The Government is providing Central assistance to the States/UTs under National Rural Health Mission (NRHM) and second phase of Reproductive and Child Health (RCH-II) programme for implementation of various family welfare activities to achieve population stabilisation in the country as envisaged in the National Population Policy (NPP), 2000 through responsible and planned parenthood, voluntary and informed choice of Family Planning method best suited to acceptors. Under the National Rural Health Mission (NRHM) emphasis has been laid to provide accessible, affordable, accountable, effective, reliable, and quality primary health care through creation of a cadre of Accredited Social Health Activities (ASHA), improved hospital care measured through Indian Public Health Standards (IPHS), decentralization of programme to district level to improve intra and inter-sectoral convergence and effective utilization of resources. As a part of NRHM, fixed day services both for terminal and spacing methods of family planning in all the upgraded Primary Health Centres, Community Health Centres, District Hospitals and Sub-District Hospital has been taken in all the States/Uts.
During the last three years the family planning measures like sterilization and IUD have shown a downward trend. A drop in sterilization by 4.1% in 2005-06 over 2004-05 and drop in IUD by 1.2% in 2005-06 over 2004-05 has been reported. However temporary methods of family planning like the condom users have gone up by 8.07% during 2005-06 over 2004-05. The sterilization and IUD have further fallen down by 10% in 2006-07. Some of the factors contributing to the gradual fall in the achievements of Family planning during last few years inter-alia include: (1) Directions of Hon’ble Supreme Court of India in March 2005 that the doctors performing the surgery should have minimal 5 years gynaecological experience. There was also a restriction of number of sterilization operations by a Team of Doctor in a day as per Government of India Guidelines. This had lead to reduction in the number of providers drastically and affected the Family Planning measures adopted by the government, as 5 year gynaecological experience clause is not there in the guidelines. (2) Non-availability of adequate number of working Laparoscope’s at the health facilities in the States for conducting Female Sterilization.
Following steps have been taken to encourage acceptance of Family Planning and to give protection to providers:
(i) National Family Planning Insurance Scheme has been started since Nov’05 to compensate the sterilization acceptors for failures, complications and deaths and also provides indemnity insurance cover to doctors.
(ii) Increasing Compensation Package for Sterilization was introduced in Oct’06 and the payment to accredited private providers has been increased markedly from Rs.400 to Rs.800 in 8 EAG States and Rs.100 per case if private doctors perform sterilization in public institutions in both EAG and non-EAG States provide services.
(iii) Specific action points/strategies have been incorporated in the States Project Implementation Plans (PIPs) under NRHM from current year to address the upgradation of Family Planning Services and increase the number of providers.