Long-term objective/goal: to achieve a stable population by 2045, at a level consistent with sustainable:
• Economic growth,
• Social development, and
• Environmental protection
Medium-term objective: to bring the TFR to replacement level (Meaning NRR=1) by 2010
Immediate objectives:
1. To address the unmet needs for
• Contraception
• Health care infrastructure and health personnel
2. To provide integrated service delivery for basic reproductive and child health care
NPP cites the following reasons for the population growth of India:
1) Large section of population is in the reproductive age group: As a result of high birth rates in past
• Due to this, momentum of population increase will continue for some more years
2) High unmet need for contraception (appx 20% of population increase)
‘Unmet need’ – for contraception refers to those couples who do not intend to have children but are still not using any contraception, due to any reason.
3) Families wanting to have higher number of children as an insurance against infant and child deaths
• Infant mortality rate (IMR) has been high in the country
4) Early age at marriage
• This results in starting reproduction too early
• These families also tend to have a higher number of children with smaller intervals
5) Almost one-third of births occur at intervals smaller than 2 years
The above discussion concludes that for population stabilization:
• We need to achieve certain level of basic health services
• NOT just the FP measures
Thus the ‘National Socio-Demographic Goals’ were formulated
• For achieving a basic level of health, step by step
• These ‘Socio-Demographic Goals’ were to be reached by 2010
(1) Address the unmet needs for basic reproductive and child health services and infrastructure. (U)
(2) Make school education up to age 14 free and compulsory (E)
(3) Reduce infant mortality rate to below 30 per 1000 live births. (I)
(4) Reduce maternal mortality ratio to below 100 per 100,000 live births. (M)
(5) Achieve universal immunization of children against all vaccine preventable diseases. (I)
(6) Promote delayed marriage for girls (M)
(7) Achieve 80% institutional deliveries and 100% deliveries by trained persons. (T)
(8) Achieve universal access to information +counseling and services for contraception with a wide basket of choices. (FP)
(9) Achieve 100% registration of births, deaths, marriage and pregnancy. (R)
(10) Contain the spread of Acquired Immunodeficiency Syndrome (AIDS)
(11) Prevent and control communicable diseases. (C)
(12) Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services (as it will appeal to more households and increase coverage). (I)
(13) Keep promoting the ‘small family norm’ while striving to achieve the above. (S)
(14) Converge the related social sector programs making family welfare, a people centered program. (C)
• NPP anticipated that if fully implemented, the population by 2010 will be 1107 million only
o As against a projection of 1162 million.
• In actuality, the population (2011 census) was even higher than the projection, i.e. 1210 million.
STRATEGIC THEMES
1. Decentralized Planning and Program Implementation:
• Delegating the planning and implementing NPP to village panchayats esp. its women members
2. Convergence of Service Delivery at Village Levels
• All services related to health (both govt. and pvt.) to be provided at one center.
3. Empowering Women for Improving their Health and Nutrition
• Efforts will be made for education and empowerment of the girl child and women, thereby raising their social status and decision making power.
4. Child Health and Survival esp. neo-natal care.
• universal immunization
• control of childhood diarrheas with oral rehydration therapies
• management of acute respiratory infections
• massive doses of Vitamin A and food supplements
5. Meeting the Unmet Needs for Family Welfare Services
1. Increase distribution of contraceptives through free supply and social marketing
2. Expand the availability of safe abortion care
6. Under-Served Population Groups
• Urban Slums
• Tribal Communities, Hill Area Populations and Displaced and Migrant Populations-
• Adolescents
Needs of adolescents like, preventing unwanted pregnancies and STD have been ignored in the past.
7. Increased Participation of Men in Planned Parenthood
• Planning families and supporting contraceptive use
• Helping pregnant women stay healthy
• Arranging skilled care during delivery in time including transport if needed
• Currently, > 97% of sterilizations are tubectomies
o Need for popularizing vasectomies esp. safe and simple no-scalpel vasectomy
8. Diverse Health Care Providers
• Accrediting private medical practitioners and assigning defined beneficiary groups to them
• Revival of the system of licensed medical practitioner (IMA certified)
9. Collaboration with Non-Government Organizations and the Private Sector
• Private sector currently accounts for nearly 75% of health care expenditures.
10. Mainstreaming Indian Systems of Medicine and Homeopathy
• This will expand the pool of effective health care providers
11. Contraceptive Technology and Research on Reproductive and Child Health
• The International Institute of Population Sciences and
• The population research centers
Demographic data is made available regularly through following surveys:
• The National Health and Family Welfare Survey every five years
• The district surveys covering 50% districts per year, so every 2 yrs. All the districts are covered
• The facility surveys find out availability of infrastructure and services, covering 1 district/ month.
12. Providing for the Older Population
Promoting old age health care will, over time, serve to reduce the incentive to have large families.
• Training for providing geriatric health care
• Schemes that make the elderly economically self-reliant etc.
13. Information, Education, and Communication:
Family welfare messages in local language by local media
LEGISLATION
Lok and Rajya Sabha seats have been frozen (as per 1971 Census) via 42nd amendment till 2001, enabling state governments to fearlessly pursue population stabilization.
• This needs to be extended up to 2026.
PUBLIC SUPPORT
Demonstration of support to the small family norm, as well as personal example, by political, community, professional and religious leaders, film stars, sports personalities and opinion makers
Following NEW STRUCTURES are recommended:
1. National Commission on Population: presided over by the Prime Minister
2. State / UT Commissions on Population: Presided over by the Chief Minister
3. Coordination Cell in the Planning Commission: for inter-sectoral coordination
4. Technology Mission – Dept. of Family Welfare: technology support for RCH programs and IEC.
Other promotional and motivational measures for small family norm for example:
•Honoring Panchayats for exemplary performance in small family norm, literacy and low IMR and BR
•Maternity Benefit Scheme: Rs.500 for mother for first child after 19 yrs. of age for 1st or 2nd child.
•Health Insurance for acceptors of terminal method of contraception
•Reward for couples
-Who marry after the legal age of marriage,
-Register the marriage,
-Have their first child after the mother reaches the age of 21
-Adopt a terminal method after the birth of the second child
•Crèches and child care centers in rural areas and urban slums
•A wider & affordable choice of contraceptives
•Soft loans for village entrepreneurs and encouragement to run ambulance services
•Vocational training for girls, leading to self-employment
•Soft loans to ensure mobility of the ANMs will be increased.
References:
1. Population and Development Review. Vol. 1, No. 1 (Sep., 1975), pp. 147-161 (15 pages) Published By: Population Council
2. NPP document
What is a 'Population Policy'?: http://www.ihatepsm.com/blog/what-population-policy
National Population Policy, 2000: http://www.ihatepsm.com/blog/national-population-policy-2000
National Population Policy – 2000 Made Clear in Brief: http://www.ihatepsm.com/blog/national-population-policy-%E2%80%93-2000-m...