FAMILY PLANNING (preventative and social medicine pdf)
- 1. FAMILY PLANNING 1 PRESENTED TO: Dr. Shikha Gopal Ma’am PRESENTED BY: 1.SURESH BAIRAWA(96) 2.SWETA BHARTI(98) 3.UMA TIWARI(99) 4.VINAY KUMAR(103) 5.NITISHA GUPTA(105) (BATCH 2020)
- 2. Family planning is a strategic approach that enables individuals and couples to make informed decisions regarding the number, spacing, and timing of their children. As emphasized in Park’s Textbook of Preventive and Social Medicine, family planning is essential for improving public health outcomes, reducing maternal and infant mortality, and enhancing overall quality of life. 2
- 3. FAMILY PLANNING IS NOT SYNONYMOUS WITH BIRTH CONTROL; IT IS MORE THAN MERE BIRTH CONTROL 3
- 4. SCOPE OF FAMILY PLANNING: Proper spacing and limitations of birth Advice on sterility Education for parenthood Sex education Screening for pathological conditions related to reproductive system Genetic counselling Premarital consultation and examination Carrying out pregnancy tests Marriage counselling Preparation of couples for the arrival of first child Providing services for unmarried mothers Teaching home economics and nutrition Providing adoption services 4
- 5. TERMINOLOGIES ELIGIBLE COUPLES Couples in whom female is in reproductive age group (15-45 yrs) Contraception is given TARGET COUPLES Couple who has completed family and has at least one live child Sterilization is done 5
- 6. PLANNED FAMILY A. 1st child born after at least 2 years after marriage B. 2nd child born at least 3 years after 1st child or 5 years after marriage C. Couple adopts permanent method of family planning after 2 children COUPLE PROTECTION RATE Percentage of eligible couples effectively protected against childbirth by one or other approved methods of family planning As of National Family Health Survey (NFHS-5) the current CPR of India was 66.7% 6
- 7. Methods of assessment: 1.Lifetable Analysis 2. Pearl’s Index FAILURE OF CONTRACEPTION Lifetable method: Ideal Method Pearl’s Index: Easy and M/C 7
- 8. Number of accidental pregnancies Total women years of exposure X 100 Pearl’s Index: 10 200X1 X100 = 5 PEARL’S INDEX .Multiplicative factor will be 1200 for total women years of exposure in months . Unit: HWY(hundred woman years) EXAMPLE: If 10 pregnancies occur among 200 women using a contraceptive method for 1 year i.e. 5 pregnancies per 100 woman years of use 8
- 9. CONDOMS: 2-15 IUDs: 0.2-2 OCPs: 0.1-1 IMPLANTS: 0.05-0.3 PEARL’S INDEX OF CONTRACEPTIVE METHODS: 9
- 10. CONTRACEPTION Intentional prevention of conception or impregnation through various methods, devices, or agents These methods aim to allow individuals or couples to decide if and when to have children, thereby promoting family planning and reproductive health. 10
- 11. IDEAL CONTRACEPTIVE: Safe: Minimal health risks to the user. Effective: High success rate in preventing pregnancy. Acceptable: Culturally and personally suitable for the user. Inexpensive: Affordable and accessible to all socioeconomic groups. Reversible: Allows for the return of fertility upon discontinuation. Simple to administer: Easy to use or apply. Independent of coitus: Does not require action at the time of sexual intercourse. Long-lasting: Provides extended protection without frequent intervention. Requires little or no medical supervision: Can be used with minimal healthcare provider involvement 11
- 12. METHODS OF CONTRACEPTION NATURAL METHODS BARRIER METHODS INTRAUTERINE DEVICES ORAL CONTRACEPTIVE PILLS INJECTABLES IMPLANTS OTHERS TUBECTOMY VASECTOMY TEMPORARY PERMANENT 12
- 13. BARRIER METHOD PHYSICAL CHEMICAL COMBINED CONDOMS DIAPHRAGM VAGINAL SPONGE 13 FOAMS CREAMS,JELLIES,PASTE SUPPOSITORIES SOLUBLE FILMS
- 14. 14 1.CONDOMS Most widely used barrier device In India- NIRODH Pearl’s Index: 2-15 Both contraceptive and non contraceptive advantages Disadvantage: May slip off or tear Female Condoms: Pouch made of polyurethane which lines the vagina -has 2 rings: External and Internal
- 15. 15 2. DIAPHRAGM Vaginal cap, aka Dutch Cap Has a flexible rim made of spring or metal Inserted before intercourse, must remain in place for not less than 6 hours after intercourse Advantage: Side effects are practically nil Disadvantage: - A. Physician or trained person needed initially for demonstration - B. TSS if left in vagina for extended period
- 16. 16 CHEMICAL: Surface active agents- attach themselves to spermatozoa and inhibit oxygen intake and kill sperm Disadvantages: High failure rate, may cause burning and irritation, must be introduced to almost all regions of vagina where sperm can be deposited
- 17. 17 IMPLANTS: ROUTE: SUBDERMAL Ex. Norplant R2 : -silastic rods(silicon+plastic) -implanted beneath the skin of forearm or upper arm Disadvantages: -irregular menstrual bleeding -surgical procedures necessary to insert and remove implants
- 19. 19 1- Non medicated /Inert Iud's (1st generation) --Lippes loop --Grafe berg ring 2-Medicated /Bioactive Iud's A-- Metal ions (copper)(2nd generation) a)-Earlier devices Copper -7 Copper T-200 b)Newer device's 1)Variant of the T devices - Cu-T-220 B - Cu -T-380 A 2)Nova T (silver core) 3)Multiload device's ML-Cu-350 ML-Cu-375 (B) Hormones (progestogens ) (3rd generation) - progestasert - LNG-20/Mirena
- 20. 1)Non medicated Iud's *LIPPES LOOP:- -double s shape device -made of polyethylene -contain barium sulphate to allow x-ray observation -4 size A,B,C,D - failure rate -3% - life span - as long as required if there is no adverse effect. 20
- 21. 21 (2) Medicated Iud's A) Metal iron (cu)( 2nd generation) a)Earlier device Copper - 7 Copper-T--200- failure rate - 3%
- 22. b)newer device's *Cu-T-220 -B (B- for size) *Cu-T-380-A (A for silver or gold) - failure rate - 0.5- 0.8 % - life span -10yrs - from 2002 national family planning programme in India uses Cu-T-380A - (due to high efficacy, low acting, low expulsion rate) * Nova T - silver core - life span -5 yrs - hook shape * Multiload device's - ML -Cu-250 - ML -Cu - 375 - Cu had a strong anti fertility effect -Number- included refer to surface area 22
- 23. B-hormone (progestogens)(3rd generation) 1) progestasert - T- shape - composition - natural progestin - depot - 38 mg - releasing rate - 65mcg/per day - life span 1yrs - 1st hormonal intra UTERINE develop in 1976 - failure rate - 1.5% - (lowest expulsion rate and lowest removal rate ) 23
- 24. 24 2)LNG-20/MIRENA Shape - bend arm Composition - levonogestrel Depot- 52 gm Releasing rate - 20 microgram per day Failure rate - 0.2% (Lowest pregnancy rate and highest removal rate )
- 25. 25 MECHANISMS OF ACTION 1- COPPER enhances cellular response in endometrium and affect the enzyme in uterus alter biochemical composition of cervical mucus affect sperm motility 2- HORMONE increases viscosity of cervical mucus which prevent sperm from entering the cervix maintain high level of progesterone and low level of oestrogen making endometrium unfavorable to implantation
- 26. 26 IDEAL CANDIDATE FOR IUD'S born at least 1 child no history of PID normal menstrual cycle IUD is an ideal contraceptive for lactating women because it has no effect on the quality and composition of milk
- 27. 27 TIMING OF INSERTION OF IUD during menstruation/ within. 10 days if menstruation -best time within 5 minute of menstruation immediate post partem insertion during 1st week of delivery before leaves the hospital (Best within 24 hrs of delivery) post puerperal insertion 6 se 8 week of delivery Fertility within 1 year in 70% of users after removal of IUD
- 28. 28 ADVERSE EFFECT Bleeding -Most Common side effect of IUD Pain -Most common leading to removal of IUD Uterine perforation Pelvic infection Expulsion
- 29. 29 IUD CONTRAINDICATIONS Vaginal bleeding nulliparous PID suspected pregnancy women with multiple partners ca cervix previous ectopic pregnancy
- 30. INJECTABLES 30
- 31. 31 1) PROGESTERONE ONLY A)DMPA Depot medroxy progesterone acetate aka depop provera 150 miligram intramuscular every 3 months for female >35 yrs agr B) NET -EN norethisterone enantate 200 mg intramuscular every 2 months
- 32. 32 2) COMBINE - cyclofen - cycloprovera - mesigynae -contains progesterone and oestrogen -failure rate a) cyclofen and cycloprovera - 0.2% b)mesigynae - 0.4%
- 33. 33 #DEPOT SUB Q PROVERA 104 - subcutaneous dmpa - 30% lower dose i.e.104 mg # ANTARA PROGRAMME -Mpa (medroxy progesterone acetate ) -150 mg intramuscular every month - initial injection should be given during first 5 days if menstrual period - Adverse effect - disruption of normal menstrual cycle
- 34. 34 CONTRAINDICATIONS Suspected pregnancy Vaginal bleeding high bp deep vein thrombosis
- 35. 35 HORMONAL CONTRACEPTIVES Hormonal contraceptives when properly used are the most effective spacing methods of contraception. oral contraceptives of the Combined type are almost 100% effective in preventing pregnancy. They provide the best means of ensuring spacing between one childbirth and another. More than 65 million in the world are estimated to be taking the Pill" of which about 9-52 million are estimated to be in India.
- 36. 36 CLASSIFICATION A. Oral Pills 1. Combined Pill 2. Progestogen only Pill (Pop) 3. Post-Coital Pill 4. once-a-month (long-acting) Pill 5. Male Pill B. Depot (Slow release) formulations 1. Injectables 2 subcutaneous implants 3.vaginal rings
- 37. 37 A) ORAL PILLS 1. Combined Pill The Combined pill one of the major spacing Methods of Contraception. The "Original Pill" which entered into the Market in the early 1960s Contained 100-200 Mcg of a Synthetic estrogen and 10 mg of a Progestogen." At the Present time most formulations of the Combined Pill Contain no more than 30-35 mcg of a Synthetic estrogen and o.5 to 1.0 mg of a Progestogen. The debate continues about the minimum effective dose of the Progestogen in the Pill. which will produce the least metabolic disturbances .
- 38. 38 Orally: 21 day beginning on the 5th day of the menstrual cycle. # Break.(7days during period) Taking time: Every day at fixed time preferably at night. going to bed at night TYPES OF PILL- The Department of family welfare in the ministry of Health and family welfare Goverment of India has made two type of low-dose pills under the brand names of (MALA-N & MALA-D) Contains Levonorgestrel 0.15mg + Ethinylestradiol 0.03mg Available MALA-D -Package of 28 Pills. (21 of oral contraceptive Pills and 7 brown film Coated 60 mg ferrous fumarate tablet.) Price 3 Rs Per Packet -MALA-N is Supplied free of cost through all PHC urban family welfare Centers
- 39. 39 2. Progestogen-only Pill (Pop) This Pill is commonly referred to as "mini Pill" or micropill It contains only Progestogen given small dose throughout Cycle modern days Contraception. Risk Factors: -Cardiovascular (older women) -Neoplasia (young women) Ex. Norethisterone Levonorgestrel
- 40. 40 3. Post Coital Contraception Post-Coital (or "morning after") Contraception is recommended within 72 hours of an Unprotected intercourse 2 methods are available: 1)IUD. 2)Hormonal Ex. Mifepristone 10 mg once within 72 hours. Post-Coital Contraception is advocated as an emergency methods Examples- 1)After unprotected intercourse 2)Rape 3)contraceptive failure Failure rate -less than 1%
- 41. 41 4. Once a month (Long-acting) Pill Experiment with once a month oral Pill in Which (quinestrol). a long-acting oestrogen is given in Combination with a short -acting The progestogen have been Pregnancy rate is too high to be acceptable. In addition bleeding tends to be irregular. 5. Male Pill The Search for a male Contraceptive began in 1950 Research is following 4 main lines of approach: A)Preventing Spermatogenesis B)Interfering with Sperm Storage and maturation C)Preventing Sperm transport in the vas D) Affecting Constituents of the seminal fluid An ideal male Contraceptive would decrease Sperm Count while leaving testosterone at normal levels . But hormones that suppers sperm production tend to lower testosterone and affect potency and libido. EX.(Gossypol) -derivative of cotton seed oil. -It is effective in producing azoospermia or severe Oligospermia but as many as 10%of men may be permanently azoospermic after taking it for 6months . -further gossypol could be toxic.
- 42. 42 MODE OF ACTIONS OF ORAL PILLS Prevent the release of the ovum from the ovary. Blocking the Pituitary Secretion of gonadotorpin. inhibit sperm Penetration. Inhibit tubal motility and delay the transport of the sperm and of the ovum to the uterine Cavity. EFFECTIVENESS Oral Contraceptives of the Combined type are almost 100% effective in preventing pregnancy. Annual Pregnancy rate is less than 1% under clinical trial Conditions progestogen - only Pills is almost as good as the Combination Production Continuation rates < Clinical trials. Effectiveness may also be affected by Certain drugs such as rifampicin, ampicillin
- 43. 43 RISKS AND BENEFITS (1960) Benefit Prevention of pregnancy. (1970) Risk abnormal Cycle bleeding (1970) Risk -MI , DVT (1980) two large study of Family Planning 1)The Royal College of Central Practitioners! 2)The oxford University family Planning Association's Study A) Adverse effects- 1)Cardiovascular effects 2) Carcinogenesis - Cervical Cancer -myocardial infarction 4)Other adverse effects - Cerebral thrombosis -Liver disorders - venous thrombosis -Lactation 3) Metabolic effects -Subsequent fertility -elevation of blood Pressure -Ectopic Pregnancies fetal development decreasing high density lipo-Proteins 5) Common unwanted effects -blood Clotting Breast tenderness. -elevations of blood glucose and Plasma insulin. weight gain -long range probles - MI, stroke Headache & migraine Bleeding disturbance
- 44. 44 B) Beneficial effects Preventing Pregnancy removing anxiety unplanned Pregnancy (Give Protection against at least 6 disease)- Breast disorders (Fibrocustic & fibroadenomy) 2) ovarian cysts 3)iron deficiency anaemia 4)Pelvic inflammatory disease 5) ectopic Pregnancy 6) ovarian cancer
- 45. 45 THE MEDICAL TERMINATION OF PREGNANCY ACT 1971 MTP Act, 1971 lays down: 1)The Conditions under which a Pregnancy can be terminated. 2) The Person or persons who Can Perform Such terminations 3) The place whore such terminations can be Performed.
- 46. 46 1. THE Conditions under which a Pregnancy Can be terminated under the mtp act 1971.There are 5 conditions that have been identified in the act a) Medica -danger for mother Life Cause grave injury to her physical or mental health. b)Eugenic - -Substantial risk of the Child. -Serious handicaps due to physical or mental health. c)Humanitarian - where pregnancy is the result of rape. d)Socio-economic -Risk of injury to the health of the mother e)failure of Contraceptive device
- 47. 47 #2. The Person or Persons who can Perform abortion- The act Provides Safeguards to the mother by Authorizing only a Registered medical Practitioner or having experience in gynaecology and obstetrics to Perform abortion where the length of pregnancy exceed 12 weeks and is not more than 20 weeks, the opinion of two Registered medical Practitioners is necessary to terminate the Pregnancy. #3. Where abortion can be done - The act Stipulates that no termination of Pregnancy Shall be made at any place other than a hospital established or maintained by Government or a place approved for the purpose of this Act by Government. #MTP RULES (1975) # Rule and Regulations framed initially were altered in October 1975 to eliminate time- consuming procedures involved in MTP and to make Services more readily available.
- 48. 48 These changes have occurred in 3 administrative areas 1) Approval by Bocard- 2) Qualification required to do abortion -- " if he has assisted a RMP in the Performance of25 cases of mtp in an approved institution" a)6months housemanship in obstetric and gynacology .. b)Postgraduate qualification in OBG.. c) 3 years of practice in OBG for those doctors registered before the 1971MTP act was passed d)1 year of Practice in OBG for those doctors registered on or after the date of commencement of the act. 3) The place where abortion is performed- Under the new rules, non-govermental institution may also take up abortions Provided they obtain a licence from the chief medical officer of the district, thus eliminating the requirement of Private clinics obtaining a Board licence .
- 50. 50 1) ABSTINENCE •Complete avoidance of sexual intercourse. •Hardly consider as contraceptive method due to in practice an oversimplification. Drawback- Due to repression of natural force which result in temperamental changes even nervous breakdown. 2) COITUS INTERRUPTS •Male withdraws before ejaculation and tries to prevent deposition of semen into vagina. Drawback- Failure rate as high as 25 %.
- 51. 51 3) SAFE PERIOD (RHYTHM METHOD) • Also known as calendar method first described by ogino in 1939. • Failure rate 9 per 100 women in a year. • Method based on fact that ovulation occur 12 to 16 days before onset of menstruation. How to calculate? -Shortest menstrual cycle - 18 days (gives first day of fertile period) -Longest menstrual cycle - 10 days (gives last day of fertile period) -During these period require complete abstinence. Drawback: Irregular women's menstrual cycle Medical complication (Ectopic pregnancy, embryonic abnormalities) Not applicable during postnatal period.
- 52. 52 4) NATURAL FAMILY PLANNING METHOD: It includes 3 more methods A) BASAL BODY TEMPERATURE METHOD: • Increase in temperature of body during ovulation due to increase in progesterone. • Rise of temperature very small (0.3*C to 0.5*C) •Reliable only when intercourse restricted to post ovulatory infertile period and continue up to beginning of next cycle Drawback: Complete abstinence necessary for entire pre ovulatory period B) CERVICAL MUCUS METHOD (BILLING METHOD) : • Based on observation of changes in characteristic of cervical mucus. • At the time of ovulation mucus will be watery clear, slippery and profuse. • After ovulation mucus thickens and lesser in quantity. C) SYMPTOTHERMIC METHOD : • Combination of calendar method, cervical mucus and BBT.
- 53. 53 5) BREAST FEEDING : • Lactation prolong postpartum amenorrhea and provide some degree of protection against pregnancy. Drawback - Once menstruation cycle return, continued lactation no longer offers any protection against pregnancy. 6) BIRTH CONTROL VACCINE (MOST ADVANCED RESEARCH) : • Involve immunization with vaccine prepared from beta subunit of HCG (Human chorionic gonadotropin) to block continuation of pregnancy
- 55. 55 1) TUBECTOMY FOR FEMALES: Operative technique includes - A) MINILAP: Can be performed by an MBBS doctor. B)M/C TECHNIQUE: Modified Pomeroy's technique in which tubes are cut and ligated. Stamps are placed into pelvic area. C) LAPROSCOPIC TUBECTOMIES: By trained professional gynecologist. D)ESSURE TECHNIQUE: A micro essure coil is inserted endoscopically into fallopian tube cause fibrosis and eventual blockage of tubes. Fibrosis occurs after six weeks
- 56. 56 2) Vasectomy for males (No Scalpel vasectomy) : Less complicated and cost effective procedure. Procedure: -Remove a piece of vas at least 1 cm after clamping. -Ends are ligated and then folded back themselves and sutured into position. Post Operative Advice: -Not bathing for 24 hrs and to wear a T-bandage. -Use some other method of contraception for 30 ejaculations or 12 weeks. Complications: -Sperm granules, spontaneous recanalization (3 to 4 %) cases. -Formation of antibodies to sperm (2% cases) -Psychological complications. Guidelines for sterilization: -Male should be between 25 - 30 yrs. -Female should be between 20 - 45 yrs. -Minimum 2 children should be there. -Acceptor declares having obtained consent from spouse, both consent need not there for sterilization
- 57. 57 CONTRACEPTION OF CHOICE a) An unmarried women or married woman having no children -Barrier method, OCP Pills. -IUDs not performed. b) Married woman with one child who wants to delay the second child -IUDs or OCPs c) Married woman with complete family -Sterilization method
- 59. 59 INTRODUCTION Couple plan when to have children, using birth control & other techniques. Family welfare includes not only planning of birth, but their welfare of wholes family by means of total family health care. The family welfare programme has high priority in India because its success depends upon the quality of life of all citizens.
- 60. 60 OBJECTIVE Population Control Maternal and Child Health Reproductive Health Awareness
- 61. 61 HISTORY India was the first country to family planning programme. National family planning programme 1st time rolled out in 1951- 1952 in which many policies & schemes have been implemented. In 1977, the government of India redesignated the NATIONAL FAMILY PLANNING PROGRAMME as the NATIONAL FAMILY WELFARE PROGRAMME. They also changed the name of the ministry of health and family planning to ministry of health and family welfare. Later there maternal and child welfare, immunization, nutrition and non formal education & Medical termination of Pregnancy Acts developed
- 62. 62 KEY TARGETS OF PROGRAMME Couples protection rate > 60% Total Fertility Rate <2.1 Net Reproduction Rate = 1 India presently achieved TFR =2 & CPR=66.7% THEME OF NFWP Son or daughter = 2 will do 2nd child after 3 years Universal immunization
- 63. 63 ORGANISATIONAL SET UP At center level =central health & family bureau secretary and advisor At State level = state health & family welfare bureau Management of programs , finding human resources & other functions At district level = District health & family welfare Implementation, administration and management of family welfare programs centers Evaluation of programs
- 64. 64 URBAN FAMILY WELFARE CENTRE Type I = 10,000 - 25,000 population - 2 Paramedical staff Type II = 25000-50000 Population - 2-4 Paramedical staff Type III = > 50,000 Population - 6 staff with a medical officer URBAN HEALTH POST TYPE A= < 50,000 population :- Paramedical staff & attached to hospital TYPE B = <5000- 10,000Population:- Paramedical staff & attached to hospital TYPE C = 10,000 - 25,000 Population:- Paramedical staff & attached to hospital TYPE D = 25,000 - 50,000 Population :- medical officer, paramedical staff & attached to hospital VILLAGE LEVEL ASHA ( Accredited social health activists) Trained birth attended Village health guides.
- 66. 66 1. MISSION PARIVAR VIKAS KEY FEATURES: -Targeted districts with high fertility rates. -Free provision of family planning services. -Contraceptive methods promotion and supply. OBJECTIVE: This scheme aims to provide access to quality family planning services in high fertility districts of India. It focuses on the use of modern contraceptives, spreading awareness, and improving reproductive health.
- 67. 67 2. JANANI SURAKSHA YOJANA (JSY) KEY FEATURES: Provides cash incentives to pregnant women for institutional deliveries. Aims to improve maternal health and reduce home deliveries. Focuses on women from below-poverty-line families. OBJECTIVE: To reduce maternal and neonatal mortality by promoting institutional deliveries and ensuring access to skilled birth attendants.
- 68. 68 3. PRADHAN MANTRI SURAKSHIT MATRITVA ABHIYAN (PMSMA) KEY FEATURES: Free monthly checkups for pregnant women. Focuses on ensuring better health for both mothers and babies. Involves health workers, doctors, and healthcare institutions. OBJECTIVE: To provide free health checkups and services to pregnant women and ensure early detection of any complications.
- 69. 69 4. PRADHAN MANTRI MATRU VANDANA YOJANA (PMMVY) KEY FEATURES: Provides direct cash benefits to pregnant women. Focus on promoting proper nutrition and healthcare during the critical months of pregnancy and lactation. OBJECTIVE: To provide cash incentives to pregnant and lactating women to improve their health and nutrition during pregnancy and after childbirth.
- 70. 70 5. NATIONAL RURAL HEALTH MISSION (NRHM) KEY FEATURES: Strengthens rural healthcare infrastructure and services. Promotes family planning, reproductive and child health services. Aims to reduce infant and maternal mortality rates. OBJECTIVE: To improve healthcare infrastructure and the delivery of health services in rural areas.
- 71. 71 6. FAMILY PLANNING INDEMNITY SCHEME (FPIS) KEY FEATURES: Provides indemnity for women who undergo sterilization in case of any complications. Ensures safety and support for women opting for sterilization as a form of contraception. OBJECTIVE: This scheme aims to provide compensation to women who undergo sterilization procedures under the government’s family planning programs.
- 72. 72 7. INDIRA GANDHI MATRITVA SAHYOG YOJANA (IGMSY) KEY FEATURES: Aims to promote maternity benefits to women. Targets women from marginalized or underprivileged sections. OBJECTIVE: To provide cash incentives to pregnant and lactating women for improving their health and nutritional status.
- 73. 73 8. ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH (ARSH) KEY FEATURES: Focuses on educating adolescents about reproductive health. Encourages responsible sexual behavior and the prevention of early pregnancies. OBJECTIVE: To provide reproductive health services to adolescents and promote healthy sexual behavior.
- 74. 74 9. RASHTRIYA KISHOR SWASTHYA KARYAKRAM (RKSK) KEY FEATURES: Provides a range of services including counseling, education, and healthcare for adolescents. Addresses gender inequality, HIV/AIDS prevention, and promotes a healthy lifestyle. OBJECTIVE: To ensure the overall health and well-being of adolescents, including their sexual and reproductive health.
- 75. 75 NATIONAL POPULATION POLICY Need was felt since 70's. It was drafted in 1976. Prepared 1976 - Both these statments were tabled in the parliament but were never discussed or adopted. National health policy of 1983; Emphasized the need for securing the small family norm through voluntary efforts & moving towards the goal of population Stabilization. It Emphasis for need for a small family. IMPORTANCE: Increase age 15 to 18 girls and 18-21yrs boys . freeze the population figures at 1971 level until 2001 Make some portion of central assistance provided to states dependent upon their performance in family planning.
- 76. 76 ADVANTAGES Population Control: The primary goal of the NFWP is to control population growth through family planning, which helps in managing resources and ensuring sustainable development. Improved Health: The program emphasizes maternal and child health, reducing maternal and infant mortality rates through proper care and nutrition. Awareness and Education: It raises awareness about family planning, contraception, and reproductive health, empowering individuals to make informed choices. Economic Benefits: By controlling the population, the program helps in reducing the strain on resources, leading to economic stability and improved standards of living. Health Infrastructure Improvement: The program has led to the development of healthcare facilities, especially in rural areas, improving access to healthcare for all.
- 77. 77 DISADVANTAGES Cultural Resistance: Family planning programs may face resistance from certain communities due to cultural or religious beliefs, limiting their effectiveness. Coercion: In some instances, there have been reports of coercive sterilization or forced family planning methods, which undermine human rights. Gender Bias: The focus on female sterilization has led to gender imbalances, with women often being the primary targets for contraception, sometimes without their consent. Lack of Awareness in Rural Areas: Despite efforts to increase awareness, there is still a significant lack of education on family welfare in rural areas, which hampers the program’s success. Economic Barriers: The financial and logistical barriers for low-income families may prevent them from accessing the full benefits of the program.
- 78. BIBLIOGRAPHY 78 Park's Textbook of Preventive and Social Medicine 1. Internet 2. AI 3.
- 79. THANK YOU 79