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PFI Brochure 2010 |
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Population Foundation of India (PFI), established in the year
1970 by a group of visionary industrialists led by late Mr.
JRD Tata and Dr. Bharat Ram, has now entered into the
40th year of its existence. A series of events and activities are being
organized across the country over a year to commemorate the 40th
year. PFI's vision and mission will find prominence in all the events
and activities throughout the year.
Fortunately, the overall population growth rate in the country has
declined since 1981. However, in the four large states viz. Bihar,
Uttar Pradesh, Madhya Pradesh and Rajasthan, the growth rates
continue to be high. Thus, the crux of India's population problem
lies in these four states. These states account for nearly 40 percent
of the country's population and will contribute well over 50 percent
of population growth in coming decades. The performance and
demographic outcomes of these states will determine the timing
and the size of population at which India will achieve population
stabilization. These four states with high fertility rates are the very
states that have low literacy rates, low status of women, low health
indicators with high infant and maternal mortality.
However, the macro perspective of staggering numbers being a
hindrance to development is of little consequence to the family
struggling to earn their next meal. Such families, constituting majority
in India, have an equal right to good health and a better quality of
life. The need of the hour then is to effectively communicate the
large benefits of a small family.
PFI recognizes this fact and has been advocating for promoting small
families from a people's perspective. This includes tackling population
issues within a non-coercive, rights-based and gender sensitive
framework that is pro-people, pro-poor, pro-women and pro-youth,
which addresses the issues of access and quality of services.
With the events, PFI aims to promote with renewed vigor, the
importance of a people friendly approach to population stabilization.
The effort would be to highlight the significance of population
stabilization and reproductive health from the family's perspective.
The emphasis would be on the following key issues that have a major
impact on population stabilization and reproductive health.
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FAMILY
PLANNING
The past two decades have seen a decline in Total Fertility Rate (TFR), with TFR
dropping from 4.1 in 1987 to 2.7 in 2007. Among the major States (population of
20 million and above), Bihar (3.9), Uttar Pradesh (3.9), Rajasthan (3.4) and Madhya
Pradesh (3.4) have very high TFR.Although knowledge about one or more methods
of contraception is almost universal (as high as 98% of women and 99% of men,
NFHS-III), it is seen that there is a gap between knowledge and practice.
As per the NFHS-III, the contraceptive prevalence rate is 56 percent. Out of the total
users, majority (38.3 percent) have undergone sterilization. The sex wise break up
of sterilization shows that the majority (37.3 percent) is female sterilization and the
rest (1 percent) are male sterilizations. Among the modern family planning methods,
only 5.2 percent are using condoms followed by 3.1 percent using pill and 1.7
percent are using IUD. 'Unmet need' suggests the existence of a gap between the
reproductive intentions and contraceptive behaviors of men and women, resulting
large number of individuals and couples around the country being unable to plan
their families as they would like to. According to NFHS-III, the unmet need for
contraception is 12,8 percent. The unmet need for limiting methods (6.6 percent) is
slightly more than that of spacing methods (6.2 percent).The challenge that India
faces therefore, is to provide informed choice and quality of care to couples for a
better reproductive life,
AGE
AT MARRIAGE
Nationally over one fifth (21.5%) of women aged 20-24 are married below 18 years
as per NFHS-3, 2005-2006 with variations at the state level from a low of 11.7 percent
(Goa) to a high of 61,2 percent (Jharkhand). When a girl marries early, she invariably
has children early owing to social pressures, which directly affect hers and her child's
health, often even leading to death of either. Early marriage also has a direct impact
on the number of children a woman will have in her lifetime.
For population stabilization one of the important factors is raising the age at
marriage/cohabitation especially for girls. The strongest impact of this can come
through increasing years of schooling for girls. Investing in adolescents with
emphasis on raising girl's social and economic prospects and enhancing their self
esteem are strongly recommended strategies that are bound to have an impact.
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MATERNAL
MORTALITY
It is estimated that India accounts for nearly 20 percent of maternal deaths in the
world. Nearly 12 percent of all maternal deaths are attributable to abortion related
complications. Anaemia is the underlying cause for 20 percent and bleeding during
pregnancy for 23 percent of maternal deaths. The most deplorable fact is that all
these deaths could have been averted with timely care.
Maternal mortality is high in those states, where fertility is high. Maternal mortality is
also high in those states, where children are born to very young women and to women
who have multiple, closely spaced pregnancies. Hence in addition to promoting
adequate care during pregnancy, increasing spacing and use of contraceptives
would also prove effective strategies for reducing maternal mO,rtality.
MALE
PARTICIPATION
While Contraceptive Prevalence Rate (CPR) has consistently increased over the
years, the proportion of male sterilization acceptors has progressively declined. The
lack of male participation results in poor utilization of prenatal, natal and postnatal
services by pregnant women.
Men's involvement is placed within the wider context of gender equity. The active
cooperation and participation of men is vital for programme acceptance. Their
involvement is not limited to use of condom or vasectomy but is also called for
in planning families, supporting contraceptive use, helping, pregnant women stay
healthy, arranging skilled care during delivery, helping after the baby is born and
finally being a responsible father.
INFANT
MORTALITY RATE
As per the latest available SRS2008 data, the IMR for India stands at 53 (58 Rural
and 36 Urban) per 1000 live births with huge variations at the state and district
levels. The states where infant mortality is high happen to be the states where the
fertility is also high. These states and districts have to be focused and must have
area specific interventions to reduce IMR, 100 percent recording of births & deaths
and strengthening of essential new born care at district levels.
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CHILD
SEX RATIO
The imbalance in Child Sex Ratio (CSR) Le the sex ratio of children in the age group
of 0-6 years has set alarm bells ringing. Census 2001 showed a decline of 18 points
in CSRfrom 945 in 1991 to 927.
Indications are that this alarming trend is due to large scale practice of sex selective
abortion. There are various socio-economic and health implications of declining sex
ratio. Decreasing number of females in the society is likely to increase the sex related
crimes against women, polyandry, bride selling, prostitution, sexual exploitation
and increase in cases of STD and HIV/ AIDS. The health of the woman is affected as
she is forced to go for repeated pregnancies and abortions.
Strategies to promote the value of a girl child, awareness about the PCPNDT Act
and Government schemes for the girl child are being adopted to tackle this issue. It
has been found that imposition of a two child norm (where there are disincentives
associated with the number of children) also has a negative impact on the sex ratio
and needs to be strongly discouraged.
ADOLESCENT /
YOUNG PEOPLE'S
REPRODUCTIVE HEALTH
Adolescents in the age group 10-19 constitute about a fifth (23%) of India's
population. There are about 331 million (33.1 crores) young people (in the age
group 10 to 24 years) in India, representing little less then one third of the total
population. This group is the largest generation of young people India ever had and
ever will have.
Recognizing adolescents/ young people as a distinct group with their own unique needs
and concerns, issues related to them can not be ignored in the policies and programmes
of population stabilization. What happens in the future depends to a large extent on the
decisions taken by adolescents as they enter the reproductive years.
Improvements in the health status of adolescent girls have an intergenerational
impact. It reduces the risk of low birth weight and minimizes neo-natal mortality.
Their special requirements comprise information, counseling, population education,
accessible, friendly and affordable reproductive health services, food supplements
and nutritional services. Programmes should encourage delayed marriage and child-
bearing and education of adolescents about the risk of unprotected sex.
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QUALITY
OF CARE
Good quality of care creates demand from clients and ensures satisfied clients, who
in turn come back for services. Quality services are commonly accepted as services
that meet the needs of clients. While the client perspective focuses on individuals, the
provider and managerial perspectives are equally important.
PFI's efforts in the 40th year will be to undertake intensive
advocacy efforts to promote strategies for achieving
population stabilization. Four regional conferences are
planned to be held across the year, which will throw
up region specific priorities, issues and recommended
strategies. These will be disseminated in a culminating
National Conference.
POPULATION FOUNDATION OF INDIA
B-28, Qutab Institutional Area, Tara Crescent, New Delhi
Tel.: +91-11-40894100, Fax: +91-11-43894199
Email: popfound@sify.com, Website: www.popfound.org