Population Policy: Population Policy of India

Read this article to learn about the Population Policy of India:

India launched its family planning programme in 1951 as part of the First Five-Year Plan, and became the first country in the world to have a state-sponsored population programme.

Family planning was recognised officially in order to safeguard the health and welfare of mothers and children. The programme was also aimed at aiding the national economy by reducing the birth rate concurrently with the death rate in order to stabilise the population.

There was not much progress for the next ten years. The health infrastructure, which formed the delivery system for the family planning programme, was still developing. The choice of contraceptives was limited to a few barrier and chemical methods, and natural methods like the rhythm method and coitus interrupts. Sterilisation for males and females was still not a popular contraceptive choice.

The programme got a tremendous boost with the creation of a separate Department of Family Planning in the health ministry in 1966. An extension approach was adopted, as against the ‘clinic approach’ of the previous two plans, to increase the outreach of services and improve awareness and knowledge about family planning among the masses.

There was a significant shift in the strategy of the government under the Fifth Five-Year Plan (1974-79). Several important policy decisions were taken and action initiated to give the family planning programme a greater thrust and a new direction. Maternal and child health services were made part of the programme.

A landmark in the population policy of the country was the draft statement of Population Policy, issued in the Parliament in 1976, expressing the government’s determination to control population growth. Increasing the legal age of marriage (from 15 to 18 years for girls and from 18 to 21 years for boys), freezing the population at the 1971 level until 2000 for the purpose of legislature elections, and devolution of Central assistance to states for development were some important decisions taken by the government following the 1976 draft population policy statement.

The 1976 population policy was completely at variance with the earlier population policy of the government. In the past, it was believed that development and education would themselves restrict the rate of population growth, while the government’s own programme was restricted to family planning, by way of motivating people to accept family planning and providing clinical facilities and other services to its acceptors.

The 1976 policy statement, however, noted: To wait for education and economic development to bring out a drop in fertility is not a practical solution. The very increase in population makes economic development slow and more difficult to achieve. The time factor is so pressing, and the population growth so formidable, that we have to get out of the vicious circle through a direct assault upon this problem as a national commitment.”

During the Emergency period (1975-77), coercion and pressure were used in implementing the family planning programme. The Central assistance of 8 per cent was linked with the family planning performance. For the first time the Union government allowed some states to initiate legislation for compulsory sterilisation. The policies, however, discredited the entire family planning programme, and the experiment of the government to implement the so-called bold measures for lowering the birth rate in a relatively short period ended in a fiasco.

In 1977, the new government ruled out the use of force and coercion, and the family planning programme was renamed as the ‘family welfare programme’.

During the Sixth Five-Year Plan (1980-85), population control was specifically mentioned as one of the plan objectives, and integrated in the twenty-point programme.

After the Seventh Plan (1985-90) was finalised, a revised strategy was adopted for the family planning programme. It emphasised on increasing the minimum age for marriage of women, making them literate, enhancing their status by increased economic and employment “opportunities, improving the health of mothers and children, greater coordination and linkages with poverty alleviation programmes and greater involvement of the NGOs in the family planning programmes.

Under the Eighth Plan (1992-97), human development was adopted as the ultimate goal and population control was listed as one of the priorities. The Plan undertook a different approach and there was a complete shift towards indirect measures.

The main components of this new approach were as follows:

i. There was a shift in the emphasis from the couple protection rate to lowering of the birth rates. Inter-state variations were taken into account.

ii. Better performance on the population front by the states was to ensure larger share of Central assistance.

iii. Non-governmental organisations and the community leaders were involved in population control programmes.

iv. Emphasis on improving the social status of women through poverty alleviation, employment generation, greater participation in panchayat institutions, etc.

v. Improvement of basic inputs—information, education and communication.

vi. Improving training and infrastructure.

vii. Taking up measures to reduce infant mortality and maternal mortality rates, such as Reproductive and Child Health Care Scheme, Integrated Child Development Services, Child Survival and Safe Motherhood Scheme (launched in 1992-93) and Mid-Day Meal Scheme, etc.

viii. Population study was to be introduced as a subject in school and adult education.

The International Conference on Population and Development (ICPD) held at Cairo, in 1994, formalised the opinions all over the world that improvement of reproductive health (including family planning) is an essential element of human welfare and development.

Prompted by the ICPD, the Indian government decided to adopt a Target Free Approach (TFA) for implementing the Reproductive and Child Health (RCH) programme. As its nomenclature suggests, the RCH approach lays stress on reproductive and child health and quantity of care is an important dimension of the programme.

In April 1996, all the districts in India were declared as target-free. An evaluation of the programme, a year later, came up with the finding that the first reaction of the districts was to run the programme with ‘no’ targets and hence 1996- 97 witnessed a sharp decline in performance.

The position improved later on, but even now the TFA is not target-free in the real sense.

The Ninth Five Year Plan (1997-2002) aimed at accelerating the rate of decline in population growth. Efforts were made to remove or minimise inter- and intra-state differences on vital statistics through decentralised area-specific planning based on the need assessment; emphasis on improved access and quality of services to women and children; and creation of district-level data base on quality and coverage indicators for monitoring of the programme.

From 1996, the Centrally-defined method specific targets for family planning have been replaced by: (i) need assessment and fulfillment through decentralised primary health centre-based planning and implementation of the programme, and (ii) improved access and quality of comprehensive reproductive and child health statistics.

With the launch of the RCH in 1997, the focus is on decentralised area-specific macro-planning and implementation with emphasis on improving the quality and coverage of family welfare services. Child survival, safe motherhood, control of sexually transmitted infections and reproductive tract infection are some of the welfare measures needed to improve the quality and coverage of health care for women, children and adolescents.

The Tenth Plan endeavored to continue the paradigm shift which began in the Ninth Plan. The shift was from:

i. Demographic targets to focussing on enabling couples to achieve their reproductive goals;

ii. Method-specific contraceptive targets to meet all the unmet needs for contraception to reduce unwanted pregnancies;

iv. Numerous vertical programmes from family planning and maternal and child health to integrated health care for women and children;

v. Centrally defined targets to community need assessment and decentralised area-specific micro-planning and implementation of programme for health care for women and children, to reduce infant mortality and reduce high fertility;

vi. Quantitative coverage to emphasise on quality and content of care;

vii. Predominantly women-centred programmes to meeting the health care needs of the family with emphasis on involvement of men in Planned Parenthood;

Table 18.19 Projected Age Distribution of Population:

viii.Supply-driven service delivery to need and demand driven service; improved logistics for ensuring adequate and timely supplies to meet the needs;

ix. Service provision based on providers’ perception to addressing choices and conveniences of the couples.

The Tenth Plan strove to operationalise efforts to:

i. Assess and meet the unmet needs for contraception;

ii. Achieve reduction in the high desired level of fertility through programmes for reduction in IMR and maternal mortality ratio (MMR); and

iii. Enable families to achieve their reproductive goals.

Reductions in fertility, mortality and population growth rate were the major objectives during the Tenth Plan.

According to the Eleventh Plan document, the percentage of married women using contraception has increased. However, gender imbalance in the family planning programme is indicated by the fact that despite being the most invasive and tedious contraceptive intervention, female sterilisation remains the most common method of family planning. Men are not being addressed as responsible partners and the use of condoms or male sterilisation remains very low. There are also inter-state differences in the magnitude of unmet need for contraception.

The RCH Phase-II Programme which was launched with effect from April 1, 2005 for a period of 5 years. It will continue during the Eleventh Plan. Couples with unmet need will be identified by auxiliary nurse midwives (ANM) and accredited social health activists (ASHA) who will also address each couple’s concerns.

The Eleventh Plan aims to achieve a reduction of TFR to 2.1 by 2012. (The National Population Policy hoped to achieve TFR of 2.1 by 2010, and a stable population by 2045.)

The Jansankhya Sthirata Kosh  is expected to work in close cooperation with the government, private, and voluntary sectors to promote small and healthy families..

The Eleventh Plan will pay greater attention to voluntary fertility reduction through:

i. Expanding the basket of contraceptive choices

ii. Improving social marketing

iii. Increasing male involvement

iv. Enhancing role of the mass media for behavioural change

v. Disseminating through satisfied users.

National Population Policy, 2000:

The National Population Policy (NPP), 2000, was endorsed by the Union cabinet in February 2000.

The NPP 2000 provides a policy framework for advancing goals and prioritising strategies during the next decade to meet the reproductive and child health needs of the people of India and to achieve net replacement levels, which is otherwise called reduced total fertility rate (TFR), by 2010.

The immediate objective of the policy was to address the needs for contraception, health-care infrastructure, health-personnel and integrated service delivery; the medium-term objective is to bring the TFR to replacement levels—two (or to be exact, 2.1) children per couple—by 2010 by a vigorous implementation of ‘sectoral strategies’; and the long-term objective is to achieve a stable population by 2045.

The NPP seeks to achieve the immediate and mid-term goals though the following means:

i. Address the unmet needs for basic reproductive and child health services, supplies and infrastructure.

ii. Make school education up to age 14 free and compulsory and reduce drop-outs at primary and secondary school levels to below 20 per cent for both boys and girls.

iii. Reduce infant mortality rate to below 30 per 1000 live births; reduce maternal mortality ratio to below 100 per one lakh live births.

iv. Promote delayed marriage for girls, not earlier than age of 18 and preferably after 20 years of age.

v. Achieve 80 per cent institutional deliveries and 100 per cent deliveries by trained persons.

vi. Achieve universal access to information/counselling, and services for fertility regulation and contraception with a wide basket of choices.

vii. Achieve 100 per cent registration of births, deaths, marriage and pregnancy.

viii. Contain the spread of Acquired Immuno Deficiency Syndrome (AIDS), and promote greater integration between the management of reproductive tract infections (RTI) and sexually transmitted infections (STI) and the National AIDS Control Organisation.

ix. Prevent and control communicable diseases.

x. Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services, and in reaching out to households.

xi. Promote vigorously the small family norm to achieve replacement levels of TFR.

xii. Bring about convergence in implementation of related social sector programmes so that family welfare becomes a people-centred programme.

Implementing the NPP As recommended by the National Population Policy (NPP), a National Commission on Population has been constituted. In place of a coordination cell, a policy convergence cell has been created in the Planning Commission.

In place of a Technology Mission, an Empowered Action Group (EAG) was launched to give focussed attention to eight demographically weaker states, namely, Bihar, Jharkhand, Chhattisgarh, Madhya Pradesh, Uttarakhand, Uttar Pradesh, Orissa, and Rajasthan. The National Rural Health Mission (NRHM) was launched in April 2005.

Table 18.20 Global Differentials in Human Development:

The HDI classifies the world into four broad segments of very high, high, medium and low human development.

Several states and Union territories have formulated their own population policies with specific strategies, goals and programmes. All states have been advised to formulate population policies in consonance with the spirit of the NPP 2000.

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