National family welfare programme

Presented By Mrs. sujatha
Page 1

India is the second populous country in the world, next only to China. It holds 17.5% of the world’s population within just 2.5% of the total land mass of the earth. In an area of about one third of the United States, it supports a population three times of that country. This emphasizes the need for population programs to control population growth.


The family planning aims at small family which will serve the welfare of the individual the family and the community. It is also associated with numerous misconceptions. The recognition of welfare concept came only a decade and half after its inception when it was named Family Welfare Programme (1977). Family Planning is a family welfare programme and its aim is to create a social welfare state.
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 National Family Planning program launched 100% centrally sponsored program First country in the world  Family Planning Dept..integration of Family Planning services with MCH services MTP Act introduced 1972  National Family Welfare Programme  12/23/2013 nhcon.bgl 4 .National Family Welfare Program National Family Welfare Program 1952.created in 3 rd FYP 4 th FYP .

bgl 5 . disownment client driven Quality  12/23/2013 nhcon.Objective “Reducing the birth rate to the extent necessary to stabilize the population at a level consistent with the requirement of the National economy  Stabilize Population Targets as an “end” Reduction in Births Administrative &Performance Informed decision Resentment.

information. Family Welfare Programme will provide comprehensive maternal and child health services and also family planning services . 12/23/2013    6 . For creating awareness.Basic Principles of Family Welfare Program  Basic Principles of Family Welfare Program Family welfare services are voluntary.bgl be provided free of cost. education and communication will be used effectively. Popular and easily available family planning services will nhcon.

The emphasis was shifted from the purely clinical approach to the more vigorous extension education approach" for motivating the people for acceptance of the "small family room".family planning was declared as "the very centre of planned development". • During the Third and Five Year Plan (1961-66).NATIONAL FAMILY WELFARE PROGRAMME • India launched a nationwide family planning programme in1952 making it the first country in the world to do so.  The introduction of the Lippies Loop in 1965 necessitated a major structural reorganization of the programme. 12/23/2013 7 nhcon. leading to the creation of a separate Department of Family Planning in 1966 in the Ministry of Health.bgl . though records show that birth control clinics have been functioning in the country since 1930.

bgl 8 . family welfare phase. urban family planning centres. subcentres.Continue…… • During the years 1966 the family planning infrastructure (eg. signifying evolution of the programme. gathered momentum over the decades. child survival and safe motherhood (CSSM) phase and reproductive and child health (RCH) phase. These phases. • The Govt. primary health centres. In 1970 an all India hospital postpartum programme and in 1972. The Programme was made an integral part of MCH activities of PHCssand their subcentres. of India gave top priority to the programme. And in the process. in fact. district and State bureaus) was strengthened. the Medical Termination of Pregnancy (MTP) were introduced . it has passed through four major phases of its development. are known as family planning phase. 12/23/2013 nhcon. During the fourth five year plan (1966-1974). • The programme continues ever since and has.

India Population Project  VIII & IX FYP: Differential planning scheme  Increasing involvement of NGOs UIP & CSSM TFA  Approach 1st and 2 nd FYP:“Clinical” approach  2 nd FYP .“Target approach”  3 rd FYP – “Extension & Education” approach  4 th FYP .Approach Approach VII FYP: Area Development Projects.3  7 th FYP . reduce CBR to 32  5 th FYP – NFPP replaced by size to 2. community participation and promotion of MCH care  12/23/2013 nhcon. reduce CBR to 30  6 th FYP.spacing methods.bgl 9 .Net Reproduction Rate (NRR)of 1.Post Partum scheme.

9 th FYP stressed on reduction in population growth 10 th FYP focused on reduction on IMR. Increase in Literacy Rates to 75 per cent within the Tenth Plan period (2002 to 2007).2%. Reduction of Infant mortality rate (IMR) to 45 per 1000 live births by 2007 and to 28 by 2012 nhcon. Objectives: Reduction in the decadal rate of population growth between 2001 and 2011 to 16. decadal growth rate & increased literacy rate.bgl 12/23/2013 10       .Continue……  8 th FYP-stress on the involvement of NGOs to supplement and complement the Government efforts.

    . Reduce malnutrition among children of age group 0-3 to half its present level Reduce anemia among women and girls by 50% by the end of the plan Family planning insurance Scheme Jansankhya Sthirata Kosh Raising the sex ratio for age group 0–6 to 935 by 2011–12 12/23/2013 nhcon.bgl 11 and 950 by 2016–17.. Reduce TFR to 2.Continue….  XI FYP Targets / Goals: Reduce IMR to 28 and MMR to 1 per 1000 live births.1  Provide clean drinking water for all by 2009 and ensure that there are no slip-backs.

M.   All the untrained DGOs.Strategies to be adopted to achieve the Goals of XI FYP:  1706 private nursing homes have been involved besides the Government institutions to provide family welfare services in the State. (Surgery) will be trained in Laparoscopic Sterilization. All the untrained MBBS doctors will be trained in tubectomy sterilization and Non Scalpel Vasectomy. More number of unapproved private nursing homes will be approved to render Family Welfare services to the eligible couples.bgl 12/23/2013 12  . nhcon.S.D (Obstetrics & Gynaecology ). M.

Steps will be taken to make the Operation theatres in all the Primary Health Centres functional in a phased manner.Continue……  At present 254 Operation theatres are functioning in the Primary Health Centres. 12/23/2013 nhcon. All the untrained VHNs and ANMs will be given training in insertion of IUD.bgl 13    . Area specific approach will be adopted to identify village wise eligible mothers with three and above children and motivate them by a block level team to accept Family Welfare Sterilization.

The clinical approach was replaced by an extension education approach. The clinical approach extended for the first two Five Year Plan periods and obviously failed to create a dent on the population growth. during the Third Plan period. and its outlay was raised to Rs 27 crores.  However. family planning was treated as an important area of national planned development. The total outlay on the family planning during the first two Five Year Plans was just Rs 5.PROGRAMME EVOLUTION FAMILY PLANNING PHASE:  The family planning phase was started by adopting a clinical approach and establishing a limited number of clinics that distributed educational material and offered opportunities for training and research in the field of family planning. and the infrastructure for the family planning activity was established within the primary health care system of the country.bgl 14 .65 crores. 12/23/2013 nhcon.

(b) refer women with complications to appropriate institutions for care. especially for those with health or obstetric problems. 12/23/2013 nhcon.bgl 15 . © achieve 100% coverage of women under Tetanus Toxoid immunization.Maternal health care  Maternal health care envisaged is expected to be able to (a) generate community awareness to promote universal screening of pregnant women to identify those with problems. refer obstetric emergency cases to the nearest first referral units (FRUs) for expert management and provide skilled attendance at delivery and advise institutional delivery.

early detection and appropriate management of acute respiratory infections and acute diarrhoeal disease episodes in children. immunization of infants/children against vaccinepreventable diseases. food and micronutrient supplementation of children.bgl 16 . 12/23/2013 nhcon.Child health care The child health care envisaged is expected to ensure 1. universal newborn care at delivery. detection and management of growth faltering in children. 2. 4. nutrition promotion of children through exclusive breastfeeding for 6 months. timely introduction of complementary feeding of infants and 7. 6. 5. 3.

12/23/2013 nhcon. following an unwanted pregnancy.bgl 17 .Fertility regulation  It is envisaged that the programme shall help (a) to improve access of consumers to fertility regulation services (b) to recognize and strengthen institutions providing safe MTP (medical termination of pregnancy) service sand © to ensure that women do accept appropriate contraception at the time of MTP to prevent repeating of abortion service.

It can also be defined as “the way clients are treated by the system. couples.  Family planning is not just a demographic issue It is also an issue related to individual issue rights. 12/23/2013 nhcon. preservation of the environment. families and society at large. There is a huge unmet need for Family Planning and improving Quality will increase the utilization of services. and the health and wellbeing of women.bgl 18  . socio-economic development.Quality of Family planning service  Quality in family Planning can be defined as offering a range of services that are safe and effective and that satisfy clients’ needs and wants.

bgl 19 .Family planning / Contraceptives  The National Family Welfare Program provides the following contraceptive services for spacing births:  Condoms  Oral Contraceptive Pill  Intra Uterine Devices (IUD)  Terminal Methods:  Tubectomy : i)Mini Lap Tubectomy ii) Lapro Tubectomy  Vasectomy : i) Conventional Vasectomy  ii) No-Scalpel Vasectomy 12/23/2013 nhcon.

12/23/2013 nhcon.Centrally Sponsored Scheme since 1981 to compensate the acceptors of sterilization for the loss of wages Implemented through ICICI Lombard General insurance Company Compensation: (w.f.bgl 20 . January 1st .f-07.07) Compensation in case of adverse event (w. 2009).e.e.Family Planning Insurance scheme  To encourage people to adopt permanent method of Family Planning .09.

sterilization &Postpartum clients. ANMs& VHNDs: Counseling FP services(OCs. Regular supervision Active participation of PRIs. ECPs). Availability of IEC materials. Referral. Follow up of IUCD. Community Mobilization Areas to be strengthened. Creating Role Models 12/23/2013 nhcon. Capacity building & Role Clarity Incentives to ASHA.bgl 21 .Strengthening Service Delivery in Family Planning            At Household/ Village Level: At Household/ Village Level Services /Activities Home to Home visits by ASHAs. Condoms.

 Support &Supervision of ASHA & AWW  Areas to be strengthened Facility readiness according to IPHS standards  Training in IUCD (No –Touch Technique)  Provision of IEC Materials  Supportive supervision by LHV / MO PHC  Strengthening Referral nhcon  .At Sub centre Activities/Services Maintaining Eligible Couple Register  Counseling and service provision during ANC.bgl 12/23/2013 22 . PNC & Immunization visits  IUCD insertions  Follow up services  Referral Services  Contraceptive supply.

equipments & instruments  Referral Services  12/23/2013 nhcon.At PHC Activities/Services All FP services including Tubal ligation (interval & postpartum)& NSV  Follow up services  Counseling and appropriate referral for couples having infertility  Training and supportive supervision of field level staff like ANMs.bgl 23 . MPWs& ASHAs  Areas to be strengthened :  Ensuring availability of 24/7Services as per IPHS  Ensuring availability of trained personnel in Minilap /NSV/IUCD insertion  Fixed Day Static Services for sterilization  Regular supply of drugs.

bgl 24 . Diagnostic Services  Areas to be strengthened  Up gradation as per Strengthening of counseling component  Rational posting of specialists Operationalize District Clinical Training Centres  Fixed Day Static Services for sterilization  Strengthening of RKS  Management of couples having infertility  12/23/2013 nhcon.At CHC Activities/Services 24*7 specialist services  All FP services including Laparoscopic Sterilization services. Training and supervision of field level staff. Follow up services. Regular supply of drugs.

health care infrastructure. Long-term objective: To achieve a stable population by 2045 12/23/2013 nhcon. and health personnel.National Population Policy 2000  Immediate objective : To address the unmet needs for contraception. and to provide integrated service delivery for basic reproductive and child health care Medium-term objective: To bring the TFR to replacement levels by 2010.bgl 25   . through vigorous implementation of intersectoral operational strategies.

bgl 26 .  Promote initiatives which leverage the strength of different economic and social sectors  To reach out needy population groups  12/23/2013 nhcon.Jansankhya Sthirata Kosh National Population Stabilization Fund -registered as an autonomous Society Combination of government and civil society Working to promote innovations.

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ROLE OF NURSE IN FWP Administrative role Supervisory role Functional role Educational role Role in research Role in evaluation 12/23/2013 nhcon.bgl 28 .

 12/23/2013 nhcon. ANM’s etc.  Initializing and contributing toward research.  Supervising and guiding the other female paramedical personnel such as health workers. conducting. Dais.ROLE OF NURSE (IN GENERAL) Identifying people who desire to have children and those who don’t Listening. counseling and making appropriate referrals for fertility control.  Providing and interpreting family planning information and to tap community resources for health workers and community.  Planning.  Planning. participating and evaluating family welfare services and organizing camp.bgl 29 . evaluating in co-ordination with medical officer in community health centre level training for other paramedical staff inc. understanding.

bgl 30 .ADIMINISTRATIVE ROLE  Nurse who are in senior position participate in the organization Of FWP at national. Regional or community level and the development of nursing Activities. 12/23/2013 nhcon.

bgl 31 .SUPERVISORY ROLE  As an supervisor nurse should encourage their staff to watch carefully for indication that mother or couples would accept on how to space their Children and so on. 12/23/2013 nhcon.

FUNCTIONAL ROLE  The primary role of nurse is case finding.bgl 32 . 12/23/2013 nhcon. routine clinical function and to help the client choose one of the more simplest methods of Contraception. making referral.

services available in FWP and they must be able to transmit this knowledge effectively to the community. 12/23/2013 nhcon.bgl 33 . family and for the individuals .EDUCATIONAL ROLE  Nurses must have sound knowledge of FWP.

 12/23/2013 nhcon. These provides valuable data upon which research may be based.ROLE IN RESEARCH Nurses are essential members of the Multidisciplinary research team.bgl 34 .  Nurses know to keep careful records and reports relating to their nursing activities.

ROLE IN EVALUATION  Evaluation is an important part of planning for nursing Services.bgl 35 . 12/23/2013 nhcon.

Govt. Culture. Through clinic visits. She should provide counseling services. COMMUNICATION AND HEALTH EDUCATION : Be a good listner. MOTIVATION: Motivation of eligible couple for family planning methods. beliefs.bgl 36       . FOLLOW UP :Through home visits. Customs. Resources available. KNOWLEDGE ABOUT FP: Nature and family planning. KNOWLEDGE ABOUT PERSON: Individual’s needs and awareness.NURSES RESPONSIBILITY  UNDERSTANDING feelings and attitudes about sex and family planning. 12/23/2013 nhcon. CLINICS : Assist doctors in conducting clinics. Policies. Methods of FP. Assist in postnatal checkups.


bgl 38 .THANK YOU 12/23/2013 nhcon.