b fogsi and population stabilization
TRANSCRIPT
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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
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1
2
2
3
2
3
1
3
2
5
4
2
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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