2. FRAMEWORK
Defining a policy and Population Policy
Need for population policy in India
Milestones in evolution of Population Policy of India
India‟s demographic achievements till NPP-2000
Objectives of the NPP-2000
National socio-demographic goals for 2010
Major strategic themes in the NPP-2000
Legislation, public support and funding.
New structures for coordination of the activities
Action plan or operational strategies.
Promotional and motivational measures.
State population policies.
Conclusion.
3. WHAT IS A POLICY?
Set of Ideas or Plans that is used as a basis for decision making;
Attitude and actions of an organization regarding a particular issue;
General Statement of understanding which guide decision making.
It is more than mere statement of goals:
How the stated goals can be achieved?
Who will carry out the tasks?
In what manner?
BASIS FOR A POLICY
Set of Values
Commitments
Assessment of current situation
Image of a desired future situation
4. STAGES OF POLICY PROCESS
Problem Identification and Issue Recognition
Policy Formulation
Policy Implementation
Policy Evaluation
POLICIES RELATED TO HEALTH SECTOR
National Health Policy
Nutrition Policy
Population Policy
5. WHAT IS POPULATION POLICY?
Measures formulated by a range of social institutions including Government
which may influence the size, distribution or composition of human
population (Driver,1972).
A deliberate effort by a national government to influence the demographic
variables like fertility, mortality and migration (Organski & Organski,1961)
A set of Coordinated laws aimed at reaching some demographic goal
(Biurgeois-Pichat,1974)
6. WHY THERE IS A NEED FOR POPULATION POLICY IN INDIA?
7. NEED FOR POPULATION POLICY IN INDIA
On 11th May, 2000, India had 1 billion (100 crores) 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 by 2045, to become
the most populous country in the world.
Global population : ↑ 3 folds during this century (from 2 to 6 billion)
Population of India : ↑ nearly 5 times (from 238 million to 1 billion), during
the same period.
Stabilizing population is an essential requirement for promoting sustainable
development with more equitable distribution .
9. FIGURE: GROWTH OF POPULATION OF INDIA
% Growth/10 years, India: Censes-2001
-5.00
0.00
5.00
10.00
15.00
20.00
25.00
30.00
1911 1921 1931 1941 1951 1961 1971 1981 1991 2001
C E N S U S Y E A R S
%Growth/10yrs
10.
11. CAUSES OF HIGH POPULATION GROWTH
A large size of population in the reproductive age group (estimated contribution
58 percent).
Higher fertility due to unmet needs of contraception (estimated contribution 20
percent).
High desire for fertility due to high infant mortality rate (estimated contribution
20 percent) .
Approximately 50 percent of the girls marry below the age of 18 years,
resulting in a typical reproductive pattern of “too early, too frequent, too many.”
Preference for male child.
More children are preferred by poor parents as more workforce.
12. MILESTONES IN THE DEVELOPMENT OF THE NATIONAL
POPULATION POLICY
1940- The sub committee on Population , appointed by the National Planning
Committee, considered „ Family Planning and limitation of children‟ essential
for the interest of social economy, family happiness and national planning.
1946- The Bhore Committee reported that control of disease and famine would
cause a serious problem of population growth.
1951- The Draft outline of the First Five Year Plan recognized „ population policy‟
as an „essential to planning‟ and „family planning‟ as a „step towards
improvement in health of mothers and children‟.
1952- Launching of the first National Family Planning Programme in India.
13. 1976- Statement of National Population Policy, by Shri K. Singh, Minister
of Health and Family planning, to deter population growth and
events that contributed to it.
1977- A revised Population Policy Statement was tabled on Parliament. It
emphasized the voluntary nature of the family planning programme.
The term „Family Welfare‟ replaced the term „Family Planning‟.
1983- The National Health Policy emphasized “securing the small family
norm, through voluntary efforts and moving towards the goal of
population stabilization”
14. 1991- The National Development Council (NDC) appointed a committee
with Shri K Karunakaran as the chairperson.
The Karunakaran report endorsed by the NDC , in 1993 proposed
the formulation of a National Population Policy to take:
“a long term holistic view of development, population growth and
environmental protection”,
“to suggest policies and guidelines”
“ a monitoring mechanism with short, medium and long term goals”
1993 - An expert group headed by Dr. M.S. Swaminathan –asked to prepare draft
of a National Population Policy to be discussed.
1994 - Report on a „ National Population Policy‟ by the expert group circulated
among members, and comments sought from the state and central
agencies
15. 1997 - On 50th anniversary of Indian independence , Prime Minister, Gujral
promised to announce a National Population Policy in near future.
- During 11/97 Cabinet approved draft, directed to be placed before
the Parliament, but could not be placed as both the Houses stood
adjourned.
1999 - Another round of consultation in 1998, and another draft finalised
and placed before the Cabinet in March, 1999.
- Cabinet appointed a Group of Ministers (GOM) headed by Deputy
Chairman, Planning Commission, to examine the draft.
- The GOM then finalised a draft, placed before the Cabinet, discussed on
19th November 1999.
16. BACKGROUND OF THE 1976 POPULATION POLICY
In 1976, with India‟s population growing rapidly, the Emergency extended for
another year.
Minister of Health and Family Planning , Karan Singh, announced National
Population Policy, to deter population growth.
The policy hoped to reduce the nation‟s hardships, established how incentives
would be allocated to those who participate in population management efforts, and
sought to reduce the nation‟s birth rate from 35 to 25 per 1000 by 1984.
The policy also acknowledged that the country‟s population growth concerns could
not wait for increased development and education to result in fertility drop.
17. The policy called for the Education Ministry to encourage and promote girls‟
education.
The population policy stated that the central government did not wish to legislate
compulsory sterilization
But if a state legislature felt prepared to pass a policy making sterilization
compulsory, then it could do so.
The results of population policy 1976 , if measured by the number of sterilizations
would be a success ( although there were false reporting).
18. From a rights based perspective, when effectiveness is measured by deaths, violence
or rights compromised in an attempt to goals of the Population Policy, initiatives
were unsuccessful.
Failure was reflected by the lack of sustainability and being counter-protective to
improve the nation‟s health.
For example, compensation for sterilization operations rose to 10 percent of the
total health budget.
It concentrated resources at one place, more of the health professionals were being
used to reach sterilization goals, rather than other services towards patient welfare.
19. DEMOGRAPHIC ACHIEVEMENTS OF INDIA BEFORE NPP-2000
Reduced Crude Birth Rate from 40.8 (1951) to 26.4 (1998,SRS);
Halved the Infant Mortality Rate from 146 per 1000 live births (1951) to 72 per
1000 live births (1998, SRS);
Quadrupled the Couple Protection Rate from 10.4 percent (1971) to 44 percent
(1999);
Reduced Crude Death Rate from 25 (1951) to 9.0 (1998, SRS);
Added 25 years to life-expectancy from 37 years to 62 years;
Achieved nearly universal awareness of the need for and methods of family
planning, and ;
Reduced Total Fertility Rate from 6.0 (1951) to 3.3 (1997, SRS)
20. OBSERVATIONS ON THE NATIONAL POPULATION
POLICY OF INDIA- 2000
3 Objectives
4 New Structures
12 Strategic Themes
14 National Socio-demographic Goals (2010)
16 Promotional and Motivational Measures
150 Interventions
21. OBJECTIVES OF THE NATIONAL POPULATION POLICY-
2000
IMMEDIATE OBJECTIVE :
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.
MEDIUM TERM OBJECTIVE:
to bring the TFR to replacement level by 2010 through vigorous
implementation of intersectoral operational strategies.
LONG TERM OBJECTIVE:
achieve a stable population by 2045 at a level consistent with
requirement of sustainable economic growth, social development
and environmental protection.
22. NATIONAL SOCIO-DEMOGRAPHIC GOALS FOR 2010
1. Address the unmet needs for basic RCH services, supplies and infrastructure.
2. Make school education up to age 14 years free and compulsory, and reduce
drop outs rate from primary and secondary school levels to below 20 percent
for both boys and girls.
3. Reduce IMR to 30/1000 live births
4. Reduce maternal mortality ratio (MMR) to less than 100 per 1000 live births
5. Achieve universal immunization of children against all Vaccine Preventable
Disease (VPD).
6. Promote delayed marriage for girls, at age not less than 18,and preferable
after 20 years.
7. Achieve 80% institutional delivery and 100% by trained personnels
23. 8. Achieve universal access to information/ counseling services for fertility
regulation and contraceptive with wide basket of choices
9. Achieve 100% registration of births, deaths, marriage, and pregnancy.
10. Containment of AIDS, and greater integration between the management of AIDS
and STD.
11. Prevention and control of communicable diseases.
12. Integration of Indian system of medicine in provision of RCH services, and in
reaching out to households.
13. Promote small family norm to achieve replacement level of Total Fertility Rate
2.1.
14. Bring about convergence in implementation of related social sector programmes
so that family welfare become people centered programme.
24. MAJOR STRATEGIC THEMES FOR THE NPP-2000
Strategic themes must be simultaneously pursued in “stand alone” or intersectoral
programmes in order to achieve the national socio-demographic goals for 2010.
Following strategic themes are presented in the policy:
1. Decentralized planning and programme implementation
2. Availability of services delivery at village levels
3. Empowering women for improved health and nutrition
4. Child survival and child health
5. Meeting the unmet needs for Family Welfare Services
25. 6. Greater emphasis for underserved population group
• Urban Slums
• Tribal communities, Hill Area populations and displaced and migrant
populations
• Adolescents
• Increased participation of men in planned parenthood
7. Diverse health care providers
8. Collaboration with the commitments from private agencies and NGOs
9. Involvement of Indian system of medicine in delivery of RCH services
10. Contraceptive technology and research in RCH
11. Providing health care and support for the older population
12. Information, Education and Communication .
26. LEGISLATION:
The 42nd Constitutional amendment: Lok Sabha and Rajya Sabha seats are
frozen on the basis of 1971 census were valid up to 2001 that is further extended
till 2026.
79th Amendment Bill of 1992 disqualify a person for being a member of either
house of legislature of a state, if he/she has more than 2 children.
PUBLIC SUPPORT: Strong support of political, community, business,
professional, religious leaders, media, film stars, sports personalities, and opinion
makers has been sought for small family norms.
FUNDING: National Population Policy expressed that the programme, projects and
schemes promised on the goals and objectives of the policy 2000 will be adequately
funded.
27. NEW STRUCTURES
The NPP-2000, is to be largely managed at the Panchayat and Nagar Palika levels,
in coordination with concerned State/ UTs.
For comprehensive and multi-sectoral coordination of planning and implementation
between health and family welfare on the one hand, along with schemes from
various other departments (like education, nutrition, and women and child
development,etc) the following structure has been proposed:
1. NATIONAL COMMISSION ON POPULATION;
2. STATE/ UT COMMISSIONS ON POPULATION;
3. COORDINATION CELL IN THE PLANNING COMMISSION;
4. TECHNOLOGY MISSION IN THE DEPARTMENT OF FAMILY WELFARE
28. PROMOTIONALAND MOTIVATIONAL MEASURES FOR ADOPTION
OF THE SMALL FAMILY NORM:
• Panchayats and Zila Parishads will be rewarded and honoured for exemplary
performance.
• Balilka Samridhi Yojana (Department of Women and Child Development)
provide cash incentive of Rs.500 at the birth of the girl child of birth order 1 or 2.
• Maternity Benefit Scheme (Department of Rural Development) provide cash
incentive to mothers who have their first child after 19 years of age, for birth of
the 1 and 2 child only.
• A Family Welfare linked Health Insurance plan will be established.
• Couples below the poverty line will be rewarded for their active involvement in
Family Planning activities.
• Village- level self help groups will be set up.
29. • Creches and child care centers will be opened in rural and urban slums.
• A wider and affordable choice of contraceptives will be made accessible.
• Facilities for safe abortion will be strengthened.
• Innovative social marketing schemes will be promoted.
• Ambulance services at the villages level will be strengthened.
• Increased vocational training schemes for girls, leading to self-employment
will be encouraged.
• Strict enforcement of the Child Marriage Restraint Act, 1976.
• Strict enforcement of the Pre-Natal Diagnostic Act, 1994.
• Soft loans to ensure mobility of the ANMs will be increased.
30. OPERATIONAL STRATEGIES
Village self help groups to organize and provide basic services for RCH care ,
combined with the on going ICDS scheme.
Implement at village levels, a one-stop integrated and coordinated service delivery
package for basic health care, family planning and MCH care.
Where ever these village self help groups have not developed, community
midwives, practitioners of ISM, retired school teachers may be organized to perform
similar functions.
At village level, the Anganwadi centre may become the pivot of basic health care
activities, contraceptive counseling and supply, nutrition education and
supplementation and pre school activities.
Establishment of a maternity hut in every village with equipments, supplies and
medicines for safe delivery.
31. Trained birth attendants and traditional dais should be made familiar with
emergency and referral procedures.
Provide wider basket of choices in contraception through innovative social
marketing schemes to reach household levels.
Improve district, sub-district and panchayat level health management.
Strengthen Community Health Centres (CHC) and Primary Health Centres to
provide comprehensive essential and emergency obstetric and neo-natal care.
Strengthening skills of health personnels through various training activities.
Focus attention on men to promote the small family norm.
Sensitize train and equip rural and urban health centres and hospitals towards
providing geriatric health care
32. STATE POPULATION POLICIES
Population Management falls in the concurrent list of activities envisaged
in the constitutional framework of India – but state responsibility to a large
extent.
Thus a new phenomena of policy formulation at state level has begun which
may reintensify the efforts of Union Government.
In 1997 - land mark in the history of population policy in India, the State
Government of Andhra Pradesh formulated a very well articulated Andhra
Pradesh Population Policy, well before the NPP-2000.
Followed in quick succession by several other states.
Till date 17 states and UTs have formulated their state population policies.
34. MAHARASHTRA POPULATION POLICY
The population of Maharashtra as per census
2011 is 11.23 crores, which forms 9% of the
total population of the country.
The population of Maharashtra doubled from
1901-1961.
Next double came from 1961-1991.
From 1991-2011 ,a decline , 22.73 to 15.99.
DECADE DECADAL PERCENTAGE
GROWTH OF POPULATION
MAHARASHTR
A
INDIA
1961-1971 27.45 24.80
1971-1981 24.54 25.00
1981-1991 25.73 23.85
1991-2001 22.73 21.54
35.
36. MAHARASHTRA POPULATION POLICY
OBJECTIVES OF THE POLICY:
1. To reduce Total Fertility Rate ( TFR) from 2.5 to 2.1 upto to 2004.
2. To reduce Infant Mortality & Maternal Mortality Significantly
3. To improve comprehensive health of family.
4. To provide special services to tribal area, small size villages ; and urban slum
areas
37. GOALS DECIDED FOR VARIOUS INDICATORS
INDICATOR PRESENT STATUS (1998
, SRS)
GOALS TO ACHIEVE
2004 2010
Crude birth rate 22.3 18 15
Crude death rate 7.6 6.4 5
Total fertility rate 2.5 2.1 1.8
Infant mortality
rate
49 25 15
Neonatal mortality
rate
35 20 10
38. PROPOSED ACTIVITIES AND INTERVENTIONS
1. Acceptance of small family norm Small family has been defined as one with “
two children”.
2. Compulsory acceptance of two child norm for individual benefits in government
jobs.
- For subsidies
- Condition for government jobs- Govt. facilities will be extended to such families
- Medical claims for these families only.
3. Performance of family welfare in their area to be part of officer‟s assessment at
various levels.
4. Improving accessibility of health services
- 2 yrs compulsory post-PG rural service
- Prompt implementation of service rules
- Infrastructure development for NSV
- “Matru Suraksha Wahini” for prompt referral in difficult areas
39. 5. Organization of FW camps with financial assistance from cooperative societies,
sugar factories & other industrial establishments.
6. Strict implementation of existing acts and policies such as child marriage act,
prenatal sex determination act, birth and death registration act.
7. Acceptance of small policy norm as a condition for qualifying for elections to
various bodies such as Zilla Parishad, Panchayat Samiti, Cooperative societies etc.
8. Jagruk Grampanchayat Yojana
9. Improving quality of services – incentives
10. Strengthening ante, intra, post-natal services
11. Strengthening services in urban areas
12. MCH centers at village level
40. 13. Constituting Mahila Vikas Groups under the chairmanship of Hon. CM‟s
wife at state level and Guardian minister‟s wife at district level.
14. Sudharit Savitribai Fule Kanya Kalyan Yojana
- For BPL families
- Sterilization on one daughter-
Rs. 10,000 + 5,000 FD
- Sterilization on two daughters-
Rs. 5,000 + 5,000 FD
42. TABLE : TARGETS UNDER VARIOUS PLANS
INDICATOR TENTH PLAN
GOALS
(2002-2007)
RCH-II GOALS
(2005-2010)
NPP-2000
GOALS
(BY 2010)
MILLENIUM
DEVELOPMENT
GOALS
Infant Mortality Rate <45/1000 <30/1000 <30/1000 -
Under Five Mortality - - - Reduce by 2/3
from 1990 levels
by 2015
Maternal Mortality
Ratio
200/100000 <100/100000 <100/100000 Reduce by ¾ from
1990 levels by
2015
Total Fertility Rate 2.3 2.1 2.1 -
Couple Protection
Rate
65% 65% 100% -
43. CONCLUSION
In the new millennium nations are judged by the well being of their people-
their level of health, education, nutrition, civil and political liberties,
provisions for vulnerable and disadvantaged.
In India, vast majority of the population would become assets, if they are
given means to lead a healthy and economically productive life.
Population stabilization is an inter-sectoral endeavour, and would be
successful only if the action plan contained in the NPP-2000 is pursued as a
national movement.
44. REFERENCES:
National Health Policy Document, New Delhi, 2000. Govt. of India. Ministry of Health and Family Welfare.
Eleventh Five Year Plan 2007-2012. Planning Commission,Govt. of India, New Delhi.
Agarwal S. Public Health and Community Medicine Related Policies in India. Textbook of Public Health and
Community Medicine, Dept of Community Medicine, AFMC, Pune in collaboration with WHO, India office, New
Delhi; 1st edition,2009.
Visaria P, Chari V. India‟s Population Policy and Family Planning Programme: Yesterday, Today and Tomorrow. Do
Population Policies Matter? Fertility and Politics in Egypt, India, Kenya and Mexico; The Population Council, 1998.
www.censusindia.gov.in/2011-common/CensusDataSummary.html
www.populationcommission.nic.in
Khadija T. A Population Policy Transition: Human Rights and Population Politics in India during Emergency and at
the present moment. Workshop “Population Politics and Reproductive Rights: State Intervention and Fertility
Control.”
Dr. Reddy MR. Integrating Population into Development: Emergence of State Population Policies in India.
NRHM, Health and Population Policies. www.mohfw.nic.in
www.maha-arogya.co.in/policies