Recognizing that the planning of families would enhance individual health and welfare, the Government of India was the first in the world to initiate a comprehensive Family Welfare during the First-Five Year Plan. The Cairo Conference on Population Development in 1994 called for a broad based approach to population stabilization and fulfilling the reproductive needs of people. The Child Survival and Safe Motherhood (CSSM) programme introduced in 1992, has brought about great improvements in the field of immunization.
1. Reproductive and Child Health Programme
It was launched on 15 October 1997; draw its mandate from the Programme of Action of the International Conference on Population and Development 1994.
Foreign assistance for the RCH programme will be worth more than US $ 1 billion during the Ninth Plan. The World Bank (IBRD) has sanctioned phase-II of the projects to begin after two and a half years. The European Commission has approved the project for US $ 250 million, UNICEF for US $ 121 million and UNFPA for US $ 100 million. Bilateral agencies like DANIDA, DFID, and KFW have also committed themselves to sizeable amounts. The estimated cost of the RCH Programme will be Rs. 5,112.53 crore during the Ninth Plan.
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Community Needs Assessment Approach
From April 1, 1996 the Family Welfare Programme is being implemented all over India on the basis of target free approach. This approach renamed Community Needs Assessment Approach, envisages replacement of the system of setting contraceptive targets from a system of decentralized participatory planning of the grassroots.
Pulse Polio Immunization
The Pulse Polio Immunization (PPI) was successfully implemented during 1998-99. A system of surveillance for cases of Acute Flaccid Paralysis has been set up for the detection and containment of poliomyelitis all over the country.
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2. Implementation Machinery
The Family Welfare Programme is implemented through the State Governments with full Central assistance. Establishment of sub-centres has been made a hundred per cent centrally sponsored scheme (except the salary of male health worker and construction of sub-centre building) since April 1981.
3. Maternal Health
India’s Maternal Mortality Rate is 437 per one lakh births. It is 50 times higher compared to the developed countries. To tackle this enormous problem, a number of interventions have been provisional for the current RCH programme such as: a) provision of emergency obstetric case through establishment of first referral units; (b) promotion of institutional delivery by providing round the clock delivery services in PHCs/CHCs etc.
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Medical Termination of Pregnancy
In order to prevent health hazards like maternal mortality and morbidity, to women, Medical Termination of Pregnancy Act, 1971 was promulgated. Under this Act, medical termination of pregnancy can be done in pregnant women up to 20 weeks, if pregnancy is likely to result in birth of a congenitally malformed child or continuation of pregnancy is likely to harm the mother in the existing circumstances and in cases of rape and contraceptive failures.
Any test to determine the sex of an unborn child by techniques like ultrasonography, amniocentesis, has become illegal since the pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse), Act, 1994 which came into effect in January 1996.
4. Research and Evaluation
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The Union Ministry of Health and Family Welfare has established a network of Population Research Centres (PRCs) scattered in 17 states for carrying out research on various topics of population control, demographic and socioeconomic surveys.
The National Health Policy (1983) envisages integration of ISM and H (Indian Systems of Medicine and Homeopathy) with the modern system of medicine.
Under the Reproductive Child Health (RCH) scheme, the ISM and H has been associated with the Department of Family Welfare. For providing training to ISM and H physicians in RCH, training institution, have been identified.
During the Ninth Plan period the Family Welfare Programme will be geared to meet the unmet demand for contraception with the twin objectives of reducing maternal morbidity and mortality and achieving rapid decline in birth rates.