Lok Sabha Question No. 2184 (UNSTARRED), answered on 2016-07-29
Subject: Total Fertility Rate
Ministry: HEALTH AND FAMILY WELFARE
Asked by: SAUGATA ROY, MEKAPATI RAJAMOHAN REDDY

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

## LOK SABHA UNSTARRED QUESTION NO. 2184 TO BE ANSWERED ON 29 TH JULY, 2016

## TOTAL FERTILITY RATE

## 2184. PROF. SAUGATA ROY: SHRI M. RAJA MOHAN REDDY:

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

- (a) whether the Government has implemented/propose to implement any project for reducing the Total Fertility Rate across the country;
- (b) if so, the details thereof, State/ UT - wise;
- (c)whether the Government is aware that India may fall short of its Family Planning targets of providing contraceptive devices/services to additional 48 million users by 2020 due to shortage of funds; and
- (d) if so, the details thereof and the corrective st eps taken in this regard?

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

- ( a)& ( b) : Yes, the G overnment is implementing various initiatives and schemes under the National Family Planning Program for reducing the total fertility rate across the country. The de tails are mentioned in Annexure.
- (c): No,  there  is  no  shortage  of  funds  under  the  Family Planning  programme  which  can impact the achievement of Family Planning 2020 goals.
- (d): Does not arise .

## SCHEMES/INITIATIVES FOR REDUCING TOTAL FERTILITY RATE UNDER FAMILY PLANNING PROGRAMME

## Recent interventions under the Family Planning Programme:

1. Expansion of basket of choice through introduction of Injectable contraceptives DMPA (Antara), Centchroman pills (Chhayya)  and Progesteron only pills (POP)
2. Improved Contraceptive Packaging : The packaging for Condoms, Oral Contraceptive Pills (O CP) and Emergency Contraceptive Pills (ECP) has now been improved so as to increase the demand.
3. New Family Planning communication campaign with a new logoand Shri Amitabh Bachchan as the brand ambassador has been launched.
4. Increasing  private  sector  parti cipation  through Social  Franchising  Scheme is  being rolled out in the states of Uttar Pradesh and Bihar.

## On - going interventions:

- Scheme for Home delivery of contraceptives by ASHAs under whichASHA s deliver contraceptives at the doorstep of beneficiaries ( HDC Scheme ) .
- Scheme  for  ASHAs  to ensure  spacing  in  births under which ASHAs arecounselling newly married couples to ensure delay of 2 years in birth of the first child after marriage and for ensuring spacing of 3 years after the birth of 1 st child ( ESB Scheme ) .
- Compensation scheme for sterilization acceptors has been enhanced for 11 High Focus States with high TFR.
- Compensation  scheme  for  PPIUCD has  been  introduced under  which  the  service providers as well as ASHAs who escort the clients to the hea lth facility for facilitating the IUCD insertion are compensated.
- Introduction of a new contraceptive device  Cu IUCD 375 , which is effective for 5 years.
- Boost to spacing methods by introduction of a new method PPIUCD (Post - Partum Intra Uterine Contracept ive Device ) .Over 20 lakh PPIUCD insertions have been conducted in the country till 2015 - 16.
- Scheme for provision of pregnancy testing kits at the sub -centres as well as in the drug kit of the ASHAs for use in the communities to facilitate the early detection and d making for the outcome of pregnancy ( PTK Scheme ) .
- RMNCH (Reproductive Maternal New  Born and Child Health) Counselors have been recruited for high delivery facilities, to ensure counseling of clients visiting the faciliti , on various Family Planning options .
- Scheme  for  ensuring  'drop  back' services  to  sterilization  clients has  beenlaunched whereby funds are provided to the states for facilitating ' drop back ' to sterilization clients.

## Annexure

- Compensation scheme for sterilization provides compensation for loss of wages to the beneficiary and also to the service provider s for conducting sterilisation operations .
- Increasing male participation and promotion of Non Scalpel Vasectomy .
- Operating  a  ' National  Family  Planning  Indemnity  Scheme' (NFPIS)  under  which clients  are  insured  in  the  eventualities  of  deaths,  complications  and  failures  f sterilization and the providers/ accr edited institutions are indemnified against litigations those eventualities.
- Observation of World Population Day 11 th July & Fortnight: The event is observed over a month long period, split into an initial fortnight of mobilization/sensitization followed by a fortnight of assured family planning service delivery .
- Emphasis  on Postpartum  Family  Planning  (PPFP) services including  Post - Partum Sterilisation (PPS) and PPIUCD.
- Emphasis  on Miniap  Tubectomy services  because  of  its  logistical  simplicity  and requirement of only MBBS doctors and not post graduate gynecologists/surgeons.
- Availability of Fixed Day Services atpublic health facilities.
- Monitoring  q uality  in  Family  Planning  services  by  establishing Quality  Assurance Committees at state and district levels.
- Improving contraceptives supply management up to peripheral facilities.
- Undertaking demand generation activities in the form of display of posters, billboar and other audio and video materials in the various facilities.
- Accreditation of more private/NGO facilities to increase the provider base for family planning services under PPP.

## Strategies adopted by Jansankhya Sthirta Kosh/ N ational Population Stabilization Fund :

- Prerna Strategy: this strategy has been designed to push up the age of marriage of girls and delay in first child birth following marriage and spacing thesecond child birth in the interest of thehealth of young mothers and infants. The couple who adopt this strategy are provided cash incentives. Thishasthe potential to change the mind - set of the community.
- Santushti Strategy : Under this strategy, sterilization service s are deliver ed through Public Private Partnership . The private hospitals/nursing homes who achieve the benchmark of 10 sterilisation operations in a month are provided incentives as per the scheme .
- National Helpline :JSK isoperating a call centre for providing free advice on reproductive health, family planning, maternal health and child health etc. It has a dedicated toll free no.i .e. 1800116555.

## STATE WISE TOTAL FERTILITY RATES

| SNo.   | State                      |   Total Fertility | Source   |
|--------|----------------------------|-------------------|----------|
| 1      | Goa                        |               1.4 | SRS 2010 |
| 2      | Tripura                    |               1.4 | SRS 2010 |
| 3      | Manipur                    |               1.5 | SRS 2010 |
| 4      | Andaman and Nicobar Island |               1.6 | SRS 2010 |
| 5      | Lakshadweep                |               1.6 | SRS 2010 |
| 6      | West Bengal                |               1.6 | SRS 2013 |
| 7      | Chandigarh                 |               1.7 | SRS 2010 |
| 8      | Delhi                      |               1.7 | SRS 2013 |
| 9      | Himachal Pradesh           |               1.7 | SRS 2013 |
| 10     | Mizoram                    |               1.7 | SRS 2010 |
| 11     | Punjab                     |               1.7 | SRS 2013 |
| 12     | Sikkim                     |               1.7 | SRS 2010 |
| 13     | Tamil Nadu                 |               1.7 | SRS 2013 |
| 14     | Andhra Pradesh             |               1.8 | SRS 2013 |
| 15     | Kerala                     |               1.8 | SRS 2013 |
| 16     | Maharashtra                |               1.8 | SRS 2013 |
| 17     | Nagaland                   |               1.8 | SRS 2010 |
| 18     | Puducherry                 |               1.8 | SRS 2010 |
| 19     | Jammu Kashmir              |               1.9 | SRS 2013 |
| 20     | Karnataka                  |               1.9 | SRS 2013 |
| 21     | Daman and Diu              |               2   | SRS 2010 |
| 22     | Odisha                     |               2.1 | SRS 2013 |
| 23     | Uttarakhand                |               2.1 | AHS 2012 |
| 24     | Haryana                    |               2.2 | SRS 2013 |
|        | INDIA                      |               2.3 |          |
| 25     | Arunachal Pradesh          |               2.3 | SRS 2010 |
| 26     | Assam                      |               2.3 | SRS 2013 |
| 27     | Gujarat                    |               2.3 | SRS 2013 |
| 28     | Chhattisgarh               |               2.6 | SRS 2013 |
| 29     | Jharkhand                  |               2.7 | SRS 2013 |
| 30     | Rajasthan                  |               2.8 | SRS 2013 |
| 31     | Dadar and Nagar Haveli     |               2.9 | SRS 2010 |
| 32     | Madhya Pradesh             |               2.9 | SRS 2013 |
| 33     | Meghalaya                  |               2.9 | SRS 2010 |
| 34     | Uttar Pradesh              |               3.1 | SRS 2013 |
| 35     | Bihar                      |               3.4 | SRS 2013 |

The states from SNo. 1 to 24 has achieved the replacement fertility level