b fogsi and population stabilization

7/27/2019 B FOGSI and Population Stabilization

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POPULATION DYNAMICSFOGSIs ROLE in

Population StabilizationDr. Mandakini Parihar


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Unmet need

Millions of women would prefer to avoidbecoming pregnant either right away or ever,but are not using any contraception

These women have an unmet need

31 million women with unmet need inIndia

Young people face serious health risks

too little factual information

inadequate guidance

restricted access to health care


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World scenario

The world population has crossed 6 billion markin the mid 2000 and is currently growing at arate of about 1.2 per cent annually (UnitedNation 2001)

India alone accounts for over one-fifth of thistotal increment

The population of the less developed countriesof today is projected to rise steadily from about5 billion in 2000 to over 8 billion by the year

2050


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Contraceptive prevalence is influenced by twofactors:

demand for fertility regulation

use of contraceptive to meet such demand

influenced by socio-economic and culturalfactors and a perceived costs and benefits of

having children couples would demand contraception, if low

fertility rates were considered beneficial.


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Trends in Use of Contraception

27

1

2

2

3

2

3

1

3

2

5

4

2

34

37FemaleSterilization

MaleSterilization

Pill

IUD

Condom

NFHS-1 NFHS-2 NFHS-3

NFHS 1 (1992-93) NFHS 2 (1998-99) NFHS 3 (2005-06)


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Population stabilization- adream?

One of the most proximate detriments of fertilityis effective use of contraceptives.

clear relationship between total fertility rate

and contraceptive prevalence rate.

As per NFHS-2, contraceptive prevalence rate for

modern methods of contraception is only 48.2percent


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Population stabilization- adream?

As per release of census 2001 data, there is very littledecline in TFR, since 1991 census results

It has been estimated to be 3.04 only marginallylower than census 1991 estimates of 3.07.

Two out of every five births in the year 2000 werebirths of third or higher order

For India to achieve the policy goal of TFR of 2.1 by2010 to achieve population stabilization, concertedprogrammatic interventions are required to improvecontraceptive prevalence amongst eligible couples


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The aim of family welfare is toimprove maternal and child

health by reducing the numberof children and spacing of thechildren and abortion should

not be used as a contraceptivetool


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Family planning helps everyone

protects from unwanted pregnancies

avoided 400 million unwanted pregnancies

the maternal deaths could fall by 1/4

13 to 15 million children under 5 die each year if children were born at least 2 years apart, 3 to

5 million of these deaths would be avoided

helps men and women care for their families

helps nations develop

demands on natural resources will be less


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Family Planning couldbring more benefits to morepeople at less cost than any

other single technology nowavailable to the humanrace.

UNICEF


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FOGSIs Role in PopulationStabilization


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Indian scenario

Indias future population dynamics would greatly depend onthe performance of the four large north Indian Hindispeaking states of Bihar, Madhya Pradesh, Rajasthan andUttar Pradesh

TFR remains over 4 children per woman as late as2000. typically characterized as high fertility poor health conditions of the population poor performance on almost every front of socio-

economic development.

Of all the factors, the levels of fertility in these states arekey determinant of the population growth in the country.


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Contraceptive UseIndian Scenario

There has been consistent improvement in the levels ofcontraceptive use in the country over time.

However, these changes have not necessarily brought along

corresponding decline in fertility levels for various reasons

The data from the NFHS I and II indicate that thecontraceptive prevalence rate for India was about 41 per cent

during 1992-3 that increased to slightly over 48 per cent bythe end of the last century, an increase of 7 per cent points in6 years which is not significant and is the main reason for ourmammoth population growth


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Reproductive Health in India

India is acknowledged to annually producemore babies than any other country

Low contraception prevalence rate ishindering national development

Birth spacing is lacking

More users of terminal methods


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Trends in unmet need

Most countries follow a similar demographictransition from high to low fertility .

Population passes through four stages

high fertility change in attitudes:

Contraceptive use begins

change in behavior:

contraceptive use rises

lower fertility


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Reasons for unmet need

difficulties in access and quality of familyplanning advise

health concerns about contraceptives and side

effects lack of information

opposition from husbands, families andcommunities

little perceived risk of pregnancy


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Who can make the difference?

Government - action limited by political compulsions

Media - can only report status or support credible,corrective actions but is negative today

Consumer groups lack complete information andsuspect all policies due to negative media reporting

Public helpless, seeking direction

Indian Medical profession has very wide, diverseresponsibilities and FOGSI is an obvious key playerin womens reproductive health issues


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Can FOGSI be the solution?

Includes all Indian state and city Ob/GynSocieties

Handles more pregnancies and child births thanany other body on Earth

23,000 members spread across 202 societies

FOGSI is the obvious option to worktowards addressing this unmet need by

reaching out to the general public


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FOGSIs environment

Single, final authority on womens reproductivehealth

Vast all-India organisation and operation

Specialized committees with commendableactivities

Annually, works with additional focused objectives

Can help to bring out change in the environment

effected by changing governments and policies,plus wide ignorance in media, consumer groups &public


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FOGSIAims & Objectives for improving

Family Planning services To create awareness about need of populationstabilization

Identify the people to spread the message

FOGSI members

Related Medical & Para Medical Personal

Family Physicians


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Addressing Unmet need

improving the quality of family planning servicesand making contraceptives easier to obtain

emphasize communication & proper counsellingabout side effects.

focus on men as well as women

collaborate with other services and worktowards Setting Up effective Public PrivatePartnerships with GOI and FOGSI


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Population stabilizationHOW?

It is very well known that women informed about side

effects at the time of contraceptive initiation, are

more likely to use contraceptives for longer duration

and thus reducing method discontinuation

significantly.


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The need for actionisdesperate,urgent&overdue


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Are we losing an opportunityand why?

Providers in contraceptive services are mainly thedoctorsand this group is demotivatedinproviding FP services due to-

1. court litigations against sterilisation failures2. poor service conditions in the camps3. no compensation/ recognition for the difficult andstrenuous efforts in conducting camps

4. Information on measures taken from the centre

forthe benefit of doctors yet to reach them-indemnityinsurance, empanelment of doctors,

compensation scheme


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Are we losing an opportunityand why?

Counselling is a crucial component in decision makingin Reproductive health and the most neglected

Poor counseling on contraceptives by providers further

compromise limited method choice. Findings from RCH HH survey indicates poor counseling

only one third of sterilization users

less than half of IUD users

fewer than are one fourth of pill userswere informed about side effects before accepting the

method


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Conclusion

Increasing contraceptive prevalence is oneof the crucial strategies for achieving the goalof population stabilization.

FOGSI is the solution for GOI to pave effectivePublic Private Partnerships and help in bridgingthe gap for contraceptive services

every opportunity should be utilized fully forpropagating the message of small family normand ensure service availability.


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Contraceptives should be usedat every conceivable occasion

Spike Milligan


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Thanks to all contributors.

Dr Adarsh Bhargava. Dr Ashwini Bhalerao.

Dr Alka Kriplani.

Dr. Kalpana Apte.

Dr Mala Arora.

Dr.Meenakshi Bharath.

Dr. Mandakini Parihar.

Dr.Nozer Sheriar.

Dr.Parikshit Tank.

Dr. Roza Olyai.

Dr.Sasikala Kola.

Dr Sujata Mishra

b fogsi and population stabilization

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