9. Scheme for provision of Pregnancy Testing Kits in the drug kits of ASHAs for use in communities. The Scheme was introduced in 2013.
10. National Family Planning Indemnity Scheme (NFPIS) under which clients are insured in the eventualities of death , complication and failure following sterilization. The scheme was introduced in 2005 and implemented through an insurance company. It was revised in 2013 and is now being operated by the state government sdirectly with NHM funding.
11. 11.Ensuring quality of car e in Family Planning services by establishing Quality Assurance Committees in all states and districts.
12. Family  Planning  Logistic  Management  and  Information  System  (FP - LMIS): A dedicated  software launched  in  2017, to  ensure  smooth  forecasting,  procurement  a nd distribution of family planning commodities across all the levels of health faciliti
13. 13.Appointment of dedicated RMNCH+A counselors at high case load facilities since 2013 .
14. 14.Improved Demand generation activities through a 360 degree media campaign -1 st phase launched in 2015 , and the present 2 nd phasein2016.