NATIONAL FAMILY WELFARE PROGRAMME

INTRODUCTION
India launched the National Family Welfare Programme in 1951 with the objective of "reducing
the birth rate to the extent necessary to stabilize the population at a level consistent with the
requirement of the National economy. The Family Welfare Programme in India is recognized as
a priority area, and is being implemented as a 100% Centrally sponsored programme.

EVOLUTION OF FAMILY WELFARE PROGRAM

The approach under the programme during the First and Second Five Year Plans was mainly
"Clinical" under which facilities for provision of services were created. However, on the basis of
data brought out by the 1961 census, clinical approach adopted in the first two plans was
replaced by "Extension and Education Approach" which envisaged expansion of services
facilities along with spread of message of small family norm.

In the IV Plan (1969-74), high priority was accorded to the programme and it was proposed to
reduce birth rate from 35 per thousand to 32 per thousand by the end of plan. 16.5 million
couples, constituting about 16.5% of the couples in the reproductive age group, were protected
against conception by the end of IVth Plan.

The objective of the V plan (1974-79) was to bring down the birth rate to 30 per thousand by
the end of 1978-79 by increasing integration of family planning services with those of Health,
Maternal and Child Health (MCH) and Nutrition, so that the programme became more readily
acceptable. The years 1975-76 and 1976-77 recorded a phenomenal increase in performance of
sterilisation. However, in view of rigidity in enforcement of targets by field functionaries and an
element of coercion in the implementation of the programme in 1976-77 in some areas, the
programme received a set-back during 1977-78. As a result, the Government made it clear that
there was no place for force or coercion or compulsion or for pressure of any sort under the
programme and the programme had to be implemented as an integral part of "Family Welfare"
relying solely on mass education and motivation. The name of the programme also was
changed to Family Welfare from Family Planning.

In the VI Plan (1980-85), certain long-term demographic goals of reaching net reproduction
rate of unity were envisaged.
The Family Welfare Programme during VII five year plan (1985-90) was continued on a purely
voluntary basis with emphasis on promoting spacing methods, securing maximum community
participation and promoting maternal and child health care. The Universal Immunization
Programme (UIP) was launched in 1985 to provide universal coverage of infants and pregnant
women with immunization against identified vaccine preventable diseases and extended to all
the districts in the country

The approach adopted during the Seventh Five Year Plan was continued during 1990-92. For
effective community participation, Mahila Swasthya Sanghs(MSS) at village level was
constituted in 1990-91. MSS consists of 15 persons, 10 representing the varied social segments
in the community and five functionaries involved in women's welfare activities at village level
such as the Adult Education Instructor, Anganwari Worker, Primary School Teacher, Mahila
Mukhya Sevika and the Dai. Auxiliary Nurse Midwife(ANM) is the Member-Convenor. From the
year 1992-93, the UIP has been strengthened and expanded into the Child Survival and Safe
Motherhood (CSSM) Project. It involves sustaining the high immunization coverage level under
UIP, and augmenting activities under Oral Rehydration Therapy, prophylaxis for control of
blindness in children and control of acute respiratory infections. Under the Safe Motherhood
component, training of traditional birth attendants, provision of aseptic delivery kits and
strengthening of first referral units to deal with high risk and obstetric emergencies were being
taken up.

To impart new dynamism to the Family Welfare Programme, several new initiatives were
introduced and ongoing schemes were revamped in the Eighth Plan (1992-97). Realizing that
Government efforts alone in propagating and motivating the people for adaptation of small
family norm would not be sufficient, greater stress has been laid on the involvement of NGOs to
supplement and complement the Government efforts.

Reduction in the population growth rate has been recognized as one of the priority objectives
during the Ninth & Tenth Plan period. The strategies are:

i) To assess the needs for reproductive and child health at PHC level and undertake area-
specific micro planning.

ii) To provide need-based, demand-driven, high quality, integrated reproductive and child
health care reducing the infant and maternal morbidity and mortality resulting in a reduction in
the desired level of fertility.
CONTRACEPTIVES

The National Family Welfare Programme provides the following contraceptive services
for spacing births:

a) Condoms

b) Oral Contraceptive Pill

c) Intra Uterine Devices (IUD)

Whereas condoms and oral contraceptive pills are being provided through free distribution
scheme and social marketing scheme, IUD is being provided only under free distribution
scheme. Under Social Marketing Programme, contraceptives, both condoms and oral pills are
sold at subsidized rates. In addition, contraceptives are commercially sold by manufacturing
companies under their brand names also. Govt. of India does not provide any subsidy for the
commercial sale.

COPPER-T

Cu-T is one of the important spacing methods offered under the Family Welfare Programme.
Cu-T is supplied free of cost to all the States/UTs by Govt. of India for insertion at the PHCs,
Sub-centres and Hospitals by trained Medical Practitioners/trained Health Workers.

The earlier version of Cu-T 200 ‘B’ (IUDs) has been replaced by Cu-T 380-A from 2002-03
onwards which provides protection for a longer period(about 10 years) as against Cu-T 200 ‘B’
which provided protection for about 3 years only.

EMERGENCY CONTRACEPTIVE PILL (ECP) was introduced under Family Welfare

TERMINAL METHODS

Under National Family Welfare Programme following Terminal/ Permanent Methods are being
provided to the eligible couples.

A) TUBECTOMY
i) Mini Lap Tubectomy

ii) Lapro Tubectomy

Laparoscopic sterilization is a relatively quicker method of female sterilization.

B) VASECTOMY

i) Conventional Vasectomy

ii) No-Scalpel Vasectomy

It is one of the most effective contraceptive methods available for males. It is an improvement
on the conventional vasectomy with practically no side effects or complications. This new
method is now being offered to men who have completed their families. The No-Scalpel
Vasectomy project is being implemented in the country to help men adopt male sterilization
and thus promote male participation in the Family Welfare programme.