NATIONAL POPULATION POLICY-2000

FRAMEWORK

Defining a policy and Population Policy Need for population policy in India Milestones in evolution of Population Policy of India India’s demographic achievements till NPP-2000 Objectives of the NPP-2000 National socio-demographic goals for 2010 Major strategic themes in the NPP-2000 Legislation, public support and funding. New structures for coordination of the activities Action plan or operational strategies. Promotional and motivational measures. State population policies. Conclusion.

WHAT IS A POLICY?

Set of Ideas or Plans that is used as a basis for decision making; Attitude and actions of an organization regarding a particular issue; General Statement of understanding which guide decision making. It is more than mere statement of goals:

How the stated goals can be achieved? Who will carry out the tasks? In what manner?

BASIS FOR A POLICY Set of Values Commitments Assessment of current situation Image of a desired future situation

STAGES OF POLICY PROCESS

Problem Identification and Issue Recognition Policy Formulation Policy Implementation Policy Evaluation

POLICIES RELATED TO HEALTH SECTOR

National Health Policy Nutrition Policy Population Policy

WHAT IS POPULATION POLICY?

Measures formulated by a range of social institutions including Government which may influence the size, distribution or composition of human population (Driver,1972).

A deliberate effort by a national government to influence the demographic variables like fertility, mortality and migration (Organski & Organski,1961)

A set of Coordinated laws aimed at reaching some demographic goal (Biurgeois-Pichat,1974)

WHY THERE IS A NEED FOR POPULATION POLICY IN INDIA?

NEED FOR POPULATION POLICY IN INDIA

On 11th May, 2000, India had 1 billion (100 crores) people, i.e., 16 percent of the world’s population on 2.4 percent of the globe’s land area.

If current trends continue, India may overtake China by 2045, to become the most populous country in the world.

Global population : ↑ 3 folds during this century (from 2 to 6 billion)

Population of India : ↑ nearly 5 times (from 238 million to 1 billion), during the same period.

Stabilizing population is an essential requirement for promoting sustainable development with more equitable distribution .

TABLE: GROWTH OF POPULATION OF INDIA

FIGURE: GROWTH OF POPULATION OF INDIA

% Growth/10 years, India: Censes-2001

-5.00

0.00

5.00

10.00

15.00

20.00

25.00

30.00

1911 1921 1931 1941 1951 1961 1971 1981 1991 2001

C E N S U S Y E A R S

% G

row

th/1

0 yr

s

CAUSES OF HIGH POPULATION GROWTH

A large size of population in the reproductive age group (estimated contribution 58 percent).

Higher fertility due to unmet needs of contraception (estimated contribution 20 percent).

High desire for fertility due to high infant mortality rate (estimated contribution 20 percent) .

Approximately 50 percent of the girls marry below the age of 18 years, resulting in a typical reproductive pattern of “too early, too frequent, too many.”

Preference for male child.

More children are preferred by poor parents as more workforce.

MILESTONES IN THE DEVELOPMENT OF THE NATIONAL POPULATION POLICY

1940- The sub committee on Population , appointed by the National Planning

Committee, considered ‘ Family Planning and limitation of children’ essential

for the interest of social economy, family happiness and national planning.

1946- The Bhore Committee reported that control of disease and famine would

cause a serious problem of population growth.

1951- The Draft outline of the First Five Year Plan recognized ‘ population policy’

as an ‘essential to planning’ and ‘family planning’ as a ‘step towards

improvement in health of mothers and children’.

1952- Launching of the first National Family Planning Programme in India.

1976- Statement of National Population Policy, by Shri K. Singh, Minister

of Health and Family planning, to deter population growth and

events that contributed to it.

1977- A revised Population Policy Statement was tabled on Parliament. It

emphasized the voluntary nature of the family planning programme.

The term ‘Family Welfare’ replaced the term ‘Family Planning’.

1983- The National Health Policy emphasized “securing the small family

norm, through voluntary efforts and moving towards the goal of

population stabilization”

1991- The National Development Council (NDC) appointed a committee

with Shri K Karunakaran as the chairperson.

The Karunakaran report endorsed by the NDC , in 1993 proposed

the formulation of a National Population Policy to take: “a long term holistic view of development, population growth and

environmental protection”, “to suggest policies and guidelines” “ a monitoring mechanism with short, medium and long term goals”

1993 - An expert group headed by Dr. M.S. Swaminathan –asked to prepare draft

of a National Population Policy to be discussed.

1994 - Report on a ‘ National Population Policy’ by the expert group circulated

among members, and comments sought from the state and central

agencies

1997 - On 50th anniversary of Indian independence , Prime Minister, Gujral

promised to announce a National Population Policy in near future.

- During 11/97 Cabinet approved draft, directed to be placed before

the Parliament, but could not be placed as both the Houses stood

adjourned.

1999 - Another round of consultation in 1998, and another draft finalised

and placed before the Cabinet in March, 1999.

- Cabinet appointed a Group of Ministers (GOM) headed by Deputy

Chairman, Planning Commission, to examine the draft.

- The GOM then finalised a draft, placed before the Cabinet, discussed on

19th November 1999.

BACKGROUND OF THE 1976 POPULATION POLICY

In 1976, with India’s population growing rapidly, the Emergency extended for another year.

Minister of Health and Family Planning , Karan Singh, announced National Population Policy, to deter population growth.

The policy hoped to reduce the nation’s hardships, established how incentives would be allocated to those who participate in population management efforts, and sought to reduce the nation’s birth rate from 35 to 25 per 1000 by 1984.

The policy also acknowledged that the country’s population growth concerns could not wait for increased development and education to result in fertility drop.

The policy called for the Education Ministry to encourage and promote girls’ education.

The population policy stated that the central government did not wish to legislate compulsory sterilization

But if a state legislature felt prepared to pass a policy making sterilization compulsory, then it could do so.

The results of population policy 1976 , if measured by the number of sterilizations would be a success ( although there were false reporting).

From a rights based perspective, when effectiveness is measured by deaths, violence or rights compromised in an attempt to goals of the Population Policy, initiatives were unsuccessful.

Failure was reflected by the lack of sustainability and being counter-protective to improve the nation’s health.

For example, compensation for sterilization operations rose to 10 percent of the total health budget.

It concentrated resources at one place, more of the health professionals were being used to reach sterilization goals, rather than other services towards patient welfare.

DEMOGRAPHIC ACHIEVEMENTS OF INDIA BEFORE NPP-2000

Reduced Crude Birth Rate from 40.8 (1951) to 26.4 (1998,SRS);

Halved the Infant Mortality Rate from 146 per 1000 live births (1951) to 72 per 1000 live births (1998, SRS);

Quadrupled the Couple Protection Rate from 10.4 percent (1971) to 44 percent (1999);

Reduced Crude Death Rate from 25 (1951) to 9.0 (1998, SRS);

Added 25 years to life-expectancy from 37 years to 62 years;

Achieved nearly universal awareness of the need for and methods of family planning, and ;

Reduced Total Fertility Rate from 6.0 (1951) to 3.3 (1997, SRS)

OBSERVATIONS ON THE NATIONAL POPULATION POLICY OF INDIA- 2000

3 Objectives 4 New Structures 12 Strategic Themes 14 National Socio-demographic Goals (2010) 16 Promotional and Motivational Measures 150 Interventions

OBJECTIVES OF THE NATIONAL POPULATION POLICY-2000

IMMEDIATE OBJECTIVE : to address the unmet needs for contraception, health care infrastructure and health personnel and to provide integrated service delivery for basic reproductive and child

health care.

MEDIUM TERM OBJECTIVE: to bring the TFR to replacement level by 2010 through vigorous

implementation of intersectoral operational strategies.

LONG TERM OBJECTIVE: achieve a stable population by 2045 at a level consistent with

requirement of sustainable economic growth, social development and environmental protection.

NATIONAL SOCIO-DEMOGRAPHIC GOALS FOR 2010

1. Address the unmet needs for basic RCH services, supplies and infrastructure.

2. Make school education up to age 14 years free and compulsory, and reduce drop outs rate from primary and secondary school levels to below 20 percent for both boys and girls.

3. Reduce IMR to 30/1000 live births

4. Reduce maternal mortality ratio (MMR) to less than 100 per 1000 live births

5. Achieve universal immunization of children against all Vaccine Preventable

Disease (VPD).

6. Promote delayed marriage for girls, at age not less than 18,and preferable

after 20 years.

7. Achieve 80% institutional delivery and 100% by trained personnels

8. Achieve universal access to information/ counseling services for fertility regulation

and contraceptive with wide basket of choices

9. Achieve 100% registration of births, deaths, marriage, and pregnancy.

10. Containment of AIDS, and greater integration between the management of AIDS

and STD.

11. Prevention and control of communicable diseases.

12. Integration of Indian system of medicine in provision of RCH services, and in

reaching out to households.

13. Promote small family norm to achieve replacement level of Total Fertility Rate 2.1.

14. Bring about convergence in implementation of related social sector programmes so

that family welfare become people centered programme.

MAJOR STRATEGIC THEMES FOR THE NPP-2000

Strategic themes must be simultaneously pursued in “stand alone” or

intersectoral programmes in order to achieve the national socio-demographic

goals for 2010. Following strategic themes are presented in the policy:

1. Decentralized planning and programme implementation

2. Availability of services delivery at village levels

3. Empowering women for improved health and nutrition

4. Child survival and child health

5. Meeting the unmet needs for Family Welfare Services

6. Greater emphasis for underserved population group

• Urban Slums

• Tribal communities, Hill Area populations and displaced and migrant

populations

• Adolescents

• Increased participation of men in planned parenthood

7. Diverse health care providers

8. Collaboration with the commitments from private agencies and NGOs

9. Involvement of Indian system of medicine in delivery of RCH services

10. Contraceptive technology and research in RCH

11. Providing health care and support for the older population

12. Information, Education and Communication .

LEGISLATION:

The 42nd Constitutional amendment: Lok Sabha and Rajya Sabha seats are

frozen on the basis of 1971 census were valid up to 2001 that is further extended

till 2026.

79th Amendment Bill of 1992 disqualify a person for being a member of either

house of legislature of a state, if he/she has more than 2 children.

PUBLIC SUPPORT: Strong support of political, community, business,

professional, religious leaders, media, film stars, sports personalities, and opinion

makers has been sought for small family norms.

FUNDING: National Population Policy expressed that the programme, projects and

schemes promised on the goals and objectives of the policy 2000 will be adequately

funded.

NEW STRUCTURES

The NPP-2000, is to be largely managed at the Panchayat and Nagar Palika levels, in

coordination with concerned State/ UTs.

For comprehensive and multi-sectoral coordination of planning and implementation

between health and family welfare on the one hand, along with schemes from various

other departments (like education, nutrition, and women and child development,etc)

the following structure has been proposed:

1. NATIONAL COMMISSION ON POPULATION;

2. STATE/ UT COMMISSIONS ON POPULATION;

3. COORDINATION CELL IN THE PLANNING COMMISSION;

4. TECHNOLOGY MISSION IN THE DEPARTMENT OF FAMILY WELFARE

PROMOTIONAL AND MOTIVATIONAL MEASURES FOR ADOPTION OF THE SMALL FAMILY NORM:

• Panchayats and Zila Parishads will be rewarded and honoured for exemplary

performance.• Balilka Samridhi Yojana (Department of Women and Child Development)

provide cash incentive of Rs.500 at the birth of the girl child of birth order 1 or 2.

• Maternity Benefit Scheme (Department of Rural Development) provide cash

incentive to mothers who have their first child after 19 years of age, for birth of

the 1 and 2 child only.

• A Family Welfare linked Health Insurance plan will be established.

• Couples below the poverty line will be rewarded for their active involvement in

Family Planning activities.• Village- level self help groups will be set up.

• Creches and child care centers will be opened in rural and urban slums.

• A wider and affordable choice of contraceptives will be made accessible.

• Facilities for safe abortion will be strengthened.

• Innovative social marketing schemes will be promoted.

• Ambulance services at the villages level will be strengthened.

• Increased vocational training schemes for girls, leading to self-employment

will be encouraged.

• Strict enforcement of the Child Marriage Restraint Act, 1976.

• Strict enforcement of the Pre-Natal Diagnostic Act, 1994.

• Soft loans to ensure mobility of the ANMs will be increased.

OPERATIONAL STRATEGIES

Village self help groups to organize and provide basic services for RCH care , combined with the on going ICDS scheme.

Implement at village levels, a one-stop integrated and coordinated service delivery package for basic health care, family planning and MCH care.

Where ever these village self help groups have not developed, community midwives, practitioners of ISM, retired school teachers may be organized to perform similar functions.

At village level, the Anganwadi centre may become the pivot of basic health care activities, contraceptive counseling and supply, nutrition education and supplementation and pre school activities.

Establishment of a maternity hut in every village with equipments, supplies and medicines for safe delivery.

Trained birth attendants and traditional dais should be made familiar with emergency and referral procedures.

Provide wider basket of choices in contraception through innovative social marketing schemes to reach household levels.

Improve district, sub-district and panchayat level health management.

Strengthen Community Health Centres (CHC) and Primary Health Centres to provide comprehensive essential and emergency obstetric and neo-natal care.

Strengthening skills of health personnels through various training activities.

Focus attention on men to promote the small family norm.

Sensitize train and equip rural and urban health centres and hospitals towards providing geriatric health care

STATE POPULATION POLICIES

Population Management falls in the concurrent list of activities envisaged in the constitutional framework of India – but state responsibility to a large extent.

Thus a new phenomena of policy formulation at state level has begun which may reintensify the efforts of Union Government.

In 1997 - land mark in the history of population policy in India, the State Government of Andhra Pradesh formulated a very well articulated Andhra Pradesh Population Policy, well before the NPP-2000.

Followed in quick succession by several other states.

Till date 17 states and UTs have formulated their state population policies.

TABLE: CHRONOLOGY OF THE FORMULATION OF STATE POPULATION POLICIES

MAHARASHTRA POPULATION POLICY

The population of Maharashtra as per census 2011 is 11.23 crores, which forms 9% of the total population of the country.

The population of Maharashtra doubled from 1901-1961.

Next double came from 1961-1991. From 1991-2011 ,a decline , 22.73 to 15.99.DECADE DECADAL PERCENTAGE

GROWTH OF POPULATION

MAHARASHTRA

INDIA

1961-1971 27.45 24.80

1971-1981 24.54 25.00

1981-1991 25.73 23.85

1991-2001 22.73 21.54

MAHARASHTRA POPULATION POLICY

OBJECTIVES OF THE POLICY: 1. To reduce Total Fertility Rate ( TFR) from 2.5 to 2.1 upto to 2004.

2. To reduce Infant Mortality & Maternal Mortality Significantly

3. To improve comprehensive health of family.

4. To provide special services to tribal area, small size villages ; and urban slum areas

GOALS DECIDED FOR VARIOUS INDICATORS

INDICATOR PRESENT STATUS (1998 , SRS)

GOALS TO ACHIEVE

2004 2010

Crude birth rate 22.3 18 15

Crude death rate

7.6 6.4 5

Total fertility rate

2.5 2.1 1.8

Infant mortality rate

49 25 15

Neonatal mortality rate

35 20 10

PROPOSED ACTIVITIES AND INTERVENTIONS

1. Acceptance of small family norm Small family has been defined as one with “ two children”.

2. Compulsory acceptance of two child norm for individual benefits in government jobs.

- For subsidies

- Condition for government jobs- Govt. facilities will be extended to such families

- Medical claims for these families only.

3. Performance of family welfare in their area to be part of officer’s assessment at various levels.

4. Improving accessibility of health services

- 2 yrs compulsory post-PG rural service

- Prompt implementation of service rules

- Infrastructure development for NSV

- “Matru Suraksha Wahini” for prompt referral in difficult areas

5. Organization of FW camps with financial assistance from cooperative societies, sugar factories & other industrial establishments.

6. Strict implementation of existing acts and policies such as child marriage act, prenatal sex determination act, birth and death registration act.

7. Acceptance of small policy norm as a condition for qualifying for elections to various bodies such as Zilla Parishad, Panchayat Samiti, Cooperative societies etc.

8. Jagruk Grampanchayat Yojana

9. Improving quality of services – incentives

10. Strengthening ante, intra, post-natal services

11. Strengthening services in urban areas

12. MCH centers at village level

13. Constituting Mahila Vikas Groups under the chairmanship of Hon. CM’s wife at state level and Guardian minister’s wife at district level.

14. Sudharit Savitribai Fule Kanya Kalyan Yojana- For BPL families- Sterilization on one daughter-

Rs. 10,000 + 5,000 FD- Sterilization on two daughters-

Rs. 5,000 + 5,000 FD

TABLE: 1. TARGETS SET BY NPP-2000 AND CURRENT SCENARIO

TABLE : TARGETS UNDER VARIOUS PLANS

INDICATOR TENTH PLAN GOALS (2002-2007)

RCH-II GOALS (2005-2010)

NPP-2000 GOALS(BY 2010)

MILLENIUM DEVELOPMENT GOALS

Infant Mortality Rate

<45/1000 <30/1000 <30/1000 -

Under Five Mortality

- - - Reduce by 2/3 from 1990 levels by 2015

Maternal Mortality Ratio

200/100000 <100/100000 <100/100000 Reduce by ¾ from 1990 levels by 2015

Total Fertility Rate 2.3 2.1 2.1 -

Couple Protection Rate

65% 65% 100% -

CONCLUSION

In the new millennium nations are judged by the well being of their people- their level of health, education, nutrition, civil and political liberties, provisions for vulnerable and disadvantaged.

In India, vast majority of the population would become assets, if they are given means to lead a healthy and economically productive life.

Population stabilization is an inter-sectoral endeavour, and would be successful only if the action plan contained in the NPP-2000 is pursued as a national movement.

REFERENCES:

  National Health Policy Document, New Delhi, 2000. Govt. of India. Ministry of Health and Family Welfare.

Eleventh Five Year Plan 2007-2012. Planning Commission,Govt. of India, New Delhi.

Agarwal S. Public Health and Community Medicine Related Policies in India. Textbook of Public Health and Community Medicine, Dept of Community Medicine, AFMC, Pune in collaboration with WHO, India office, New Delhi; 1st edition,2009.

Visaria P, Chari V. India’s Population Policy and Family Planning Programme: Yesterday, Today and Tomorrow. Do Population Policies Matter? Fertility and Politics in Egypt, India, Kenya and Mexico; The Population Council, 1998.

www.censusindia.gov.in/2011-common/CensusDataSummary.html

www.populationcommission.nic.in

Khadija T. A Population Policy Transition: Human Rights and Population Politics in India during Emergency and at the present moment. Workshop “Population Politics and Reproductive Rights: State Intervention and Fertility Control.”

Dr. Reddy MR. Integrating Population into Development: Emergence of State Population Policies in India.

NRHM, Health and Population Policies. www.mohfw.nic.in

www.maha-arogya.co.in/policies