The importance of family planning and welfare programme as a device in controlling population is universally recognised today.
Such a programme focuses on bringing down birth rates directly (through promoting use of birth control devices, etc.) or indirectly (through propagation and education, providing incentives and disincentives for population control methods), and on providing improved public health and child nutrition programmes.
Special emphasis is given on reducing infant mortality and maternal mortality rates, and providing ante-natal, intra-natal and postnatal care for both mother and child through better health infrastructure. Experience has shown that decrease in child mortality and, therefore, increase in chances of the first-born to survive results in parents opting for fewer births.
The performance of the various population welfare programmes being undertaken is indicated below:
(i) There has been a steady decline in the Crude Birth Rate (CBR) during the 1990s in spite of the fact that the rise in the Couple Protection Rate (CPR) during the nineties has been very slow.
(ii) A steady and progressive decline in acceptors of vasectomy has been witnessed in the last two decades. At present, over 97 per cent of all sterilisations are tubectomies. Steps to popularise vasectomy through IEC campaigns have been initiated.
(iii) In 1996-97, the Department of Family Welfare requested the states to undertake a PHC- based need assessment and attempt to meet the felt needs of contraception. A comparison of performance for the period before and after abolition of method specific targets indicates a reduction at the national level in the acceptance of sterilisation, IUD and conventional contraceptives, in contrast to acceptors of oral contraceptives which have shown an increase.
(iv) Between 1994-95 and 1999-2000, the performance of four states with poor demographic indices indicates that in UP and Bihar there has been a fall in acceptance of all contraceptive methods, as compared to their performance in 1994-95.
(v) Additional Medical Termination of Pregnancy (MTP) training centres are being recognised to accelerate skill development training of Community Health Centre/PHC doctors. Equipment and trained doctors are also being sent regularly to improve access to the facilities.
(vi) The prevailing high maternal and prenatal morbidity and mortality is a cause of concern. Awareness generation, skill upgradation training, improving ante-natal and intra-partum care facilities, training of dais, provision of emergency obestetric care are important interventions being taken in this regard. Unsafe abortion is one of the major causes of maternal mortality.
According to the SRS (RGI, 1998), 8.9 per cent of maternal deaths are due to unsafe abortion. Medical Termination of Pregnancy Act 1971, was enacted with the objective to reduce maternal morbidity and mortality due to unsafe abortions. Under this Act, termination of pregnancy can be done in pregnant women up to 20 weeks, if pregnancy is likely to result in birth of congenitally malformed child or continuation of pregnancy is likely to harm the mother in the existing circumstances and in cases of rape and contraceptive failures.
(vii) Reproductive Tract Infection (RTI) and Sexually Transmitted Infections (STI)-prevention and management component of RCH programme is being implemented in close collaboration in the National AIDS Control Organisation (NACO).