FAMILY PLANNING FOUNDATION
Item
- Title
-
FAMILY
PLANNING
FOUNDATION - extracted text
-
■'^1
FAMILY
PLANNING
fdUNpATION
The 20th century’s many achievements have transformed the life of mankind in much of the world,
mostly for the better, but it has also posed the most difficult problem humanity has ever grappled with.
The population has stabilised in those countries where the achievement of high standards of living has
induced people to plan and control the size of their families. In other parts of the world, including India,
the population has grown unchecked to an extent that distorts and endangers a fragile ecosystem, creates
overwhelming pressures on the economy, and is the main cause of our slow progress towards the
elimination of the poverty that afflicts such a large section of our people.
One sixth of the world's population—including nearly half the world's absolute poor—resides in India
and a great moral responsibility rests on all of us in industry and commerce to play a part in the solution
of this grievous problem.
The Family Planning Foundation was created just over ten years ago as an act of faith by a small group
of people who felt the imperative need for voluntary effort to supplement government family planning and
welfare programmes. In the light of the immensity of the task and the relatively small resources that could be
mustered from its donors in India and abroad, generous as they were, the record of the Foundation's
decada of work has been highly commendable, as will be seen from the following pages. The constructive
value of its research, promotional and funding activities has been recognised in India and in other countries.
Today, India stands on the decisive crossroads of Time. The direction its demographic destiny takes
will determine the future course of events for the country. The 1981 census results have revealed our
population to be 684 million — doubled from the days of Independence already, and adding more than
15 million annually. Some evidence of public concern at this situation has been manifest in recent months.
Not only has the Prime Minister personally addressed the issue of family planning on several occasions,
highlighting its importance to the well being and health of the nation, but it has been included as a priority
in the 20 Point Programme, while parliamentarians and legislators from across the political parties have
endorsed the need to depoliticise family planning and to work unitedly for its promotion. I am happy to say
that the Foundation has played an important part in contributing, to this national renewal of commitment.
A Statement moved and publicised by the Foundation first elicited the support of the leaders of 11 political
parties and set into motion the political consensus of support for the programme.
Altogether, in its decade of activities the Foundation has supported nearly 160 projects across the
country allocating a sum of about Rs. 1.78 crores. Its overall thrust has been on promoting and
supporting relevant and practical research and demonstration programmes of replicative value.
The Foundation can sustain its catalytic activities in this significant national work only with the
continuing support of the business and industrial community of this country. I therefore appeal to you to join
this worthwhile effort by committing funds to support the work on a continuing basis. All contributions
to the Family Planning Foundation are fully deductible for the purpose of assessing taxable income.
Our industrial and business community has the resources. It must additionally realise that philanthrophy
for the population cause is more than a conscience debt the prosperous must pay towards those less fortunate.
For on the success of this work will ultimately depend its own long term service and prosperity.
(J. R. D. Tata)
community HEALTH cell
326, V Main. I Block
Koramongala
Bangalore-560034
India
THE CONTEXT
'Second India'
The burden of a 'Second India' —
the nightmare projection of earlier
demographers — is now a reality
of life. From a population of 344
million at the time of Independence,
India had grown to 684 million
by 1st March 1981 and is now
moving inexorably towards a billion
by the turn of the century.
Can India's developing economy,
struggling to right the wrongs of
centuries of colonial rule that has
left vast segments of her people
impoverished and exploited, cope
with this tidal inundation of more
numbers along side ? The Eighties
present a particularly critical period.
On the one hand, there is now the
full brunt of the physical pressures
created on limited resources by the
human explosion of the past two
decades, as the children of
yesterday become the job seekers of
today and the parents of tomorrow.
On the other, there is the grave
moral responsibility of bringing
about a more rational, responsible
reproductive behaviour for this huge
young generation, if the future is
not to be hopelessly mortgaged to
despair and deprivation. Therefore,
beyond dispute the most important
challenge of this decade lies in the
demographic sphere. But how
many persons are concerned and
committed on this score ? Can
we afford not to be ? That is the
question more people need to ask
themselves today.
National Policy
India was among the first few
countries in the world to recognise
the dangers inherent in rampant
population growth. Following
Independence, as the country's
leaders embarked on the challenging
task of raising the standards of
living of every citizen of free India
through planned development
within the framework of democracy,
it was apparent to them that this
would not be accomplished unless
there was a concomitant effort to
contain the size of the population.
Family Planning as a national policy
was, therefore, adopted in 1952.
This was a historic first in the annals
of governmental population policy,
but unfortunately the earlier
initiative was not matched by an
effective commitment to work.
Population and
Poverty
Beginning with the First Plan
the official programme has, to
date, invested nearly Rs 1,300 crores
on family planning. But so far,
only about 1 in 5 couples in the
country has been persuaded to adopt
a modern method of contraception
to limit the size of the family.
In the 34 years of free existence,
the country's population has
doubled. India is now in the
staggering position of having a
population that is more than the
combined populations of USA,
USSR and Indonesia, the world's
third, fourth and fifth most populous
countries respectively. In the last
decade alone it has added more to
its numbers than the total population
of Brazil, the world's sixth most
populous nation, with a land area
two and a half times that of India.
The 1981 Census results
highlighted the population to be not
only 1 2 million more than earlier
expected at this point of time, but
still more alarmingly the fact that
it was growing at a much faster
pace than had been projected by the
experts so far. The decadal growth
rate of 1971 -81 stood at 24.75
percent. It turned out to be no
different than the decadal growth
rate of the sixties, earlier thought to
be an exceptional period of
phenomenal population increase.
But because of the larger population
base now existing, the seventies
added 136 million, instead of
the 109 million brought in during the
sixties. If allowed to continue
unchecked, this same growth
rate will add 171 million over
the present decade of
the eighties — a staggering 17
million a year.
Population density has already
spiralled to 221 per square
kilometer as against a world average
of 30 and will hit over 300 as India
looms towards a billion. With 2.5
per cent of the world's land area
India has already 1 5 per cent of the
world's population. In the coming
century it is likely to outstrip the
other demographic giant China to
become the world's most populous
country. In the process, finite
resources are being stretched
to breaking point as they cope
with infinite demands. Essential
human needs, basic human rights
cannot but suffer in the face of such
an assault of ever-increasing
needs.
As of the present, India's
population profile is dismal
enough. Roughly half the 684
million citizens live submerged
below the poverty line —
denied even the Rs 75 per
capita per month considered
adequate to provide two square
meals a day. Nearly two thirds of
the population remains illiterate —
thus denied access to skill
formation that would in turn give it
access to the opportunities arising
from developmental activities.
42 per cent of the population
consists of children below the age
of 14 and another 6 per cent of
those above the age of 60, together
making up an intolerably high
dependency ratio of 87 per cent,
which militates against the capacity
of the economically active to
generate enough savings for
betterment. The negation of the
sum total of development efforts is
intrinsic to this situation. To allow
an unbridled population increase to
continue is, therefore, nothing
short of a death knell to peace,
progress and prosperity. The
obvious conclusion, that follows,
is the need to ensure family planning
efforts accelerate and become more
acceptable and effective within a
reasonable time frame.
The Task Ahead
As of the present, there are 11 6
million “eligible couples" — defined
as those married and with the wife
in the active reproductive years of
15-44 — in the country Of these,
about 22 per cent or 26 million
couples have been effectively
protected through the efforts of
the programme so far.
India has now set itself the
long-term demographic goal of
reaching replacement level of
fertility by the end of the century.
Technically termed NRR of I (Net
Reproduction Rate of Unity) this
means that given certain
levels of fertility and mortality a
woman will replace herself by a
single daughter in tha reproductive
years. It implies a
nationwide acceptance of the two
child family — a virtual halving of
family size from the present average
of 4.3 children. The statistical
calculations carving out the path to
this goal stipulate a birth rate of 21
per 1,000 population and a death
rate of 9 per 1,000 must prevail
towards the close of the century.
(The current corresponding figures
are a birth rate estimated at
anything between 33 and 37 and a
death rate of 1 5). Experts further
calculate that a minimum of 60 per
cent of the "eligible couples" will
have to be won over to family
planning to achieve this goal.
Since by the end of the century the
population base will have further
grown, the 60 per cent will amount
to something between 95 to 100
million couples, depending upon the
ultimate population size reached.
Thus, it may be seen that for every
one couple convinced to practise
family planning during the last 30
years, three more couples will have
to be persuaded in the next
15 years or so.
The avowed aim of the Sixth Plan
is to extend coverage to 36 5 per
cent eligible couples by 1985.
Its operational figures — which have
not been revised in the light of the
1981 Census results and so are
conservative compared to the actual
need — outline reaching 40 million
couples over the five years
(22 million sterilisations, about 8
million IUD insertions and 11
million conventional contraceptive
and oral pill users).
The first two years have hopelessly
shortfalled their assigned share of the
performance. The remaining years
will have to do double work if the
immediate goals, and with them the
long term aims, are not to be
jeopardised.
A Renewal of Effort
In recent months a climate of
concern over the inadequacy of
existing family planning efforts has
developed. The Prime Minister has
made several personal appeals to
the nation and particularly to the
critical political, administrative and
community leadership at all levels,
to address itself to the family
planning question as a fundamental
plank for the nation's betterment.
Family Planning is now a priority
of the 20 Point Programme which
states that "family planning will be
promoted on a voluntary basis as a
people's movement.'' The Sixth Plan
has earmarked Rs 1,010 crores — the
highest allocation ever made to family
planning so far A Cabinet Sub
committee on Family Planning has
been set up under the chairmanship
of the Prime Minister. At the experts
level the Population Advisory Council
has been constituted within the
Ministry of Health, as a "thinktank"
to guide population policy
formulation and implementation.
These are heartening developments
which must now be helped to
amount to something more
substantive in the field.
Voluntary Role
However, more than ever before,
there is need for voluntary effort to
supplement, complement and act as
a force to move government
towards more responsive directions
so that family planning actually
becomes a people's
movement.
The attack has to be multipronged.
On the one side, there is need to
stimulate social and economic
actions to the utmost extent
possible, particularly emphasising
the status and opportunities for
women and ensuring access to
health care, so that tangible
development creates an
environment of aspiration and hope
for a quality of life. At the same
time there is need to develop
strategies that will reach both
knowledge and services for simple,
safe and foolproof methods of
family planning to the doorsteps of
the people. In all this, there is
need to realise that curbing the
growth of population is not merely
a technical problem of finding
the best means to limit births.
It involves fundamental political
decisions and changes in social
attitudes. Altogether, it requires a
total voluntary movement to
upsurge across the nation — in the
ultimate, the only guarantee for
sure success.
FPF:THE CONCEPT
AND CONCERNS
The Family Planning Foundation
is a major voluntary effort to
inject appropriate stimulii to the
country's population policies and
activities. A private non-profit
organisation, it is committed to the
task of supporting innovative
programmes and playing a
catalytic role for research and
action in population and family
planning, with the aim of
constructively influencing national
population programmes and
policies.
FPF's Birth
FPF came into being as a
registered society in October 1970.
Its birth was the outcome of the
deep concern of a number of
leading industrialists led by
Mr J R D Tata, plus dedicated
social workers and professionals,
who felt strongly that the
magnitude and complexity of 1he
population problem required the
official approaches to be further
augmented, supplemented and
supported by effective
non-official initiative.
In FPF the nation acquired a
responsible non-governmental
forum for germinal population
action. Its structure provided
industry, organisations and
individuals with the opportunity for
involvement in the country's
struggle to improve the quality of
life — a struggle that could only be
a losing one, if the unbridled
population growth went
unchecked. This has filled a felt
need. For as time has shown,
the efforts of the core group of
concerned workers that brought
FPF into existence have been
further reinforced by the unstinted
support in diverse ways of
numerous distinguished
professional men and women,
scientists, researchers and persons
prominent in public life, who have
come together to make FPF
perform a seminal role in charting
new courses to study and
solve the complex challenges of the
population problem.
FPF's Stance
FPF does not normally undertake
direct family planning activities.
Its primary purpose is to provide
funds, guidance and support to
appropriate agencies, organisations,
institutions, and individuals
directly engaged in the field.
The Foundation has a small well
organised staff with high technical
competence. It brings into its
operatonal stance both economy and
efficiency. It responds to requests
made and also often develops
projects with the hslp of other
institutions. It has successfully
involved the best scientific talent in
the country in practically every
aspect of its working — identifying
innovative ideas, designing projects
and in monitoring and evaluation,
FPF's critical importance lies in
identifying and, wherever needed,
stimulating agencies to take up a
creative role in action programme and
or being involved in forward looking
research in population control.
It has thus played a particularly
pioneering role in bringing to bear
on Family planning programmes, a
wide, variety of professional and
scientific expertise and experience,
promoting an interaction
between academic experts and
actual field workers that has had
mutually beneficial results.
From this research has flowed
frequent feedback of material on
many aspects that has helped to
interpret policies and programmes
in population. FPF’s strengths and
pathstriking characteristics further
stem from the fact that while it
attempts to function, by and large,
within the framework of the
Government's policies and
priorities, closely liasing and
relating its efforts meaningfully with
the official programmes— it is by
no means circumscribed by the
official pattern of activities.
FPF's Performance
In just about 10 years of active
existence (FPF’s administrative
office was set up in March 1971
and the funding programme started
in June 1972) the practical
research projects sponsored by it
have already foreshadowed national
policy developments. But FPF
has not shirked to apply on itself
the rigorous yardstick of monitoring
and evaluation with which it keeps
tab on funded projects so as to
ascertain their progress. Aware of
the importance of an objectve
assessment of its role, FPF recently
took the initiative to ask for an
independent, high-powered
evaluation committee to review
its work since inception.
It is a matter of gratification that
the Evaluation Committee headed
by ex-Chief Justice G D Khosla had
the following comments to make:
"After careful consideration of
the various aspects of its working
and the results obtained so far
we are firmly of the view that:
(i)
The Foundation has so far
performed a significant and
worthwhile role in the promotion of
its objectives in the context of the
crucial pervasive problem of
population growth and the official
programme of family planning;
(ii) It has established its
credentials as one of the most
effective organisations of national
importance of its kind ;
(iii) Its role in the promotion of
much needed bio-social research is
well appreciated by individuals
and institutions who know and
understand the nature and wide
canvass of its activities;
(iv) Due care has, on the whole,
been exercised in the selection
and support of research projects;
(v) It has shown requisite initiative
and discrimination in supporting
research projects of varied nature;
(vi) The Foundation's Executive has
generally kept a close watch over
the progress of projects supported
by it and has not hesitated to
withdaw the support as and when
circumstances warranted it;
(vii) There have, however, been a
few instance of projects not coming
up to expectations for reasons which
were not always such as could not
have been anticipated ; and
(viii) Miscarriage of project has,
in most such cases, occurred from
factors beyond the control of the
Foundation and their proportion
has been much below what
would be expected in a pioneering
venture in a hitherto uncharted
field of action research concerning
such intimate behaviour as
that of reproduction
Policies and
Procedures
FPF furnishes the necessary
underpinnings of technical and
financial aid for programmes which
fall within the scope of its policy
for promoting action research
in areas which offer hope of
practical solution for problems
identified as targets of attack.
The criteria for selection of such
programmes is exacting : not only
must projects approved for support
have a critical connection to
SUMMARY OF
PROJECTS SUPPORTED
1972 TO I98l
I
I
s
»
1
L
Health Related Programmes
Bio-medical programmes—basic
research and study
C. Information, Education and
Communication
D. Policy Research and Evaluation
E. Marketing! Management!A dministration
A.
B.
family planning needs, but they
must be, in addition, development
oriented, innovative, replicable and
economical with an emphasis on
optimum use of existing technical
and allied infrastructure. There
is no duplication of government
efforts, rather it provides a
critical support in a creative spirit.
Notwithstanding, FPF's marginal
funds in comparison to the
government budget for this work,
its flexibility in action and
independence of judgement enables
it to perform a crucial function,
since it can move quickly to
support projects with potential that
might be denied oi delayed
government support under the
latter's specified procedures.
It can initiate and support schemes
calling for unorthodox research
approaches. This entrepreneurial —
type dynamism has secured for
FPF an avante-garde repuiauon :
of an organisation capable of
remote sensing problems yet to
come and ahead with leads and
directions to solve them.
programmes has gradually risen to
Rs 30 lakhs, although the
demands upon it continue to
grow. The annual budget for
Establishment and Promotional
Activities is about Rs 10 lakhs.
The Governing Board has now
decided to start another drive for
fund raising in India. It is also
seeking support from some of the
international agencies and
philanthropic individuals abroad.
FPF is approved by the prescribed
authority for the purpose of Section
Resources
The bulk of the funds for FPF
operations have been raised from the
private sector, largely from industrial
houses within India. In the
formative stage, the Ford
Foundation made a generous grant
of S300.000 subject to three times
of this amount being raised by the
Indian Industrial Community. In
addition, the Ford Foundation gave
$200,000 for a collaborative
programme of research in the field
of Human Reproductive Physiology
and Contraceptive Techniques.
In 1980 the Ford Foundation made a
further grant of 8700,000, this time
on a more generous condition,
namely, on one-to-one matchinb
basis.
FPF has so far raised Rs 1 55.60
lakhs from the Industrial and
Business Community in India and
has been able to earn interest of
Rs 108.54 lakhs on its capital fund.
al Kt <-r.f nt for Sl.m nrtinr
35 (1) (ii) of the Income Tax Act of
1961 and as such donations made
to the Family Planning Foundation
are hundred per cent deductible
from the income of the donors for
the purpose of assessing taxable
income. Further, this is
irrespective of the amount involved
as the ceiling on contribution by a
company, as stipulated under
Section 293(1 )(e) of the Companies,
Act, does not apply to the
donations made to FPF.
AREAS OF ACHIEVEMENT
In over ten years of its activities,
FPF has approved grants to the
extent of nearly Rs 177.44 lakhs in
support of about 1 60 projects,
big and small, spread across the
entire canvas of the country.
These projects range the spectrum :
from basic research in the
biomedical and behavioural science
fields to action programmes
that encompass demonstration and
experimen al path-finding efforts
to studies, surveys and eva’uations
which aim at providing hard
data inputs for policy decisions.
This has engineered a constant
cycle of action and quick feedback
in areas considered critical at any
point of time and reinforced the
FPF's image as a responsive,
responsible, independent
organisation with the resources and
ability to be a catalytic force for a
prime national cause.
The underlying denominator of
FPF's functioning is the search for
methodologies that can converge
to create a national ethos of
urgency to the population question
in which population limitation
becomes a national ethic.
As the Evaluation Committee put it:
"It has succeeded in securing
recognition as an important
organisation with a dynamic role in
helping to solve the national
problem of population control.
It has become known as a national
body seeking and promoting
various potentials in the field of
biomedical research for acceptable
contraceptives and initiating and
support programmes of educating
the people and arousing their
awareness of the consequences
of over population "
Thus, FPF is set out to identify
and support the most relevant
approaches; to place possible
solutions in proper perspective and
project them on wider planes for
maximum impact; to mobilise
personnel and popular base support
for the realisation of the population
goals; to help create an
environment in which the intricate
entwined relationship between
human numbers and social justice
is perceived and tackled with
perceptivity and in a manner that
places human dignity as the
paramount consideration.
Altogether, a complex critical
challenge. To participate in it
has been a matter of patriotic pride
and privilege for all associated
with the work.
Basic Research
Research to understand the
diverse dimensions of the problem
of human fertility and the dynamics
of the different factors that
influence it is a necessary
prerequisite for population policies
to have an integrated intellectual
perspetive and interdisciplinary
approach. The social and
economic connections in which
fertility behaviour is embedded
need to be more fully seen on the
one hand. On the other, it is
imperative to explore further
avenues to locate still safer, still
more convenient and
economically feasible techniques of
fertility regulation than exist at
present. But at the same time
there is substantial scope for
improving and facilitating the use
of existing contraceptive
techniques, especially keeping in
view the socio economic and other
problems in the Indian setting.
Basic research both in the
behavioural and biomedical
sciences is therefore of critical
importance in a selective way.
Biomedical
A Study Group of senior
biomedical experts of the country
set up by FPF examined the thrust
of biomedical research to determine
suitable priority areas for developing
appropriate technology in
contraception for Indian use. The
Study Report that emerged from this
review is providing a useful guide to
research workers in contraceptive
technology. From this review it is
also clear that research for the
improvement of the existing
contraceptive technology and their
adaptation to the particular needs of
our country requires to be
undertaken on a priority basis
However, this does not have to be
to the exclusion of research for
developing newer methods of
contraception.
Adaptation for
Appropriate
Technology
FPF's major thrust in the
biomedical field has been the
improvement of existing
contraceptive technology with the
particular view of adapting it to
India's conditions and needs. The
existing knowledge and methods of
contraception have sufficed to help
several developing countries contain
their population, but have failed to
make a similar impact in India,
particularly in the rural areas. For
instance, the IUD has not had the
same success in India as elsewhere
because its bleeding problem looms
larger for Indian women whose
widespread anaemic condition is
aggravated ; similarly, the pill
because of daily motivational
dependence and logistics of delivery
has not baen able to become the
mass method it is in many countries.
FPF supported research is now
working towards developing newer
modes of delivery of steroids into
the body, such as injectables which
will simplify its intake
Another area is indigenous
medicine. A growing body of world
medical opinion has come to realise
that indigenous methods of
contraception constitute a possibly
valuable source of acceptable
solutions. However, these mathods
require scientific evaluation to prove
their safety and efficacy beyond
doubt. FPF has initiated scientific
investigation of several herbal
preparations and other traditional
techniques which could yield a
positive outcome. Work carried out
so far has shown encouraging
results in animal studies with a herb
"Banjauri" used by Adivasis of
Bihar for prevention of pregnancy.
Innovation for New
Appropriate
Technology
In the context of the search for
newer methods of contraception
suitable to the Indian milieu, FPF
was the first to recognise the
potential and support the
development of an anti-pregenancy
vaccine. FPF's input was provided
at the very critical germinal stage
well ahead of the international
.......... scientific evaluation of indigenous contraceptive methods
acclaim of the methodology and
provided the impetus and means for
this research to establish itself. The
work already carried out in this field
by Prof G P Talwar at the All India
Institute of Medical Sciences
provides considerable hope for such
a vaccine to be available for general
use. These studies have also
resulted in the development of a kit
for testing pregnancy in its very early
stages. Pioneering research is also
been carried out with FPF's support
to understand the role hormonal
and enzymatic methods can play to
prevent pregnancy. Three projects
aiming at developing techniques for
prevention of implanatation of
fertilised ovum are providing
encouraging results. In an
effort to balance the female centred
bias of most contraceptive
technology, FPF is also encouraging
research on male methods of
contraception. Two projects aim at
studying the effects of intervention
in sperm maturity, as opposed to
preventing sperm formation which
has complications of libido
decrease.
Career
Development
One of the most critical inputs
FPF has provided to the development
of biomedical research in India is
through its Career Development
Research Awards Scheme., which
was geared to the creation of human
resources for the country in the
shape of a cadre of middle level and
senior scientists to provide quality
technical manpower in reproductive
research. The programme
supported the most promising areas
of research in fertility control
through a scheme of fellowships
awarded to outstanding and/or
promising scientists in the field.
This programme identified and
encouraged promising, as well as
well known, Indian scientists to take
up research on reproduction
mechanisms as part of a long term
interest; it also seeks to reverse brain
drain to an extent by stimulating
and bringing back talented Indian
scientists residing abroad to work in
suitable laboratories in India.
Eight fellowships were awarded
under CDRS and it is heartening that
most of these fellows have now
been employed as scientific staff of
their institutes.
...... Research to support the development of anti-pregnancy Vaccine
Behavioural! & Social Science Research
From its inception FPF has been
sensitive to the fact that the social
and behavioural sciences have
not yet impacted sufficiently on
population research which has been
monopolised greatly by the
demographic overview. There is a
pressing need to understand
fertility behaviour at the micro
level — at the family and
community level — before it can be
influenced to change in
accordance to national needs.
FPF has tried to fill some of the
lacunae by identifying the crucial
areas of needed research and by
bringing about an involvemem of
some of the country's foremost
social and behavioural scientists in
population research work.
The maiden exercise in this
pioneering work was the
commissioning of a status study in
population research with focus on
behavioural sciences, the first
such attempt in 1he country.
As a sequel to this investigation.
followed a review of existing
sociological and related literature
with focus on fertility and culture
undertaken by three leading social
scientists of the country —
Dr M N Srinivas, Dr A R Desai
and Dr Roy Burman — in order to
understand rural, urban and tribal
family communitv.
Another study with considerable
methodological interest currently
under way is that of poor slum
women in six cities of northern
India — Delhi, Meerut, Kanpur,
Lucknow, Indore and Agra.
Through observation of the self
perception and articulation
of these women this study is
attempting to develop social and
demographic profiles of
women in their multiple roles as
influenced by the social change
process, with a particular focus on
fertility behaviour and family
planning practices. In another
study of Muslim families the
emphasis is on contrasting fertility
attitudes within the community,
to understand the differential
impact of the modernisation
process.
Each one of these studies is not
only pioneering in the matter of
identifying important areas of
study, but also in conceptualising the
approach and methodology
for these types of studies
The examples cited here are
illustrative of the wide sample of
activity stimulated in this particul r
sphere, hitherto relatively
unexplored.
COMMUNITY HEALTH CELfe
326, V Main, I Block
Koramangala
Bangalore,'^..
India
. . . . studies to develop social and demographic profiles
Action Programmes
A p-c-ssing need of the
developing world in general, and
India in particular, is to identify
some strategies that can help
create for its millions a new design
for living. A design that is
compatible with human dignity,
non disruptive of the cultural
context and implementable within
the frame work of severe resource
and time limitations. The process of
social change must be hastened
and progress telescoped to reach
the nation's submerged millions so
as to draw them abreast with the
dynamic developments of
industrial societies.
Social action to restructure
society and recast it in a more
equitable mould takes many forms.
But a critical component of this
action is the integration of the
population concern within the
overall developmental thrust —
since the small family is not only
pivotal to economic development
but equally to the improvement of
the quality of life, and particularly
critical to the betterment of the
status of women and children.
Projects that provide insights into
the psyche of the people, that
demonstrate ways and means to
reach the community with pertinent
messages, that develop the
instruments for doing it and offer
models for replicability and
extension — these have been
FPF’s concern in several different
ways' the sum total of which
makes up a comprehensive
programme of social action by FPF,
and the predominant share
of its funding.
Community
Approach in
Action
Health and
Health Related
Ca re
Locating an appropriate
methodology for the delivery of
health care, including family
planning services, has been a prime
area of focus for FPF. Within this,
special importance has been given
to strategies that particularly protect
and promote the health of mother
and children, which has been
recognised as a fundamental plank
for the acceptance of the small
family norm. To mention some
highlights: FPF funded projects have
preceded by several years the new
official approach for a community
health worker thrown up from
within the community — women
slum dwellers trained as effective
pregnancy counsellors in Madras by
an interdisciplinary approach that
brought together for the first time
medical and social work
educationists; community nurses in
Kerala attempting to define a new
category of middle level worker as a
supervisory link service between
the doctors and the periphery
workers (foreshadowing the health
assistant in the national pattern);
direct action by voluntary
organisations: through several such
projects FPF has provided models
of the potential of community
participation in health and health
related delivery work. Today, as the
government has taken up the CHW
approach as a major national
strategy, FPF is further attempting to
provide regional and community
specific variants on the theme to
supplement the official stereo typed
approach which is inevitably facing
difficulty. Currently, FPF is also
documenting case studies of six
different successful community
based voluntary projects. The idea
is to provide through these profiles,
a glimpse of the mix of the
ingredients and strategies that have
worked in these situations —
notable examples of which are
Tilonia in Rajasthan and Jamkhed in
Maharashtra — with the object of
triggering replication.
. .. .the Village Health Committee is one
approach in community involvement
One notable project that seeks to
deliver comprehensive health care
services to the community through
voluntary efforts and local
leadership is in the tribal belt in
Bihar with Shri Jayaprakash
Narayan's Sarvodaya Ashram at
Sokhodeora as the nucleus.
Practitioners of indigenous medicines
are also involved in this.
COMMUNITY MF At TO! cell
projects are being supported in
Kashmir, Andhra Pradesh and West
Bengal. In Madurai, Tamil Nadu an
action research project covering the
entire district has shown how
existing government infrastructure
and primary haalth centres can
be further sensitised and improved
to serve community needs.
Although, all the demonstration
projects have the common thread
of a search for the best health care
and family service delivery pattern
through the training and
utilisation of local workers, each
one of these projects has its own
specialised stance. The hope is
that the cumulative sum of
information and knowledge
emerging from these projects will
be able to provide the national
programme more appropriate
methodologies to achieve its
objectives.
programme. In this direction, FPF
has been able to strengthen the
instruments of dialogue for a more
effective integration of practising
physicians in the national
population programme, as well as
in the training of physicians to
take on this role with more
appropriate zeal.
Side by side with the need to
develop paramedical and
non-traditional systems of delivery
of health and family planning
services, there remains a critical
need to intensify, to a much greater
degree, the involvement and
commitment of the medical
profession to the family planning
Improvement of
MTP Service
....Community health
agents of change.
workers
as
The continuing high incidence of
illegal abortion despite the passing
of the MTP Act, points to the dire
need for development of better
services, particularly in the rural
areas, via qualified personnel
and new technology that is now
available to simplify the
procedure to the minimum.
..... women slum dwellers trained as
effective pregenancy counsellors.
Community Based
Distribution
A major contribution in this field
has been FPF's support to a
network of government MTP
clinics in various parts of UP,
upgrading skills and equipment,
and alongside seeking to
understand the psychology of the
abortion seeker.
A new approach for an effective
offtake of contraceptives is currently
been developed in Manipal where
a community based distribution
programme for supply of pills and
condoms backed by specialised
marketing and managerial techniques
is being initiated. This is another
aspect of FPF’s continuing efforts to
stimulate different components of
society to paiticipa.te in the family
planning effort Another project
organised male sterilisation camps in
Madras : a small infusion of funds
triggered off enthusiasm and
catalysed collaboration between
voluntary and official systems
resulting in high achievement of
targets. This has provided a model
for the mass sterilisation camp
approach.
Policy Research and Evaluation
The monitoring of ongoing
programmes in different sectors to
assess their intrinsic worth for
population needs, replicative value
and/or scope for furthering
population goals, is a vital function
of FPF work. This has resulted in
several publications of note which
have been useful in influencing
national trends.
Family Planning &
Organised Industry
In a totally different sector — the
industrial arena — FPF was the
first in the country to recognise that
the infrastructure of the industrial
units provided an excellent
opportunity for pursuing population
goals and identified a spacial
strategy for family planning work
with industrial workers.
Six profiles of successful family
planning programmes in the
industrial sector are now under
preparation.
A highly innovative experiment
to which FPF provided sustaining
strength at a critical juncture
and which has been evaluated for
the local impact it has made, as
also the leads it offers to other
organised labour units, is the
UPASI project. Here the impact
on fertility of deferred incentives
through an unique. No Birth Bonus
Scheme plus a comprehensive
labour welfare plan that provides
health care, creches, recreation
clubs, and primary schools
has been supported and studied.
Now, a cost benefit analysis is
being made.
Studies with Policy
Implications
With the release of the 1981
Population Census Results it has
become apparent that the poputetion
growth rate during 1971 -?1 has
shown no signs of decline as
compared to the previous decade.
Major population concerns facing
the nation in the coming decade,
assume more gravity as the
growth-rate now works on a
larger population base, adding as
many as 16 to 17 million persons
every year.
While examining various aspects
of the recent population trend, FPF
has decided to commission some
major studies with focus on
population policies. As a follow-up
of the salient features of the 1981
population census, studies on states
registering a decline in population ;
growth-rates in 1 971-81 over
1961-71 are being matched withthose displaying higher growth-rates.
The studies ori states are intended to
make a diagnosis of the
i
. i
determinants of both declining and
rising population growth.
Considering the enormity of the
Rs 1,010 crore funds allocated to
family planning and family welfare
programmes during the Sixth Five
Year Plan, FPF also considered
worthwhile to review the allocation
aspect of the resources. The review,
inter-alia, aims to answer a few
pertinent questions which have now
come to surface. What is the
rationale governing the allocation of
funds on family planning and family
welfare and what are their policy
beneficiaries and what are the
benefits realised? Similarly, studies
on infant mortality behaviour in India
and their implications on fertil ty
regulation and fertility conrtol are
also coming into major purview of
FPF’s activities in the coming years.
It has come to light that high levels
of infant mortality persist inter-alia
when family planning efforts become
ineffective. In other words, there
is need to place higher priority to
reduction of infant mortality rates
as a first vital step to precede any
efforts to promote family planning
acceptance.
As a part of the programmes of the
International Women's decade, FRF
has organised a project on Status
of Women and their role in decision
making in the family in different
communities. The focus naturajly
lies in ascertaining how far women
influence the decision making process
regarding acceptance of family
planning methods. Besides, in view
of the crucial role played by
female age at marriage in
determining fertility behaviour,
the FRF has considered to support a
project to isolate "Socio economic
Determinants of Age of Female
at Marriage."
Population
Monograph
At the international level ESCAP
which is currently bringing out
monographs on population for
each country in the region has in
acknowledgement of the high
degree of population expertise
available within India, made an
exception of the task of preparing
India's monograph. This
document has been entrusted to
FPF in collaboration with Indian
Association for the Study of
Population. The population
monograph is being prepared with
a view to provide an authoritative
demographic profile, alongside a
review of tho areas that influence
fertility, with a view to enhance
national and international
understanding of population facts
for the purposes of developmental
planning.
....FPF film Parvati won the Best
Promotional Documentary Award in the
National Film festival 1978.
Information & Communication
A primary task of any population
programme is to provide
information, education and
communication services. It is only
through awareness and
understanding of the problem that
political commitment and
popular acceptance — the two
planks necessary for the
programme to move — can be
generated. Mention has already
been made elsewhere of the
pioneering work in population
education conducted under the
aegis of the FPF. The work in the
communication field has covered
several different aspects — from
sensitising rural leaders in
population and development
concerns to developing material
providing simple and accurate
information on sex, contraception
and family planning for
neo-literates. Another sociological
study sponsored by FPF has
provided insights garnered from a
six month exposure to young
married rural couples in the form of
a report and a film with a strong
family planning message in a
popular idiom. Particular mention
is due to another FPF film —
Parvati — which focuses on the
women's status issue and its
inextricable link with family
'planning. Parvati won the Best
Promotional Documentary film
award in the national film festival
held in 1978 and has been
released by the government for
wide dissemination throughout
the country.
An important aspect of FPF's
contribution in the communication
field is a project that was
launched in the wake of the post
emergency derailment of the family
planning programme. This has
There is considerable evidence
today that society has begun to
change and research and action
is needed to enhance the force of
those elements of social change
which are favourable to the
adoption of national responsible
behaviour in relation to family
formation. This is where the Family
Planning Foundation finds it has a
still more critical role to play in
the years that is ahead.
The intervention will be in diverse
ways and in keeping with FPF's
tradition to be responsive to felt
needs with a responsible distilling
of the essence of past experience
to take action forward. Specific
areas of concern that are already
emergent are: a strengthening of
the health care structure to be more
relevant through (i) programmes
that will help replicate successful
demonstration projects so that
they no longer remain islands of
excellence in the vast rural
hinterland; (ii) programmes that will
help provide more local specific
strategies relevant to the area of
operation; (iii) strengthening
of research that will on the one
hand simplify and expedite the use
of existing contraceptive
technologies even as it quests for
bold new solution ; and (iv) on the
other hand bear focus on
social change and development, as
for instance efforts to improve the
status of women which is a
fundamental factor of population
dynamics.
As FPF confidently moves
towards fulfilling these challenges,
there is expanded opportunity for
the business and professional
leaders of the country and elsewhere,
to participate in this noble
assignment: an adventure of
service in the most critical crusade
of the 20th century. FPF has been
struggling these several years to
tackle a monumental problem with
slender resources. If it has to do,
what must be done with urgency,
speed, imagination and integrity
to make India sensitive and
responsive to its population needs,
the critical need is to have these
resources augmented.
Family Planning is a humane
activity as vital to the interest of the
individual as to the entire nation.
But in a social environment of
general deprivation and despair,
its critical links to the betterment of
this condition is often not perceived.
While all developmental work
to bring about a qualitative
improvement in the lifestyle of the
people must move apace and be
given full support from population
programmes, there remains the
immediacy to establish an outright
connection for family planning,
even within a social environment
not characterised by favourable
changes.
Set as we are today in the
trajectory of geometrical progress
of growth, the time lag needed for
the cause and effect relationship
of development to bring about
desired structural change in
population, as it did in industrialised
countries, is just not available.
In any case there is no question of
either/or; it must be both. Both
streams simultaneously pushed
to meet at the same goal:
a better life for all.
Above all, family planning action
must begin to be understood and
rehabilitated in the perspective of a
human rights movement that
seeks to bring the scope of survival
and dignity of living to the
condition of India's women and
children. To wait in the wings
while development alone provides
the contraceptive would be to
deprive many of a whole generation
of this chance. There can be no
imbalances one way or the other —
contraceptive technology must
reinforce the thrust of social
technologies to build a better,
more equal world.
Based upon Survey of Indra map with the permission et the Surveyor General of India.
The boundary of Meghalaya shown on this map is as interpreted from
the North-Eastern Areas (Reorganisation) Act. 1971, but has yet to be verified.
The territorial waters of India extend into the sea to a distance erf tw&lve nautical miles
measured from the appropriate base Hne.
jCJ Government of India copyright. 1981.
- Media
1687.pdf
Export
Position: 371 (6 views)