DEMOGRAPHY AND

FAMILY PLANNING
 INTRODUCTION

WHAT IS DEMOGRAPHY

Demography is the scientific study of the human population.

• It focuses its attention on :

(a) changes in population size (growth or decline)
(b) the composition of the population and
(c) the distribution of population.

It deals with five "demographic processes", namely fertility, mortality,

marriage, migration and social mobility.
DEMOGRAPHIC CYCLE:
IT IS A CYCLE OF 5 PHASES THROUGH WHICH A NATION PASSES.

• 1ST stage/high stationary: high birthrate, high death rate- cancel each other- population remains
stationary. Eg India till 1920.

• 2nd stage/early expanding: low death rate, unchanged birth rate

• 3rd stage/late expanding: declining birth rate, low death rate- growth of population (India has
entered this phase)

• 4th stage/low stationary: low birth rate, low death rate- population becomes stationary.(most
industrialized countries have reached here)

• 5th stage/declining: birth rate is lower than the death rate- population declines.
 Birth and death rates
• The decline in the crude death rate of the SEAR countries has been more marked, from
14.1 to 7.5 per 1000 population

• In countries with a relative young population, crude death rates are mainly affected by
infant and child mortality. With improvement in maternal and child health services,
successful implementation of the expanded programme on immunization there has been
marked reduction in infant and child mortality rates, which are reflected in the declining
crude death rates.

• Approximately 95 per cent of this growth is occurring in the developing countries.

• Currently, one-third of the world's population is under the age of 15, and will soon enter
the reproductive bracket, giving more potential for population growth.
CURRENT FEATURES OF THE POPLUATION GROWTH:

• 95% of population growth is occurring in developing countries.

• India with a population of 1,364 million is the second most populous
country.
• With only 2.4 per cent of the world's land area, India is supporting
about 17.5 per cent of the world's population
• India's population is currently increasing at the rate of 16 million each
year.
• According to UN, India is projected to overtake China as the world's
most populous country by 2027.
 DEMOGRAPHIC TRENDS
IN INDIA
• Sex ratio: The sex ratio in India has been generally adverse to women, i.e., the number of
women per 1,000 men has generally been less than 1,000. Apart from this, the sex ratio
has also declined over the decades- a low sex ratio indicates strong male child preference,
neglect of the girl child resulting in higher mortality at younger age, female infanticide,
female foeticide, higher maternal mortality.

• Density of population -It is the ratio between (total) population and surface (land) area

• Family size-it indicates the total number of children borne by a woman during her child-
bearing age, which is generally assumed to be between 15 and 45 years.

• Dependency ratio: The proportion of persons above 65 years of age and children below 15
years of age are considered to be dependant on the economically productive age group
• Urbanization: The continuous migration of people from country side to urban
areas in India constitute a social crisis, the ramification of which may eventually
impair the quality of life.

• Literacy and education: The benefits that accrue to a country by having a literate
population are multidimensional. Spread of literacy is generally associated with
modernization, urbanization, industrialization, communication.
A significant milestone reached in Census 2011 is that the total number of illiterates has come
down from 304.1 million in 2001 to 272.9 million in 2011 showing a decline of 31.1 million.
 FAMILY PLANNING
• Family planning refers to practices that help individuals or couples to
attain certain objectives : ·
(a) to avoid unwanted births
(b) to bring about wanted births
(c) to regulate the intervals between pregnancies
(d) control the time at which births occur in relation to the ages of the
parent; and
(e) to determine the number of children in the family.
Scope of family planning services
• the proper spacing and limitation of births,
• advice on sterility,
• education for parenthood,
• sex education,
• screening for pathological conditions related to the reproductive system (e.g cervical cancer),
• genetic counselling,
• premarital consultation and examination,
• carrying out pregnancy tests,
• marriage counselling,
• the preparation of couples for the arrival of their first child,
• providing services for unmarried mothers,
• providing adoption services
 Contraceptive usage

Couple protection rate (CPR)- CPR is an indicator of the prevalence of contraceptive practice in the community.
• Contraceptive methods are, by definition, preventive methods to help men and women avoid unwanted pregnancies. They
include all temporary and permanent measures to prevent pregnancy resulting from coitus.

• METHODS:
I. Spacing methods
1.Barrier methods
(a) Physical methods-condoms, diaphragm,vaginal sponge
(b) Chemical methods-foams,creams,jellies,soluble films
(c) Combined
2. Intra-uterine devices-non hormonal(copper containing), hormonal(progestin releasing)
3. Hormonal methods –gonadal steroids, oral pills, depot (injectables), male pills
4. Post-conceptional methods-abortion
5. Miscellaneous
II. Terminal methods
1. Male sterilization-vasectomy
2. Female sterilization methods-tubal ligation
ABORTION
• Abortion is theoretically defined as termination of pregnancy before the foetus
becomes viable (capable of living independently).

• The EARLY COMPLICATIONS of abortion include haemorrhage, shock, sepsis;

uterine perforation, cervical injury, thromboembolism and anaesthetic and
psychiatric complications. The LATE SEQUELAE include infertility, ectopic gestation,
increased risk of spontaneous abortion and reduced birth weight.

• Data indicates that the seventh and eighth week of gestation is the optimal time
for termination of pregnancy. Studies indicate that the risk of death is 7 times
higher for women who wait until the second trimester to terminate pregnancy.
The Indian Law (MTP Act, 1971) allows abortion only up to 20 weeks of pregnancy.
DELIVERY SYSTEM
AT THE CENTRE
• India became the first country in the world to initiate the family planning program in 1952 with the
goal of lowering fertility and slowing the population growth rate.

• The emphasis is on a 2-child family. As of 2014, there were 11 Indian states that implemented the
two-child policy. there have been two major changes in the approach to delivery of family planning
services : first, a greater emphasis on spacing methods, side by side with terminal methods, and
secondly to take the services to every door-step and motivate families to adopt the small family
norm.

• The Government of India adopted a new approach, which places a well-defined focus to the family
planning efforts under a larger and more comprehensive umbrella of RMNCH+A (Reproductive,
Maternal, Newborn and Child Health and Adolescents) program.
• This paradigm shift was adopted recognizing the need and long-term goal of addressing a target free
approach (beyond the simple strategy of achieving population stabilization), under the larger
purview of improving maternal and child (and adolescent) health in India.
• In 2017, Ministry of Health and Family Welfare launched Mission Pariwar Vikas, a central
family planning initiative. The key strategic focus of this initiative is on improving access to
contraceptives through delivering assured services.

• Along with that two contraceptive pills, MPA (Medroxyprogesterone acetate) under
Antara program and Chaya will be made freely available to all government hospitals.

• The National Rural Health Mission (NHRM) have made special provisions to address
concerns for reproductive health, especially for adolescents who are more likely to
participate in risky sexual behaviors and less likely to visit health facilities than adults

• Nischay-Home based pregnancy test kits· (PTKs) was launched under NRHM in 2008
across the country. The PTKs are being made available at sub-centres.

• National Family Planning Indemnity Scheme (NFPIS) under which clients are insured in
the eventualities of deaths, complications and failures following sterilization and the
providers/ accredited institutions are indemnified against litigations in those eventualities
At the state level

To co-ordinate the family welfare activities between the state governments and the central
government, one Family Welfare Cell has been sanctioned for each State.

At the district level

the set-up consists of District Family Welfare Bureau consisting of 3 divisions:
1. an administrative division headed by the District Family Welfare Officer;
2. mass education and media division, in charge of District Mass Education
3. and Media Officer, and an evaluation division, in charge of a Statistical Officer.
At the community health centre
Community health centre is established and maintained by the state governments. It
provides emergency obstetric care, full range of family planning services including
laproscopic services and safe abortion services.
At the village level

(a) The Village Health Guides : a band of village Health Guides (mostly women},
one for each village or a population of 1000. They are made responsible for
spreading information to the eligible couples and providing them with supplies
of Nirodh and oral pills.

(b) Trained dais :They conduct safe deliveries in rural areas. They also act as family
planning counsellors and motivators, supplementing the delivery system.

(c) ASHA :A new scheme has been launched to utilize the services of ASHA to
deliver contraceptives at the doorstep of beneficiaries- Home Delivery of
Contraceptives (HDC)
 REFERENCES
• K. PARK- PARKS TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE (23RD EDITION)
• Govt. of India (1978). Manual for Health Worker, Female, Vol I, Ministry of Health & Family welfare,
New Delhi
• Govt. of India (2006), Annual Report 2005-06, DGHS, Ministry of Health and Family Welfare, New Delhi.
• http://planningcommission.nic.in/reports/articles/venka/index.php?repts=m-popu.htm
• https://www.business-standard.com/article/government-press-release/programmes-schemes-
launched-by-the-government-to-promote-family-planning-in-115031300458_1.html
THANK
YOU