What gets measured, gets managed

Family Welfare Programmes in UP

  • The National Family Welfare Programme was launched in India in 1951 with the objective of reducing the birth rate to the extent necessary to stabilize the population at a level consistent with the requirements of the national economy. In keeping with the democratic traditions of the country, the Family Welfare Programme seeks to promote responsible and planned parenthood through voluntary and free choice of family planning methods, best suited to individual acceptors. People's participation is sought through local self government including voluntary organizations and opinion leaders at different levels. Innovative use of mass media and interpersonal communication is made for highlighting the benefit of the small family norm and removal of socio-cultural barriers for adoption of family limitation programmes.
  • In view of the general consensus that the quality of the National Family Welfare Programme has often suffered because of the target oriented approach, no target was fixed during the year 1995-96 for the States of Kerala, Tamil Nadu and Union Territory of Chandigarh. Besides one or two districts of each major States were kept target free on an experimental basis. Having found this approach to be successful particularly in addressing the felt needs of the community, the target free approach has been adopted from 1st April, 1996 throughout the country.
  • The long-term demographic goals, as laid down in the National Health Policy (1983), was to achieve a Net Reproduction Rate of Unity (NRR-1) by the year 2000 A.D. This corresponds to achieving a Birth Rate of 21 per thousand, death rate of 9 per thousand and natural population growth rate of 1.2%. The National Health Policy envisaged reducing infant mortality rate to below 60 per thousand live births by the turn of the century. However, keeping in view the level of achievement already made, it was stated in the Eighth Five Year Plan Document that NRR-1 would be achievable only in the period 2011-16A.D. The National Population Policy 2000 details the objectives and strategy for this.
  • Family Welfare services are provided to the community through a network of Sub-centres, Primary Health Centres (PHCs) and Community Health Centres (CHCs) in the rural areas and hospitals and dispensaries in the urban areas. This network, set up under the Minimum Needs Programme {now redesigned as Basic Minimum Services (BMS) Programme}, is also supported by an expanding number of Post Partum Centres at district and sub-district level.
  • The Auxiliary Nurse & Midwife (ANM), a female paramedical worker posted at the Sub-centre and supported by a Male Multipurpose Worker (male MPW) is the frontline worker in providing the Family Welfare services to the community. She is supervised by the Lady Health Visitor (LHV) posted at PHC.
  • For skill development of medical and paramedical worker deployed at the sub centres, PHCs and CHCs etc., Family Welfare Programme supports Health & Family Welfare Training Centres, Lady Health Visitor Training Centres, Male Multipurpose Worker Schools and ANM Training Schools many of which are situated in U.P.
  • The major schemes currently under implementation are described in succeeding paragraphs:
Minimum Needs Programme (Redesigned as BMS)
  • The Primary Health Care infrastructure in rural areas has been developed as a three tier system. The norm is to set up one sub-centre for every 5,000 population (3000 for Hilly and Tribal areas). At present sub-centres, PHCs and CHCs are functioning in the country.
Child Survival and Safe Motherhood (CSSM) Programme
  • During 1992-93, an integrated MCH and Immunization Programme was taken up for implementation. This World Bank and UNICEF assisted Programme, named Child Survival and Safe Motherhood Programme, seeks to sustain the high coverage levels achieved under UIP in good performing areas and strengthening the immunization services where the coverage is still not satisfactory. The Programme also provides for augmenting various activities under the Oral Rehydration Therapy (ORT) Programme, universalising the prophylaxis schemes for the control of anaemia in pregnant women and control of blindness in children and initiating a programme for control of Acute Respiratory Infection (ARI) in children. Under the Safe Motherhood component, training of traditional birth attendants in selected high IMR/MMR districts, provision of aseptic delivery kits and strengthening of first referral units to deal with high risk and obstetric emergencies are being taken up.

Under the Child Survival component, the UIP, ORT, Prophylaxis schemes and essential maternal care at the community level are already being implemented in all districts of the country. Additional activities related to ARI control are being expanded. The impact of the programme is reflected in the significant drop in the infant mortality rate.

U.P. Project : Innovations in Family Planning Services

A US$ 325 million USAID assisted project named 'Innovations in Family Planning Services in U.P.' was launched for strengthening the family welfare programme in the State of Uttar Pradesh. The project to be implemented over a ten year period, aims at

  • Increasing access to family planning services by extending service delivery in the public sector as well as non-governmental sector and through promotion of social marketing of contraceptives,
  • Improving the quality of family planning services by expanding the choice of contraceptive methods and improving the technical competence of personnel through training and upgrading of their skills, and
  • Promoting family planning by broadcasting support among leadership groups and increased public understanding of the benefits of family planning
  • It is expected that at the end of the project period, the total fertility rate (TFR) of Uttar Pradesh will decline to 4.0 and there will be an increase in the couple protection rate (CPR) by 15%

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