In 1952, India launched the world first national program emphasizing family planning to the extent necessary for reducing birth rates "to stabilize the population at a level consistent with the requirement of national economy". Since then, the family planning program has evolved and the program is currently being repositioned to not only achieve population stabilization but also to promote reproductive health and reduce maternal, infant & child mortality and morbidity.

1. Family Planning in India
Background
In 1952, India launched the world first national program emphasizing family planning to the
extent necessary for reducing birth rates "to stabilize the population at a level consistent with the
requirement of national economy". Since then, the family planning program has evolved and the
program is currently being repositioned to not only achieve population stabilization but also to
promote reproductive health and reduce maternal, infant & child mortality and morbidity.
The objectives, strategies and activities of the Family Planning division are designed and
operated towards achieving the family welfare goals and objectives stated in various policy
documents (NPP: National Population Policy 2000, NHP: National Health Policy 2002, and
NHM: National Rural Health Mission) and to honour the commitments of the Government of
India (including ICPD: International Conference on Population and Development, MDG:
Millennium Development Goals and others).
Factors that influence population growth: Factors influencing population growth can be
grouped into following 3 categories-
Unmet need of Family Planning: This includes the currently married women, who wish to stop
child bearing or wait for next two or more years for the next child birth, but not using any
contraceptive method. Total unmet need of Family Planning is 21.3% (DLHS-III) in our country.
Age at Marriage and first childbirth: In India 22.1%of the girls get married below the age of
18 years and out of the total deliveries 5.6% are among teenagers i.e. 15-19 years. The situation
regarding age of girls at marriage is more alarming in few states like, Bihar (46.2%), Rajasthan
(41%), Jharkhand (36%), UP (33%), and MP (29.2%). Delaying the age at marriage and first
child birth could reduce the impact of Population Momentum on population growth.
Spacing between Births: Healthy spacing of 3 years improves the chances of survival of infants
and also helps in reducing the impact of population momentum on population growth. SRS 2013
data shows that In India, spacing between two childbirths is less than the recommended period of
3 years in 59.3% of births.
Some positives: Total Fertility Rate (TFR):
Total Fertility Rate (TFR) in the country has recorded a steady decline to the current levels of 2.3
(SRS 2013):
2005 2006 2007 2008 2009 2010 2011 2012 2013

2. 2005 2006 2007 2008 2009 2010 2011 2012 2013
2.9 2.8 2.7 2.6 2.6 2.5 2.4 2.4 2.3
Survey Data (NFHS & DLHS): Nationwide, the small family norm is widely accepted (the
wanted fertility rate for India as a whole is 1.9: NFHS-3) and the general awareness of
contraception is almost universal (98% among women and 98.6% among men: NFHS-3).
Both NFHS and DLHS surveys showed that contraceptive use is generally rising. Contraceptive
use among married women (aged 15-49 years) was 56.3% in NFHS-3 (an increase of 8.1
percentage points from NFHS-2) while corresponding increase between DLHS-2 & 3 is
relatively lesser (from52.5% to 54.0%).
Current family planning programme under public sector: The public sector provides the
following contraceptive methods at various levels of health system:
Spacing Methods Limiting Methods
IUCD 380 A and Cu IUCD 375 Female Sterilization:
Oral Contraceptive Pills Laparoscopic and
Condoms Minilap
Emergency Contraceptive Pills Male Sterilization (No Scalpel Vasectomy)
Above services are provided at various levels of public sector facilities; following table provides
details of the same:
Family Planning Method Service Provider Service Location
SPACING METHODS
IUCD 380 A, IUCD 375
Trained & certified ANMs, LHVs,
SNs and doctors
Sub centre & higher levels
Oral Contraceptive Pills
(OCPs)
Trained ASHAs, ANMs, LHVs, SNs
and doctors
Village level Sub centre &
higher levels
Condoms
Trained ASHAs, ANMs, LHVs, SNs
and doctors
Village level Sub centre &
higher levels
EMERGENCY CONTRACEPTION
Emergency Contraceptive
Pills (ECPs)
Trained ASHAs, ANMs, LHVs, SNs
and doctors
Village level Sub centre &
higher levels
LIMITING METHODS

3. Family Planning Method Service Provider Service Location
Minilap
Trained & certified MBBS doctors &
Specialist Doctors
PHC & higher levels
Laparoscopic Sterilization
Trained & certified MBBS doctors &
Specialist Doctors
Usually CHC & higher
levels
NSV: No Scalpel Vasectomy
Trained & certified MBBS doctors &
Specialist Doctors
PHC & higher levels
Note: Contraceptives like OCPs, Condoms are also provided through Social Marketing
Organizations.
Thrust areas under family planning programme: Emphasis on Spacing methods like IUCD
Revitalizing Postpartum Family Planning including PPIUCD in order to capitalise on the
opportunity provided by increased institutional deliveries. Appointment of counsellors at high
institutional delivery facilities is a key activity.
Strengthening community based distribution of contraceptives by involving ASHAs and
Focussed IEC/ BCC efforts for enhancing demand and creating awareness on family planning
Availability of Fixed Day Static Services at all facilities.
Emphasis on minilap tubectomy services because of its logistical simplicity and requirement of
only MBBS doctors and not post graduate gynaecologists/ surgeons.
A rational human resource development plan for IUCD, minilap and NSV be chalked up to
empower the facilities (DH, CHC, PHC, SHC) with at least one provider each for each of the
services and Sub Centres with ANMs trained in IUD insertion
Ensuring quality care in Family Planning services by establishing Quality Assurance Committees
at state and district levels Plan for accreditation of more private/ NGO facilities to increase the
provider base for family planning services under PPP.
Increasing male participation and promoting Non scalpel vasectomy
Demand generation activities in the form of display of posters, billboards and other audio and
video materials in the various facilities be planned and budgeted
Strong Political Will and Advocacy at the highest level, especially in states with high fertility
rates