Lok Sabha Question No. 290 (STARRED), answered on 2015-12-18
Subject: Population Control
Ministry: HEALTH AND FAMILY WELFARE
Asked by: PARVESH SAHIB SINGH, J.C. DIVAKAR REDDY

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO. 290 TO BE ANSWERED ON THE 18 TH DECEMBER 2015 POPULATION CONTROL

## *290. SHRI PARVESH SAHIB SINGH: SHRI J.C. DIVAKAR REDDY:

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

- (a)  the  trend  of  the  population  growth  registered  during  the  last  d State/UTwise;
- (b) whether the Government has undertaken any measure to contain the growth of population  in  the  country  and  if  so,  the  details  thereof  along  with  the achieved thereunder;
- (c) whether  the Government  proposes to implement  two - child policy for stabilization o f population in the country, if so, the details thereof along w manner in which the said policy is likely to be implemented and if not, the therefor; and
- (d) the other steps being taken/ proposed to be taken by the Government to thebalanced population growth in the country?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE ( SHRI JAGAT PRAKASH NADDA )

- (a) to ( d):  A statement is laid on the Table of the House

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 290* FOR 18 TH DECEMBER, 2015

[a] :As a result of the efforts of the government, the decadal growth rate country  has  declined  significantly  from  21.54%  for  the  period  1991 - 2001  to 17.64%  during  2001 - 1.  The  State/UT  wise  decadal  growth  rate  is  placed  at Annexure I.

[b]: The measures being taken for population stabilization and targets achiev detailed in Annexure II

[c]: No. The government does not have such a proposal at present on two chi policy  norm  since  India  is  a  signatory  to  ICPD  declaratio n  of  1994  which advocates target free approach and honouring of reproductive rights of coup decide freely and responsibly the number and spacing of their children.

[d]: The government is now expanding the basket of choice for contraceptives cater to the unmet need for contraception prevailing in the country.

## State/UT wise Decadal growth rate

|   SNo. | Name of State/UT          |   Percentage decadal growth (2001-2011) |
|--------|---------------------------|-----------------------------------------|
|      1 | Andaman & Nicobar Islands |                                    6.68 |
|      2 | Andhra Pradesh            |                                   11.1  |
|      3 | Arunachal Pradesh         |                                   25.92 |
|      4 | Assam                     |                                   16.93 |
|      5 | Bihar                     |                                   25.07 |
|      6 | Chandigarh                |                                   17.1  |
|      7 | Chhattisgarh              |                                   22.59 |
|      8 | Dadra &Nagar Haveli       |                                   55.5  |
|      9 | Daman &Diu                |                                   53.54 |
|     10 | Goa                       |                                    8.17 |
|     11 | Gujarat                   |                                   19.17 |
|     12 | Haryana                   |                                   19.9  |
|     13 | Himachal Pradesh          |                                   12.81 |
|     14 | Jammu &Kashmir            |                                   23.71 |
|     15 | Jharkhand                 |                                   22.34 |
|     16 | Karnataka                 |                                   15.67 |
|     17 | Kerala                    |                                    4.86 |
|     18 | Lakshadweep               |                                    6.23 |
|     19 | Madhya Pradesh            |                                   20.3  |
|     20 | Maharashtra               |                                   15.99 |
|     21 | Manipur                   |                                   18.65 |
|     22 | Meghalaya                 |                                   27.82 |
|     23 | Mizoram                   |                                   22.78 |

## Annexure I

| 24    | Nagaland      |   0.47 |
|-------|---------------|--------|
| 25    | NCT of Delhi  |  20.96 |
| 26    | Orissa        |  13.97 |
| 27    | Puducherry    |  27.72 |
| 28    | Punjab        |  13.73 |
| 29    | Rajasthan     |  21.44 |
| 30    | Sikkim        |  12.36 |
| 31    | Tamil Nadu    |  15.6  |
| 32    | Tripura       |  14.75 |
| 33    | Uttar Pradesh |  20.09 |
| 34    | Uttarakhand   |  19.17 |
| 35    | West Bengal   |  13.93 |
| INDIA | INDIA         |  17.64 |

## Measures being taken for stabilization of population in the country

## On-going Interventions under Family Planning Programme

- A rational human resource development plan is in place for provision of IUCD, Minilap and NSV to empower the facilities (DH, CHC, PHC, SHC) with at least one provider each for each of the services and Sub Centres with ANMs trained in IUD insertion
- Emphasis on Minilap Tubectomy services because of its logistical simplicity and requirement of only MBBS doctors and not post graduate gynaecologists/ surgeons.
- Ensuring  quality care in Family Planning services by establishing  Quality  Assurance Committees at state and district levels
- Increasing male participation and promotion of 'Non Scalpel Vasectomy''.
- Compensation  scheme  for  sterilization  acceptors -under  the  scheme  MoHFW  provides compensation for loss of wages to the beneficiary and also to the service provider (& team) for conducting sterilizations. The compensation has been enhanced in 11 high focus states.
- 'National Family Planning Indemnity Scheme' (NFPIS) under which clients are insured in the eventualities of deaths, complications and failures following sterilization and the providers/ accredited institutions are indemnified against litigations in those eventualities.
- Fixed day Fixed Place Family Planning Services: Availability of Fixed Day Static Services at all facilities round the year made possible on account of growing number of 24x7 PHCs and better functioning CHCs and other health facilities under NHM (National Health Mission).
- Improving contraceptives supply management up to peripheral facilities
- 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 other audio and video materials in the various facilities
- Strong Political Will and Advocacy at the highest level, especially in states with high fertility rates

## New interventions

Family  Planning  Program  has  witnessed  a  paradigm  shift  from  a  program  resulting  in  population stabilization  to  a  program  ensuring  better  maternal  and  child  health.  The  GoI's  new  strategy  of RMNCH+A  encompasses  Reproductive  Health,  Maternal  Health,  Newborn  Health,  Child  Health  and Adolescent Health.

The GoI is now ensuring a greater thrust on spacing methods (especially PPIUCD and IUCD).

- Promotion of IUCDs as a short & long term spacing method:
- Emphasis on Postpartum Family Planning (PPFP) services with introduction of PPIUCD and promotion of minilap as the main mode of providing sterilization in the form of post-partum sterilization to capitalize on the increase in institutional delivery under JSY.
- Introduction of Cu IUCD-375 (5 years effectivity) under the Family Planning Programme.
- On-site training of service providers conducted for PPIUCD at delivery points.
- PPIUCD incentive Scheme- The PPIUCD incentive scheme has been introduced in the whole country by the Govt in January 2014 whereby; The service provider (doctors/ Nurses/ANM)

is  paid  Rs.150 per insertion as compensation for the extra work done in addition to their normal work and the ASHAs are paid Rs.150 per insertion for escorting the clients to the health  facility  and  facilitating  the  IUCD  insertion. Appointment  of  dedicated  RMNCH+A counselors at high case load facilities for counseling eligible couples for adoption of Family Planning methods..

- Scheme for Home delivery of contraceptives by ASHAs at doorstep of beneficiaries has been expanded to the entire country w.e.f.  17 th Dec, 2012.
- Drop back scheme to sterilization acceptors: The states make provision for free drop back to sterilization clients under this scheme.
- Scheme for ASHAs to ensure spacing in births:
-  The  scheme  is  being  implemented  in  18  states  of  the  country  (8  EAG,  8  North  East, Gujarat and Haryana). Additionally the spacing component has been approved in West Bengal, Karnataka, AP, Telangana, Maharashtra, Daman Diu and Dardar Nagar Haveli
-  Under  the  scheme,  services  of  ASHAs  to  be  utilised  for  counselling  newly  married couples to ensure delay of 2 years in birth after marriage and couples with 1 child to have spacing of 3 years after the birth of 1st child.
-  ASHAs are being paid the following incentives under the scheme:
- o 500/- for ensuring spacing of 3 years after the birth of 1 st child
- o 500/- for ensuring spacing of 2 years after marriage.
- o 1000/- in case the couple opts for a permanent limiting method up to 2 children only
- Celebration of World Population Day & fortnight (July 11 - July 24):
-  The scheme is operational from 16th May 2012.
-  The World Population Day celebration is a step to boost Family Planning efforts all over the country all over the year.
- o June 27 to July 10: 'Dampati Sampark Pakhwada' or 'Mobilisation 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.  It  has  been  made  a  mandatory  activity  and  budgets  approved  in  advance  in PIPs of all States.
- o July  11  to  July  24  'Jansankhya  Sthirtha  Pakhwada'  or  'Population  Stabilisation Fortnight'

## Performance:

## Family Planning indicators:

| Indicator            |   2008 |   2009 |   2010 |   2011 |   2012 |   2013 |
|----------------------|--------|--------|--------|--------|--------|--------|
| Total Fertility Rate |    2.6 |    2.6 |    2.5 |    2.4 |    2.4 |    2.3 |
| Crude Birth Rate     |   22.8 |   22.5 |   22.1 |   21.8 |   21.6 |   21.4 |
| Crude Death Rate     |    7.4 |    7.3 |    7.2 |    7.1 |    7   |    7   |

- TFR has declined from 2.6 in 2008 to 2.3 in 2013
- 2 States having TFR more than 3 Uttar Pradesh 3.1 and Bihar 3.4 and
- 24 States/UTs i.e. Goa, Manipur, Tamil Nadu, Tripura, Kerala, Andhra Pradesh, Telangana, Himachal Pradesh, West Bengal, Punjab, Delhi, Maharashtra, Karnataka, Mizoram, Nagaland,  Jammu  &  Kashmir,  Sikkim,  Uttarakhand,  Odisha  and  5  UTs  i.e.  Andaman &Nicobar  Islands,  Puducherry,  Chandigarh,  Daman  &  Diu  and  Lakshadweep  have  already achieved replacement level fertility (i.e. 2.1 or less).
- 10 states having TFR between 2.2 and 3.0 viz. Jharkhand 2.7, Chhattisgarh 2.6, Arunachal Pradesh 2.3,  Gujarat 2.3,  Assam 2.3, Haryana 2.2, MP 2.9, Rajasthan 2.8, Dadra & Nagar Haveli 2.9 and Meghalaya 2.9.

## Physical achievement:

|           | 2012-13   | 2013-14   | 2014-15   | 2015-16 (Till Nov)   |
|-----------|-----------|-----------|-----------|----------------------|
| IUCD      | 54,05,777 | 51,99,053 | 52,77,460 | 30,93,063            |
| Vasectomy | 1,20,466  | 90,396    | 78,362    | 38,958               |
| Tubectomy | 44,62,299 | 42,13,172 | 39,51,972 | 15,57,420            |

FOLLOWING  STRETAGIES  HAVE  BEEN ADOPTED BY  JANSANKHYA  STHIRATA  KOSH/NATIONAL POPULATION STABILIZATION FUND AS POPULATION CONTROL MEASURES:

Prerna  Strategy:JSK has  launched  this strategy  for  helping  to  push  up  the  age  of marriage of girls and delay in first child and spacing in second child birth in the interest of health of young mothers and infants. The couple who adopt this strategy awarded suitably. This helps to change 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  Private Partnership mode. The private hospitals/nursing home who achieved target of 10 or more are suitably awarded as per strategy.

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