Method Of Family Welfare Programme
Prathmesh V. Chute CSE 2nd Year Section B
Sohan R. Hatwar CSE 2nd Year Section B
Abstract: its SPIP 2013-14 capacities of private sector were
to be utilized for service delivery. Availability of
Family planning or Family welfare means planning PPP possibilities were to be explored. There has
by individuals to have only the Children they want, been a general expectation that expansion of
when they want them. Family welfare includes not private-sector services will increase the outreach of
only planning of births, but also their welfare of India’s family welfare programme, enhance the
whole family by means of total family health care. programme’s credibility, improve the quality of
family welfare services, increase the acceptability
INTRODUCTION: of contraceptive methods, and reduce unintended
pregnancies. One possible explanation is that
The Family welfare programme of India has been women may use private-sector services not
successful in spreading the message of the small because they are of high quality, but rather because
family norm, improving contraceptive acceptance public-sector services are of poor quality or are
and reducing fertility rate but data on unmet need unavailable The private sector is defined as all the
for contraception in annual health survey 2010- providers, suppliers, and ancillary and support
2011, 2011-2012, 2012-2013 shows that the unmet services that lie outside the public sector. These
need for contraception remains too high. This include commercial or for-profit entities, non-
inequity is fuelled by both a growing population profit organizations, community groups, informal
and a shortage of family welfare services and there vendors, and a small but growing number of
is still a huge need for improving availability and private providers, such as doctors, pharmacies, and
accessibility of family welfare services. hospital staff .5
Total fertility rate of Rajasthan shows decline from India has the largest private health sector in the
3.7 in 2005 to 2.9 in 2012 as well as CBR has world with over one million qualified doctors of
declined from 0.6 in 2005 to 25.9 in 2012. 1 The various systems of medicine (Allopathic -918303,
involvement of Male counterparts in family AYUSH- 686318 ).6 Available evidence suggests
welfare is still an issue of concern as data on Male that private providers are a major source of care in
sterilization shows no progress from last three rural areas of India. Surveys of health seeking
surveys (Table 1).2-4 behaviour in India indicate that the poor
increasingly prefer and use private providers of
healthcare, as opposed to public providers. 7 This
preference is largely due to reasons of access
and perceived quality is high of private providers,
in spite of the fact that the services of public
providers are free.
As the government health system in India is
beset by problems of physical distance, long
waiting times, unavailability of doctors, the
private practitioner is by default, the de facto
primary care provider. They are often the first
point of contact that the community have
with the health system.
The government is placing more emphasis on Private providers have a comparative
involving the private sector in the delivery of advantage because they are close to the
family welfare services. As per roadmap for community, both geographically and socially.
priority action decided by state government under Private providers are also trusted by the
community, so collaborating with them MTP, Tubectomy, IUCD, Oral pills condoms &
presents a unique. providing counselling for temporary or spacing
methods also. 90% registered
Study design Institutions/Organizations providing counselling
services, Female sterilization, 45% (17) male
A Descriptive Cross Sectional study was sterilization,92% (35) providing IUCD
conducted from March, 2013 to Dec 2013 in services,71% (27) providing Injectables for
selected districts of Rajasthan, India. spacing (ex. Depopvera, DMPA) and similarly all
the Non registered Institutions/Organizations
Sampling technique providing counselling and other sexual &
reproductive health services (Figure 1).
Stratified Simple Random Sampling technique was
used in the study.
Study area
Private hospitals /NGOs/agencies of 5 districts,
catering to 24 % of total population of Rajasthan,
India.
Sampling process
The 5 districts were selected based on availability
of private providers there. The 30% of the selected
registered private hospitals, NGOs, Social
marketing agencies & private providers were taken
for the survey. Non registered private hospitals,
NGO, agencies and private providers were taken in
equal number to the registered providers.
Definitions
Registered As per the available records the male sterilization
services are very less compare to female
Registered hospitals were those who have already sterilization, only 34% (13) non registered (non-
done their Accredited through a process decided by accredited) Institutions/Organizations were
state and submitting their report on monthly basis. providing male sterilization services (NSV) . The
registered & non registered
Non-registered Institutions/Organizations were asked, whether
Family welfare services they are providing are
Non-Registered hospitals were those who have not demand based or provider based.
registered with the Government. Or the registration The 50% (19) of registered and 74% (28) non
of hospital is under process or yet to be finalized registered Institutions /Organizations replied
by committee constituted under the chairmanship that the services are demand based, the reason
district Collector quoted by the providers was that on their part,
they inform clients about all available family
Questionnaire welfare services .They provide permanent &
temporary methods of family welfare with
A Semi structured questionnaire for information the consent of the client .
of private providers (open and close- ended) and Out of 38 Registered and Non registered
an observation checklist and four types of facilities only 24% (9) registered and 11% (4)
schedules were used in the study. nonregistered organizing family welfare camps
and most of the camps were organized within
DISCUSSION the facility. None of them mentioned about
Total 38 registered and 38 non-registered outreach camps because then most of the
Institutions/Organizations were observed. Out of facilities replied the family welfare services
them, all of the registered (38) and 97% (37) non are the least priority services.
registered hospitals were conducting deliveries and
providing family welfare services such as
permanent & temporary methods of sterilization
improve the Family welfare services in
Rajasthan. Special focus is to be given in rural
areas, as limited no of private providers are
So it was observed that the private sector have there.
a greater influence on usage and increase of
family welfare services, if proper involvement Recommendations
will be there than the private sector can create • From the study findings it was
wonders and the usage of the products will observed that media and campaigns plays an
extensively increase, it can expand the total important role in family welfare promotions.
family welfare market which will help in Intensive awareness campaign needs to be
catering the existing and future unmet need for done to avail the services of the private sector.
contraception. Some studies have suggested Each district need to evolve a systematic
that even though the cost of quality approach for involving private sector hospitals
improvements may be passed on to the client, to contribute in family welfare. Expression of
contraceptive use rises with greater method interest may be called through advertisement
choice and improvements in quality.8 The shift or through correspondence.
users from subsidized to more nearly self- • As private sector contribution shows
supporting outlets without compromising a great impact in service delivery. So a plan
coverage, quality and quality of care. should develop where private sectors
Therefore it is to the government’s advantage involvement will also shown so that the people
to encourage greater private sector will aware that they will avail the similar
involvement in the national family welfare services which they are availing in government
program (Nonretail outlets, private providers) hospitals in the private institutions also .
but in some suggest that Private Sector • Private sector hospitals can be
conducting FP services is also viewed as promoted to hold the family welfare camps in
competition by the public health providers. their hospitals on monthly basis and
Private sector is seen as an open market where department can support them to hold such kind
behavioural economics can influence client of camps.
motivation and uptake of services.9Public • Incentivization is a powerful strategy
Health providers perceive that this may lead to to involve and attract private sectors in
a decline in uptake of services against the providing family welfare services. According
targets allocated to the Government has a to the study , the private sectors does not find
legitimate role in regulating private sector potential in this service as it requires lot of
family welfare activities, such as licensing counselling and it is demand based service.
facilities, maintaining professional standards Private sectors have all the equipment’s and
among practitioners and quality of facilities to cater the services but due to lack of
contraceptive commodities.10 Disseminating motivation the private sectors are not putting
information about the benefits of fertility efforts. So incentive structure needs to be
regulation and contraceptive options is the revised and amount paid per case need to be
responsibility of the government as it supports increased.
to users who are excluded from the private • Accreditation is important in family
market because of geographic isolation or welfare services. It’s not ensuring the services
inability to pay. The kind of private sector availability but also ensure the quality. But as
activities should depends in part on which it is tiresome procedure the private sectors
contraceptive methods are to be used. Even doesn’t want to be a part of it. During the
non registered hospitals were interested in study many private hospitals mentioned that
providing FP services, so Government should they want to be accredited but in spite of their
develop a simple mechanism for the repeated reminders.
registration & reporting etc.
References
CONCLUSION
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On the basis of above mentioned results and
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