Family Planning in India is a part of the Family Welfare Programme to tackle the population problem in India. The family planning programs are run by the 'Ministry of Health and Family Welfare”.
The Indian Government has taken massive efforts for family planning. There has been an increase in the usage of contraceptives in the past few decades. Still, considering the present population, the rate of a surge in population is a national issue.
The increasing population in India is a problem. By 1981, India's population had doubled since 1947. Since then, it is increasing by about 150 lakh/ per year. By 2012, India's population touched over 1.22 billion.
Such a rapid increase in population has very serious repercussions on the socio-economic development of the country. Varying social customs and beliefs favor large families which impede the process of change which could accelerate with the adoption of modern methods of contraception. A universal desire to have at least one or two male children and the 'mean age of the marriage of women at 18 years could also become contributory factors to large families.
In India, family planning of having one or two children is not mandatory by law. It is promoted by the Government by highlighting the benefits of using birth-control methods to control the population. In keeping with the democratic traditions of the country, the Family Welfare Programme seeks to promote voluntarily, responsible and planned parenthood with a two-child norm, male, female, or both, through the independent choice of family welfare methods best spat to the acceptors.
Family welfare services are offered through the total healthcare delivery system. People's participation is sought through all institutions, voluntary agencies, opinion leaders, people's representatives, government functionaries, and various other structures and influential groups. Imaginative use of the mass media and interpersonal communication is resorted to for explaining the various methods of contraception and removing socio-cultural barriers wherever they exist. As a result of this approach, the number of acceptors of various methods of family welfare has started to register a progressive increase over the years.
The Family Welfare Programme which began as a people's movement continues to be implemented voluntarily. Maternal and child healthcare, family welfare, women's rights, and nutrition are integral to it. The strategy being followed is constantly tailored to cater to the needs of the changing society.
The programs are implemented through the state governments for which Central assistance is provided. In rural areas, the program is being further extended through a network of primary health centers and sub-centers.
Maternal and child health care and expanded program of immunization is also a part of the family welfare program.
The Central Family Council advises on family welfare programs at the national level. Several Central committees like the Research Coordination Committee have been set up to study the progress of research programs.
Nirodh is provided under the social marketing program which is being operated through a network of retail outlets of leading consumer goods and pharmaceutical and oil companies. Under the free distribution scheme besides Nirodh, Jelly cream tubes are also distributed.
The oral pill program under the free scheme was extended to all the urban centers, including those run by local bodies and voluntary organizations. Besides this, social marketing of oral pills has also been undertaken with the help of four pharmaceutical companies on a zonal basis. Oral pills are being sold under the social marketing program under the brand name `Mala-D'.
It is estimated that 39.8 percent of 13.57 crore eligible couples whose wives are in the reproductive age group of 15-44, were protected by one or another of the approved methods of family welfare as on 31 March 1988. As a result, 953 lakh births had been averted.
The program of medical termination of pregnancy through well-trained doctors in well-equipped approved hospitals is essentially a healthcare measure. But in a way, it supplements the family welfare program as it provides for legalized abortion in cases of contraceptive failures also. A good proportion of the acceptors of abortion go in for some form of contraception like sterilization, IUD, etc. The Medical Termination of Pregnancy Act, 1971 is in operation since April 1972.
Care for mothers and children and vulnerable groups in society plays a pivotal role in family welfare programs. The Maternity and Child Health Programmes (MCH) are directed towards effective ante-natal care, ensuring safe and aseptic delivery and appropriate post-natal care, initiation, and maintenance of breast-feeding, timely immunization against common infectious diseases, control of diarrhea, attention to growth, and provision of basic medical care, etc.
The infrastructure of health is being extended and manpower is being trained to achieve these objectives of MCH care. To provide specialized pediatric care, pediatric units in districts, sub-divisional hospitals, and newly set-up units of district hospitals have been and are being equipped. A sum of Rs. 33 crores had been provided during 1987-88 for the procurement of vaccines and MCH drugs for immunizing children and mothers against diseases and preventing nutritional anemia. An amount of Rs.5 crore had been provided for the program of control of diarrheal diseases among children through one rehydration therapy during 1987-88. This program had been initiated during 1986-87 and there was a provision of Rs.25 crore for this new program during the Seventh Plan.
The question of more effective coverage of population and coordinative working was considered by the Executive Committee of the Central Family Planning Council in 1972, which led to the formation of a package of health and family welfare services at the peripheral level by multi-purpose health workers. Under this scheme, the state-level health administrators were trained at the National Institute of Health and Family Welfare in the concept and philosophy of the multi-purpose workers' scheme. The district-level medical officers and key trainers of health and family welfare training centers were trained at Central training institutes.
The post-partum program is a maternity-centered hospital-based approach to a family welfare program and now, covers medical institutions at the national, state, and district levels. These include medical colleges and post-graduate institutions. Besides, medical colleges are also implementing PAP smear-test facilities programs for early detection of cervical cancer among acceptors of family welfare methods. The purpose of extension of the post-partum program to sub-district hospitals is to provide maternal and child health-care services in rural and semi-urban areas to bring an overall improvement in the health status of the mother and the infants
The Urban Revamping Scheme has been introduced to provide improved service delivery out-reach system of primary healthcare, family welfare, and maternity services in urban areas. No new urban family welfare centers are to be set up but existing urban forces are to be reorganized and new health posts established as per the recommendations of the working group.
The sterilization beds scheme provides immediate facilities for tubectomy operations in the hospitals where such cases could not be admitted due to a lack of facilities. Under the scheme, beds are sanctioned to those medical institutions/hospitals which are run by voluntary organizations based on their performance during the previous year. Beds are sanctioned to the voluntary institutions on the recommendations of the state governments and regional directors of health and family welfare of the respective states.
As of 2009, the fertility rate of India was 2.7. The family welfare program in India depends on its voluntary acceptance by the people. To approach a large population of couples in the reproductive age group, living in urban and remote rural areas, a broad-based mass education and motivation program had been launched. The ultimate objectives of the projects are to improve health and family welfare infrastructure in the area covered and to reduce maternal and child mortality and morbidity.
Bio-medical research in the field of reproductive biology and fertility control is being done in the Indian Council of Medical Research, Central Drug Research Institute, All India Institute of Medical Sciences, and the National Institute of Health and Family Welfare.