FP_NRHM_SFT

7/31/2019 FP_NRHM_SFT

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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

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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

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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

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EC PillsEC Pills

OC PillsOC Pills

CC dual ur ose condomsCC dual ur ose condoms

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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

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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

-- ..

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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

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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

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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

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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

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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

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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)

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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

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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)

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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)

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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

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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)

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..

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

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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

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FP_NRHM_SFT

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