1. The National Family Welfare
Programme was launched in India in 1951 with the objective
of reducing the birth rate to the extent necessary to
stabilize the population at a level consistent with
the requirements of the national economy. In keeping
with the democratic traditions of the country, the Family
Welfare Programme seeks to promote responsible and planned
parenthood through voluntary and free choice of family
planning methods, best suited to individual acceptors.
People's participation is sought through local self
government including voluntary organizations and opinion
leaders at different levels. Innovative use of mass
media and interpersonal communication is made for highlighting
the benefit of the small family norm and removal of
socio-cultural barriers for adoption of family limitation
programmes.
2. In view of the general consensus
that the quality of the National Family Welfare Programme
has often suffered because of the target oriented approach,
no target was fixed during the year 1995-96 for the
States of Kerala, Tamil Nadu and Union Territory of
Chandigarh. Besides one or two districts of each major
States were kept target free on an experimental basis.
Having found this approach to be successful particularly
in addressing the felt needs of the community, the target
free approach has been adopted from 1st April, 1996
throughout the country.
3. The long-term demographic
goals, as laid down in the National Health Policy (1983),
was to achieve a Net Reproduction Rate of Unity (NRR-1)
by the year 2000 A.D. This corresponds to achieving a
Birth Rate of 21 per thousand, death rate of 9 per thousand
and natural population growth rate of 1.2%. The National
Health Policy envisaged reducing infant mortality rate
to below 60 per thousand live births by the turn of the
century. However, keeping in view the level of achievement
already made, it was stated in the Eighth Five Year Plan
Document that NRR-1 would be achievable only in the period
2011-16A.D. The National Population Policy 2000 details
the objectives and strategy for this.
4. Family Welfare services are
provided to the community through a network of Sub-centres,
Primary Health Centres (PHCs) and Community Health Centres
(CHCs) in the rural areas and hospitals and dispensaries
in the urban areas. This network, set up under the Minimum
Needs Programme {now redesigned as Basic Minimum Services
(BMS) Programme}, is also supported by an expanding number
of Post Partum Centres at district and sub-district level.
5. The Auxiliary Nurse & Midwife
(ANM), a female paramedical worker posted at the Sub-centre
and supported by a Male Multipurpose Worker (male MPW)
is the frontline worker in providing the Family Welfare
services to the community. She is supervised by the Lady
Health Visitor (LHV) posted at PHC.
6. For skill development of medical
and paramedical worker deployed at the sub centres, PHCs
and CHCs etc., Family Welfare Programme supports Health
& Family Welfare Training Centres, Lady Health Visitor
Training Centres, Male Multipurpose Worker Schools and
ANM Training Schools many of which are situated in U.P.
7. The major schemes currently
under implementation are described in succeeding paragraphs:
8. Minimum Needs Programme (Redesigned
as BMS)
The Primary
Health Care infrastructure in rural areas has been
developed as a three tier system. The norm is to
set up one sub-centre for every 5,000 population
(3000 for Hilly and Tribal areas). At present sub-centres,
PHCs and CHCs are functioning in the country.
9. Child Survival and Safe Motherhood
(CSSM) Programme
During
1992-93, an integrated MCH and Immunization Programme
was taken up for implementation. This World Bank
and UNICEF assisted Programme, named Child Survival
and Safe Motherhood Programme, seeks to sustain
the high coverage levels achieved under UIP in good
performing areas and strengthening the immunization
services where the coverage is still not satisfactory.
The Programme also provides for augmenting various
activities under the Oral Rehydration Therapy (ORT)
Programme, universalising the prophylaxis schemes
for the control of anaemia in pregnant women and
control of blindness in children and initiating
a programme for control of Acute Respiratory Infection
(ARI) in children. Under the Safe Motherhood component,
training of traditional birth attendants in selected
high IMR/MMR districts, provision of aseptic delivery
kits and strengthening of first referral units to
deal with high risk and obstetric emergencies are
being taken up.
10. Under the Child Survival
component, the UIP, ORT, Prophylaxis schemes and essential
maternal care at the community level are already being
implemented in all districts of the country. Additional
activities related to ARI control are being expanded.
The impact of the programme is reflected in the significant
drop in the infant mortality rate.
11. U.P. Project : Innovations in
Family Planning Services
A US$ 325 million USAID assisted project
named 'Innovations in Family Planning Services in U.P.'
was launched for strengthening the family welfare programme
in the State of Uttar Pradesh. The project to be implemented
over a ten year period, aims at
increasing
access to family planning services by extending
service delivery in the public sector as well as
non-governmental sector and through promotion of
social marketing of contraceptives,
improving
the quality of family planning services by expanding
the choice of contraceptive methods and improving
the technical competence of personnel through training
and upgrading of their skills, and
promoting
family planning by broadcasting support among leadership
groups and increased public understanding of the
benefits of family planning
It is
expected that at the end of the project period,
the total fertility rate (TFR) of Uttar Pradesh
will decline to 4.0 and there will be an increase
in the couple protection rate (CPR) by 15%
