SEMINAR

ON
NATIONAL POPULATION POLICY


Submitted to:
Dr. Navaneetha
Professor, Community Health Nursing
CON, PIMS

Submitted By :
T. Muthukumaran
1
st
Year M.Sc.(N)
CON, PIMS `

S.NO CONTENT PAGE NO
1.
Defining a policy and Population Policy


2.
Need for population policy in India


3.
Milestones in evolution of Population Policy of India


4.
Indias demographic achievements till NPP-2000


5.
Objectives of the NPP-2000


6.
National socio-demographic goals for 2010


7.
Major strategic themes in the NPP-2000


8.
Legislation, public support and funding.


9.
New structures for coordination of the activities


10.
Action plan or operational strategies.


11.
Promotional and motivational measures.


12. Conclusion



Introduction
After independence the first objective of Indian government was economic and social
development. In economic and social development government focus on to create the choices for
the people to enhance the well being of the population. In 1952 India was first country in the
world who launch the family planning program to decrease the birth rates in India. The time line
of various committees for national population policies are given below.
1. In 1946 Bhore Committee Report,
2. 1952 Launching of Family Planning Programme
3. 1976 Statement of National Population Policy
4. 1977 Policy Statement on Family Welfare Programme
5. 1983 The National Health Policy of 1983 emphasized the need for securing the small
family norm, through voluntary efforts and moving towards the goal of population
stabilization.
6. 1991 a long term holistic view of development, population growth and, environmental
protection
DEFINITION OF 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.

POLICIES RELATED TO HEALTH SECTOR
National Health Policy
Nutrition Policy
Population Policy

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)


WHY THERE IS A NEED FOR POPULATION POLICY IN INDIA?
NEED FOR POPULATION POLICY IN INDIA
On 11
th
May, 2000, India had 1 billion (100 crores) people, i.e., 16 percent of the worlds
population on 2.4 percent of the globes 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 .

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.

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.
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
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
1997 - On 50
th
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 19
th

November 1999.
BACKGROUND OF THE 1976 POPULATION POLICY
In 1976, with Indias 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 nations hardships, established how incentives would
be allocated to those who participate in population management efforts, and sought
to reduce the nations birth rate from 35 to 25 per 1000 by 1984.
The policy also acknowledged that the countrys population growth concerns could
not wait for increased development and education to result in fertility drop.
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).
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 nations 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.





DEMOGRAPHIC ACHIEVEMENTS OF INDIA BEFORE NPP-2000
Reduced Crude Birth Rate from 40.8 (1951) to 26.4 (1998)
Halved the Infant Mortality Rate from 146 per 1000 live births (1951) to 72 per 1000
live births (1998)
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)
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)

India's population in 1991 and projections to 2016 are as follows:
Population Projections for India (million)3
March 1991 March 2001 March 2011 March 2016
846.3 1012.4 1178.9 1263.5


NATIONAL POPULATION POLICY OF INDIA- 2000
OBJECTIVES OF THE NATIONAL POPULATION POLICY-2000
I MMEDI ATE OBJ ECTI VE :
1. to address the unmet needs for contraception,
2. health care infrastructure and health personnel and
3. to provide integrated service delivery for basic reproductive and child health care.

MEDI UM TERM OBJ ECTI VE:
1. to bring the TFR to replacement level by 2010 through vigorous implementation
of intersectoral operational strategies.

LONG TERM OBJ ECTI VE:
1. achieve a stable population by 2045 at a level consistent with requirement of
sustainable economic growth, social development and environmental protection.


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
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.

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
The 73rd and 74th Constitutional Amendments Act, 1992, made health, family
welfare, and education a responsibility of village panchayats. The panchayati raj
institutions are an important means of furthering decentralised planning and programme

implementation in the context of the NPP 2000. However, in order to realize their
potential, they need strengthening by further delegation of administrative 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 woman panchayat
member) should be formed to promote a gender sensitive, multi-sectoral agenda for
population stabilisation, 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-centred and integrated, basic
reproductive and child health care. 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.
2. Availability of services delivery at village levels
Efforts at population stabilisation 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 centres (each covering a population of 30,000), and 1.36 lakh subcentres (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 centres
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.
Since the management, funding, and implementation of health and education
programmes has been decentralised 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.

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.
3. Empowering women for improved health and nutrition
4. Child survival and child health
5. Meeting the unmet needs for Family Welfare Services
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 .

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.

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:

PROMOTIONAL AND MOTIVATIONAL MEASURES FOR ADOPTION OF THE
SMALL FAMILY NORM:
1. Panchayats and Zila Parishads will be rewarded and honoured for exemplary
performance.
2. 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.
3. 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.
4. A Family Welfare linked Health Insurance plan will be established.
5. Couples below the poverty line will be rewarded for their active involvement in Family
Planning activities.
6. A revolving fund will be set up for income generating activities by Village- level self
help groups.
7. Creches and child care centers will be opened in rural and urban slums.
8. A wider and affordable choice of contraceptives will be made accessible.
9. Facilities for safe abortion will be strengthened.
10. Innovative social marketing schemes will be promoted.
11. Ambulance services at the villages level will be strengthened.

12. Increased vocational training schemes for girls, leading to self-employment will be
encouraged.
13. Strict enforcement of the Child Marriage Restraint Act, 1976.
14. Strict enforcement of the Pre-Natal Diagnostic Act, 1994.
15. Soft loans to ensure mobility of the ANMs will be increased.

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,
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.
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





Family Planning Efforts
First five year plan
The first five year plan focus on family planning program. The draft of first five year plan said,
the increasing population on natural resources retards economic progress and limits seriously the
rate of extension of social services, so essential to civilized existence. It is very essential to plan
population policy. The main components of this plan were mortality, fertility and migration. For
the planning and research Rs. 15 lakh were earmarked. The objective of this plan were-
1. To get the factor which cause fast increase of population
2. To understand human fertility and methods to regulate it.
3. To plan effective methods to educate people.
4. To create family planning counseling in hospitals and health centers.
Second five year plan
This five year plan gave more emphasis on population assessment having four main components.
1. To educate the people for using contraceptive.
2. To provide sterilization facilities on rural and urban health centers.
3. Training of personal
4. Research
Third, fourth and fifth plan
These plans also focus on implementation of population policy through family planning
programs. The expenditure on population control also increased as the increase of time. In
second, third and fifth plan the expenditure was Rs. 2.16 carores, Rs. 284 carores and Rs. 497
carore respectively. The prominent features of these plans were voluntary adoption of small
family. People were convinced to take up small family norm. Now family planning renovate as a
family welfare. The government provided various facilities to control population on health
centers on free of cost. These facilities were sterilization, IUCD conventional contraceptive
(Nirodh). These facilities played significant role in controlling population. Government provided
financial incentives to the couples who accept family planning. The government employs get
increment in their salaries if they accept family planning. To implement effectively these
programs medical personnel and health workers were trained.
Sixth to ninth five year plan
Now the government gave more emphasis on overall development not only pupuplation control.
The priority was given to social restructuring. Small family norm was continued on voluntary
basis. Awareness was increase through effective communication strategies including multimedia

and inter personal communication. Facilities were provided at doorstep as possible. Population
education were given to all youth students and non students. Area specific approach was
followed for states like West Bengal, Uttar Pradesh, Bihar and Madhay Pradesh. Close
monitoring of these program were ensured with state government to enhance the machinery and
accountability of workers at field level.
Tenth five year plan
To control the trend of population growth the tenth five year plan (2002-2007) gives a
comprehensive outline of efforts in three areas. The first objective was meeting the unmet needs
for contraception. The second focus area was to reduce maternal and infant mortality and third to
enable families to get their reproductive goals.

Projection: Population in India
If the present trend will be continuing, in coming future our population will touch the sky.
Population control is necessary for the economic and social development of country. The
expected projection of population is given below.
1. March 1991 846.3 million
2. March 2001 1012.4 million
3. March 2011 1178.9 million
4. March 2016 1263.5 million

Issue and challenges
Socio economic status
The socio economic status of households plays a substantial role in the success of
programs. In our country illiteracy, poverty, poor access to information, gender disparity. In India
women do not have right to take decision on family planning and there is lack of involvement of
male person leads to poor results of family planning program.
Resources and inadequate knowledge and awareness
Most of the time people do not have access to services in lack of resources. Government
is not able to reach in remote areas and sometimes lack of efficient medical personnel is also a
very big challenge. Most of the time trained health personnel were not available and if available,
they do not have training to work efficiently to meet the demand of population. There was lack
of proper IEC support and proper management in rural and urban areas. The information given to
men and women about contraceptive was inadequate.

Access to quality health services
Both urban and rural area people face this problem. People of slum areas and remote village
people do not have access to services in lack of infrastructure, inefficient staff and adequate
knowledge. People do not have contraceptive choices for the family planning in the program. At
present this is a very big challenge for the government to provide quality health services to
people