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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