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FP_NRHM_SFT

Apr 05, 2018

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    POPULATION OF INDIA

    1.96 1.932.14

    2.20 2.22

    1000

    1200

    2.0

    2.5

    1.25

    1.04

    .

    800 1.5

    9 1 39

    1029

    48

    686

    846

    .

    -0.03400 0.5

    .

    251

    252

    27 3

    1

    3

    0

    200

    -0.5

    0.0

    01

    -11

    11

    -21

    21

    -31

    31

    -41

    41

    -51

    51

    -61

    61

    -71

    71

    -81

    81

    -91

    2001*

    1 1 1 1 1 1 1 1 1

    1991

    -

    PO PULATIO N GRO WTH RATE %

    22Source:- Registrar General India

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    DEMOGRAPHIC SCENARIO

    1. India is the second most populous country in the

    world.

    .

    3% of earths land area.

    . e e g o a popu a on as ncrease mes,India has increased its population 5 times during the

    last century.

    4. Indias o ulation is ex ected to exceed that of Chinabefore 2030 to become the most populous country in

    33

    .

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    PERFORMANCE OF STERILISATION

    4.70 4.835.04

    6

    .4.29

    4

    3.73

    3.343.17

    3.67.

    3

    LAKHS

    0.88 0.96

    2.86

    .

    2.88

    1.201.211.12

    2

    0.91

    1.01

    0.830.940.74

    1

    '2002-0

    '2003-0

    2004-05

    2005-06

    2006-07

    44Bihar MP Orissa Rajasthan UP

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    PROJECTED POPULATION OF INDIA AS ON Ist MARCH (IN CRORES)

    160

    119.3

    126.9134.0

    .140

    102.9.

    100

    80Cror

    e

    40

    20

    55

    2001 2006 2011 2016 2021 2026

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    a woman would have if she were to pass through hera woman would have if she were to pass through her

    the women now in each age group.the women now in each age group.

    rates for all ages.rates for all ages.

    g ves a magn u e og ves a magn u e o comp e e am y s zecomp e e am y s ze

    In simple terms TFR denotesIn simple terms TFR denotes

    66

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    TOTAL FERTILITY RATE, NFHS (2005-06)

    4.0

    2.85 2.683.0

    3.5

    2.0

    2.5

    FR

    1.5

    0.5

    .

    0.0NFHS-I (1992-93) NFHS-II (1998-99) NFHS-III (2005-06)

    77TOTAL FERTILITY RATE

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    a ses popu a ona ses popu a on

    ReducesReducesmaternal mortalitymaternal mortality

    Re uces in ant an c iRe uces in ant an c i

    88

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    Slower rates of population growthSlower rates of population growth

    AgricultureEducation

    Population

    Economy Environment

    99Urbanisation

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    National Population Policy, 2000National Population Policy, 2000

    IMMEDIATE OBJECTIVEIMMEDIATE OBJECTIVE

    ,,Reproductive andReproductive and Child Health careChild Health care

    MEDIUM TERM OBJECTIVEMEDIUM TERM OBJECTIVE

    Achieve Replacement Level Fertility by 2010Achieve Replacement Level Fertility by 2010

    LONG TERM OBJECTIVELONG TERM OBJECTIVE

    1010

    r ngr ng a oua ou popu a onpopu a on s a sa ons a sa on yy

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    1.1. 20102010 Population replacement (put backPopulation replacement (put back

    now onow o

    now tonow to 20602060 (1.53 billion in 2060).(1.53 billion in 2060).

    3.3. states const tutestates const tute 42%42% o t eo t eo ulationo ulation TFR between 3.4 and 4.3TFR between 3.4 and 4.3

    1111

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    (Servicing t he unmet need)(Servicing t he unmet need) Based on felt needs of the communityBased on felt needs of the community

    TAR T FRTAR T FR

    Children by choice & not chanceChildren by choice & not chance

    methodsmethods

    being formulated for calculating state wisebeing formulated for calculating state wise

    Populat ion st abilizat ion is a prior it yPopulat ion st abilizat ion is a prior it y

    1212

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    MEETING UNMET NEEDSMEETING UNMET NEEDS

    11 Two third Indians want to use contraceptionTwo third Indians want to use contraception

    22 There is no scope for coercionThere is no scope for coercion

    44 Meet the felt needs of coupleMeet the felt needs of couple

    55 Enable couple to achieve their RH goalsEnable couple to achieve their RH goals

    1313

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    Programatic interventions in Family PlanningProgramatic interventions in Family Planning

    1.1. Addressing the unmet need in contraceptionAddressing the unmet need in contraceptionthroughthrough

    r iv rr iv r f famil lannin servicesf famil lannin services DevelopingDeveloping skilled manpow erskilled manpow er for the samefor the same

    ..

    intensive promotion of NSVintensive promotion of NSV

    3.3. Promotion ofPromotion ofIUDsIUDs as a short & long termas a short & long term

    spacing methodspacing method4.4. Promotion ofPromotion ofEmergency Cont racept iveEmergency Cont racept ive

    14145.5. Increasing basket of choicesIncreasing basket of choices

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    Promotional Interventions in FamilyPromotional Interventions in Family

    Planning (GOI)Planning (GOI)

    1.1. Ensuring quality care in FP servicesEnsuring quality care in FP services2.2. Revised compensation schemeRevised compensation scheme

    3.3. urur4.4. Promotin Public Private Partnershi sPromotin Public Private Partnershi s

    5.5. Promoting contraception through increasedPromoting contraception through increased

    1515

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    EC PillsEC Pills

    OC PillsOC Pills

    CC dual ur ose condomsCC dual ur ose condoms

    1616

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    Reduce unmet need in SpacingReduce unmet need in Spacing

    yearsyears ura on no yearsura on no years

    insertions only (25insertions only (25-- 45 yrs.)45 yrs.)

    Can potentiallyCan potentially replace the sterilizationreplace the sterilization

    Can be inserted atCan be inserted at subcentresubcentre levellevelANM/ MOs could be given refresherANM/ MOs could be given refresher

    1717ranngranng

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    . .. .hrs of intercourse in the following situations:hrs of intercourse in the following situations:

    Unplanned intercourseUnplanned intercourse

    Failed CC (NirodhFailed CC (Nirodh-- torn)torn)

    Levonorgesterol onlyLevonorgesterol only

    o s e e ecto s e e ect

    One time activit to re lace MTPOne time activit to re lace MTP

    1818 Reduces Maternal Mortality by 10Reduces Maternal Mortality by 10--15%15%

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    Reducing unmet need in TerminalReducing unmet need in Terminal

    met omet o

    Assuring service provision throughAssuring service provision through

    Periodic campsPeriodic camps

    Augmenting trained manpower inAugmenting trained manpower in

    MinilapMinilap

    1919

    ap. er.ap. er.

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    Male participationMale participation

    y o ca pe asec omyy o ca pe asec omy--

    1.1. At tain o ulat ion st abil izat ionAt t ain o ulat ion st abil izat ionin a short per iodin a short per iod

    2.2. ng respons y o am yng respons y o am y

    2020

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    6 Ss:6 Ss:-- (advantages)(advantages)Scalpel lessScalpel less

    t t c esst t c ess

    Sim leSim le

    2121ShortShort

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    explained)explained)

    No postgraduate surgeon/ gynaecologistNo postgraduate surgeon/ gynaecologist

    re uiredre uired

    No anesthetistNo anesthetist required normallyrequired normally No neumo eritoneum inflatin with asNo neumo eritoneum inflatin with as Less post operative distressLess post operative distress

    If client still demands Laparoscopic TubectomyIf client still demands Laparoscopic TubectomyOffer services routinely at DH, FRU, CHC, BLOCKOffer services routinely at DH, FRU, CHC, BLOCK

    2222

    PHC (wherever OT is available)PHC (wherever OT is available)

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    As the client is fasting since the previousAs the client is fasting since the previouseveningevening

    camp site andcamp site and

    Is dehydratedIs dehydrated

    observation before being discharged afterobservation before being discharged after

    2323

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    Ensur ing quali t y care in FPEnsur ing quali t y care in FP

    The manual onThe manual on StandardsStandards in sterilization has beenin sterilization has been, ., .

    u y uu y u been updated, printed & uploaded on the website.been updated, printed & uploaded on the website.

    Six RegionalSix Regional Disseminat ion WorkshopsDisseminat ion Workshops on the revisedon the revised

    -- ..

    2424

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    Ensur ing quali t y care in FPEnsur ing quali t y care in FP All states reported to have set up theAll states reported to have set up the QACsQACs atat

    state and district levels as per affidavit filed bystate and district levels as per affidavit filed bythem in the supreme courtthem in the supreme court

    Revised extended QACRevised extended QAC as per the updatedas per the updated

    the districts for QAthe districts for QA

    2525

    COMPENSATION

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    COMPENSATION

    A.For Public (Govt.) facilities

    BreakageBreakage ofof

    thethe

    CompensatiCompensati

    AcceAcce

    ptorptor

    MotivaMotiva

    tortor

    DrugsDrugs

    andand

    dressindressin

    SurgeoSurgeo

    nn

    chargescharges

    AnestAnest

    hetisthetist

    StaffStaff

    nursenurse

    OTOT

    technitechni

    cian/hcian/h

    RefreshRefresh

    mentment

    CampCamp

    managemmanagem

    entent

    TotalTotal

    onon packagepackage gg elperelper

    HighHigh VASVAS.. 11001100 200200 5050 100100 -- 1515 1515 1010 1010 15001500focusfocus

    statesstates TUBTUB..(ALL)(ALL)

    600600 150150 100100 7575 2525 1515 1515 1010 1010 10001000

    NonNonHighHigh

    VASVAS..(ALL)(ALL)11001100 200200 5050 100100 ---- 1515 1515 1010 1010 15001500

    ocusocus

    statesstates

    TUBTUB

    (BPL(BPL ++

    SC/STSC/ST

    600600 150150 100100 7575 2525 1515 1515 1010 1010

    10001000

    NonNon

    HighHigh TUBTUB

    2626

    focusfocus

    statesstates

    (APL)(APL) 250250 150150

    650650

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    COMPENSATION

    a egorya egory ypeype oo opera onopera on ac yac y o va oro va or o ao a

    focusfocus (ALL)(ALL) 13501350 150150 15001500

    s a ess a es u ec omyu ec omy

    (ALL)(ALL)

    NonNon HighHigh VasectomyVasectomy 13001300 200200 15001500

    statesstates TubectomyTubectomy (BPL(BPL

    2727

    F il Pl i I S hF il Pl i I S h

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    Family Planning Insurance SchemeFamily Planning Insurance Scheme

    limit of indemnitlimit of indemnit

    Claims arising out of St er ilizat ion Operat ionClaims arising out of St er ilizat ion Operat ion AmountAmount

    AA DeathDeath at hospital/ within seven days of dischargeat hospital/ within seven days of discharge Rs. 2,00,000/Rs. 2,00,000/ --

    BB DeathDeath due to sterilization (8due to sterilization (8thth 3030thth day from theday from thedate of discharge )date of discharge ) Rs. 50,000/Rs. 50,000/ --

    CC Expenses for treatment of MedicalExpenses for treatment of Medical ComplicationsComplicat ions Rs. 25,000/ Rs. 25,000/ --

    a urea ure r zr z s. ,s. , --

    EE Doctors/ Facilit iesDoctors/ Facilit ies covered for litigations up tocovered for litigations up to4 cases per year including defence cost4 cases per year including defence cost Rs. 2,00,000/Rs. 2,00,000/ --

    Dissemination meetin s conducted for all state officialsDissemination meetin s conducted for all state officials

    2828

    Public institutions to display boards on the schemePublic institutions to display boards on the scheme_________________________

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    .. supplysupply NSV inst rumentsNSV inst ruments

    Revised Specifications prepared in 2006 (on website)Revised Specifications prepared in 2006 (on website) LaparoscopesLaparoscopes

    Revised Specifications prepared in 2006 (on website)Revised Specifications prepared in 2006 (on website)

    as per approved specifications (can place indents with the TNMSC )as per approved specifications (can place indents with the TNMSC )

    Procurement has restarted recentlyProcurement has restarted recently Requirements from states received and being suppliedRequirements from states received and being supplied

    2929

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    10. Promot ion of cont racept ion t hrough10. Promot ion of cont racept ion t hrough

    ntens ve a vocacyntens ve a vocacyA v ki n n r ivA v ki n n r iv

    Expert committee and core committee set upExpert committee and core committee set up All existing material reviewed and updatedAll existing material reviewed and updated New materials developed for NSV, IUD380A, ECP, OCPNew materials developed for NSV, IUD380A, ECP, OCP All prototypes forAll prototypes for

    audio,audio, video andvideo and rint leaflets fli charts ostersrint leaflets fli charts ostersfinalised and passed on to the IEC division for production andfinalised and passed on to the IEC division for production and

    distribution to the states (Jan, 08)distribution to the states (Jan, 08)

    Dissemination of FP capsule through regional workshopsDissemination of FP capsule through regional workshops(WHO biennium 08(WHO biennium 08--09)09)

    3030

    Approval obtainedApproval obtained Funding awaitedFunding awaited

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    at t e s ou oo orat t e s ou oo or

    Contrace tionContrace tionConception (infertility management)Conception (infertility management)

    Quality AssuranceQuality Assurance

    Empanelment of providersEmpanelment of providersCompensationCompensation

    3131

    nsurancensurance

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    Res onsibilities of the states districtsRes onsibilities of the states districts

    ncrease num er o serv ces cen resncrease num er o serv ces cen res

    Availability of servicesAvailability of servicesAccessibility of servicesAccessibility of services

    pgra a on o s, s, s, s spgra a on o s, s, s, s sunder NRHM)under NRHM)

    Accreditation of private providers (PPP)Accreditation of private providers (PPP)

    3232

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    Res onsibilities of the states districtsRes onsibilities of the states districts

    a DHa DH -- on demand dail weeklon demand dail weeklb) FRU/CHCb) FRU/CHC -- weekly/fortnightly/monthlyweekly/fortnightly/monthlyc PHCc PHC -- monthl bimonthlmonthl bimonthl

    -- (Tubectomy only if OT available)(Tubectomy only if OT available)d SCd SC -- IUD ECP on demandIUD ECP on demand

    Tubectom :Tubectom : Wednesda o tionalWednesda o tionalVasectomy:Vasectomy: Saturday (optional)Saturday (optional)

    3333

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    Res onsibilities of the states/ districtsRes onsibilities of the states/ districts

    1.1. Ensure at leastEnsure at least

    One TubectomyOne Tubectomy Surgeon per PHCSurgeon per PHC (ultimate aim)(ultimate aim)

    One IUDOne IUD Provider per SCProvider per SC (ultimate aim)(ultimate aim)

    2.2. Effect Manpower RationalizationEffect Manpower Rationalization

    Manpower TrainingManpower Training Manpower PlacementManpower Placement

    3.3. Develop Comprehensive Training Plan forDevelop Comprehensive Training Plan for

    MinilapMinilap LTTLTT

    3434

    ECPECP

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    ppo n o a o cer or am y ann ngppo n o a o cer or am y ann ng

    (for Planning, Implementing, Monitoring, Supervising & Evaluation)(for Planning, Implementing, Monitoring, Supervising & Evaluation) Constitute QAC at state level (10 members) & notifyConstitute QAC at state level (10 members) & notify

    ..

    Accredit facilities (Public/Private/NGO)Accredit facilities (Public/Private/NGO)

    Empanel doctors (Public/Private/NGO)Empanel doctors (Public/Private/NGO)

    Half yearly meetings of state QAC (to be minuted)Half yearly meetings of state QAC (to be minuted)

    3535

    ..

    l ll l

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    Action at State Dist. levelAction at State Dist. level

    Orientation of CMOs onOrientation of CMOs on NFPIS (National Family Planning Insurance Scheme)NFPIS (National Family Planning Insurance Scheme)

    Compensation Scheme (Revised)Compensation Scheme (Revised) ELA istrict wise or imiting spacing met o s ase onELA istrict wise or imiting spacing met o s ase on

    dist. Unmet Need)dist. Unmet Need)

    NSVNSV (MOs)(MOs) Minilap/ LTTMinilap/ LTT (MOs)(MOs) IUDIUD (MOs/ SNs/ LHVs/ ANMs)(MOs/ SNs/ LHVs/ ANMs) ECPsECPs (MOs/ SNs/ LHVs/ ANMs/ ASHAs)(MOs/ SNs/ LHVs/ ANMs/ ASHAs)

    District budget allocation and disbursementDistrict budget allocation and disbursement

    3636Monthly Review of FP performance with CMOsMonthly Review of FP performance with CMOs

    A ti t St t /Di t l lA ti t St t /Di t l l

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    Action at State/Dist. levelAction at State/Dist. levelDisplay prominently (facility wise)Display prominently (facility wise)

    Family planningFamily planning insuranceinsurance schemescheme

    Service availabilit district action lanService availabilit district action lan Fixed day serviceFixed day service calendarcalendar

    NSVNSV

    Minilap/ LTTMinilap/ LTT IUDIUD

    Camp calendarCamp calendar for abovefor above

    IEC materialsIEC materials onon

    NSVNSV

    IUDIUD

    3737

    ss

    Budget may be provided accordinglyBudget may be provided accordingly

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    ..Lay down benchmarks (performanceLay down benchmarks (performance

    Rank DistrictsRank Districts

    Reward districtsReward districts

    ewar s s a e awarewar s s a e awar

    3838

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    3939