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Focus 1988 July - September |
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Bulletin of Family Planning Foundation, Volume II, NO.3 July-September, 1988
National Seminar to Discuss Report of Project
on Infant Mortality in Relation to Fertility
The Family Planning Foundation
has organised a national level
seminar on July 1 and 2, 1988 at
NewDelhi. Mr. J .. R. D. Tata,
Chairman, Family Planning Founda-
tion will inaugurate the seminar
which will discuss the findings of
the recently completed Project on
Infant Mortality in Relation to
Fertility,
Eminent experts in demography,
social sciences and health plann-
ing, both from the government and
private bodies have been invited to
participate in the seminar. Re-
presentatives of international
organisations actively engaged in
child survival and population pro-
grammes like the Ford Foundation,
UNICEF, World Bank, USAID etc.
are participating.
A collaborative venture between
International Development Re-
search Centre, Canada (IDRC) and
Family Planning Foundation (FPF),
the all-important project was ini-
tiated one-and-a-half years ago
with the approval of the Central
and five concerned State govern-
ments, viz., U.P., M.P., Orissa,
Karnataka and Maharashtra.
Its main purpose was to identify
risk factors responsible for high
infant mortality, examine their
relationship with fertility and
suggest interventions to bring down
both infant mortality and fertility.
When parents become more
confident that their children will
survive they tend to have smaller
families. That is one reason why
there has never been a steep and
sustained fall in child births which
has not been preceded by a steep
and sustained fall in child deaths.
- UNICEF's Report Oil State of
the World's Children 1988.
Large coverage and Sampling
The project, probably the first of
its kind, covered three 'hilly and
five rural districts of U.P., 10 rural
and tribal districts of M.P., five
tribal districts of Orissa, five dis-
tricts (with interlocked sample of
rural and urban areas) of Karnataka
and 10 slums of Bombay. These
were selected on the basis of
predominance of those characteris-
tics. In all, data was collected from
about 800 rural and urban units,
2,500 grass-root health workers,
1,10,000 households and 25,000
mothers who have borne children
in the last two years.
Highlights of Project-report
The following are the main find-
ings of the Project-report:
1. Among currently married
women, the percentage of those
who were mPrried before the legal
age of 18 years was as high as 90
in M.P., 87 in hilly and 73 in rural
areas of U.P., 52" in Orissa, 86 in
rural and 64 in urban areas of
Karnataka and 77 in slums of
Bombay. The percentage of those
who conceived before this legal
age of 18, was also as high as 59
in M.P., 38 in hilly and 26 in rural
areas of U.P., 28 in Orissa, 48 in
rural and 33 in urban areas of
Karnataka and 47 in Bombay slums.
2. When children were born to
mothers too early, too close, too
many and too I<.>teth, e chances of
their survival decreased by 30 to
60 percent, which further' de-
creased with the previous history
of pregnancy complications, losses
and infant deaths.
3. Out of the women giving live
births in 1986-87, about 5-10
per cent became pregnant within
two years in whose case the infant
(Continued on page 8)
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Growing Population Destroying Environment
and Resources
The 1'988 State of World Popu-
lation report released recently by
Dr. Nafis Sadik, Executive Director
of the United Nations Population
Fund (UNFPA), presents a grim
scenario vis-a-vis burgeoning
human population and its delete-
rious effects on environment and
resources that sustain life on our
planet,
With the world's population now
over 5 billion and expected to reach
6 billion by 2000 A.D., the report
says, human race adds every year
a nation the size of Mexico to its
population - about 80 million
people, and nearly all this growth
is in the developing countries of
Africa, Asia and Latin America
which are least capable of absorb-
ing it.
"Scissors Effect"
In the poorest areas, the "scissors
effect" of poverty a,nd increasing
popule,tion is slicing away at their
ability to sustain human life.
Even though the majority of
developing countries are now try-
ing to limit population growth,
their needs are increasing and their
attempts to find new land and
increase food production are des-
troying the environment at a rapid
rate, the report adds.
Forests shrink,
Deserts Expand
TfOpical forests are shrinking at
a rate of 11 million hectares (27
million acres) a year. Topsoil is
being lost at the rate of 26 billion
tons a year. New deserts are
being created at the rate of 6
million hectares (13 million acres)
a year and about half the world's
irrigated land is in danger, warns
the report.
Tens of millions of people have
migrated to cities, partly as a result
of this "environmental stress", but
the cities themselves have become
major sources of environmenta I
damage.
2000 A.D, Scenario
World Population 6 billion
Half of the world living in
urban areas.
75 per cent of Latin America,
37 percent of Asia, 42 per cent
of Africa urbanised.
600 million live in 'mega-cities'
of four million or more.
Cities Become 'unlivable'.
tion and transport system struggle
to keep pace with the millions of
new arrivals each year.
Women as Resource Managers
The report highlights the impor-
tance of women both to slower
_, population growth and to rescuing
the environment. Ii, addition to
child rearing, providing health care
for the family, running 1he house-
hold, cooking and earning cash
incomes, women in the develop-
ing·world have another role: that of
resource manager.
Cities at Bursting Point
By the end of the century, half
the world will be living in urban
areas and one fifth of the urban
population will live in "mega-
cities" of four million or more.
Dr. NBtis Sadik while launching
the report, observed, "all countries
must face the fact that the combina-
tion of population and industrial
growth could destroy the land,
water and air on which every-
thing else depends."
The number of city dwellers has
almost tripled since 1950. If cities
continue to grow at the current
rate, then urban environment would
become "unlivable" by the turn
of the century when 75 per cent
of Latin America's, 37 per cent of
Asia's and 42 per cent of Africa's
population will be urbanised.
The report iunderlines that many
third world cities are now under
severe pressure as housing, sanita-
Safeguarding the Future
She expressed the hope that
joint actjon by governments, indi-
viduals and international organisa-
tions to curb population growth
and encourage conservation and
economic development will safe-
guard the future of our planet.
But she also warned that "popula-
tion and resources could become
more seriously out of balance un-
less we do something about it
today."
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New Initiatives to Rejuvenate Family Planning Progr,amme
A whole series of new measures are in the offing to revamp and re-
juvenate the Family Planning programme which seems to have stopped
in its tracks insofar as the lowering of birth rate is concerned.
Not only the birth rate, the whole question of programme manage-
high on the government agenda.
Mr. Gandhi said, for the first time
a major thrust was being made or.
education of women and girls
ment and the sharing of responsibilities between the national govern- particularly of the weaker sections
ment, which 'provides cent per cent funds, and the States, on whom
lies the responsibility of implementation has come to the fore.
under the newly launched literacy
mission. This would have an
Critical Appraisal
The initiatives come from none
other than the Prime Minister,
Mr. Rajiv Gandhi himself, who
gramme would not be the same as
those of the past since it had been
realised that input costs were going
up almost exponentially while the.
effect on the population growth
as two factors influenced it signi-
ficantly - education and economic
upliftment.
while addressing the full meeting
of the Planning Commission on
April 8th, 1988 named family
planning as a strategic area de-
birth rate was, at best, stagnant.
Earlier, Mr. J. R. D. Tata, a
crusader for the Family Planning
The Government had also asked
the Planning Commission to look
afresh at the incentives for popula-
manding a very critical appraisal
and resolution of the enigma of
increasing couple protection rate,
and a birth rate virtually stalled
sincc 1977. He has asked the
experts to examine why no dent
has been made into the overall
fertility rate despite such large
spendings in each successive Plan
and aIso to find out the relevance
of factors such as age at marriage,
female literacy in reducing birth
rate, which continues to be dis-
turbingly high in some northern
States, viz.,. U.P., Rajasthan,
Madhya Pradesh, Bihar. This
critical appraisal will help in the
formulation of the 8th Five Year
Plan (1990-95).
No Shirking from
Tough Measures
Soon after the Prime Minister's
directive to the Planning Commi-
ORGANISED SECTOR CONCERN OVER GROWING POPULATION:
At the national convention of ASSOCHAM, the Prime Minister announced that the
population issue was high on the govt. agenda in response to Mr. J.R.D. Tata's
call to treat lowering of high population growth rate 8S a major national objective.
ssion to prepare a policy paper on movement, had in his speech re- tion growth offered by the States
family planning came his announce- ferred to the growing population since the curr~t incentives worked
ment (May 16) at the national as one of the major contributory 'more as disincentives. Mr. Gandhi
convention organised by the Asso- factors to the current ills of the said States with larger popu lation
ciated Chambers of Commerce and economy and emphasised that the were entitled to more resources and
Industry (ASSOCHAM) that the rate of population growth should this was basically wrong. The
government was changing its stra- be treated as "a major natio"al Planning Commission had been
tegies on population control pro- objective" and the Centre should told to look into this and come out
grammes.
unequivocally declare this as offi- with answers. "None of them are
The Prime Minister said that a cial policy. Responding to these going to be very simple or easy but
new attack on the problem was suggestions, Mr. Gandhi reassured these are areas where tough mea-
required and that the new pro- him that the population issue was sures are required and we will not
(Continued on page 8)
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Indepth Investigation of Birth Rate Stagnation
F.P.F. Study Suggests Reasons and Remedies
A study commissioned by the
Family Planning Foundation, New
Delhi and conducted by the
Gokhale Institute of Politics and
Economics, p'une, has raised doubts
about the official target-achieve-
ment figures of sterilisation and
spacing techniques of birth control.
The report of the study group,
headed by Dr. K. Sivaswamy
Srikantan was discussed at a
round-table meeting chaired by
Mr. P. Padmanabha, in Bangalore
recently where it receiv€'d generaI
acceptance by members of the
Foundation and experts. Since the
recommendations of the report had
relevance to policy issues and
administrative aspects, these too
were discussed in detail at this
expert group meeting.
The Sixth Five Year Plan (1980-
85) had set a goal <:>rf~aching a net
reproduction rate of one by 1996
for the country as a whole, and by
2001 in all Sates. The Seventh
Five Year Plan (1985-90) en-
dorsed these goals with some
minor changes.
To reach these goals, it was
estimated that 60 per cent of the
couples in the reproductive ages
of 15-44 should be protected by
various methods by 2001. This
was expected to bring down the
birth rate from 34 to 21.
CPR Increases,
Birth Rate Stagnates
Fertility declined significantly
between the late 1960s and the
early 1970s. However, since 1976,
the decline in fertility has slowed
down. In fact, the declining trend
in the birth rate has seemingly
halted; it has been stagnant at
aboat 33-34 from about the early
1980s.
This stalling in the birth rate is the data on which the claims of
a matter of conCEirn,particularly in achievements were often based,
the face of a reported steady in- was not so reliable. Several inde-
crease in the couple protection rate pendent studies on the I.U.D. pro-
(CPR), which according to official grammes carried out in different
figures, increased from 11 per cent parts of the country fail€'d to get a
in 1970-71 to 32 per cent in 1984- response from 50 per cent of the
85. In the more recent interval of acceptors, Dr. Srikantan points
1979-80 to 1984-85, the CPR has out in the report. This was mainly
increased from 22 per cent to 32, because there was no trace of the
per cent, in just five years.
acceptors. This threw up the
Why then had the birth rate nct possibility of bogus entries in the
gone down further? An answer clinic registers.
to this was sought through the
"With a target-oriented and time-
in-depth study by the Gokhale bound programme, Family Planning
Institute.
Programme workers are forced to
Some Relevant Factors
bring in a certain number of cases
every month. This leads to some
One of the reasons for the birth fudging of the programme statis-
rate being constant after 1977 tics. Offering of incentives has
could be the larger proportion of further increased the possibility of
women in the child-bearing ages fudging," the report underlines.
which increased from 22.2 per cent
in 1971 to 23.1 per cent in 1984';'" 'Faulty Methodology
the study notes.
The report suggests that th,e
Another reason was the not-so- methodQ%gy adopted by the
encouraging trend in the CPR. authorities for estimation of the
Between 1970-71 and 1976-77, couple protection rate is also faulty.
the CPR based on service statistics, The assumptions on various para-
increased from 10.6 per cent to , meters that went into the estima-
23.7 per cent while it did not- tion would need a re-examina-
increase at all but remained steady tion.
around 23 per cen between 1976-
There is an empirical relationship
77 and 1980-81.
between contraceptive prevalence
Other relevant factors to be taken
into account, include: marriage
pattern, prevalence of iRduced
abortion, post-partum infecundi-
bility, etc. While the relaxation of
traditional checks on fertility also
slow down the fall in birth rate,
improvements in medical care and
and fertility. It has been estimated
that for every 2.2 points increase
in contraceptive prevalence rate,
the birth rate. would fall by one
point. In the absence of Contra-
ceptive Prevalence Surveys, the
Couple Protection Rate is utilised
as a measure.
hospital facilities tend to reduce
However, it is essential to obtain
mortality at all levels. All these data on contraceptive continuation
factors in combination would tend rates. The CPR is not equivalent to
to keep the birth rate steady.
the prevalence rate. As such the
Fudging of Figures
method specific assumptions now
The study group also found that
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UPoor, Powerless and Pregnant""
New Study Ranks Status of Women in 99 Countries
Women in Sweden enjoy the
highest status and greats·st equality
with men, followed by Finland and
the United States. Women in
Bangladesh 'face the greatest dis-
crimination and have the lowest
status, according to "Poor, Power-
less c.nd Pregnant", a major new
study ranking the status of women
in 99 countries representing more
than 92 per cent of the world's
women, undertaken by the Popula-
tion Crisis Committee, Washington.
Countries are given following
ranking: excellent, very good, good,
fair, poor, very poor, and extremely
poor. India receives a rating of
43.5 against the top score 87 of
Sweden, grading it in the "very
poor" category. Other countries
receiving lower scores are Mali,
AfghanIstan,
North
Yemen,
Pakistan, Nigeria, and Saudi Arabia.
More than sixty percent of the
world's women live In countries
where widespread poverty and
sexual discrimination have created
conditions of deprivation far be-
yond the experience of most
women in industrialized countries.
"The world's poorest women live
on the edge of subsistence", says
Dr. Sharon L. Camp, editor of the
study and Vice President of the
Population Crisis Committee. "They
are politically and legally power-
less. They are caught in a life
cycle that begins with early
marriage and pregnancy and too
often ends with death in child-
birth. "
The study dramatizes major
patterns negatively affecting the
status of women. One is early
childbearing. Early and frequent
childbearing closes off opportuni-
ties for women in education and
paid employment.
"One of the most pressing needs
for half the world's women is
achieving real choices over child-
bearing," says Dr. Camp. "This
means assuring universal access to
safe and effective birth control."
Although women's struggle for
equal status takes different forms
in different countries, there are
some basic measures that govern-
ments could take to improve
women's lives, the study pin-
points. These are:
.
* Reforms to give women more
equal access to better paying
jobs, equal rights to own pro-
perty, and access to credit.
* Greater investments in the re-
productive health needs of
women, to make childbirth safer,
to coxtendfamily planning services
and increase contraceptive
choices.
* Expansion of education and
training for· women, especially
at the secondary and vocational
level and greater efforts to
prevent adolescent girls from
dropping out of school.
* Recognition by Governments,
employers and husbands of the
(Continued. from page 4)
adopted for calculations of the
CPR need a total review.
Further, in measuring the demo-
graphic impact of contraception,
age and parity of acceptors of
family planning methods are im-
portant determinants. A scrutiny
of the data indicates that the age
and parity distribution of acceptors
of sterili~ation and the IUD have
not undergone significant changes
downward over time. It is apparent
.that these predominant methods of
family planning continue to be
adopted by the same age group and
parity levels as before, the study
notes.
social value of childbearing so
as to make it easier for women
to fulfill both productive and
reproductive roles.
Country ranking of the status of
women has been done under five
sections: health, marriage and
,cht!dreh, education, employment
and- social equality. Each section
is composed of four data sets,
meaning each country is ranked
according to 20 variabls-s. A
special feature of the study is the
fourth data set in each section
called "the Gender Gap" which
compares inequality between men
and women in each country. Mea-
surements of women's well-being
and the gender gap between men's
and women's status combine to
provide a ranking - .in a single
figure - of the differences in
women's condition between coun-
tries.
The ranking received by India is
a reminder that the battle for
securing our women their due
status in society has to be relent-
lessly waged for long long years.
Desirable Intervention
The steady birth rate after 1981
would seem to be attributable to
the prevalence of contraception in
the younger age groups not being
at an adequate level. Since the
proportion of- women in the child-
bearing ages is likely to keep in-
creasing in the years ahead, contra-
ceptive prevalence must be in-
creased substantially ir. the near
furure if the declared goals regard-
ing CPR (42 in 1990 and 21 in
2000 AD) are to be achieved. This
would call for specific programme
modifications and changes in the
service delivery systems, the study
emphasises.
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Has F. P. Again Reached a Plateau?
New Communication Strategies to Boost Programme
The present Indian population
of 800 million means that all
schemes of development shall have
to contend with the fact that 50
babies are born every minute. This
demography crisis is quite evident
in increasing numbers of jobless,
shelterless and illiterate persons.
At the macro level, baby boom
manifests in low savings becallse
of high consumption, low capital
formation, high prices, shortages,
rising unemployment and low pro-
ductivity. At the micro level, the
families are split as land holdings
are divided and the weaker mem-
bers of the families, mostly women,
are thrown out to fight for them-
selves. For once, this crisis which
has inseperable links with retarded
development has given a jolt to
the country. No more general
p latitudes or dry-as-dust statistica I
abstract!:, but a candid admission
of failure, and questioning of effi-
cacy of our population control
strategies.
One hopes this questioning will
produce answers to questions like:
why is acceptance so low? why
has the family planning programme
not become a people's programme
if it is meant fO.r the benefit of
the people?
Some perceptive analysts have
stressed the point that apart from
the ever-present factor of tradi-
tional inertia, contradictory com-
munity perceptions and the
presence of elements of social
conflict in the present economic
structures, there is the basic ques-
tion of management. It has been
advocated that through better
manageme'nt, the gap between de-
mand and supply can be reduced
and through proper training, the
vast field cadres can acquire
valuable new skills and learn to
use more imaginative techniques
of counselling and persuasion. In
fact, the Ministry has launched a
major program in collaboration with
UNFPA and USAID which con-
centrates on communications
which has been recognised as. a
factor of pivotal significance in
establishing a positive nexus bet-
ween demand and supply, in sus-
taining the level of awareness
about the role of population and
human survival and in directing
inchoate public concerns into
positive directions at the level of
the individual, the family and the
community.
Whether it is the use of com-
munications to sensitize community
leadership or whether it is the use
of communications to remove fears
and apprehensions which have
been identified as major barriers to
smooth adoption, whether it is the
use of communications to create in
the listeners and the viewers pro-
per desire to improve their lives,
the entire range of media have to
be pressed into service. With a 100
million viewership and the glamour
of colour and movement, television
naturally commands a distinctive
position. But much greater reliance
needs to be placed on Radio
which has by far the wider access
and which can better take care of
regional variations and linguistic
factors. However, b::>ththe media
suffer from lack of freshness and
contemporaneity.
Developing New Techniques
Although, there is a' marked im-
provement in both the quantum
and quality of media output in
support of population objectives,
and related themes like ecology
and environment are no longer
considered esoteric, the dominant
impression is that the delivery of ,"
these messages is segmented and
occasional; therefore, their cumu-
. lative impact on the mass mind is
feeble.
A team of social scientists, writers,
and communicators is experiment-
ing with the soap opera format
whose appeal is to the whole
family but the principal target will
be younger generation. Unless the
youth develop a personal stake in
the success of the family planning
programme, this 45 per cent seg-
ment which also constitutes the
eventual target group for contra-
ceptive protection, will remain
J.
weakly motivated.
How can this cycle of apathy be
reversed? How can mass invotve-
ment ••be brought about? The
obvious answer is by giving
mass media a new direction.
There is an urgent need for pro-
fessional communicators to eva-
luate past practice, create the right
kind of environment for appro-
priate strategy choices and then
direct a sustained programme aim-
~II a~;ti~n~:;:Ii:nc:~~~~~ ~~ili~ii~~ ~
up of community leadership at all
levels, brin~ a,bout an appreciation
of the value of be:ter management
practices ar.d in infusing the pro-
gramme where it is d0rmant with
the right kind of zeal.
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ACTION PLAN TO TONE UP
QUALITY OF F. P. SERVICES
The maxim that one satisfied
client brings in 10 new clients
while one unsatisfied client may
drive away 100 others, was never
truer than in the case of family
planning services, especially in the
conduct of male and female steri-
lisation operations.
The death of 44 wom£·n in
Rajasthan in the course of family
planning operations since 1986 is
reason enough ro cause alarm. All
over the country 107 such deaths
took place last year.
Both tubectomy and vesectomy
are considered to be among the
simplest operations in the medical
world and fatalities are rare. The
World Health Organisation has
fixed the acceptable casualty rate
at one death per one lakh opera-
tions. Thus, the Indian average of
17 per one lakh opera.tions is quite
on the high side, especially in
view o'f the fact that news of these
deaths undermine public confi-
dence in the safety of family palnn-
ing operations.
Disturbed by continuing reports
of deaths and complications In
the wake of sterilisation operations,
the Ministry of Hea.lth and Family
Welfare has worked out an action
plan to tone up the quality of
family planning services··.a. nd··im-
prove the overa.11acce~bt~itY' of
the programme.
The plan includes the setting up
of 16 centres of excellence on
family planning work, extensive
training and reorientation to
doctors, laying down of rigorous
norms on the number of sterilisa-
tion operations to be performed in
a day and improving operation
theatres.
In the first phase, the centres of
excellence will be established in
Bombay, Calcutta, Delhi and
Madras. Short courses to improve
skills in conducting laparoscopic
sterilisa.tion, minilap and c::mven-
tiona 1 methods will be held under
expert guidance. A highlight will
be the provision of skills to per-
form recanalisation operation by
micro surge'ry.
Each Death to be Investigated
The Ministry has also decided
to set up an apex institute in New
Delhi to carry out intensive tests
and ensure that only the best
qu:l:ty of IUDs, fallope rings and
other family planning materials are
marketed. Beside these facilities,
it is proposed to hold thorough
investigations hereafter of every
case of ste;i1isation death. Commi-
ttees will be constituted· at the
State and district levels to fix
responsibility for deaths as well
as other complications.
The Health Ministry has already
initiated a liberal grant-in-aid pro-
gramme to improve the sta.te of
operation theatres, recovery rooms
and wards in the State.
Vice-President to
Inaugurate IAPPD
Centre
The Vice-Pres~dent of India Dr.
Shanka.r Dayal Sharma will inaugu-
rate on August 15, 1'988 the Centre
for Parliamentarians on Population
.and Development, established by
the Indian Association of Parlia-
mentarians on PopUlation and
Development (IAPPD).
Shri Sat Paul Mitta.l, Chairman of
the IAPPD and Ex-Rajya Sabha
Member said that the Centre is to
be dedicated to the memory of the
first Prime Minister of India, Shri
Jawahar Lal Nehru and will cater
to the needs of parliamentarians
for data. informetion. advice. re-
search and training in their en-
deavour to reconcile popu lation
trends with the requirement of
development.
The Ce·ntre will offer its services
to parliamentarians irrespective of
their party affiliation or id€olcgical
preferences.
The Centre building in the Siri
Fort Institutional Area, adjoining
the Asiad village complex in South
Delhi, has an auditorium, confe-
rence and committee rooms, a
library with a reading room, docu-
mentation unit, and related facili-
ties.
Study to Help Revamp
Organised Sector Family
Welfare Programme
The 'LO Labour and Population
Team for Asia and the Pacific
(LAPTAP) has completed an in-
depth study of the entire organised
sector family welfare programme
in India, Rinpointing the gaps and'
shortcomihgs in its cove'rage, scope
ancfadmlnTstra:1:Tvestructure, etc.
Tne study designed to develop a
comprehensive plan for _the family
welfare programme in the organ is-
ed sector was undertaken at th€
request of the Department of
Family Welfare, Government of
India.
The study includes an extensive
agenda for a series of major actions
to be taken in t~~gani~ed sector
in the neX1...d::J..y~~· rs .
It may be recalled that the Fami;y
Planning Foundation, had launch-
ed 3 model projects in the organis-
ed sector last year on July 11 - th3
day of the five billion. Encouraged
by the response from Industry and
Labour, the programme will soon
be extended to four other contres
located in U.P., Rajasthan, Bihar
and M.P.
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water and sanitation on the one lity rate: improvement in housi;:~.
hand, and by poverty, illiteracy environmental, water and sanitary
mortality rate was almost double
than the rest. In addition to t~is
t:,a desira to have more children
as replacement for the dead and to
ensure the survival of the required
number was, stronger among those
who lost thf'ir children. This con-
firmed the hypothesis that high
fertility leads to high infant morta-
lity and vice-versa, and emphasised
the urgency of controlling both
simultaneously.
4. At the pre-natal stage,
mother's illness due to anaemia
and oedema or malaria am.. measles,
and mother's inadequate dietary
intake particularly that of milk, eggs
and meat during pregnancy in-
creased the risk to the life of
children later on, and in the ab-
sence of pre-natal care it increased
working class background and lack
of women's participation in
women's organisation on the other.
7. Poverty seems to be the root
cause which operates through mal-
nutrition and infections and takes
the highest toll of infants in the
absence of p~oper pre-natal, peri-
natal and post-natal care. Poverty
implied access to resources and
services required to improve the
chances of infants' survival.
condition of the P;)O.Y ; food supple~
mentation of both mothers and
children; improvement in the de-
livery of pre, peri a.nd post-natal
care and referral and fOllow-up
services; proper training of T.B.As
and ANMs; education and orga-
nisation of women to control rele-
vant risk factors in accordance with
loca.lconditions and priorities. And
last but not least monitoring and
evaluation of the efficacy of these
interventions before they are ex-
tended and replicated elsewhere.
The concluding session of the
Seminar wi;j be devoted to evolv-
ing appropriate strategies with a
view to achieving the goal set in
the National Health Policy to bring
down the I.M.R. from about 100
today to 60 by 2000 A.D.
considerbly, particularly among
those who were below poverty
line. This underlines the im-
( Continued from page 3)
be shirking that toughness," he said.
portance of pre-natal care and food
Heavy Investments,
supplementation during preg-
Minimal Impact
nancy.
Quick on the heels of the Prime
5. At the peri-natal stage, the
Minister's pronouncements, Mr.
highest risk to infant's life was due
MotHaT Vora, Union Minister of
to antepartum haemorrhage for
Health and Family Welfare, called
mothers and birth related problems
8. The configuration of risk a one-day' conference of State
tor children such as immaturity factors varies from one population Health Ministers on May 29 to
and low birth weight. cord-intec- group to another. For example, in review the situation.
tion and birth injury, respiratory slum areas of Bombay it includes
That the Family Welfare pro-
distress and cyanosis. Absence of inadequate breast and supplemen- gramme had not made sufficient
proper medical care during these tary feeding and lack of immuniza- impact despite heavy investments
problems at birth increased the tion and women's organization. and the situation on the popula-
risk IT anifold. Training and safe- In urban areas of Karnataka it tion front was pretty 'serious', was
delivery kit for traditional birth includes malnutrition and infec- the burden of speeches of both
attendants, early detection of high tion, peri-natal complications and Mr. Vora and his Deputy Ms. Saroj
risk mothers and children and short birth intervals; in M.P. it Khaparde, at this conference.
timely referral are the suggested includes inadequate supplementary
Mr. Vora pointed out that the'
appropriate interventions, for this feeding of infant, inadequate dietary seriousness of the situation was
purpose.
intake of mothers during preg- reflected in the fact that the birth
6. At the post-natal stage inade- nancy, and lack of immunization; rate had "remained more or less
quate breast and supplementary in Orissa it includes almost all stagnant from 1978 onwards". The
feeding, post-natal care and treat- major risk factors operating on increasing population constituted a
ment of infections, malnutrition both mothers and infants at stages serious threat to national develop-
and growth-faultering are the main mentioned above.
risk factors. These risk factors
The report indicates the follow-
ment and there was an urgent need
to gear up the policies and strate-
get aggravated by poor housing ing interventions to bring about gies of population control acrosS
and environmental conditions and ~ desirable reduction in infant morta- the country.
Published by the Family Planning Foundation, 198 Golf Links, New Delhi 110003. Tel: 621135, 697583, 619278
Printed at the Statesman Press, The Statesman Ltd., Connaught Circus, New Deihl 110001.