FAMILY

WELFARE

INTRODUCTION
India launched the national family welfare
programme in 1951 with the objective of
"REDUCING THE BIRTH RATE TO THE EXTENT
NECESSARY TO STABILISE THE POPULATION AT A
LEVEL CONSISTENT WITH THE REQUIREMENT OF
THE NATIONAL ECONOMY".Tamil nadu is a
pioneer in the implementation of family welfare
programme.it is viewed and implemented as a
peoples programme involving the active cooperation of many sectors and the participation
of the community

AIMS
At early stage it was to REDUCE BIRTH BY FIXING
CONTRACEPTIVE TARGET
Now it has been changed to BRING DOWN
FERTILITY THROUGH IMPROVING MATERNAL AND
CHILD HEALTH CARE
Assessment of the community needs

DIRECTOR OF FAMILY WELFARE

INCHARGE of implementation of family welfare
programme in the states
assisted by TWO JOINT DIRECTORS
TWO DEPUTY DIRECTORS
ONE CHIEF ACCOUNT OFFICER &
ONE DEMOGRAPHER

V FIVE YEAR 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. The programme was included as a
priority sector programme during the v plan with
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.

CONTD
Government made it clear that there was no
place for force 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.

VI FIVE YEAR PLAN

In the VIplan (1980-85), certain long-term
demographic goals of reaching net
reproduction rate of unity were envisaged. the
implications of this were to achieve the following
by the year 2000 ad.
Reduction of average size of family from 4.4
children in 1975 to 2.3
children.
Reduction of birth rate to 21 from the level of 33
in 1978 and Death rate from 14 to 9 and Infant
mortality rate from 127 to below 60.
Increasing the couple protection level from 22%
to 60%.

VII FIVE YEAR PLAN

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. in order to provide facilities/services
nearer to the door steps of population, the
following steps/initiatives were taken during the
VII plan period.

CONTD
The achievements of the family welfare
programme at the end of the VII plan were
Reduction in crude birth rate from 41.7 (1951-61) to
30.2 (srs:1990).
Reduction in total fertility rate from 5.97 (1950-55)
to 3.8 (srs:1990).
Reduction in infant mortality rate from 146 (197071) to 80 (srs:1990).
Increase in couple protection rate from 10.4%
(1970-71) to 43.3% (31.3.1990).
Setting up of a large network of service delivery
infrastructure,
which was virtually non-existent at the inception of
the programme.

VIII FIVE YEAR PLAN

This seek to upgrade infrastructure and
development of trained manpower have been
continued during the 8th five year plan. Two new
area projects namely India population project
(IPP)-VIII and IX have been initiated during the
8th plan.

IX FIVE YEAR PLAN

(1997-2002)
Reduction in the population growth rate has been
recognised as one of the priority objectives during
the ninth plan period.

the objectives during the ninth plan are:

i)to meet all the felt-needs for contraception
ii)to reduce the infant and maternal morbidity and
mortality so that there is a reduction in the
desired level of fertility.

CONTD
The strategies during the ninth plan will be:
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.

INFRASTRUCTURE
FACILITIES
Primary health centers
1409
Health sub centers
8682
Rural family welfare centers
-382
Post partum centers
-118
Urban family welfare centers
-65
Urban health posts
-293
Voluntary organization

HEALTH SUB CENTERS

In rural area it is at the rate of one for every
50,000 population in plains
One for every 30,000 population in hilly areas
These centers are looked after byTrained health nurses
Health inspectors

PRIMARY HEALTH CENTERS

There is one center for every 30,000 population in
rural areas
Function
to provide family welfare , maternal & child
health services

RURAL FAMILY WELFARE

CENTERS
They provide family welfare services
Facilities for MTP & Vasectomy

POST PARTUM CENTERS

They cover 50,000 population in the urban area
FunctionsProvide an integrated package of maternal &
child health & family welfare services

URBAN FAMILY WELFARE

CENTERS
It is functioning in medium & smaller towns
It covers less than 50,000 population
3 types are theretype 1-covers population of 10,000 and less
type 2- covers 25,00 to 50,000 of population
type 3-covers 50,000 to 1 lakh of population

URBAN HEALTH POSTS

Provides services to slum areas

VOLUNTARY ORGANIZATION
They receive grant from government
They functions in towns except gandhigram
institute

PRIVATE APPROVED
SURGERIES
Headed by district collector in various districts
FacilitiesO.T
Qualified doctors
Trained staf
Instruments

COMMUNITY INVOLVED
PROJECTS
In order to foster community involvement in
the family welfare programme, two new
schemes have been started on pilot basis-

FIRST SCHEME
Under one of these, one revenue village in
every district, among villages with a
population of 500 or more, will be given an
award of RS.2 lakhs for achieving lowering
of the crude birth rate, infant mortality rate
and child mortality

SECOND SCHEME
The second scheme aims to integrate family
welfare and health care into the ongoing National
Watershed Development Project For Rain Fed
Areas (NWDPRA) of the ministry of agriculture.
Under this scheme, the watershed level
community based management structures,
known as the Mitra Krishak Mandal ( MKM) will
conduct surveys and prepare watershed level
family welfare and health care plans. An amount
of RS.5000/- will be given to each village in the
watershed, for specified activities.

UNIVERSAL IMMUNIZATION
PROGRAMME
Universal Immunisation Programme is
being conducted in the country for
vaccine preventable diseases.
Under this programme every year,
about 25 million infants are to be
vaccinated before they are one year
old with three doses of DPT vaccine
(diphtheria, pertussis and tetanus),
three doses of Polio vaccine and one
dose each of the Measles and BCG
vaccines.
About 27 million pregnant women
were also to be administered two
doses of Tetanus Toxoid (TT) .

PRE-NATAL DIAGNOSTIC
TECHNIQUES

The pre-natal diagnostic

techniques like amniocentesis
and sonography are useful for
the detection of genetic or
chromosomal disorders or
congenital malformations or sex
linked disorders, etc.
This technology is misused on
a large scale for sex
determination of the foetus and
mostly if the foetus is
pronounced as female,
This prompts termination of the
pregnancy and brings to an end
the unborn child. This has led
to decline in child sex ratio.
According to Census 2001
reports child sex ratio in the
age group 0-6 years has
declined from 945 in 1991 to
927 in 2001

CONTD
In order to check female foeticide, the Pre-natal
Diagnostic Techniques (Regulation and Prevention
of Misuse) Act, 1994, was enacted and brought
into operation from 1st January, 1996.
Rules have also been framed under the Act. The
Act prohibits determination and disclosure of the
sex of foetus .
It also prohibits any advertisements relating to
pre-natal determination of sex and prescribes
punishment for its contravention.
The person who contravenes the provisions of
this Act is punishable with imprisonment and fine.

MTP PROGRAMME
It is used to decrease maternal morbidity &
mortality
it is a health care measure
it can also supplement family planning as large
percentage of women undergo MTP are willing to
accept sterilization or any contraception methods

INFORMATION EDUCATION
AND COMMUNICATION
Family Planning communication received a new
impetus with the creation of the Mass Education
Media (MEM) division within the Department of
Family Welfare during the Inter Plan period of
1966-69. Simultaneously, the media units of
Information and Broadcasting Ministry were
strengthened for Family Planning communication.
The objective was to evolve a diferential
communication strategy. Simple messages with
simple pictures were selected for wider
dissemination and through media which were
easily visible and audible

TRAINING AND
DEVELOPMENT
The Village Health Guide Scheme was initially
started as Community Health Workers Scheme
on 2nd October, 1977 in all the States except
Arunachal Pradesh, J & K, Kerala and Tamil Nadu.
The Scheme was renamed as Village Health
Guide Scheme in 1981 when it was made 100%
centrally sponsored scheme under Family Welfare
Programme. According to the scheme the village
community selects a volunteer as Village Health
Guide who after training acts as a link between
the community and the governmental health
system.

HEALTH AND FAMILY

WELFARE TRAINING
CENTRES SCHEME
It have been established in the country with the
objective to improve the quality of services by
providing in-service orientation
training to the medical and para- medical
personnel engaged in the delivery of health and
family welfare services.

MOTIVATION
It depends on voluntary
acceptance by the people
co-operation and assistance
of all official,non official
agencies are also enlisted for
promoting the programme

RESEARCH & EVALUATION

It is contained in the field of demography &
communication action brought 16 demographic
and communication action research centers
situated in various states

FAMILY WELFARE METHODS

FOR POSTPONING OR
PREVENTING BIRTHS

CONTRACEPTION
Two methods of contraception are thereTemporary contraception
Permanent contraception

METHODS OF TEMPORARY
CONTRACEPTION
For Female
-hormonal
-intra uterine devices
-barrier methods
-chemical methods
-rhythm or natural method
For Male
-barrier method
-withdrawal or coitus interrupts
-abstenance

PERMANENT
CONTRACEPTION
For female
-Sterilization or tubectomy
For male
-Male sterilization or vasectomy

ROLE OF COMMUNITY
HEALTH NURSE

In general
Identify people who desire to
have children
Providing family planning
information
Planning , participating and
evaluating family welfare
services
Supervising and guiding other
female paramedical personnel
Initiating and contributing
towards research

IN THE CLINICS
Organise the physical set up
Assist MO in conducting clinics
Maintanence of register and
records
Teaching other concerned
personnel in the clinics
Evaluation
Referral services

HOME VISITS
It is to supervise the field staf
Classify couples in to high,medium or low parity
groups
Collect data of temporary and permanent used
MFP
Supervise efective follow up of users
Refer when necessary to doctor
Motivate the users

Identify the women in need and

refer them to hospital for
following factors
medical
eugenic
humanitarian
socio-economic
failure of contraceptive devices
maitainence of registers

SUMMERIZATION
Introduction
Aims
Director of family welfare
Infrastructure facilities
Community involved projects
Universal immunization programme
Pre-natal diagnostic tecniques
MTP programme
Information education & communication
Training and development

Research & evaluation

Contraception
Role of community health nurse in family welfare

BIBLIOGRAPHY
SWANKAR KUHAR ;COMMUNITY HEALTH
NURSING(2004);N R BROTHERS ; 2ND EDITION ;PG
58-64
PARK.K ; PREVENTIVE AND SOCIAL
MEDICINE(2005);18TH EDITION;PG 180-182
www.family welfare.ppt (1999-2003)