Go Back   ManagementParadise.com | Management & Business Education Learning Platform PUBLISH / UPLOAD PROJECT OR DOWNLOAD REFERENCE PROJECT > Management Of Co-operatives

National Population Policy 2000

Discuss National Population Policy 2000 within the Management Of Co-operatives forums, part of the PUBLISH / UPLOAD PROJECT OR DOWNLOAD REFERENCE PROJECT category; ...

Reply

 

Thread Tools Display Modes
National Population Policy 2000
Old
 (1 (permalink))
divyeshpatel
divyeshpatel is on a distinguished road
 
divyeshpatel
Status: Offline
Posts: 86
Join Date: Dec 2006
Smile National Population Policy 2000 - July 29th, 2007

National Population Policy 2000

INTRODUCTION
1 The overriding objective of economic and social development is to improve the
quality of lives that people lead, to enhance their well-being, and to provide them
with opportunities and choices to become productive assets in society.

2 In 1952, India was the first country in the world to launch a national programme, Emphasizing family planning to the extent necessary for reducing birth rates "to Stabilize the population at a level consistent with the requirement of national Economy” After 1952, sharp declines in death rates were, however, not Accompanied by a similar drop in birth rates. The National Health Policy, 1983 Stated that replacement levels of total fertility rate2 (TFR) should be achieved by The year 2000.

3 On 11 May, 2000 India is projected to have 1 billion3 (100 crore) people, i.e. 16
Percent of the world's population on 2.4 percent of the globe's land area. If current Trends continue, India may overtake China in 2045, to become the most populous Country in the world. While global population has increased threefold during this Century, from 2 billion to 6 billion, the population of India has increased nearly five Times from 238 million (23 crores) to 1 billion in the same period. India's current Annual increase in population of 15.5 million is large enough to neutralize efforts to conserve the resource endowment and environment.

5 Stabilising population is an essential requirement for promoting sustainable
development with more equitable distribution. However, it is as much a function of making reproductive health care accessible and affordable for all, as of increasing the provision and outreach of primary and secondary education, extending basic amenities including sanitation, safe drinking water and housing, besides empowering women and enhancing their employment opportunities, and providing transport and communications.

6 The National Population Policy, 2000 (NPP 2000) affirms the commitment of
Government towards voluntary and informed choice and consent of citizens while
Availing of reproductive health care services, and continuation of the target free
Approach in administering family planning services. The NPP 2000 provides a
Policy framework for advancing goals and prioritizing strategies during the next
Decade, to meet the reproductive and child health needs of the people of India,
And to achieve net replacement levels (TFR) by 2010. It is based upon the need to Simultaneously address issues of child survival, maternal health, and
Contraception, while increasing outreach and coverage of a comprehensive
Package of reproductive and child heath services by government, industry and the Voluntary non-government sector, working in partnership.

OBJECTIVES
The immediate objective of the NPP 2000 is to address the unmet needs for Contraception, health care infrastructure, and health personnel, and to provide integrated service delivery for basic reproductive and child health care. The Medium-term objective is to bring the TFR to replacement levels by 2010, through Vigorous implementation of inter-sectoral operational strategies. The long-term Objective is to achieve a stable population by 2045, at a level consistent with the Requirements of sustainable economic growth, social development, and Environmental protection.




STRATEGIC THEMES
1 We identify 12 strategic themes which must be simultaneously pursued in "standalone" or inter-sectoral programmes in order to achieve the national socio demographicgoals for 2010. These are presented below:

(i) Decentralized Planning and Programme Implementation
2 The 73rd and 74th Constitutional Amendments Act, 1992, made health, family welfare, and education a responsibility of village panchayats. The panchayati rajinstitutions are an important means of furthering decentralized planning and programme implementation in the context of the NPP 2000. However, in order to realize their potential, they need strengthening by further delegation ofadministrative and financial powers, including powers of resource mobilization. Further, since 33 percent of elected panchayat seats are reserved for women, representative committees of the panchayats (headed by an elected womanpanchayat member) should be formed to promote a gender sensitive, multi sectoral agenda for population stabilization, that will "think, plan and act locally, and support nationally". These committees may identify area specific unmet needs for reproductive health services, and prepare need-based, demand driven, socio-demographic plans at the village level, aimed at identifying and providing responsive, people-centered and integrated, basic reproductive and child healthcare. Panchayats demonstrating exemplary performance in the compulsory registration of births, deaths, marriages, and pregnancies, universalizing the small family norm, increasing safe deliveries, bringing about reductions in infant and maternal mortality, and promoting compulsory education up to age 14, will be nationally recognized and honored.

(ii) Convergence of Service Delivery at Village Levels
3 Efforts at population stabilization will be effective only if we direct an integrated package of essential services at village and household levels. Below district levels, current health infrastructure includes 2,500 community health centres, 25,000 primary health centers (each covering a population of 30,000), and 1.36lakh sub centers (each covering a population of 5,000 in the plains and 3,000 in hilly regions)4. Inadequacies in the existing health infrastructure have led to an unmet need of 28 percent for contraception services, and obvious gaps in coverage and outreach. Health care centers are over-burdened and struggle to provide services with limited personnel and equipment. Absence of supportive supervision, lack of training in inter-personal communication, and lack of motivation to work in rural areas, together impede citizens' access to reproductive and child health services, and contribute to poor quality of services and an apparent insensitivity to client's needs. The last 50 years have demonstrated the unsuitability of these yardsticks for provision of health care infrastructure, particularly for remote, inaccessible, or sparsely populated regions in the country like hilly and forested areas, desert regions and tribal areas. We need to promote a more flexible approach, by extending basic reproductive and child health care through mobile clinics and counseling services. Further, recognizing that government alone cannot make up for the inadequacies in health care infrastructure and services, in order to resolve unmet needs and extend coverage, the involvement of the voluntary sector and the nongovernmental sector in partnership with the government is essential.

4 Since the management, funding, and implementation of health and education programmes has been decentralized to panchayats, in order to reach household levels, a one-stop, integrated and coordinated service delivery should be provided at village levels, for basic reproductive and child health services. A vast increase in the number of trained birth attendants, at least two per village, is necessary to universalize coverage and outreach of ante-natal, natal and postnatal health care. An equipped maternity hut in each village should be set up to serve as a delivery room, with functioning midwifery kits, basic medication for essential obstetric aid, and indigenous medicines and supplies for maternal and new born care. A key feature of the integrated service delivery will be the registration at village levels, of births, deaths, marriage, and pregnancies. Each
Village should maintain a list of community midwives and trained birth attendants, village health guides, panchayat sewa sahayaks, primary school teachers and aanganwadi workers who may be entrusted with various responsibilities in the implementation of integrated service delivery.

5 The panchayats should seek the help of community opinion makers to communicate the benefits of smaller, healthier families, the significance of educating girls, and promoting female participation in paid employment. They should also involve civil society in monitoring the availability, accessibility and affordability of services and supplies.

(iii) Empowering Women for Improved Health and Nutrition
6 The complex socio-cultural determinants of women's health and nutrition have cumulative effects over a lifetime. Discriminatory childcare leads to malnutrition and impaired physical development of the girl child. Under nutrition and micronutrient deficiency in early adolescence goes beyond mere food entitlements to those nutrition related capabilities that become crucial to a woman's well-being, and through her, to the well-being of children. The positive effects of good health and nutrition on the labour productivity of the poor is well documented. To the extent that women are over-represented among the poor, interventions for improving women's health and nutrition are critical for poverty reduction.

7 Impaired health and nutrition is compounded by early childbearing and consequent risk of serious pregnancy related complications. Women's risk of premature death and disability is highest during their reproductive years. Malnutrition, frequent pregnancies, unsafe abortions, RTI and STI, all combine to keep the maternal mortality ratio in India among the highest globally.

8 Maternal mortality is not merely a health disadvantage; it is a matter of social injustice. Low social and economic status of girls and women limits their access to education, good nutrition, as well as money to pay for health care and family planning services. The extent of maternal mortality is an indicator of disparity and inequity in access to appropriate health care and nutrition services throughout a
lifetime, and particularly during pregnancy and child-birth, and is a crucial factor contributing to high maternal mortality.

9 Programmes for Safe Motherhood, Universal Immunization, Child Survival and Oral Rehydration have been combined into an Integrated Reproductive and Child Health Programme, which also includes promoting management of STIs and RTIs. Women's health and nutrition problems can be largely prevented or mitigated through low cost interventions designed for low income settings.
10 The voluntary non-government sector and the private corporate sector should actively collaborate with the community and government through specific commitments in the areas of basic reproductive and child health care, basic education, and in securing higher levels of participation in the paid work force for women.

(iv) Child Health and Survival
11 Infant mortality is a sensitive indicator of human development. High mortality and morbidity among infants and children below 5 years occurs on account of inadequate care, asphyxia during birth, premature birth, low birth weight, acute respiratory infections, diarrhoea, vaccine preventable diseases, malnutrition and deficiencies of nutrients, including Vitamin A. Infant mortality rates have not significantly declined in recent years.

12 Our priority is to intensify neo-natal care. A National Technical Committee should be set up, consisting principally of consultants in obstetrics, pediatrics (neonatologists), family health, medical research and statistics from among academia, public health professionals, clinical practitioners and government. Its terms of reference should include prescribing perinatal audit norms, developing quality improvement activities with monitoring schedules and suggestions for
facilitating provision of continuing medical and nursing education to all perinatal health care providers. Implementation at the grass-roots must benefit from current developments in the fields of perinatology and neonatology. The baby friendly hospital initiative (BFHI) should be extended to all hospitals and clinics, up to sub centre levels. Additionally, besides promoting breast-feeding and complementary feeds, the BFHI should include updating of skills of trained birth
Attendants to improve new born care practices to reduce the risks of hypothermia and infection. Essential equipment for the new born must be provided at sub centre levels.

13 Child survival interventions i.e. universal immunization, control of childhood
diarrhoeas with oral rehydration therapies, management of acute respiratory
Infections and massive doses of Vitamin A and food supplements have all
Helped to reduce infant and child mortality and morbidity. With intensified efforts,
The eradication of polio is within reach. However, the decline in standards,
Outreach and quality of routine immunization is a matter of concern. Significant improvements need to be made in the quality and coverage of the routine
Immunization programme.

(v) Meeting the Unmet Needs for Family Welfare Services
14 In both rural and urban areas there continue to be unmet needs for
Contraceptives, supplies and equipment for integrated service delivery, mobility
Of health providers and patients, and comprehensive information. It is important
to strengthen, energies and make accountable the cutting edge of health
infrastructure at the village, sub centre and primary health centre levels, to
improve facilities for referral transportation, to encourage and strengthen local
initiatives for ambulance services at village and block levels, to increase
innovative social marketing schemes for affordable products and services and to
improve advocacy in locally relevant and acceptable dialects.

(vi) Under-Served Population Groups
(a) Urban Slums
15 Nearly 100 million people live in urban slums, with little or no access to potable water, sanitation facilities, and health care services. This contributes to high infant and child mortality, which in turn perpetuate high TFR and maternal
Mortality. Basic and primary health care, including reproductive and child health
Care, needs to be provided. Coordination with municipal bodies for water,
Sanitation and waste disposal must be pursued, and targeted information,
Education and communication campaigns must spread awareness about the
Secondary and tertiary facilities available.

(b) Tribal Communities, Hill Area Populations and Displaced and Migrant Populations
16 In general, populations in remote and low density areas do not have adequate
Access to affordable health care services. Tribal populations often have high
Levels of morbidity arising from poor nutrition, particularly in situations where they Are involuntarily displaced or resettled. Frequently, they have low levels of
Literacy, coupled with high infant, child, and maternal mortality. They remain
Under-served in the coverage of reproductive and child health services. These
Communities need special attention in terms of basic health, and reproductive
And child health services. The special needs of tribal groups which need to be
Addressed include the provision of mobile clinics that will be responsive to
Seasonal variations in the availability of work and income. Information and
Counseling on infertility, and regular supply of standardized medication will be
Included.

(c) Adolescents
(17) Adolescents represent about a fifth of India's population. The needs of
Adolescents, including protection from unwanted pregnancies and sexually
Transmitted diseases (STD), have not been specifically addressed in the past.
Programmes should encourage delayed marriage and child-bearing, and
Education of adolescents about the risks of unprotected sex. Reproductive health services for adolescent girls and boys is especially significant in rural India, where adolescent marriage and pregnancy are widely prevalent. Their special requirements comprise information, counseling, population education, and making contraceptive services accessible and affordable, providing food
supplements and nutritional services through the ICDS, and enforcing the Child
Marriage Restraint Act, 1976.

(d) Increased Participation of Men in Planned Parenthood
(18) In the past, population programmes have tended to exclude men folk. Gender Inequalities in patriarchal societies ensure that men play a critical role in
Determining the education and employment of family members, age at marriage,
Besides access to and utilization of health, nutrition, and family welfare services
For women and children. The active involvement of men is called for in planning
Families, supporting contraceptive use, helping pregnant women stay healthy,
Arranging skilled care during delivery, avoiding delays in seeking care, helping
After the baby is born and, finally, in being a responsible father. In short, the
active cooperation and participation of men is vital for ensuring programme
acceptance. Further, currently, over 97 percent of sterilizations are tubectomies
and this manifestation of gender imbalance needs to be corrected. The special
needs of men include re-popularizing vasectomies, in particular no scalpel
vasectomy as a safe and simple procedure, and focusing on men in the
information and education campaigns to promote the small family norm.


(vii) Diverse Health Care Providers
19 Give n the large unmet need for reproductive and child health services, and
inadequacies in health care infrastructure it is imperative to increase the
numbers and diversify the categories of health care providers. Ways of doing this
include accrediting private medical practitioners and assigning them to defined
beneficiary groups to provide these services; revival of the system of licensed
medical practitioner who, after appropriate certification from the Indian Medical
Association (IMA), could provide specified clinical services.

(viii) Collaboration With and Commitments from Non-Government Organizations and the Private Sector

20 A national effort to reach out to households cannot be sustained by government alone. We need to put in place a partnership of non-government voluntary organizations, the private corporate sector, government and the community. Triggered by rising incomes and institutional finance, private health care has grown significantly, with an impressive pool of expertise and management skills, and currently accounts for nearly 75 percent of health care expenditures. However, despite their obvious potential, mobilizing the private (profit and nonprofit) sector to serve public health goals raises governance issues of contracting, accreditation, regulation, referral, besides the appropriate division of labor between the public and private health providers, all of which need to be
Addressed carefully. Where government interventions or capacities are insufficient and the participation of the private sector unviable, focused service
Delivery by NGOs may effectively complement government efforts.

(ix) Mainstreaming Indian Systems of Medicine and Homeopathy
21 India's community supported ancient but living traditions of indigenous systems of medicine has sustained the population for centuries, with effective cures and remedies for numerous conditions, including those relating to women and children, with minimal side effects. Utilization of ISMH in basic reproductive and child health care will expand the pool of effective health care providers, optimize utilization of locally based remedies and cures, and promote lowcost health care. Guidelines need to be evolved to regulate and ensure standardization, efficacy and safety of ISMH drugs for wider entry into national markets

22 Particular challenges include providing appropriate training, and raising
Awareness and skill development in reproductive and child health care to the
Institutionally qualified ISMH medical practitioners. The feasibility of utilizing their
Services to fill in gaps in manpower at village levels, and at subcentres and
Primary health centers may be explored. ISMH institutions, hospitals and
Dispensaries may be utilized for reproductive and child health care programmes.
At village levels, the services of the ISMH "barefoot doctors", after appropriate
training, may be utilised for advocacy and counseling, for distributing supplies
and equipment, and as depot holders. ISMH practices may be applied at village
maternity huts, and at household levels, for ante-natal, natal and post natal care,
and for nurture of the new born.

(x) Contraceptive Technology and Research on Reproductive and Child Health
23 Government must constantly advance, encourage, and support medical, social science, demographic and behavioral science research on maternal, child and reproductive health care issues. This will improve medical techniques relevant to the country's needs, and strengthen programme and project design and implementation. Consultation and frequent dialogue by Government with the
Existing network of academic and research institutions in allopathy and ISMH,
And with other relevant public and private research institutions engaged in social
Science, demography and behavioral research must continue. The International
Institute of Population Sciences and the population research centers which have
Been set up to pursue applied research in population related matters, need to be
Revitalized and strengthened.

24 Applied research relies upon constant monitoring of performance at the
programme and project levels. The National Health and Family Welfare Survey
Provides data on key health and family welfare indicators every five years. Data
from the first National Family Health Survey (NFHS- 1), 1992-93, has been
Updated by NFHS-2, 1998-99, to be published shortly. Annual data is generated
by the Sample Registration Survey, which, inter alia, maps at state levels the
birth, death and infant mortality rates. Absence of regular feedback has been a
weakness in the family welfare progamme. For this reason, the Department of
Family Welfare is strengthening its management information systems (MIS) and
has commenced during 1998, a system of ascertaining impacts and outcomes
through district surveys and facility surveys. The district surveys cover 50%
districts every year, so that every 2 years there is an update on every district in
the country. The facility surveys ascertain the availability of infrastructure and
services up to primary health centre level, covering one district per month. The
feedback from both these surveys enable remedial action at district and sub-
district levels.

(xi) Providing for the Older Population
25 Improved life expectancy is leading to an increase in the absolute number and
proportion of persons aged 60 years and above, and is anticipated to nearly
double during 1996-2016, from 62.3 million to 112.9 million5 . When viewed in
the context of significant weakening of traditional support systems, the elderly
are increasingly vulnerable, needing protection and care. Promoting old age
health care and support will, over time, also serve to reduce the incentive to have
large families
.
26 The Ministry of Social Justice and Empowerment has adopted in January 1999 a National Policy on Older Persons. It has become important to build in geriatric health concerns in the population policy. Ways of doing this include sensitizing, training and equipping rural and urban health centers and hospitals for providing geriatric health care; encouraging NGOs to design and implement formal and informal schemes that make the elderly economically self-reliant; providing for and reutilizing screening for cancer, osteoporosis, and cardiovascular conditions in primary health centers, community health centers, and urban health care centers at primary, secondary and tertiary levels; and exploring tax incentives to encourage grown-up children to look after their aged parents.

(xii) Information, Education, and Communication
27 Information, education and communication (IEC) of family welfare messages
Must be clear, focused and disseminated everywhere, including the remote
Corners of the country, and in local dialects. This will ensure that the messages
Are effectively conveyed. This need to be strengthened and their outreach
Widened, with locally relevant and locally comprehensible media and messages.
On the model of the total literacy campaigns which have successfully mobilized
Local populations, there is need to undertake a massive national campaign on
Population related issues, via artists, popular film stars, doctors, vaidyas, hakims,
Nurses, local midwives, women's organizations, and youth organizations.


PROMOTIONAL AND MOTIVATIONAL MEASURES FOR ADOPTION OF THE SMALL FAMILY NORM
The following promotional and motivational measures will be undertaken:
(i) Panchayats and Zila Parishads will be rewarded and honored for exemplary
performance in universalizing the small family norm, achieving reductions in infant mortality and birth rates, and promoting literacy with completion of primary
schooling.

(ii) The Balika Samridhi Yojana run by the Department of Women and Child
Development, to promote survival and care of the girl child, will continue. Cash
Incentive of Rs. 500 is awarded at the birth of the girl child of birth order 1 or 2.

(iii) Maternity Benefit Scheme run by the Department of Rural Development will
continue. A cash incentive of Rs. 500 is awarded to mothers who have their first
child after 19 years of age, for birth of the first or second child only. Disbursement
of the cash award will in future be linked to compliance with ante-natal check up,
institutional delivery by trained birth attendant, registration of birth and BCG
immunisation.


(iv) A Family Welfare-linked Health Insurance Plan will be established. Couples
below the poverty line, who undergo sterilisation with not more than two living
children, would become eligible (along with children) for health insurance (for
hospitalisation) not exceeding Rs. 5000, and a personal accident insurance cover
for the spouse undergoing sterilisation.

(v) Couples below the poverty line, who marry after the legal age of marriage,
register the marriage, have their first child after the mother reaches the age of 21,
accept the small family norm, and adopt a terminal method after the birth of the
second child, will be rewarded.

(vi) A revolving fund will be set up for income-generating activities by village-level
self help groups, who provide community-level health care services.

(vii) Crèches and child care centres will be opened in rural areas and urban slums.This will facilitate and promote participation of women in paid employment.

(viii) A wider, affordable choice of contraceptives will be made accessible at
Diverse delivery points, with counseling services to enable acceptors to exercise
Voluntary and informed consent.

(ix) Facilities for safe abortion will be strengthened and expanded.

(x) Products and services will be made affordable through innovative social
marketing schemes.

(xi) Local entrepreneurs at village levels will be provided soft loans and encouraged to run ambulance services to supplement the existing arrangements
for referral transportation.

(xii) Increased vocational training schemes for girls, leading to self-employment
will be encouraged.

(xiii) Strict enforcement of Child Marriage Restraint Act, 1976.

(xiv) Strict enforcement of the Pre-Natal Diagnostic Techniques Act, 1994.

(xv) Soft loans to ensure mobility of the ANMs will be increased.

(xvi) The 42nd Constitutional Amendment has frozen the number of
representatives in the Lok Sabha (on the basis of population) at 1971 Census
levels. The freeze is currently valid until 2001, and has served as an incentive for
State Governments to fearlessly pursue the agenda for population stabilisation.
This freeze needs to be extended until 2026.






CONCLUSION
In the new millennium, nations are judged by the well-being of their peoples; by
Levels of health, nutrition and education; by the civil and political liberties enjoyed
By their citizens; by the protection guaranteed to children and by provisions made for the vulnerable and the disadvantaged. The vast numbers of the people of India can be its greatest asset if they are provided with the means to lead healthy and economically productive lives. Population stabilization is a multisectoral endeavor requiring constant and effective dialogue among a diversity of stakeholders, and coordination at all levels of the government and society. Spread of literacy and education, increasing availability of affordable reproductive and child health services, convergence of service delivery at village levels, participation of women in the paid work force, together with a steady, equitable improvement in family incomes, will facilitate early achievement of the socio-demographic goals. Success will be achieved if the Action Plan contained in the NPP 2000 is pursued as a national movement.
Advertisements

Friends: (0)
Reply With Quote
The Following User Says Thank You to For This Useful Post:
Re: National Population Policy 2000
Old
 (2 (permalink))
James Cord
jamescord is an unknown quantity at this point
 
jamescord
Management Paradise Guru
 
Status: Offline
Posts: 2,112
Join Date: Mar 2016
Re: National Population Policy 2000 - April 5th, 2016

Quote:
Originally Posted by divyeshpatel View Post
National Population Policy 2000

INTRODUCTION
1 The overriding objective of economic and social development is to improve the
quality of lives that people lead, to enhance their well-being, and to provide them
with opportunities and choices to become productive assets in society.

2 In 1952, India was the first country in the world to launch a national programme, Emphasizing family planning to the extent necessary for reducing birth rates "to Stabilize the population at a level consistent with the requirement of national Economy” After 1952, sharp declines in death rates were, however, not Accompanied by a similar drop in birth rates. The National Health Policy, 1983 Stated that replacement levels of total fertility rate2 (TFR) should be achieved by The year 2000.

3 On 11 May, 2000 India is projected to have 1 billion3 (100 crore) people, i.e. 16
Percent of the world's population on 2.4 percent of the globe's land area. If current Trends continue, India may overtake China in 2045, to become the most populous Country in the world. While global population has increased threefold during this Century, from 2 billion to 6 billion, the population of India has increased nearly five Times from 238 million (23 crores) to 1 billion in the same period. India's current Annual increase in population of 15.5 million is large enough to neutralize efforts to conserve the resource endowment and environment.

5 Stabilising population is an essential requirement for promoting sustainable
development with more equitable distribution. However, it is as much a function of making reproductive health care accessible and affordable for all, as of increasing the provision and outreach of primary and secondary education, extending basic amenities including sanitation, safe drinking water and housing, besides empowering women and enhancing their employment opportunities, and providing transport and communications.

6 The National Population Policy, 2000 (NPP 2000) affirms the commitment of
Government towards voluntary and informed choice and consent of citizens while
Availing of reproductive health care services, and continuation of the target free
Approach in administering family planning services. The NPP 2000 provides a
Policy framework for advancing goals and prioritizing strategies during the next
Decade, to meet the reproductive and child health needs of the people of India,
And to achieve net replacement levels (TFR) by 2010. It is based upon the need to Simultaneously address issues of child survival, maternal health, and
Contraception, while increasing outreach and coverage of a comprehensive
Package of reproductive and child heath services by government, industry and the Voluntary non-government sector, working in partnership.

OBJECTIVES
The immediate objective of the NPP 2000 is to address the unmet needs for Contraception, health care infrastructure, and health personnel, and to provide integrated service delivery for basic reproductive and child health care. The Medium-term objective is to bring the TFR to replacement levels by 2010, through Vigorous implementation of inter-sectoral operational strategies. The long-term Objective is to achieve a stable population by 2045, at a level consistent with the Requirements of sustainable economic growth, social development, and Environmental protection.




STRATEGIC THEMES
1 We identify 12 strategic themes which must be simultaneously pursued in "standalone" or inter-sectoral programmes in order to achieve the national socio demographicgoals for 2010. These are presented below:

(i) Decentralized Planning and Programme Implementation
2 The 73rd and 74th Constitutional Amendments Act, 1992, made health, family welfare, and education a responsibility of village panchayats. The panchayati rajinstitutions are an important means of furthering decentralized planning and programme implementation in the context of the NPP 2000. However, in order to realize their potential, they need strengthening by further delegation ofadministrative and financial powers, including powers of resource mobilization. Further, since 33 percent of elected panchayat seats are reserved for women, representative committees of the panchayats (headed by an elected womanpanchayat member) should be formed to promote a gender sensitive, multi sectoral agenda for population stabilization, that will "think, plan and act locally, and support nationally". These committees may identify area specific unmet needs for reproductive health services, and prepare need-based, demand driven, socio-demographic plans at the village level, aimed at identifying and providing responsive, people-centered and integrated, basic reproductive and child healthcare. Panchayats demonstrating exemplary performance in the compulsory registration of births, deaths, marriages, and pregnancies, universalizing the small family norm, increasing safe deliveries, bringing about reductions in infant and maternal mortality, and promoting compulsory education up to age 14, will be nationally recognized and honored.

(ii) Convergence of Service Delivery at Village Levels
3 Efforts at population stabilization will be effective only if we direct an integrated package of essential services at village and household levels. Below district levels, current health infrastructure includes 2,500 community health centres, 25,000 primary health centers (each covering a population of 30,000), and 1.36lakh sub centers (each covering a population of 5,000 in the plains and 3,000 in hilly regions)4. Inadequacies in the existing health infrastructure have led to an unmet need of 28 percent for contraception services, and obvious gaps in coverage and outreach. Health care centers are over-burdened and struggle to provide services with limited personnel and equipment. Absence of supportive supervision, lack of training in inter-personal communication, and lack of motivation to work in rural areas, together impede citizens' access to reproductive and child health services, and contribute to poor quality of services and an apparent insensitivity to client's needs. The last 50 years have demonstrated the unsuitability of these yardsticks for provision of health care infrastructure, particularly for remote, inaccessible, or sparsely populated regions in the country like hilly and forested areas, desert regions and tribal areas. We need to promote a more flexible approach, by extending basic reproductive and child health care through mobile clinics and counseling services. Further, recognizing that government alone cannot make up for the inadequacies in health care infrastructure and services, in order to resolve unmet needs and extend coverage, the involvement of the voluntary sector and the nongovernmental sector in partnership with the government is essential.

4 Since the management, funding, and implementation of health and education programmes has been decentralized to panchayats, in order to reach household levels, a one-stop, integrated and coordinated service delivery should be provided at village levels, for basic reproductive and child health services. A vast increase in the number of trained birth attendants, at least two per village, is necessary to universalize coverage and outreach of ante-natal, natal and postnatal health care. An equipped maternity hut in each village should be set up to serve as a delivery room, with functioning midwifery kits, basic medication for essential obstetric aid, and indigenous medicines and supplies for maternal and new born care. A key feature of the integrated service delivery will be the registration at village levels, of births, deaths, marriage, and pregnancies. Each
Village should maintain a list of community midwives and trained birth attendants, village health guides, panchayat sewa sahayaks, primary school teachers and aanganwadi workers who may be entrusted with various responsibilities in the implementation of integrated service delivery.

5 The panchayats should seek the help of community opinion makers to communicate the benefits of smaller, healthier families, the significance of educating girls, and promoting female participation in paid employment. They should also involve civil society in monitoring the availability, accessibility and affordability of services and supplies.

(iii) Empowering Women for Improved Health and Nutrition
6 The complex socio-cultural determinants of women's health and nutrition have cumulative effects over a lifetime. Discriminatory childcare leads to malnutrition and impaired physical development of the girl child. Under nutrition and micronutrient deficiency in early adolescence goes beyond mere food entitlements to those nutrition related capabilities that become crucial to a woman's well-being, and through her, to the well-being of children. The positive effects of good health and nutrition on the labour productivity of the poor is well documented. To the extent that women are over-represented among the poor, interventions for improving women's health and nutrition are critical for poverty reduction.

7 Impaired health and nutrition is compounded by early childbearing and consequent risk of serious pregnancy related complications. Women's risk of premature death and disability is highest during their reproductive years. Malnutrition, frequent pregnancies, unsafe abortions, RTI and STI, all combine to keep the maternal mortality ratio in India among the highest globally.

8 Maternal mortality is not merely a health disadvantage; it is a matter of social injustice. Low social and economic status of girls and women limits their access to education, good nutrition, as well as money to pay for health care and family planning services. The extent of maternal mortality is an indicator of disparity and inequity in access to appropriate health care and nutrition services throughout a
lifetime, and particularly during pregnancy and child-birth, and is a crucial factor contributing to high maternal mortality.

9 Programmes for Safe Motherhood, Universal Immunization, Child Survival and Oral Rehydration have been combined into an Integrated Reproductive and Child Health Programme, which also includes promoting management of STIs and RTIs. Women's health and nutrition problems can be largely prevented or mitigated through low cost interventions designed for low income settings.
10 The voluntary non-government sector and the private corporate sector should actively collaborate with the community and government through specific commitments in the areas of basic reproductive and child health care, basic education, and in securing higher levels of participation in the paid work force for women.

(iv) Child Health and Survival
11 Infant mortality is a sensitive indicator of human development. High mortality and morbidity among infants and children below 5 years occurs on account of inadequate care, asphyxia during birth, premature birth, low birth weight, acute respiratory infections, diarrhoea, vaccine preventable diseases, malnutrition and deficiencies of nutrients, including Vitamin A. Infant mortality rates have not significantly declined in recent years.

12 Our priority is to intensify neo-natal care. A National Technical Committee should be set up, consisting principally of consultants in obstetrics, pediatrics (neonatologists), family health, medical research and statistics from among academia, public health professionals, clinical practitioners and government. Its terms of reference should include prescribing perinatal audit norms, developing quality improvement activities with monitoring schedules and suggestions for
facilitating provision of continuing medical and nursing education to all perinatal health care providers. Implementation at the grass-roots must benefit from current developments in the fields of perinatology and neonatology. The baby friendly hospital initiative (BFHI) should be extended to all hospitals and clinics, up to sub centre levels. Additionally, besides promoting breast-feeding and complementary feeds, the BFHI should include updating of skills of trained birth
Attendants to improve new born care practices to reduce the risks of hypothermia and infection. Essential equipment for the new born must be provided at sub centre levels.

13 Child survival interventions i.e. universal immunization, control of childhood
diarrhoeas with oral rehydration therapies, management of acute respiratory
Infections and massive doses of Vitamin A and food supplements have all
Helped to reduce infant and child mortality and morbidity. With intensified efforts,
The eradication of polio is within reach. However, the decline in standards,
Outreach and quality of routine immunization is a matter of concern. Significant improvements need to be made in the quality and coverage of the routine
Immunization programme.

(v) Meeting the Unmet Needs for Family Welfare Services
14 In both rural and urban areas there continue to be unmet needs for
Contraceptives, supplies and equipment for integrated service delivery, mobility
Of health providers and patients, and comprehensive information. It is important
to strengthen, energies and make accountable the cutting edge of health
infrastructure at the village, sub centre and primary health centre levels, to
improve facilities for referral transportation, to encourage and strengthen local
initiatives for ambulance services at village and block levels, to increase
innovative social marketing schemes for affordable products and services and to
improve advocacy in locally relevant and acceptable dialects.

(vi) Under-Served Population Groups
(a) Urban Slums
15 Nearly 100 million people live in urban slums, with little or no access to potable water, sanitation facilities, and health care services. This contributes to high infant and child mortality, which in turn perpetuate high TFR and maternal
Mortality. Basic and primary health care, including reproductive and child health
Care, needs to be provided. Coordination with municipal bodies for water,
Sanitation and waste disposal must be pursued, and targeted information,
Education and communication campaigns must spread awareness about the
Secondary and tertiary facilities available.

(b) Tribal Communities, Hill Area Populations and Displaced and Migrant Populations
16 In general, populations in remote and low density areas do not have adequate
Access to affordable health care services. Tribal populations often have high
Levels of morbidity arising from poor nutrition, particularly in situations where they Are involuntarily displaced or resettled. Frequently, they have low levels of
Literacy, coupled with high infant, child, and maternal mortality. They remain
Under-served in the coverage of reproductive and child health services. These
Communities need special attention in terms of basic health, and reproductive
And child health services. The special needs of tribal groups which need to be
Addressed include the provision of mobile clinics that will be responsive to
Seasonal variations in the availability of work and income. Information and
Counseling on infertility, and regular supply of standardized medication will be
Included.

(c) Adolescents
(17) Adolescents represent about a fifth of India's population. The needs of
Adolescents, including protection from unwanted pregnancies and sexually
Transmitted diseases (STD), have not been specifically addressed in the past.
Programmes should encourage delayed marriage and child-bearing, and
Education of adolescents about the risks of unprotected sex. Reproductive health services for adolescent girls and boys is especially significant in rural India, where adolescent marriage and pregnancy are widely prevalent. Their special requirements comprise information, counseling, population education, and making contraceptive services accessible and affordable, providing food
supplements and nutritional services through the ICDS, and enforcing the Child
Marriage Restraint Act, 1976.

(d) Increased Participation of Men in Planned Parenthood
(18) In the past, population programmes have tended to exclude men folk. Gender Inequalities in patriarchal societies ensure that men play a critical role in
Determining the education and employment of family members, age at marriage,
Besides access to and utilization of health, nutrition, and family welfare services
For women and children. The active involvement of men is called for in planning
Families, supporting contraceptive use, helping pregnant women stay healthy,
Arranging skilled care during delivery, avoiding delays in seeking care, helping
After the baby is born and, finally, in being a responsible father. In short, the
active cooperation and participation of men is vital for ensuring programme
acceptance. Further, currently, over 97 percent of sterilizations are tubectomies
and this manifestation of gender imbalance needs to be corrected. The special
needs of men include re-popularizing vasectomies, in particular no scalpel
vasectomy as a safe and simple procedure, and focusing on men in the
information and education campaigns to promote the small family norm.


(vii) Diverse Health Care Providers
19 Give n the large unmet need for reproductive and child health services, and
inadequacies in health care infrastructure it is imperative to increase the
numbers and diversify the categories of health care providers. Ways of doing this
include accrediting private medical practitioners and assigning them to defined
beneficiary groups to provide these services; revival of the system of licensed
medical practitioner who, after appropriate certification from the Indian Medical
Association (IMA), could provide specified clinical services.

(viii) Collaboration With and Commitments from Non-Government Organizations and the Private Sector

20 A national effort to reach out to households cannot be sustained by government alone. We need to put in place a partnership of non-government voluntary organizations, the private corporate sector, government and the community. Triggered by rising incomes and institutional finance, private health care has grown significantly, with an impressive pool of expertise and management skills, and currently accounts for nearly 75 percent of health care expenditures. However, despite their obvious potential, mobilizing the private (profit and nonprofit) sector to serve public health goals raises governance issues of contracting, accreditation, regulation, referral, besides the appropriate division of labor between the public and private health providers, all of which need to be
Addressed carefully. Where government interventions or capacities are insufficient and the participation of the private sector unviable, focused service
Delivery by NGOs may effectively complement government efforts.

(ix) Mainstreaming Indian Systems of Medicine and Homeopathy
21 India's community supported ancient but living traditions of indigenous systems of medicine has sustained the population for centuries, with effective cures and remedies for numerous conditions, including those relating to women and children, with minimal side effects. Utilization of ISMH in basic reproductive and child health care will expand the pool of effective health care providers, optimize utilization of locally based remedies and cures, and promote lowcost health care. Guidelines need to be evolved to regulate and ensure standardization, efficacy and safety of ISMH drugs for wider entry into national markets

22 Particular challenges include providing appropriate training, and raising
Awareness and skill development in reproductive and child health care to the
Institutionally qualified ISMH medical practitioners. The feasibility of utilizing their
Services to fill in gaps in manpower at village levels, and at subcentres and
Primary health centers may be explored. ISMH institutions, hospitals and
Dispensaries may be utilized for reproductive and child health care programmes.
At village levels, the services of the ISMH "barefoot doctors", after appropriate
training, may be utilised for advocacy and counseling, for distributing supplies
and equipment, and as depot holders. ISMH practices may be applied at village
maternity huts, and at household levels, for ante-natal, natal and post natal care,
and for nurture of the new born.

(x) Contraceptive Technology and Research on Reproductive and Child Health
23 Government must constantly advance, encourage, and support medical, social science, demographic and behavioral science research on maternal, child and reproductive health care issues. This will improve medical techniques relevant to the country's needs, and strengthen programme and project design and implementation. Consultation and frequent dialogue by Government with the
Existing network of academic and research institutions in allopathy and ISMH,
And with other relevant public and private research institutions engaged in social
Science, demography and behavioral research must continue. The International
Institute of Population Sciences and the population research centers which have
Been set up to pursue applied research in population related matters, need to be
Revitalized and strengthened.

24 Applied research relies upon constant monitoring of performance at the
programme and project levels. The National Health and Family Welfare Survey
Provides data on key health and family welfare indicators every five years. Data
from the first National Family Health Survey (NFHS- 1), 1992-93, has been
Updated by NFHS-2, 1998-99, to be published shortly. Annual data is generated
by the Sample Registration Survey, which, inter alia, maps at state levels the
birth, death and infant mortality rates. Absence of regular feedback has been a
weakness in the family welfare progamme. For this reason, the Department of
Family Welfare is strengthening its management information systems (MIS) and
has commenced during 1998, a system of ascertaining impacts and outcomes
through district surveys and facility surveys. The district surveys cover 50%
districts every year, so that every 2 years there is an update on every district in
the country. The facility surveys ascertain the availability of infrastructure and
services up to primary health centre level, covering one district per month. The
feedback from both these surveys enable remedial action at district and sub-
district levels.

(xi) Providing for the Older Population
25 Improved life expectancy is leading to an increase in the absolute number and
proportion of persons aged 60 years and above, and is anticipated to nearly
double during 1996-2016, from 62.3 million to 112.9 million5 . When viewed in
the context of significant weakening of traditional support systems, the elderly
are increasingly vulnerable, needing protection and care. Promoting old age
health care and support will, over time, also serve to reduce the incentive to have
large families
.
26 The Ministry of Social Justice and Empowerment has adopted in January 1999 a National Policy on Older Persons. It has become important to build in geriatric health concerns in the population policy. Ways of doing this include sensitizing, training and equipping rural and urban health centers and hospitals for providing geriatric health care; encouraging NGOs to design and implement formal and informal schemes that make the elderly economically self-reliant; providing for and reutilizing screening for cancer, osteoporosis, and cardiovascular conditions in primary health centers, community health centers, and urban health care centers at primary, secondary and tertiary levels; and exploring tax incentives to encourage grown-up children to look after their aged parents.

(xii) Information, Education, and Communication
27 Information, education and communication (IEC) of family welfare messages
Must be clear, focused and disseminated everywhere, including the remote
Corners of the country, and in local dialects. This will ensure that the messages
Are effectively conveyed. This need to be strengthened and their outreach
Widened, with locally relevant and locally comprehensible media and messages.
On the model of the total literacy campaigns which have successfully mobilized
Local populations, there is need to undertake a massive national campaign on
Population related issues, via artists, popular film stars, doctors, vaidyas, hakims,
Nurses, local midwives, women's organizations, and youth organizations.


PROMOTIONAL AND MOTIVATIONAL MEASURES FOR ADOPTION OF THE SMALL FAMILY NORM
The following promotional and motivational measures will be undertaken:
(i) Panchayats and Zila Parishads will be rewarded and honored for exemplary
performance in universalizing the small family norm, achieving reductions in infant mortality and birth rates, and promoting literacy with completion of primary
schooling.

(ii) The Balika Samridhi Yojana run by the Department of Women and Child
Development, to promote survival and care of the girl child, will continue. Cash
Incentive of Rs. 500 is awarded at the birth of the girl child of birth order 1 or 2.

(iii) Maternity Benefit Scheme run by the Department of Rural Development will
continue. A cash incentive of Rs. 500 is awarded to mothers who have their first
child after 19 years of age, for birth of the first or second child only. Disbursement
of the cash award will in future be linked to compliance with ante-natal check up,
institutional delivery by trained birth attendant, registration of birth and BCG
immunisation.


(iv) A Family Welfare-linked Health Insurance Plan will be established. Couples
below the poverty line, who undergo sterilisation with not more than two living
children, would become eligible (along with children) for health insurance (for
hospitalisation) not exceeding Rs. 5000, and a personal accident insurance cover
for the spouse undergoing sterilisation.

(v) Couples below the poverty line, who marry after the legal age of marriage,
register the marriage, have their first child after the mother reaches the age of 21,
accept the small family norm, and adopt a terminal method after the birth of the
second child, will be rewarded.

(vi) A revolving fund will be set up for income-generating activities by village-level
self help groups, who provide community-level health care services.

(vii) Crèches and child care centres will be opened in rural areas and urban slums.This will facilitate and promote participation of women in paid employment.

(viii) A wider, affordable choice of contraceptives will be made accessible at
Diverse delivery points, with counseling services to enable acceptors to exercise
Voluntary and informed consent.

(ix) Facilities for safe abortion will be strengthened and expanded.

(x) Products and services will be made affordable through innovative social
marketing schemes.

(xi) Local entrepreneurs at village levels will be provided soft loans and encouraged to run ambulance services to supplement the existing arrangements
for referral transportation.

(xii) Increased vocational training schemes for girls, leading to self-employment
will be encouraged.

(xiii) Strict enforcement of Child Marriage Restraint Act, 1976.

(xiv) Strict enforcement of the Pre-Natal Diagnostic Techniques Act, 1994.

(xv) Soft loans to ensure mobility of the ANMs will be increased.

(xvi) The 42nd Constitutional Amendment has frozen the number of
representatives in the Lok Sabha (on the basis of population) at 1971 Census
levels. The freeze is currently valid until 2001, and has served as an incentive for
State Governments to fearlessly pursue the agenda for population stabilisation.
This freeze needs to be extended until 2026.






CONCLUSION
In the new millennium, nations are judged by the well-being of their peoples; by
Levels of health, nutrition and education; by the civil and political liberties enjoyed
By their citizens; by the protection guaranteed to children and by provisions made for the vulnerable and the disadvantaged. The vast numbers of the people of India can be its greatest asset if they are provided with the means to lead healthy and economically productive lives. Population stabilization is a multisectoral endeavor requiring constant and effective dialogue among a diversity of stakeholders, and coordination at all levels of the government and society. Spread of literacy and education, increasing availability of affordable reproductive and child health services, convergence of service delivery at village levels, participation of women in the paid work force, together with a steady, equitable improvement in family incomes, will facilitate early achievement of the socio-demographic goals. Success will be achieved if the Action Plan contained in the NPP 2000 is pursued as a national movement.
Hey Divyesh,

Here i am uploading Study case on Population Policy at National and State Level, so please download and check it.
Friends: (0)
Reply With Quote
Reply

Bookmarks

Tags
2000, national, policy, population


Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is On
Trackbacks are On
Pingbacks are On
Refbacks are Off


ManagementParadise.com is not responsible for the views and opinion of the posters. The posters and only posters shall be liable for any copyright infringement.



Search Engine Optimization by vBSEO ©2011, Crawlability, Inc.