npp ppt.pptx
- 1. National Population Policy 2000 Submitted by: Ms. Seema Rani Associate professor RCON, JH Submitted on: Ms. Arushi Negi M.Sc. Nursing II year RCON, JH
- 2. Introduction Currently the India’s population is at 1.4 billion. India has achieved replacement level fertility, with as many as 31 States/Union Territories reaching a Total Fertility Rate of 2.1 or less.
- 3. DEFINITION 3 Population policy in general refers to policies intended to decrease the birth rate or growth rate. Statement of goals, objectives and targets are inherent in the population policy.
- 4. History In April 1976 India formed its first "National Population Policy". It increased the legal minimum age of marriage from 15 to 18 for females, and from 18 to 21 years for males. New policy statement reiterated the importance of the small family norm without compulsion. The National Health Policy had set the long-term demographic goals of achieving a Net Reproductive Rate (NRR) of one by the year 2000 (which was not achieved). "National Population Policy 2000" is the latest in this series. It reaffirms the commitment of the government towards target free approach in administering family planning services. 4
- 5. NPP 2000 5 1.Women educatio n 2.Empowe ring women for improved health and nutrition 3.Child survival and health 4.The unmet needs for family welfare services 5.Health care for the under- served population groups like urban slums, tribal community 6.Adolesc ent's health and education 7.Increase d participatio n of men in planned parenthoo d 8.Collabor ation with NGOS. The new NPP 2000 is more than just a matter of fertility and mortality rates.• It deals with:
- 6. Objectives 6 Immediate Objectives - To address the unmet needs for contraception, health care infrastructure and health personnel and to provide integrated service delivery for basic reproductive and child health care. Medium-term Objective - To bring the TFR to replacement level by 2010, through vigorous implication of intersectoral operational strategies. Long-term Objective -To achieve a stable population by 2045, at a level consistent with the requirements of sustainable economic growth, social development and environmental protection.
- 7. SOCIODEMOGRAPHIC GOALS • Address the unmet needs for basic RCH services, supplies and infrastructure . • Make school education up to the age 14 free and compulsory, and reduce drop out at primary and secondary level to below 20% for both boys and girls. • Reduce infant mortality rate to below 30 per 1000 live births • Reduce maternal mortality ratio to below 100 per 100,000 live births • Achieve universal immunization of children against all vaccine preventable diseases. • Promote delayed marriage for girls, not earlier than the age of 18, preferably after 20 years of age. • Achieve 80% of institutional deliveries and 100% deliveries by trained persons. 7
- 8. • Achieve universal access to information/counseling, and services for fertility regulation and contraception with a wide basket of choices. • Achieve 100% registration of birth, death and pregnancy. • Contain the spread of AIDS and promote greater integration between the management of RTI, STI and the NACO. • Prevent and control communicable diseases. • Integrate Indian System Of Medicine in the provision of RCH services and in reaching out to households. • Promote vigorously the small family norm to achieve replacement level of TFR. • Bring about convergence in implementation and related social sector programs so that family welfare becomes a people centered program. 8
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- 10. On-going interventions: 10 More emphasis on Spacing methods like IUCD. Availabilit y of Fixed Day Static Services at all facilities. A rational human resource development plan is in place for provision of IUCD, minilap and NSV to empower the facilities. Quality care in Family Planning s ervices by establishin g Quality Assurance Committee s. Improving contracepti ves supply manageme nt. Demand generation activities in the form of display of posters, billboards in the various facilities.
- 11. 11 National Family Planning Indemnity Scheme’ (NFPI S) under which clients are insured in the eventualities of deaths, complications and failures following sterilization. Compensati on scheme for sterilization acceptors Increasing male participatio n and promotion of Non Scalpel Vasectomy. Emphasis on Miniap Tubectomy services because of its logistical simplicity and requirement of only MBBS doctors Accreditatio n of more private/NG O facilities to increase the provider base for family planning services under PPP. Strong political will and advocacy at the highest level, especially, in States with high fertility rates.
- 12. 1.Scheme for Home delivery of contraceptives by ASHAs at doorstep of beneficiaries 2. Scheme for ASHAs to ensure spacing in births: Under this 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 to be paid the following incentives under the scheme:- a. Rs. 500/- to ASHA for ensuring spacing of 2 years after marriage. b. Rs. 500/- to ASHA for ensuring spacing of 3 years after the birth of 1st child. c. Rs. 1000/- in case the couple opts for a permanent limiting method up to 2 children only. 12
- 13. 3. Boost to spacing methods by introduction of new method PPIUCD 4. Introduction of the new device - Cu IUCD 375 5. Emphasis on Postpartum Family Planning (PPFP) services with introduction of PPIUCD and promotion of minilap as the main mode of providing sterilisation to capitalise on the huge cases coming in for institutional delivery under JSY. 13
- 14. 6. Compensation for sterilisation acceptors has been enhanced for 11 High Focus States with high TFR. 7. Compensation scheme for PPIUCD under which the service provider as well as the ASHAs who escorts the clients to the health facility for facilitating the IUCD insertion are compensated. 8. Scheme for provision of pregnancy testing kits at the sub-centres as well as in the drug kit of the ASHAs to facilitate the early detection and decision making 9. RMNCH Counselors availability at the high case facilities to ensure counseling of the clients visiting the facilities. 10. Celebration of World Population Day 11th July & Fortnight: The event is observed over a month long period for mobilization/sensitization followed by a fortnight of assured family planning service delivery and has been made a mandatory activity. 14
- 15. 11. FP 2020- Family Planning Division is working on the national and state wise action plans.The key commitments of FP 2020 are as under : • Increasing financial commitment on Family Planning whereby India commits an allocation of 2 billion USD from 2012 to 2020. • Ensuring access to family planning services to 48 million additional women by 2020 (40% of the total FP 2020 goal). • Sustaining the coverage of 100 million (10 crore) women currently using contraceptives. 15
- 16. Population Stabilization Fund has adopted the following strategies as a population control measure:- • 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 the birth of children in the interest of health of young mothers and infants. • Santushti Strategy:- Under this strategy, Jansankhya Sthirata Kosh, invites private sector gynaecologists and vasectomy surgeons to conduct sterilization operations in Public Private Partnership mode. • 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. • Advocacy & IEC activities:- JSK as a part of its awareness and advocacy efforts on population stabilization, has established networks and partnerships with other ministries, development partners, private sectors, corporate and professional bodies for spreading its activities . 16
- 17. Decentralized Planning and Program Implementation • The 73rd and 74th Constitutional Amendments Act, 1992, made health, family welfare, and education a responsibility of village panchayats. • However, in order to realize their potential, they need strengthening by further delegation of administrative and financial powers, including powers of resource mobilization. Convergence of Service Delivery at Village Levels • If we direct an integrated package of essential services at village and household levels. • Inadequacies in the existing health infrastructure have led to gaps. • Health care centers are over-burdened and struggle to provide services with limited personnel and equipment. 17
- 18. • Absence of supportive supervision, lack of training in interpersonal communication, and lack of motivation to work in rural areas. • The service should reach at door step by universalize coverage and outreach of ante-natal, natal and postnatal health care. • An equipped maternity hut in each village should be set up to serve as a delivery room, with functioning midwifery kits, basic medication for essential obstetric aid, and indigenous medicines and supplies for maternal and new born care • A key feature of the integrated service delivery will be the registration at village levels, of births, deaths, marriage, and pregnancies. • Each village should maintain a list of community midwives and trained birth attendants, village health guides, panchayat sewasahayaks, primary school teachers and anganwadi workers who may be entrusted with various responsibilities in the implementation of integrated service delivery. 18
- 19. 19 Empowering Women for Improved Health and Nutrition • Discriminatory childcare leads to malnutrition and impaired physical development of the girl child. • Undernutrition and micronutrient deficiency in early adolescence. • Interventions for improving women's health and nutrition are critical for poverty reduction. • Avoid early childbearing, and consequent risk of serious pregnancy related complications. • Women's risk of premature death and disability is highest during their reproductive years. • Malnutrition, frequent pregnancies, unsafe abortions, RTI and STI, all combine to keep the maternal mortality ratio in India among the highest globally.
- 20. 20 Child Health and Survival • High mortality and morbidity among infants and children below 5 years occurs on account of inadequate care, asphyxia during birth, premature birth, low birth weight, acute respiratory infections, diarrhea, vaccine preventable diseases, malnutrition and deficiencies of nutrients, including Vitamin A. • Our priority is to intensify neonatal care. A National Technical Committee should be set up, consisting principally of consultants in obstetrics, pediatrics (neonatologists), family health, medical research and statistics from among academia, public health professionals, clinical practitioners and government. • Its terms of reference should include prescribing perinatal audit norms, developing quality improvement activities with monitoring schedules and suggestions for facilitating provision of continuing medical and nursing education to all perinatal health care providers.
- 21. 21 Meeting the Unmet Needs for Family Welfare Services • It is important to strengthen, energize and make accountable the cutting edge of health infrastructure at the village, subcenter and primary health center levels, to improve facilities for referral transportation, to encourage and strengthen local initiatives for ambulance services at village and block levels, to increase innovative social marketing schemes for affordable products and services and to improve advocacy in locally relevant and acceptable dialects.
- 22. 22 Under-Served Population Groups Urban Slums • Nearly 100 million people live in urban slums, with little or no access to potable water, sanitation facilities, and health care services. • This contributes to high infant and child mortality, which in tum perpetuate high TFR and maternal mortality. • Coordination with municipal bodies for water, sanitation and waste disposal must be pursued, Tribal Communities, Hill Area Populations and Displaced and Migrant Populations • In general, populations in remote and low density ares do not have adequate access to affordable health care services. • Tribal populations often have high levels a morbidity arising from poor nutrition, particularly in situations where they are involuntarily displaced or resettled. • Frequently, they have low levels of literacy, coupled with high infant, child, and maternal mortality.
- 23. 23 Adolescents • The needs of adolescents, including protection from unwanted pregnancies and sexually transmitted diseases (STD), have not been specifically addressed in the past. Programs should encourage delayed marriage and child-bearing, and education of adolescents about the risks of unprotected sex. • Reproductive health services for adolescent girls and boys are especially essential in rural India. Diverse Health Care Providers • It is imperative to increase the number and diversify the categories of health care provides. • Ways of doing this include accrediting private medical practitioners and assigning them to defined beneficiary groups to provide these services; • Revival of the system of licensed medical practitioner who, after appropriate certification from the Indian Medical Association (MA), could provide specified clinical services.
- 24. 24 Collaboration with NGOs and Private Sector • We need to put in place a partnership of non government voluntary organizations, the private corporate sector, government and the community. • However despite their obvious potential, mobilizing the private (profit and nonprofit) sector to serve public health goals raises governance issues of contracting, accreditation regulation, referral, besides the appropriate division of labor between the public and private health providers, all of which need to be addressed carefully. • Where government interventions at capacities are insufficient, and the participation of the private sector unviable, focused service delivery by NGOs may effectively complement government efforts.
- 25. 25 Mainstreaming Indian Systems of Medicine • Utilization of ISMH in basic reproductive and child health care will expand the pool of effective health care providers, optimize utilization of locally based remedies and cures, and promote low cost health care. • Guidelines need to be evolved to regulate and ensure standardization, efficacy and safety of ISMH drugs for wider entry into national markets.
- 26. 26 Contraceptive Technology and Research on Reproductive and Child Health • Government must constantly advance, encourage, and support medical, social science, demographic and behavioral science research on maternal, child and reproductive health care issues. • Consultation and frequent dialogue by Government with existing network of academic and research institutions in allopathy and ISMH, and with other relevant public and private research institutions engaged in social science, demography and behavioral research must continue.
- 27. 27 Providing Care for the Older Population • Improved life expectancy is leading to an increase in the absolute number and proportion of persons aged 60 years • When viewed in the context of significant weakening of traditional support systems, the elderly are increasingly vulnerable, needing protection and care. • Promoting old age health care and support will help to reduce burden of the society and develop a healthy successful aging.
- 28. 28 Information, Education, and Communication • Information, education and communication (IEC) of family welfare messages must be clear, focused and disseminated everywhere, including the remote corners of the country, and in local dialects. • On the model of the total literacy campaigns which have successfully mobilized local populations, there is need to undertake a massive national campaign on population related issues.
- 29. • The NPP 2000 is to be largely implemented and managed at panchayat and nagarpalika levels, in coordination with the concerned state/Union Territory administrations. • This will require comprehensive and multisectoral coordination of planning and implementation between health and family welfare on the one hand, along with schemes for education, nutrition, women and child development, safe drinking water, sanitation, rural roads, communications, transportation, housing, forestry development, environmental protection, and urban development. 29
- 30. Accordingly, the following structures are recommended: National Commission on Population • It presided over by the Prime Minister, will have the Chief Ministers of all states and UTs, and the Central Minister in charge of the Department of Family Welfare and other concerned Central Ministries and Departments and NGOs as members. Aims • To review, monitor and give directions for the implementation of the National Population Policy. • To promote synergy between demographic, educational, environmental and developmental programs. • To promote intersectoral coordination in planning and implementation. • First Meeting-23rd July 2005: Survey of all District to identify the weakness in health care delivery system. 30
- 31. 31 State Population Commission • Each state and UT may consider having a State/UT Commission on Population, presided over by the Chief Minister, on the analogy of the National Commission, to likewise oversee and review implementation of the NPP 2000 in the states/UTs. Coordination Cell in the Planning Commission • The Planning Commission will have a Coordination Cell for intersectoral coordination between Ministries for enhancing performance, particularly in States/ UTs needing special attention on account of adverse demographic and human development indicators. Technology Mission in the Department of Family Welfare • To enhance performance, particularly in states with currently below average sociodemographic indices that need focused attention, a Technology Mission in the Department of Family Welfare will be established to provide technology support in respect of design and monitoring of projects and programs for reproductive and child health, as well as for IC campaigns.
- 32. Promotional and Motivational Measures • Panchayat and Zilla Parisads will be rewarded and honored for exemplary performance in achieving the above laid goals • For maternal benefit- Rs. 500 is rewarded to mother who have delivered after 19 yr of age • Health insurance plan for the couple with BPI who under gone sterilization not less than 2 children will get insurance of Rs. 5000 • Establishment of self-help group at village level • Opening of creche at rural and urban slum • Local entrepreneur at village level will be provided soft loan for provision of Ambulance services • Vocational scheme for girl child • Strict enforcement of child marriage restraint act • Strict enforcement of prenatal diagnostic test. 32
- 33. CURRENT SCENARIOS 33 As a result of the Government’s efforts, the successes achieved are enumerated below: The Total Fertility Rate (TFR) has declined from 2.9 in 2005 to 2.2 in 2017 (SRS) and 2.1 in 2022. 25 out of 37 States/UTs have already achieved replacement level fertility of 2.1 or less. The Decadal growth rate has declined from 21.54% in 1999-2000 to 17.64 % during 2001-11. The Crude Birth Rate (CBR) has declined from 23.8 to 20.2 from 2005 to 2017 (SRS).
- 34. Summary • Through this topic we came to know about national population policy 2000, their goals and interventions, key startegic themes and current scenarios. 34
- 35. Conclusion • Efforts at population stabilization will be effective only if an integrated package of essential services is directed at village and household levels. • Inadequacies in the existing health infrastructure have led to a unmet need of 28 per cent of contraception services and obvious gap in coverage and outreach. 35
- 36. Thank You 36