✯ Demography and Family Welfare
✯Definition
✯ Demography is the scientific study of human population.
It is consent with changes in size of population and distribution in space
Demography is the scientific study of human population, which includes the size, composition, etc. of the human population, in addition to the effect of environment and food on health, as well as the population and the space it gets and the skills to satisfy its needs.
To know the factors of population growth of any country, it is necessary to know the birth rate and death rate of that country.
In other developed countries like America, Sweden, United Kingdom etc., the birth rate and death rate are similar, while in India there is a difference between these two rates.
The ratio of birth rate and death rate is called growth rate, which shows how fast the population is growing.
If the growth rate is 0, then the population is not growing fast or not growing at all.
According to family norms, if there are one or two children, it can be said that the population is not increasing.
In 1901, the population was 238 million, in 1961 it doubled to 439 million and in the next 30 years, in 1991, it became 846 million. Due to such rapid population growth, it holds the first place among the countries of the world.
Factors affecting population
Composition
33% of the total population is children below 15 years of age, i.e. the proportion of child group is high, and the proportion of old age is also more than 5% of the total population and includes people above 65 years of age.
This proportion is much higher compared to other countries.
Sex ratio
Sex ratio means the number of females per 1000 adult males.
In India, its proportion was 934 females against 1000 males in 2005-2006, but in the state of Kerala, the proportion of females is more than the proportion of males. This is the only state which is in favor of females.
Dependency ratio
The proportion of people aged around 35 and the proportion of the age group below 15 years is high. This age group below 15 years is an economically dependent group which is really worth thinking about.
The number of children below 15 years in India is very high, while in other developed countries the number of children is less than other age groups.
Density population
Density means the rate at which the population increases in a country.
This is an important population indicator.
The birth rate is high in India while the death rate is low.
Its density depends on how many square kilometers the population is spread over.
Family size shows how many total members there are in a household, how many total children there are in it.
Compared to other countries, the family size of our country is large, this shows that the fertility rate is much higher, so the population rate is higher.
Family size is based on the child bearing age of the mother
This child bearing age is from 15 to 45 years
Total Fertility is based on this period.
Apart from this, family size is also based on many other factors, such as duration of marriage, education of people, total live birth, besides the desire of male child etc. factors play a role.
Currently, the rate of urbanization is very high in developing countries.
In 1901, the rate of urban population in India was 10.84%, which increased to 25.72% in 1991 and increased to 27.4% in 2005 and 2006.
Natural growth and migration play a major role in population growth.
Literacy and education play an effective role in population.
According to the 1991 census, it was determined that mostly children go to school at the age of 7.
People believe that only those who can read and write can be called literate, but in India not everyone can read and write, some can read, some cannot write, some cannot read properly.
For this reason, the literacy campaign was started in our country.
According to the 2001 census, the literacy rate was 65.38%, in which the literacy rate of males was 76 per 100 and the literacy rate of females was 54 per 100.
7.Life expectancy
The average life expectancy in India was 62 years in 2005-2006, in which males were 63 years and females were 66 years.
In most countries of the world, the average life expectancy of females is higher than males.
Concept of fertility and infertility
Fertility means the actual bearing of children, that is, how many children there are and the age at which children are born. The word Natality is often used instead of Fertility.
✯ Factors affecting on Fertility
Age for marriage:- If marriage is done at a young age, then the number of children is more.
Lack of education
Poor living standard
limited use of contraceptives
Traditional way of life
early age at marriage
➡️Causes of over population
If marriage is done at a young age, i.e. at the beginning of the reproductive age, the mother gives birth to more children.
It has been concluded that if marriage is done at the age of 17 to 18, the number of children is more, while if marriage is done at 22 or after that, the proportion of children for that woman is less.
In 1951, marriage was done at the age of 13 in our country. From 1978, according to the marriage restriction act, the age of marriage was fixed at 18 years for females and 21 years for males.
1.Early puberty
In India, the age of puberty for girls is 12 to 14 years.
At the beginning of married life, a woman gives birth to one child in the first five years, after which she gives birth to two to three children in the next period.
Fertility rate decreases in the last five years, which is why more importance is given to family planning in the first five years of married life.
2.Education
Fertility and educational level play an important role in the population.
According to the National Family Health Service, it has been concluded that only one to two children are seen in educated women.
3.Spacing of children
If a child is not born in one or two years of married life, then the fertility rate decreases.
4.Economical status
Economical development is the best contraceptive It has been concluded that to prevent further population growth, there should be a system of continuous working and economic viability.
This is an important factor to control population growth.
5.Cast and religion
The number of children varies according to caste and religion. For example, the fertility rate is higher in Muslim communities than Hindus.
6.Nutrition
There is a direct relationship between nutrition and fertility.
It has been concluded that the fertility rate is lower in people who get adequate nutrition, while the fertility rate is higher in those who get inadequate nutrition.
7.Family planning
Family planning is the most important and key means for reducing fertility.
8.Other factors
Physical, biological, social and cultural factors also play a role, such as the position of women in the community, the value of a child, in addition to widowhood, remarriage, custom and belief, industrialization, urbanization, housing facility, all these factors are responsible for population exploration.
Small family norms
This small issue of family size can make a big difference.
According to current trends, there should be only one child in a family. This belief is prevalent, which is why it has had a huge impact on population growth in the last decade.
Since the Family Planning Program was implemented in 1952, the objective of this program in India is to make people adopt small family norms so that the population of the country can be kept stable.
The head symbol of family planning indicates that “If the three corners of the triangle are equal, then there is no need for the fourth” meaning that there should be a husband, wife and one healthy child, so that all three can form a small family.
In 1970 AD, the norm was “two or three children only” while in 1980 the norm of two children only and one son and one daughter was released which was accepted by most people.
In India, in 1950, there were four to six children per couple.
It decreased and in 2001, the fertility rate came to three.
According to the national target rate, the goal was to reach one by 2006 and for this, a lot of advertisements were made about small family norms through mass communication, and intensive efforts were made to achieve the goal.
National Family Welfare Program
✯ Definition by WHO – 1971
“The family planning is a way of thinking and living that is voluntary upon the basic of knowledge, attitude and responsible decision by individual and couple in order of promote the health and family group and this contribute effectively the social development of a country.”
“The voluntary acceptance of one’s knowledge and behavior by individuals and couples in order to improve health by keeping the family in mind, lifestyle and thoughts, is responsible, which contributes effectively to the country and social development.”
The following activities were carried out at different times for family planning.
1912 – A public health worker named Margaret Sanger started the first movement for birth control in the USA.
1923 – The birth control movement became popular in England through Dr. Stopes.
1925 – Birth control programme started in Bombay.
1930 – First birth control clinic was started in Mysore.
1951 – The planning commission prepared a program for population group control.
1953 – The first birth control program in India was started by the national government in all India and 147 family planning clinics were started.
1956 – Central Family Planning Bureau was established.
1962 – Central Family Planning Institute was established.
1965 – Lips loop was introduced as a contraceptive and family planning was organized at the state level.
1966 – Family Planning Department was organized.
1969 – “Do or Teen Bachche” norms were implemented and intensive efforts were started in 1975 to reduce the birth rate through this formula.
1970 – Post partum unit was started in district hospitals which was an important part of MCH and family welfare.
1971 – Medical Termination of Pregnancy Act was implemented.
1976 – National population policy was prepared for the first time.
1986 – National population policy was revised.
1992 – CSSM programme was implemented.
1994 – RCH programme was implemented.
2000 – National population policy was made wider to promote family welfare programme.
Eligible couple
That is, women between the ages of 15 and 45 who live with their husbands and have adopted or not adopted the method of family planning are called eligible couples.
✯ Target couple
Target couple means a couple between the ages of 15 and 45 or married women between the ages of 15 and 45 who live with their husbands and have not adopted any method of family planning and we aim towards them.
✯ CPR (Couple Protection Rate)
A couple protected by the method of family planning is called couple protection rate or CPR.
✯ Crude death rate
That is, the ratio of the number of deaths due to different causes per 1000 population in a given population, area and time to the average population in the middle of the same year is called crude death rate.
✯ Importance of family planning or effects of the family planning
Family planning and health are directly related to each other. So its effects are as follows.
Effects on mother
The rate of morbidity and mortality in the mother is seen more during the period of pregnancy, which especially affects the nutritional status and therefore anemia is seen more.
Apart from this, complications of pregnancy such as abortion, purpural sepsis etc. are also seen.
Through family planning, unwanted child birth or unwanted pregnancy can be prevented and space can be kept due to which the health of the mother can be maintained.
Pregnancy before the age of 20 and after the age of 35 is risky.
Thus, the first effect of family planning is seen on the mother.
Effects on child
If pregnancy occurs after the age of 35, the rate of congenital deformity is higher but it can be prevented.
Any adult who is suffering from a certain disease such as mental illness, HIV positive, genetic disorder etc. can be prevented through the method of family planning.
Effects on family
Sufficient attention can be given to the growth and development of children.
Parents’ love and affection are available in sufficient quantity and mortality and morbidity can be reduced due to health promotion.
With birth spacing, sufficient attention can be given to children and nutritional needs can be fulfilled.
Effects on nation
Living standard can be improved.
Unemployment can be reduced.
Basic needs can be satisfied.
Population growth can be stopped.
Malnutrition in mother and child can be reduced.
fulfill need of family
provide love and affection to child Objectives of family planning
To control population growth.
To maintain the health of mother and child.
To promote health.
To control morbidity and mortality.
To improve national status
Improvement of living standard
To avoid unwanted birth
Child spacing
To maintain desired family size.
Family Welfare policy or population
1.To reduce the birth rate or growth rate, a policy was prepared in April 1976 in which the age of marriage was fixed at 15 to 18 years for girls and 18 to 21 years for boys.
2.In 1977, the policy was modified in which small family norms were added but there was no compulsion in it and in this year the title of family planning was changed to family welfare.
3.In 1983, the Parliament approved the national health policy.
In which N.N.R. (Net Reproductive Rate) was the demographic long term goal.
In which in the year 2002, the goal was to take N.N.R. to 1 but it was not possible.
The national population policy was finally prepared in the year 2000 in which (target free approach) was applied in family planning in which people were given the opportunity to take advantage of health services according to their wishes. In addition, the above policy covered the need for women education, health improvement, nutrition, child survival and health as well as family planning services.
In which, especially population groups such as urban communities, slum areas, tribal communities, healy areas, population migration as well as adolescent health and education along with participation of men in parenthood were added.
Objectives of national population policy (NPP)- 2000
To provide complete RCH services and infrastructure by 2010 as per NPP.
School education to be free and compulsory up to the age of 14 years, including,
7.Reduce the number of children dropping out of school among boys and girls
8.Reduce IMR
9.Reduce MMR
10.Achieve universal immunization of all children against vaccine through disease.
11.Encourage girls to get married late and to explain not to get married before the age of 18.
12.100% delivery should be done by trained person and 80% delivery should be done in institute.
13.Regulate the information, counseling and services provided for fertility and encourage couples to use contraceptives as per their choice.
14.100% registration of birth, death, marriage and pregnancy.
Dissemination of necessary information on AIDS and integration between RTI, STI and management of National AIDS Control Organization (NACO).
Prevent and control of CD
Integrated Indian system of medicine (ISM) in the provision of RCH services i.e. providing complete information about it to every household.
Achieve the goal of TFR (Total Fertility Rate) through small family norms.
Implement social sectoral programmes closely so that family welfare programme becomes people welfare programme.
Implementation and management of NPP 2000 has to be done at the Panchayat level, the Municipality level as well as in the states and under training to a large extent.
Nurse’s role in family Welfare programme
✯ The role of a nurse in the family programme is as follows,
Communication is a key factor in the family programme, a nurse can explain a specific idea and a meaningful way to a person but for this she should be fully informed.
She needs to explain different meanings, her approach should be according to the needs of each person and she should have the skill to give the right message so that she can ask questions about any fear that people have in their minds and remove their fear.
When she is presenting the message about family planning, there must be many beneficiaries and she should understand the level of understanding of the common man and say it accurately and in a way that is understood properly.
She is also a counselor and a friend who helps each beneficiary.
When she gets the chance, she should motivate the beneficiary mother to avoid repeated pregnancies and should explain the different contraceptive methods to the eligible couple so that their fears and doubts can be removed.
She will arrange for other beneficiary mothers to meet mothers who have adopted the method of permanent family planning to provide reliable information about family planning so that some doubts and fears about the operation are removed, the operated mother will inform other beneficiaries about her experiences.
She will explain LTL to the mother and NSU to her husband using proverbs in the local language.
She should provide complete information to the public so that rumors about family planning can be eliminated such as, that removing the uterus does not prevent pregnancy. At such a time, the nurse should explain to the beneficiary that it is more advisable to undergo the operation than hysterectomy and it is a minor operation, she can soon start doing housework and taking care of the children after the operation of this TL, which should be explained to the beneficiary properly.
The nurse should be very careful in explaining the above matter, correct words and simple language should be used.
She gets many opportunities to provide information about the family planning programme, such as during care, in the clinic, ANC clinic, immunization session, during home visit and during counseling etc. Thus, she gets wide opportunities to disseminate information about family planning and she makes an important contribution to this programme, her role is very important.
Responsibilities of CHN in family Welfare programme
Understanding
In this type of program, the nurse should understand that problems may arise at any time, first or later.
As a nurse, she should know how her feelings and behavior should be towards sex and family planning, that is, she should be able to understand the interpretation of each person.
1.Knowledge about family planning
population problem
Nature of family planning
method
Resources available in community
government policy
Knowledge about the person
A. Individual need and awareness
B. Culture, beliefs and attitude
C. Customs and practice
3.Communication and health education
A. Be a good listener
B. Indirect counseling needs to be an offer
C. Health education through various methods
She should involve the community leader in this program or work with him/her on family planning.
4.Clinic
A. assist to doctor in conducting clinic
B. Assist in IUCD insertion
C. Assist in postnatal clinic
5.Follow up
A.through Home visit
B. Through clinical visit
C. Maintaining careful record of Follow up finding of supplies device
6.Referral
Make Referral to various agencies as per need
7.Record
How people use their method for birth control.
She should also keep a record of the date from which family planning has been adopted and if there are any other problems.
8.Research
As mentioned above, a nurse has an important role in the population control programme, as well as an interesting job.
She has to work keeping in mind some factors like illiteracy, ignorance, people’s attitude, religious and social norms etc. and keeping in mind social norms etc.
This work is very difficult for a young and married nurse to handle, but by understanding everything, she can work very easily.
There are also side effects of family planning such as nausea or vomiting from oral pills and excessive or irregular menstruation in the beneficiary due to Coper-T, she should be aware of this.
The work of family planning is not limited to the message to eligible couples to give birth to fewer children, but also explains how much and how to keep a gap between two children.
Along with the family planning service, she should integrate MCH, nutrition, and development program in the daily service.
This is a challenging role in the approach of family and community, she should maintain coordination with the new contraceptive methods available as well as other factors.
Being a responsible citizen of this country, she should play her role sincerely keeping in mind the motto “we two ours two”.
✯ National Family Welfare Programme
The first family welfare programme was started in India in 1952.
India was the first country in the world to give special importance to the family welfare programme, although even before this, several birth control programmes were running in India since 1930.
Especially in the five-year plans, the family welfare programme was given great importance, because the fruits of the country’s social and economic progress cannot be achieved without stopping population growth.
Due to population growth, social or economic benefits cannot be achieved by the people.
The word family welfare is very broad, the basic idea of family welfare is related to the standard of living, although it also includes important things like education, nutrition, health, employment, women welfare and their rights, living area facilities, amount of safe drinking water, etc.
In 1977, the Government of India gave a new form to the family planning programme and called it the national family welfare programme and renamed the ministry of health and welfare as the ministry of health and family welfare.
The reason behind the Indian government encouraging family planning is that its aim was very high and broad to advance the welfare of the entire family and improve the life style of the people.
✯ Post partum programme
In 1960-70, All India Hospital Post Partum (AIHPPP) was started.
Which was a part of the Family Welfare Programme.
Under this programme, immediate care was provided after delivery or abortion.
Most of the women avoid early delivery so that more information, education and services on family planning should be provided to such women who are an important fertile group.
This programme was started with the feeling that no woman who goes through the pain and suffering of labour will choose to get pregnant again soon and that is why she will be ready to accept any method of family welfare soon so that she does not have to endure this pain.
Thus, post partum period is the best period to make family planning services effective.
Objectives
The main objective of this program is to provide maternity hospital services on a large scale to provide immediate family planning services.
Education and motivation should continue in the post partum period.
To improve the health of mother and child through MCH and family welfare program.
To provide intensive services to antenatal, postnatal and neonatal.
To provide immunization to mother and child.
To protect against blindness and anemia.
To provide complete information about the method of family planning to the mother when she comes for delivery.
Under this program, tubectomy operation should be done in 20% and vasectomy operation should be done in 10%, as well as to provide complete information about this to the mother.