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RF_HP_3_A_PART_2_SUDHA
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"UNNiKRiSHhiAN PV (Dr)" <unnikru@yahoo.com>
<PHA-Eurcpe@egroups.com>: <pha-exchange-admin@kabissa.org >: <phancc@vahoooroups.com>
Thursday, July 24, 2003 5:57 AM
[pha-ncc] Disease burden to test new Wl 10 chief
*
iDsSSSiSSB byrycil t© t€St
iiew WHO chief
From D Ravi Kanth
DH
Service GENEVA, July 21
Deccan Herald- July 22. 2003
As Dr Lee Jong-Wook — a pubiic heaith specialist from South Korea and a leading light in
colic eradication — takes over office on Monday as Director-General of the World Health
Organization, hopes are pinned on his leadership to tackle the escalating disease burden in
poor countries.
Unlike his high-profile predecessor and former Norwegian prime minister Gro Harlem
Brundtland, Dr Lee is a WHO-insider with strong public health credentials. His election to
WHO s top job was a tough race in which he won the final lap by just one vote.
Dr Lee told Deccan Herald last week that he was fully involved in the polio eradication
campaign and has visited Bangalore and Hyderabad several times to oversee the eradication
programme.
’’If I could succeed in polio-eradication, why can't I bring measurable results in tackling
HIV/AIDS, tuberculosis, and malaria?" he asked.
Dr Lee was involved in his country’s ieprosy programme and, subsequently, moved to the
WHO to look after polio eradication.
1 lis motto is guided by three principles: We must do the right things. We must do them in
rhe right places. And we must do them the right way."
He oromised to issue a new global plan by December 1 tojaddress HIV/AIDS. "HIV/AIDS will
be given a renewed emphasis as one of WHO's priority programmes, particularly focusing on
the target of providing three million people in developing countries with antiretroviral drugs
by the end of 2005 (the "Three by Five” goal),” Dr Lee said.
Similarly, he says he will strengthen the global surveillance division to track, down
communicable diseases such as the recent SARS (Serious Acute Respiratory Syndrome) that
hit Asian countries particularly hard.
In response to a question on whether he would choose the practice of declarin'1 travel bans
on countries that face serious communicable diseases such as SARS, Dr Lee said he 'would
not wait for "one second” to impose such a ban if required.
Dr Lee concedes that there have been failings in accomplishing the public health goals set
out in the Alma Mata declaration some 25 years ago: "Health for all by 2000."
He says there is urgent need to revisit the declaration all over again.
Similarly, he agrees that trade-related intellectual property right provisions of the World
Trade Organization should not come in the way of addressing public health problems.
And hs o!so
shorply with ths criticism levied on the privete sector for not
enuauinu seiiOUSiy li'i the health Sector, aftd asserts that if proper partnerships aie designed
with tne private sector they can deliver resuits.
' "
———————— He argues that there is room for an active role for pharmaceutical companies in the public
Dr Lee will be assisted by n health experts largely drawn from rich countries to deliver
results in the ambitious agenda that he set out for himself for the next five years.
They include Denis Aitken from the United Kingdom, Jack Chow from the United States to
iook after H1V/A1DS, 1 b and malaria, I im Evans from Canada for information policy,
Catherine Le~GaIes^CamusFfroffTFrahce to look after noncommunicable diseases and mental
health, Kerstin Leitner from Germany for sustainable development and healthy
environments, Anders Nordstrom from Sweden for general management, and Vladimir
Lepaknin from Russia for technology ana pharmaceuticals.
Kazem Behbehani from Kuwait, Liu Peiiong from China, and Joy Phumaphi from Botswana
are mciuaea in Dr Lee’s cabinet.
Leo's so!setion of
puuiic lieaitii expeits iii ms Cabinet num rich countries that are not the epicentre for
disease-burden, particularly HlV/AlDb, lb, and malaria.
Message forwarded by:
Dr.unnikrisnnan PV, india : E-maii: unnikruiaiyanoo.com / Ph (M): +91 (0) 98450 91319
30,0-02 children wi!! die in the next 24 hours from preventeble diseeses.
Click wzw.ThcMillionSicnaturcCampaisn.org , to join a campaign that demands HEALTH FOR ALL
hiOvV !
Yahoo! Groups Sponsor
ADVERI ISEMEN I
©Hits®tae-Mfer’®amiMaster’«
aw-Accounting
mfe Education (5/
^Administration (7)
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PERSPECTIVE
17
India’s billionth citizen speaks
the Shardha Act many years ago prohibiting such
marriages. But little do the authors of such legisla
tive measures know what hunger means. They do
not understand that in times of drought and
famine, it is we children who rescue our parents.
That is why we are called assets even if we swell the
population to a billion or more.
In any case, my parents will not send me to
girl child, I may not survive at all. Foeticide, infanti
VATSALA VEDANTAM gives
school notwithstanding our universal primary edu- j
cide, forced suicide. Our kitchen fires burn too
cation programme. I will become the surrogate d
bright sometimes with all those accidents. Whereas,
expression to the heartfelt cry of the
mother to my siblings while they go to work. My
if 1 was a son, I would have brought prosperity to
our household. That is, if I was not among the female child which hopes to survive all brothers are wage earners too. They clean the floorj®
in eateries where their employers give them the left-. • w
unlucky 110 of every 1,000 live births who do not
overs, and to my parents the wages. They don K1
live to celebrate their first birthday. And, if I also
odds believing that perseverance,
mind. For, otherwise they would starve. Or be rum- ’
managed to survive diarrhoea, diphtheria, per
maging in garbage dumps for stale food scraps. <
tussis, tetanus, measles and malnutrition.
though delayed, ultimately triumphs.
When they are older, they will be sent to work in 1
They say my country has the world's highest
automobile garages. Or, petrol filling stations. If
infant mortality rate. Its youngest citizens are vic
their luck holds good, perhaps even to a match factims of deprivation, disease and untimely death.
tory where they would work for 14 hours a day to
But I am still proud that I belong to one of the 183
augment tire family income. The opportunities are '
member nations which ratified the United Nations
endless in this land of a 390-million labour force!K
Declaration on the Rights of the Child.
My parents are wise not to waste our precious child
1 have arrived.
hood in schools which have no buildings,
Into a land which suffers droughts, floods, earth
quakes and other natural calamities with dreadful
blackboards or teachers. An education that would
have certainly left us unemployed and unemploy- r
regularity and stoic acceptance. They wipe us out
in tens of thousands. Nature’s own population
able.
control mechanisms, I guess. A land whose gra
I have arrived.
naries overflow with food, but whose distribution
But, it is not all that hopeless. Out there, far from ■/'
my village, there are cities where things are vastly, ®
processes leave thousands more starving. We
lately made headlines by reviving preventable
different. Where towering buildings house
diseases like plague, malaria, dengue and tubercorporate offices and 5-star hotels. Wher^l
I culosis. So, they call us a backward nation. But
tech parks jostle with super specialty h
Ave do have a national health policy which long
Where prestigious scientific institutions ru
ago promised “Health for All by 2000 AD.” We
ders with savvy universities. Cities where th
may allot less than one per cent of our gross
Indian diaspora called the Middle Class li
domestic produce on health, while spending
makes a fortune. Where luxury apartnjgyit.
several times that on defence. So what? We
the latest gizmos. Where people ride ii?airnow belong to that exclusive club which
tioned limousines, drink mineral water an<
can flex its nuclear muscles at the world’s
sanitised lives. Whose children attend e
most powerful nations.
sive schools and speak the Queen's En
Yes. It is true that 800 million of us who
Who wear Levis jeans and Nike shoes. Eat°l
live in villages have no access to safe
tucky Fried Chicken and Macdonald bu
drinking water. It is also true that in our
Indulge in Scotch whiskey and Gold Hake cii
I cities, 7,000 citizens are cramped into
rettes. They are the new generatfflKfeyjg £
■ every one kilometre of space. I don’t deny
offspring of a liberal economi«Rjicv'
I that we have to make do with half a million
gladly lap up the discarded goodies frQnj „,h
I elementary schools even though we add
countries.
|■ ™
! 48,000 more to our population every day.
But wait.
; But, these are matters that do not unduly
There are other avatars too. Like the *
I1
i worry' us. Nor our national leaders
agement gurus and the dot.com Dre
I either. On the other hand, they probwho are exploding on our inf!/0
. ably wish to keep us going at the same
highway. They are going placSw?®!'.
I rate of reproduction - 18 million a year,
software skills and web site wizjr
i to be precise - because we are their preare the brilliant sons and
J?
' cious vote banks. Never mind what
same incredible land. They win di™'s ,of “ '
colours they wear. Saffron, white or
their universities, gain admisggjffiponsf
green, they are all the same. We keep
League schools and do their coun 'nto I»
,
them in power. In turn, they keep us
What’s more, other countries like
Prout I
^literate, ignorant and prolific.
falling over each other to grab these c>nLe*ica art I
<have arrived.
professionals. They are all out .there.igra-kint I
Into this vast country with its mind boggling reli
hundreds of other talented folk. EngggRig witH I
gions, dialects, castes and communities. On the not bring cheer into their drab lives. It only means tists. Artists. Writers. Who are surelyj,
Scien- I
ninth day of the waxing moon. To parents who one more mouth to feed. And, one more drain on this one billion strong country o^the’1'8 to ptf . I
i cannot read and write. Who walk several kilometres their resources. Who knows, I may be married off world. Who knows, I may become part0 f
'
*
every day to collect water for drinking and firewood before I turn five to a boy of my own age in pora some day?
i■
1 for cooking. The birth of one more daughter does exchange for some rice. We had something called
I have arrived. •
.■
HAVE arrived. The billionth citizen of this
Where poverty, injustice and
I ancient land with its 5000-year-old
I civilisation. The inheritor of the world’s atrocities against women and children
I largest democracy - with 40 political parties
are rampant, truth stands a weak
it I and 24 official languages. Each spoken by a
ZJL, million and more persons.
chance of prevailing over wrong.
/ It would have been lucky if I was bom male. As a
POPULATION EXPLOS1ON-II
Case for a realistic policy
national level, monthly meetings
HE Union Government’s
By J L AZAD, P P SING H & KARUNA SINGH
for monitoring the progress of var
medium-term objective of
bringing down the Total effective to the required extent. ethical issues. The content areas of ious development programmes are
Fertility Rate (TFR) to replace While in a democratic society like population education are popula held. These meetings also review
ment level by 2010 and the long ours, it is difficult to enforce rigid tion dynamics, population, envi the progress of family welfare pro
term objective of achieving a sta ly a programme of limiting child ronment and sustainable develop grammes. Fourth, the corpoble population by 2040 are to be birth to a single child, as China has ment, the gender equality in the rate/private sector also monitor
achieved through the pursuit of 12 done, it is necessary to introduce family system and information family welfare programme in their
strategic themes such as decen effective disincentives for produc about STO, HIV/AIDS, drug abuse industries and companies. And
tralised planning and proper ing more than one child — son or etc.
finally, private medical practition
Thirdly, community participa ers also promote family welfare
implementation, convergence of daughter.
Some of the measures, which tion with involvement of all com programme.
service delivery at the village and
household levels, empowering need to be taken urgently are: munity leaders from grassroot
The unrestricted growth of pop
women for improved health and Delayed marriages, education and level to the national level is an ulation in India is one of the very
nutrition, meeting the unmet community participation. First, essential pre-requisite for the suc serious problems staring the coun
needs for family welfare services delayed marriage is a potent cess of the programme. In this con try in the face. It has wider socio
and diversifying health care weapon for bringing about decline nection, mention may be made of economic and cultural ramifica
providers. The National Popula in population. It has been found the Indonesian model which has tions. To tame this hydra-headed
tion Policy has stressed that infor that more than half of all female been well appreciated by WHO and monster, action in multifarious
mation, education and communi marriages occur before the age of other international agencies.
fronts is required. The most impor
cation of family welfare messages 20. In some States like Rajasthan, Indonesian model
tant component of the action plan
must be clear, focussed and dissem marriages are solemnised even
is to give fillip to the education of
The main features of the girls in order to increase the level
inated everywhere.
before the children have crossed
Another significant motivation their infancy. In this connection, Indonesian model are: One, at the of awareness of this most neglect
al measure is the Atal Behari the position of age at marriage in periphery level, for every 50-60 ed segment of population.
Vajpayee Government's decision to the People’s Republic of China and houses, there is a lady volunteer
We will have to work out a real
extend the freezing of the number Vietnam is of interest. It was 18 in maintaining the record of families istic population policy and pro
of Lok Sabha and the Rajya Sabha China in 1940 and it peaked to 23 about number, educational stan gramme which will be an effective
seats for another 25 years i.e. from years in 1980 to be stabilised at 21 dards and also for motivating for amalgam of incentives and disin
2001 to 2026. The National years in recent times. In Vietnam, safe motherhood and child sur centives. The success of any pro
Commission on Population at the the average age of female mar vival with family planning meth gramme of family welfare will
Centre is also a significant step riage is around 22 years and that of ods. She also reports every month depend on the extent to which we
to the field health worker (family are able to harness community
and in the right direction.
male 26.
welfare worker) available for 3000- support and participation. All this
Among the promotional and
Women’s education
5000 population. Besides, commu would require adequate invest
motivational measure for adoption
Secondly, education is another nity has set up maternity and child ment for family welfare pro
of the small family norms, men
tion may be made of rewarding the important input for regulating health centre for minor ailments grammes as also for the expansion
Panchayats and Zilla Parishads for population growth. In this connec and normal deliveries managed by of education among girls and
their performance in universalis- tion, the education of girls midwife, approximately on three- women in the age group of 15-35.
ing small family norms, offering assumes utmost significance. As year contract basis from the area.
Two, there is a regular feature Kid-glove approach
reward for the birth of the girl already stated, in spite of earnest
child, continuing maternity bene efforts in the post-independence of monthly meetings, where chil
Unfortunately, we have been
fit scheme, rewarding couples period, girls' education at all dren below the the age of five years having a kid-glove approach to the
stages
is
lagging
behind.
It
must
be
are monitored for growth; mothers problem. In the process, the popu
below the poverty line with not
'more than two children etc. to emphasised that women's educa are helped to see their child grow lation growth has reached unaf
tion is crucial to the success of any well, family planning devices are fordable dimensions. It will be nec
undergo sterlisation.
programme of population control. supplied and advice about chil essary to adopt measures which
Effective disincentives
It is also necessary that the chil dren’s health is given. Community are effective, comprehensive, vig
’ I'he measures of regulating the dren at an appropriate age should also prepares nutritious food for orous and humane. Closing our
growth of population as listed be given information about the distribution among children.- eyes to this ever-increasing men
above are unexceptionable. It is, reproductive system, healthy sexu Third, at all levels from Gram ace will be at our peril.
however, doubtful if they will be al behaviour and related moral and Panchyat/ward, district, state and
(Concluded)
T
POPULATION EXPLQSION-I
Half-hearted approach won’t do
N May 11, 2000, India
attained the dubious dis
tinction of having one bil
lion people within its fold. It has
been estimated that this country,
with its meagre physical and mate
rial resources, will surpass China
in another 50 years, in case the
present rate of population growth
remains unabated. In this article.
the hazards of unrestricted popu
lation growth have been highlight
ed. The reasons for the phenome
nal growth of population have also
been analysed. It has been empha
sised that, besides taking other
measures, there is a need for
expanding education particularly
among the girls and women in the
reproductive age group. It is also
necessary to involve the communi
ty in implementing programmes of
family welfare.
Ever since Thomas Malthus
(1766-1834) made his gloomy pre
diction about expansion of popula
tion outstripping the growth of
food supplies, the countries have
been taking steps to avert the
catastrophe. In spite of conceited
efforts, the world population has
been increasing exponentially
resulting into, among others, veiy
serious socio-economic disparities
among the various countries. It
has been estimated that of the 4.4
billion people in developing coun
tries, nearly three Fifths lack
access to sanitation, a quarter do
not have adequate housing and a
fifth have no access to modern
health services. A fifth of primary
school age children are out of
school. {Human Development
Report. 1998-99).
O
Precarious position
“The ’position of India on the
population front is precarious. We
have already reached a billion
mark. It is estimated that in case
the current fertility rate (3.3) is not
reduced, we will surpass China by
2050. As of now, India has 16 per
cent of the world population with
2.4 per cent of the global land area.
While global population has
increased three fold in the 20th
century, the population of India
increased about five times i.e. from
238 million to one billion.
The deleterious effects of the
By J L AZAD, PP SINGH & KARUNA SINGH
unabated population growth have
manifested themselves in multi
pronged directions. In 1961, the per
capita food availability was 469
grams, which was reduced to an all
time low of 454 grams in 1981. In
1991, however, it went up to 466 —
still lower than the 1961 position!
The increasing pressure on agri
culture is another pointer to the
expanding population. In India, 72
per cent of population is engaged
in agriculture as against about 20
per cent in developing countries.
lating population reveals a some
what casual approach to the prob
lem. Soon after India attained free
dom from foreign domination, we
had pledged to reduce the "birth
rate at a level consistent with the
requirements of the economy”
(National Family Programme
1952). We have, however, not been
able to make a determined effort to
achieve this laudable goal. Several
surveys indicate our half-hearted
approach to this problem in com
parison with some of the countries
such as Korea and Thailand.
Marked deterioration
It has been, widely recognised
■ Further, there has been a that education exercises a decisive
marked deterioration in the avail influence on the. socio-economic
ability of health services. Our development of the country. It has
physician- population ratio stands also been found that it has a salu
at 01:5000 as against 1:400 to 900 in tary effect on population growth.
developed countries. The unabated In a number of studies, it was
growth of urban slums to accom revealed that women with four
modate hordes of rural popula years of education have 30 per cent
tion, leaving their rural hearths fewer children. Further, infant
and homes in search of jobs, is mortality gets reduced by 50 per
another indicator of the ever- cent. Girls education also invari
increasing pressure of population ably results in delayed marriages.
in the country. No wonder, India
An analysis of the progress of
has an abysmally low ranking (132) education in the post-independ
among 174 countries of the world ence period reveals a dismal pic
hrternrs^f'humanllevelopment ture. According to the latest avail
and human poverty indices?
able data (1997), the female literacy
—The ecological“degradatlonron stood at 50 per cent as against 73
account of. among others, the bur per cent'for males. The position of
geoning population is mind bog literacy among women in rural
gling. It has been estimated that areas was much worse — a little
the environmental damage ranged more than 30 per cent as against 58
between $10 to 14 billion in 1992 per cent for males. Among the
which is 6 per cent of India’s GNP. States, Bihar was the most back
Further, the damage to flora and ward, with female literacy in rural
fauna has reached unaffordable areas being 30 per cent as against
limits. Ganga, the holiest of the our overall literacy percentage of
holy Indian rivers, supporting a 45 for India as a whole.
staggering 400 million people
along its 1560-mile long course, is Glaring disparities
condemned to swallow 1.3 billion
Similar
disparities
were
litres of sewage discharge per day observed in the case of girls educa
This is in addition to 260 million tion in the formal school system.
litres of industrial waste, 9,000 The gross enrolment ratios (GER)
tons of pesticides and 6 million were 93.3 for girls (as against 104.3
tons of chemical fertilizers for boys) in the age group 6-11 and
(Human Development Report. 1999). 54.9 (as against 79.5 for boys) in the
What a pity that this reservoir of age group 11-14. It should hurt our
our age-old traditions and culture, pride to know that India’s illiterate
sanctified by Lord Shiva, has been population is the largest among
reduced to a slow moving garbage the countries inhabiting the globe.
dump.
So far as State-wise position is
An analysis of the causation of concerned, Bihar has again the
the Frankenstein of the ever esca dubious distinction of having the
lowest per centage of girls (55.4 per
cent) in classes I-V and 21.9 per
cent in classes VI-VHI. The other
members of the so-called ‘Bimaru’
States are a shade.better: Madhya
Pradesh (43.3 per cent), Rajasthan
32.8 (per cent), Uttar Pradesh 34.9
(per cent) of girls in classes VIVIII. This despite the fact that
India has a constitutional obliga
tion of providing free and compul
sory education to children till they
attain the age of 14 by 1960.
Steeped in ignorance
Lack of education is also partly
responsible for keeping large sec
tions of our population steeped in
ignorance and out of tune with the
changing times. It has perpetuated
our socio-cultural mindset, which
puts a premium on son(s). Many a
time, in pursuance of this selfimposed objective, the production
of children goes on unabated till
either this elusive objective is
achieved or the unfortunate
woman crosses the reproductive
age cycle.
In the process, India’s popula
tion swells to unaffordable limits.
In this often-time wild goose chase,
our religious beliefs also play their
part: Ashta putra soubhagyavati
bhav (Be the fortunate mother of
eight sons) is the oft-repeated
prayer that is invariably dinned
into the ears of the newly married
woman.
Considering the gravity of the
situation, some drastic measures
are required to remedy the situa
tion. The Union Government has
brought out the National
Population Policy with the "medi
um-term objective’ of bringing
down the Total Fertility Rate (TFR)
to replacement level .by 2010. The
long-term objective is to achieve a
stable population by 2040 at a level
consistent with the “requirements
of sustainable economic growth,
social development and environ
mental protection” (National
Population Policy, 2000).
Prof J L Azad isformer Chief of
Education Division, Planning
Commission; Dr P P Singh and Dr
Karuna Singh-are Directors of a
World Bank-assisted project on
Population Control.
(To be concluded)
:
2
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gft TH ftnn ft HR ft Fifty y^THT FWR ftl
FT-
iiPift fty
ftft
RHRft
ar?m,
ftftHTF,ftHHF-2 31221 ?T-3T-§
Women in India
(A Statistical Profile)
Women in Partnership with Men
Constitution of India Guarantees
Equality before Law for women (Article 14)
The State not to discriminate against any citizen on grounds only of religion, race, caste sex
place of birth or any of them (Article 15 (i))
The State to make any special provision in favour of women and children (Article 15 (3))
Equality of opportunity for all citizens in matters relating to employment or appointment to any
office under the State (Article 16)
The State to direct its policy towards securing for men and women equally the right to an
adequate means of livelihood (Article 39 (a)); and equal pay for equal work for both men and
women (Article 39(d))
To promote justice, on a basis of equal opportunity and to provide free legal aid by suitable
legislation or scheme or in any other way to ensure that opportunities for securing justice are not
denied to any citizen by reason of economic or other disabilities (Article 39 A)
The State to make provision for securing just and humane conditions of work and for maternity
relief (Article 42)
The State to promote with special care the educational and economic interests of the weaker
sections of the people and to protect them from social injustice and all forms of exploitation
(Article 46)
The State to raise the level of nutrition and the standard of living of its people and the improvement
of public health (Article 47)
To promote harmony and the spirit of common brotherhood amongst all the people of India and
to renounces practices derogatory to the dignity of women (Article 51 (A) (e))
Not less than one-third (including the number of seats reserved for women belonging to the
Scheduled Castes and the Scheduled Tribes) of the total number of seats to be filled by direct
election in every Panchayat to be reserved for women and such seats to be allotted by
rotation to different constituencies in a Panchayat (Article 243 D (3))
Not less than one-third of the total number of offices of Chairpersons in the Panchayats at each
level to be reserved forwomen (Article 243 D (4))
Not less than one-third (including the number of seats reserved forwomen belonging to the
Scheduled Castes and the Scheduled Tribes) of the total number of seats to be filled by direct
election in every Municipality to be reserved for women and such seats to be allotted by
rotation to different constituencies in a Municipality (Article 243 T (3))
Reservation of offices of Chairpersons in Municipalities for the Scheduled Castes, the Scheduled
Tribes and women in such manner as the legislature of a State may by law provide
(Article 243 T (4))
----------------------------- —-■ •-
PROGRESS AT A GLANCE
Development Indicators
•
•
•
•
\Women
Men
Total
Women
Men
Total
Demography
- Population (in million in 1971 & 1991)
- Decenneial Growth (1971 & 1991)
264.1
24.9
284.0
24.4
548.1
24.6
407.1
23.2
439.2
23.8
846.3
23.5
Vital Statistics
- Sex Ratio (1971 & 1991)
- Expectation of Life at Birth (1971 & 1996-2001)
- Mean Age at Marriage (1971 & 1991)
930
50.2
17.2
50.5
22.4
50.9
927
63.4
19.3
62.4
23.9
Health & Family Welfare
- Birth Rate (1971 & 1998)
- Death Rate (1970 & 1998)
- Infant Mortality Rate (1978 & 1998)
- Child Mortality Rate (1970 & 1997)
- Maternal Mortality Rate (1980 & 1998)
15.6
131
55.1
468
15.8
123
51.7
7.9
24.9
Literacy and Education
- Literacy Rates (1971 & 1991)
- Gross Enrolment Ratio (1990-91 & 1998-99)
Classes l-V
Classes VI - VIII
- Drop-out Rate (1990-91 & 1998-99)
Classes I - V
Classes I - VIII
Work and Employment
- Work Participation Rate (1971 & 1991)
- Organised Sector (No. in lakhs in 1971 & 1997)
-
Public Sector (No. in lakhs in 1971 & 1997)
-
Government (No. in lakhs in 1981 & 1996)
36.9
15.7
127
9.2
69.8
21.8
26.5
9.0
72
23.1
16.7
39.3
64.1
52.2
100.9
65.3
92.1
57.6
85.5
47.8
113.9
76.6
100.1
62.1
82.9
49.1
46.0
65.1
40.1
59.1
42.6
60.9
41.2
60.1
38.6
54.4
39.7
56.8
14.2
19.3
52.8
155.6
34.3
174.9
51.6
231.8
37.7
275.7
98.7
107.3
162.6
188.7
97.1
109.0
22.3
43.9
(15.9%)
26.1
(13.8%)
15.0
(13.9%)
92.7
107.7
535
(10.4%)
110
(3.3%)
4624
5159
3191
3301
8.14
(31.3%)
229
(5.6%)
67
(8.4%)
8
(10.9%)
17.84
25.98
3838
4067
723
790
65
73
(11 %)
8.6
(8 %)
11.9
(11 %)
•
8.8
73.5
24.5
407
Decision Making
- Administrative
IAS (1987 & 2000)
IPS (1987 & 2000)
-
Political
PRIs (No. in lakhs in 1995 & 1997)
Legislative Assemblies (No. in 1985 & 2000)
Parliament (No. in 1989 & 1999)
339
(8.1%)
21
(0.9%)
3.18
(33.5%)
141
(5.1%)
47
(6.1%)
Central Council of Ministers (1985 & 1999)
(10%)
3865
4204
2397
2418
6.30
*
9.48
2632
2773
721
768
36
40
Refers to 1995 in respect of only 9 States viz. Gujarat, Haryana, Karnataka, Kerala, Madhya Pradesh, Punjab, Rajasthan, Tripura and
West Bengal
Noted. Figures in parantheses indicate the percentage to the total and year of the data in respective columns.
2. Non-availability of data restricted to maintain a common Base-Year for comparisons.
( DEVELOPMENf INDICATORS : A COMPARATIVE PIC
Sourc
Census of India, 1991. Part II B(l). P
Vol.1, Office of the Registrar Genera
Census of India, 1991. Stale ProfflCommissioner, India, 1998
Family Welfare Programme In Inn
Health Intelligence. Ministry of Healt'
New Delhi, 1998
Census of India, 1991. Female Age
Data, Registrar General of India. Ne»
SRS Bulletin, SRS, Registrar Genei
Sample Registration System, W
India Nutrition Profile, 1998. Deps
Govt, of India, New Delhi
Education-Profile of stateS^n^u
Education, Ministry of Human Re
Delhi, 1999
Annual Report 1999-2000. Depart^
Education & Higher Education, Mintof India, New Delhi
Planning Commission, Government
Crime In India, 1998.
Government of India, New De
Lok Sabha Members: Thirteen^
Secretariat, New Delhi. 20W
Election Commission, Government c
15.
Institute of Social Sciences. New
Department of Personnel and Train n
Ministry of Home Affairs. Govern
Planning CommlsS
<S0C,a'mee"
Governme"1
New Delhi
2000
PARA FIVE PICTURE OF THE STATUS OF WOMEN AND MEN IN INDIA
LITERACY & EDUCATION
CRIME
WORK PARTICIPATION & ECONOMIC STATUS
Drop-out
Percentage Distribution of
Selected Crimes
Moderately
Enrolment Ratios9
Literacy Rate
Rates’
Total Workers (1991)’
against Women”
Work
Incidence of
Mater- & Severely
Infant
Cruelty
Participation
underCognizable
Below
nal
Mortality
Primary
Secondary
Tertiary
Classes
Rate.Crime
Classes
NSSO
by
Poverty
Morta- nourished
1991
Classes
Rate
Sector
Sector
Sector
Total Workers
53rd
VI-VIII
lity Children (%) Census1
l-VIII
Line (%) (Indian Penal Rape Husb Dowry
(1-5yrs: Weight
(1998)s
and & Death
(1991)’
(1998-99)
Code) Round
(1998-99)
1993-94)’°
Rate
(1998-99)
Rela
(1998)”
(1997)®
(1998)’
1994-96)7
tives
emale Male Female Male
Girls Boys Women Men Women Men Girls Boys Girls Boys Girls Boys Women Men Women Men Women Men Women Men Total
Total Women
(49) ‘ (50)
(30) (31) (32) (33) (34) (35) (36) (37)
(26)
(27) (28) (29)
(44) (45)
(46)
(47)
(48)
(20) (21) (22) (23) (24) (25)
(40) (41)
(42) (43)
(38) (39)
EALTH & NUTRITION
DECISION -MAKING
*
Administrative
Political
Child
Mortality
Rate
(0-4 yrs)
(1997)®
Legislative
Assembly
(2000)”
Lok
Sabha
(1999)”
Panchayati
Raj
Institutions®
(1991-997)'4
I.A.S
(As on
1.6.2000)”
I.P.S
(As on
1.4.2000)”
Men Women Men Women Men
(56)
(57)
(58) (59)
(60)
Women Men Women Men Women
(51) —(SZT '(Wj~(54f' (55)
73.5
69.8
24.5
21.8
407
40.8
42.1”
39.3
64.1 50.0
73.0
82.9 100.9
49.1
65.3
60.1
54.4
22.3
51.6
81.1
63.4
8.1
13.3 10.8
23.3
35.97
49
494
1779111 131338 15031 41318
6917
(7.4%) (11.4%) (31.5%) (5.3%) (9.0%)
229
3838 813676 1784134
(5.6%)
(31.3%)
535
4624
(10.4%)
67.8
49.8
67.4
66.5
21.1
65.9
81.4
76.6
52.1
55.7
13.1
96.5
55.6
18.4
47.2
19.9
65.0
45.6
84.9
67.5
30.5
62.7
60.7
59.7
39.5
60.9
18.0
99.5
42.5
23.7
59.2
32.3
16.4
NA
28.7
27.1
NA
22.8
25.1
16.1
NA
17.2
3.5
31.9
11.4
NA
NA
NA
17.1
NA
25.3
248
NA
19.1
19.7
15.5
NA
15.6
3.0
32.6
12.9
NA
NA
NA
159
NA
409
452
NA
28
103
NA
NA
195
198
498
135
NA
NA
NA
49.6
54.5
27.6
55.4
17.5
61.8
33.0
34.7
NA
51.1
34.2
49.6
55.6
28.6
10.7
18.2
48.6”
59.2”
29.4”
56.6C
25.1c
74.2”
34.3R
36.6”
NA
55.6”
34.4”
57.9"
52.7”
31.0c
11.5C
17.5C
32.7
29.7
43.0
22.9
67.1
48.6
40.5
52.1
19.6
44.3
86.2
28.9
52.3
47.6
44.9
78.6
55.1
51.5
61.9
52.5
83.6
73.1
69.1
75.4
44.2
67.3
93.6
58.4
76.6
71.6
53.1
85.6
50.9
68.2
69.4
42.4
82.9
72.1
67.2
88.5
79.8
70.9
97.2
75.0
89.3
77.3
56.9
78.4
83.8
89.9
86.5
91.6
44.5
81.7
72.2
89.6
NA
78.8
48,6
89.3
83.6
76.5
83.8
78.3
64 6
54.6
71.0
80.6
28.2
54.5
57.4
61.5
NA
62.7
47.8
72.7
509
65.4
69 5
58.1
38
2
12
49
2
23
8
4
6
26
19
37
44
2
2
1
28
1
6
19
2
4
4
6
2
6
13
26
12
1
3
0
281
194
216
360
X
225
180
109
109
213
157
342
311
193
XX
X
54.8
67.1
63.2
38.0
46.9
96.9
56.4
9.8.3
52.7
28.2
28.0
367
51.4
55.1c
34 7
63.1
37.4
64.8
72.1
65.3
20.8
53.8
92.1
82,7
63.3
74.3
0
13
266 83783 162483
59
125
6890
116
8203 19143
NA
NA
305
38
468
863
178 42708 85337
86 18836 38044
6655 13516
62
NA
NA
85
218 35640 49246
4050
8067
127
294 159609 324785
276 101943 206888
59
598
1019
57
Nil
Nil
40
Nil
Nil
Nil
Nil
60
33
38
10
33
X
23
32
17
3
35
21
54
40
5
XX
X
27.5"
122536 11201
1663
125
38146 3388
116045 7105
3119
109
125892 6658
37228 3002
10954
778
17420 1715
110533 5516
93020 4799
201544 15865
180288 14266
2566
86
1828
71
2531
141
1293
32
869
32
744
1421
16
368
364
128
178
233
589
3354
1154
13
42
84
27.1
12.0
12.3
6.1
4.9
25.1
20.8
13.9
12.9
NA
14.2
17.1
9.7
20.5
6.5
5.0
7.2
5.1
23.4
33.1
22.9
14.5
46.7
24.8
28.7
25.7
NA
23.1
35.0
17.6
28.6
28.1
25.4
34.7
NA
7.7
22
3.3
3.3
12 7
5.8
6.7
2.5
NA
10.8
21.7
5.2
6.0
14 1
1.5
1.8
1.2
8.5
7.9
10.2
5.1
42.9
12.5
21.1
7.9
NA
10.4
29.7
5.5
10.4
9.4
14.7
19.9
NA
72.7
67.5
68.3
75.4
4.7
56.7
19.9
28.5
31.7
59.5
-5.5
42.4
34.8
45.4
77.7
68.5
46.5
55.5
53.8
49.4
47.9
49.6
53.6
48.5
50.6
NA
54.1
47.6
52.3
52.2
45.3
50.1
53.9
NA
74 1
65.9
72.3
80.1
11.3
64.8
29.1
28.1
44.3
63.5
-3.5
57.1
44.1
47.0
78.1
65.8
38.9
34.3
37.5
21.6
14.9
20.5
26.0
10.8
34.8
NA
29.4
15.8
32.7
33.1
39.0
34.9
43.5
NA
74.0.
95.01
67.6 77.0
40.9
64.9
52.4
23.1
72.6
58.0
61.1
79.7
49.9
61.1
93 2
48.1
833
68.5
62.0
77.9
NA
17.6
33.4
12.6
26,1
199
31.6
32.2”
64.0 94.5 99.2
69.0 107.9 121.9
82.0 100.2 118.8
62.0 61.5 93.2
93.0 67.5 75.2
80.0 100.7 122.9
76.0 84.1 82.3
87.0 883 96.1
71.0 66.6 93.4
66.0 104.4 111.4
96.0 87.0 88.7
70.0 96.5 119 6
84.0 111.0 114.4
86.0 84.1 100.2
79.0 113.5 119.2
96.0 120.6 133.7
91.0 108.9 111.7
64.0 79.8 109.5
72.0 84.2 81.3
65.0
67.3
29.4
26.6
57.1
42.6
73.0 75.7 125.5
86.0 130 2 137.6
80.0 107.1 109.5
33 6
87.4
78.6
72.2
68.1
55.5
54.2
49.3
34.2
670
4.4
27.4
63.3
70.9
30.4
51.3
89.5
80 7
79.4
97.7
564
76.8
55.9
66.7
26.1
69.6
29.9
79.0 .97.5 118.7
69.0 49.3 75.9
81 0 87.0 100.1
34.8
71.1
13.8
47.5
43.0.
48.0
66.0
34.0
79.0 i
57.01
52.0
7O.b:
48.0;
50.0
90.0;
41.0.
63.0
66.0!
42.3C
50.4
20.4
NA
NA
NA- 36.8
37.7C
46 7
38.0 |
65.7 62.0!
54.9 35.0'
65.7 72.01
12.2
NA
79
NA
39.7
40.9”
50.4
14.6
NA
78.8
35.3
27.3
707
33.6C
NA
73.8 60:0
70.6 67.0 (
92.9
40.6
NA
51.3
49 7
25.3
48.0
58.6
16.1
17.5
266
NA
NA
46.6
55.7 41,0;
67 8 63.0'
35.4
21.6
NA
NA
NA
65.5
26.0
NA
NA
NA
NA
NA
30.6
25.2
21.1c
72.3
78.9 94.0! 100.0
82.0 74.01 90.0
53.6 30.0|
66.0
99.7 144.8
44.1
71.3
NA
82.7 73.0'
82.0 76.01
95.0 104.5 113.3
91.0 86.9 87.2
91.1
90.2 93.01
83.7 86.0
98.0
94.0
79.2
84.5
70.5
84.2
35.7
82.8
64.0
58.1
48.3
42.9
65.0
60.6
NA
NA
95.0
17.3
NA
45.0
23.3
NA
21.2
31.6
NA
28.6
23.9
NA
NA
37.7
44.9"
26.9
35.5 29.7"
33.4 37.0c
59.4
NA
NA
NA
NA
NA
NA
NA
72.9
NA
NA
NA
NA
65.6
66.9
31.6
13
0
0
Nil
1
7.3 7.6 10.1
11.0 15.0 54.9
18.1
27.9
48.56
11.77
51359
16922
4450
1238
679
935
397
240
2
19
219
67.3
62 3
4 0 11.3
6.5
21.4
27.41
167463 12159
1266
433
2
3
11
22
5.8 13.8 13.5
23.9
41.43
55.3
11.8 18.1
5.0
6.3
26.6
40.0
35.03
62.3
71 5
11.5
M ,22.4
W 9.1
39.01
37
7
4947
2
149293 11201
319
362
73
440
115
5113
3704
536
3616
26.4
48.9
57.9
50.6
12.3
49 7
19.1
40.85
184461 17497
1605
43.6
56.9
78.3
70.3
11.2
51.4
60.3
60.0
19.9 17.5 19.8
26.5
35.66
67950
6811
757
13.1
10.4
53.3
54.3
29.2
35.2
34.47
4.7
61.9
20.7 25.7 50.2
12,9 3A ,84.2
4.0 2™ 5.6
39.1
2.9
90 4
371
37.4
27
13.2
2.9
26.6
53.9
35.1
20.7 26.5 42.2
18.1 34.1 79.3
30 9 24.5 55.9
10.0 22 8 36.1
871
97.6
93.5
28.1
23.2
68.1
62.4
66.3
59.3
-3.3
5.5
89.9
64.5
84 8
63.1
6.8
91
24 7
99.6_ •2,1
57.3
-6.5
19.9
48.8
57.5
23.2
7.4
51.6
517
19.5 ' 7.6
15.2
-2.1
44.2
50.6
4310
8
739
1507
16
3602
977
228
18
1501
2125
2765
7728
0
0
0
219
72.6
84.6
96,2
95.6 113.6
84.5 89.5
0
4
Nil
2
5
Nil
3
2
Nil
Nil
2
1
3
4
Nil
Nil
Nil
6.7
22.19
39.35
40.86
54.96
14.92
24.21
25.05
28.44
25.17
33.16
25.43
42.52
36.86
33.78
37.92
25.66
37.92
500
0
32
1039
3
90
309
7
9
200
21
598
420
0
Nil
0
1
176
10 ^Nil
2229 ™ 9
7
63
1
39
56432
17
185
59089
84811
28
165
7
6
129
144
6
141
Nil
24
7
XXX
176
xxx
10
381
4
255
1
31
115
860
29
5
231
45
225
35315
69230
37
288
2
76
2
20
1900
3793
404 189060 554326
XXX
51
XXX
484
20
274
21168
38479
23
273
186
58
26
97
3
0
Nil
1
##
##
296
493
X
X
X
X
11.35
540
1974
4
65.3
11
25
##
27
98
X
X
15.5
513
17
7
1
##
##
50
101
X
X
X
X
X
x I
36.2
63.1
15.80
266
64882
2
2556
0
438
7
1
5| ^Nil
0 ™Nil
Nil
0
##
50.84
1
##
##
30
48
1
6
X
0
1
Nil
Nl
1
1
61
##
NA
2
69
9
##
NA
56
2674
29
93
Nil
X
1
8
Nil
X
X
48.9
42.1
14.69
25.04
37.40
103
126
0
1
1
1
X
X !
X
X
X
X
X
X
X
X i'
included under Manipur
Limited to Premier Civil
: Included under Arunachal Pradesh
: Included under Assam
to m the context of developmental planning
eembly
Sources
Work Participation Rates (1971-19911
Literacy Rates (1951-1991)
Census of India, 1991. Part II B(l). Primary Census Abstract. General Population,
Vol.1, Office of the Registrar General of India, 1994
133
100
73
80
137
114
273
201
98
XX
x
31468
40862
1
37
3
4
I
1
4
2
9
6
3
XX
x
30759
9
5
179
147
134
233
110
1
249
11
9
2
14
134
38
14
110 3191
(3.3%)
Census of India, 1991. State Profile 1991, India. Registrar General & Census
Commissioner, India, 1998
Family Welfare Programme in India, Year Book 1996-97. Central Bureau ol
Health Intelligence, Ministry of Health and Family Welfare, Government of India,
New Delhi. 1998
Census of India, 1991. Female Age at Marriage: An analysis of the 1991 Census
Data. Registrar General of India. New Delhi
SRS Bulletin, SRS, Registrar General of India. Vol.33(1). April 2000
Sample Registration System, Registrar General of India, 1996
India Nutrition Profile, 1998. Department of Women and Child Development,
Govt, of India. New Delhi
Education-Profile of States/Unlon Territories (2nd Edition). Department ol
Ed JCanon, Ministry of Human Resource Development, Government of India, New
Delhi. 1999
Report 1999-2000. Departments of Elementary & Literacy and Secondary
n & Higher Education. Ministry of Human Resource Development. Govt.
Delhi
0 ----- I------------------- i------------------- 1-------------------- 1--------------------1—
1981
1991
1971
1961
1951
Years
I
t India, 1998. National Crime Records Bureau. Ministry of Home Affairs
lent of India, New Delhi. 1999
70.0
£ 60 -
/ernment ot India. New Delhi
30 ’
25 -
“
1
20 ‘
15
______
5
65.1
607
'
**
**
^_
Boys 59.1
54.9
■ i Home Affairs. Governmer;: i India. New Delhi
Planning Commission
(Social Development a Women's Programmes Division)
Government of India
New Delhi
2000
£
1
_____ 60,1
Girls
68
Commission, Government ot India, New Delhi
c 1 Social Sciences. New Dejil
Source: Annual Report -1999-2000, Ministry of Human Resource Development
35246 ...........
25946
19750 .............
13450 .............
t"_____ ----------rAT"
11708
^208
■
...........
W’ST
J;
54.4
14846
15031
.................
4836_______ 4962_______ 4935_______ 5513____________
50 i--------- 1------------------ r------------------ 1------------------- 1---------------- r—
1980-81
1985-86
1990-91
1995-96
1998-99
Years
\
41318
45 f 40
» 35 -
70 -
. .a Members: Thirteenth Lok Sabha (First Edition). Lok Sabha
, si New Delhi. 2000
•
.’L
Selected Crimes against Women (1990-1998)
Dr op-out Rates in Classes l-VIII (1980-81 —1998-99)
79.4
80 -
imisslon. Government o| India, New Delhi
ent ol Personnel and Training. '.
Source: Census of India. 1971-1991
Source: Census of India, 1951-1991
1990
( • Rape
J
,
Source: Crime In India, 1998
1992
Dowry Death
„ 1994
1996
1998
Years
Cruelty by Husband & Relatives
J
Others in the Series
• Tribes in India
• Population and Human
& Social Development Part I, Part II & Part III
• State Finances
Status of Women in India
• Transport
,
V
Very Low (<25)
O Low (25-49)
Medium (50-75)
O High (>75)
Ranking of the Status of Women in the States/UTs as ‘Very Low’, ‘Low’, ‘Medium’
and ‘High’ has been worked out on the basis of various women-specific
development indicators in respect of health, education, employment, political
participation, decision-making etc.
Design, Layout and Printing: New Concept Information Systems, New Delhi
These Data Sheets have
been brought out to
mark the 5O'h year of the
Planning Commission.
GOVERNMENT OF HIMACHAL PRADESH
Address by Prof. Prem Kumar Dhumal
Chief Minister of Himachal Pradesh
On the occasion of first meeting of
National Population Commission
NEW DELHI
JULY 22, 2000
Esteemed Chairman and distinguished members,
This is a matter of great importance that the Government of India have
constituted the National Population Commission under the Chairmanship of
Hon’ble Prime Minister of India. The ever-increasing population of the country is
also a matter of concern to all of us, which has almost increased five times during
this century thereby depleting the scarce national resources.
This has been possible primarily because of the keen interest and
initiative taken by the Hon’ble Prime Minister and I will like to congratulate him
personally for this. We have also constituted a state population commission under
my chairmanship and I will convene a meeting of this commission shortly. I must
express my deep gratitude to the Hon’ble Prime Minister for having convened the
first meeting of the national population commission promptly and also for affording
me an opportunity to place on record the views of my government on this most
important issue before the country, namely the population problem.
Population of Himachal Pradesh which was 19.20 lakh in 1901 reached
23.85 lakh in 1951 and 51.71 lakh in 1991. The decennial growth was 1.22 in 1911
which rose to 20.79 in 1991. The density of population of the State increased from 34
in 1901 to 93 in 1991. The projected population of the State as on 31 March, 2000 is
61.48 lakh as per the report of the Registrar General India. There has been an
increase of about 10 lakh since 1991 census.
The report of National Family Health Survey-2 (1999) released
recently has shown that the achievements of the State in the field of Family Planning
are quite high and very encouraging. It reveals universal awareness about
permanent methods of family planning whereas knowledge levels about spacing
methods is more than 90 percent. Coverage of eligible couples with family planning
methods in the State is around 68 %, which is quite high. It estimates Total Fertility
Rate (TFR) of the State as constantly declining. It was 2.97 in 1992, which has
declined to 2.14 in 1998. This figure is very close to the national goal of replacement
level of fertility i.e. TFR of 2.1 to be achieved by 2010 as per the National Population
Policy-2000. Other demographic rates such as Crude Birth Rate of the State is 22.5
per 1000 population, Crude Death Rate at 7.7 per 1000 population and Infant
Mortality Rate at 64 per 1000 live births as per the Sample Registration System of
the Registrar General India-1998. These rates are lower than the national averages.
It also shows that the annual growth rate for the State in 1998 as 1.48 percent which
is quite significant. At this rate the population increase is likely to be quite slow in
the State.
However, there is a failure in the form of gap in services, which is
reflected by Unmet Need for Family Planning services. In 1993 it was to the extent
of 15 percent (9 percent for sterilization and 6 percent for spacing methods). It is
also reflected by non-observance of ideal interval (3 years) between successive
pregnancies of births. In the following years the unmet need might have declined
but survey figures are not yet available.
The State has also formulated a long term planning objectives to be
achieved by 2020 by which every resident of Himachal Pradesh will be healthy;
physically, mentally and socially and adopt small family norm. The goal of
Himachal Health Vision 2020 is to achieve CBR 12, CDR 6 IMR at 15 CMR 5,
MMR <100 and TFR <2 and over-all reduction of diseases like diarrhea, acute
respiratory infections Malaria, Leprosy, Waterborne diseases, Anemia and other
micronutrient deficiencies with specific emphasis on the containment of AIDS/ HIV
infections.
Another significant achievement of the State has been increase in age at
marriage for girls. Mean age of marriage for girls is 20.5 years. It is thus obvious
that population situation of the State is quite encouraging and we are well on way
towards containment of population explosion. But we are also faced with constraints
posed by terrain, topography and poor means of communication, which affect the
delivery, and accessibility of services. However in the coming days with
improvement in infrastructure and outreach of services, the State will steadily head
towards a goal of Zero Population Growth.
State has implemented Family Planning programme as people’s movement
and has achieved considerable success in providing information and coverage to
eligible couples by reaching as close to them as possible. As of today more than 3100
health institutions
are providing family planning services as a part of
comprehensive health care.
We are also seeking the cooperation of other related departments like
ISM, Women and Social Welfare, Public Health and Irrigation, ICDS projects,
Education etc. to increase the accessibility of the services. Community awards are
also given to Panchayati Raj Institutions and local self Government institutions in
the form of cash awards. Status of women is quite high in the state, which is
indicated by high sex ratio of 976 according to 1991 Census and 1019 in 1999 as per
NFHS-2. The NFHS-2 also reveals high decision-making power among women in all
walks of life. Recently one study estimated high literacy rates among children (94 %
in boys and 86 % in girls). Female literacy has gone up from 52% to 77 %.
Population education programmes and AIDS education programmes are being
implemented in the State. The State has made provision of free education to women
up to University level. Commission for Women is functional in the State. Numerous
Mahila-Mandals, Mahila -Swasthya- Sanghs are active.
The State is facing problems such as
lack of specialist’s services,
difficult out reach due to mountainous terrain and migratory population. This
hampers the State’s efforts in providing health and family planning services.
Therefore States should be given the flexibility in setting the norms for providing
3
sterilization and other related services. The State is spending about 6 percent of its
annual budget on the health sector. State should be given more allocation for
infrastructure development in the form of externally aided projects or outright
grant from Government of India to meet the higher cost of infrasti ucture
development in the hills.
Research about herbal contraceptives should also be
undertaken in the country for which State has favorable climate and requisite
infrastructure.
The private sector, NGO sector and Panchayti Raj Institutions have
played only a marginal role in Family Planning so far. Private and voluntary sector
is still in infancy in the State Not many private nursing homes are there in the State
nor have they contributed much to family planning but with more of such
institutions coming up in the State, some mechanism is being developed to seek
their involvement. Similarly NGO movement is in infancy in the State. However,
my Government is encouraging the involvement of both, NGOs and private sector.
In the end I would emphasize that the Health and Family Welfare
sector requires enormous resources which the States are unable to meet out of their
own budget. Already we are spending 6 percent of the total budget of the State on
this Sector. More so Himachal Pradesh has a peculiar problem of outreach, where
two districts of the State remain snow bound for about 5-6 months; the terrain is
extremely difficult due to poor means of transport and communication. The
improvement in infrastructure requires a lot of investment; and the State is unable
to provide funds with its meager resources. However, our aim is to reach the
population stabilization much before the goal set by the National Population Policy
2000.
4
t
OBSERVATIONS ON AGENDA ITEM
“ISSUES RELATING TO POPULATION STABILIZATION”
1- INITIATIVES TO MEET UNMET NEEDS
The State has adopted a two-fold strategy i.e. fixed strategy
whereby sterilization services are provided in health institutions
and secondly camp outreach approach whereby camps are
arranged in the field institutions. This strategy has helped in
making family planning services available in the interior and
rural areas.
a
Grass root level institutions are providing integrated services
such as immunisation, maternal and child care and family
planning services.
The state has popularized a new technique of male sterilization
e. vasectomy in which no incision is required and is virtually
i.
painless with least complications. This is becoming a popular
method all over the state.
Cooperation of all related departments such as ISM, Women
and Child Welfare, Education and Panchayati Raj is being taken
in order to increase accessibility of the services.
Community awards are being given to PRIs and Local Self
Government institutions in the form of cash to ensure better
participation in the family welfare programmes.
•
PROBLEMS BEING FACED:
The state is lacking the services of Specialist Doctors who are not
available in the state in required number to provide obstetrics
and neonatal care.
Geo-topography of the state hinders outreach and deployment of
manpower in rural, remote and tribal areas.
Large number of migratory population is an inhibiting factor to
provide maternal and child health and family planning cover to
100 percent population.
5
SUGGESTIONS:
Government of India may look into the qualification clause of
graduate medical officers to see whether they can perform
sterilization operations.
Population norm for sub-centres in hilly areas should be down
scaled to one sub-centre for each Gram Panchayat irrespective
of population criterion.
State should be given more allocation for infrastructure
development in the form of externally aided projects or outright
grant from the Government of India to meet higher construction
costs.
State should be allowed to enlarge the package of contraceptives
from the existing one so as to enhance acceptability. Social
marketing of contraceptives must be encouraged.
I 'i
Research about herbal contraceptives should be undertaken in
the Country for which the State has the required infrastructure.
Mobile services for family planning must be started for which
central assistance should be given.
II.
ISSUES OF QUALITY CARE:
With the introduction of concept of quality care under the
Reproductive and Child Health (RCH) Programme, the state is
finding it difficult to provide the infrastructure and trained
manpower on all its components. As a result the performance
under the programme has received a setback. Moreover the
clients have become quality conscious and prefer specialists
services only with the result that the graduate doctors who were
earlier providing the services are gradually disassociating from
the programme.
6
(fA
III. SYNERGY BETWEEN FAMILY WELFARE, HEALTH, EDUCATION,
WOMEN’S EMPOWERMENT, CHILD DEVELOPMENT, DRINKING
WATER, NUTRITION, ETC.
The state has been successfully able to converge service delivery
at village level. Health sub-centres, Anganwadis, Mahila
Mandals, Yuvak Mandals and Educational Institutions are
working in tandem. A committee at Panchayat level is being
constituted to coordinate and implement all health programmes
headed by the Pardhan Gram Panchayat. All Government
officials concerned with the programme will be its members.
There is high prevalence of water borne diseases such as
gastroenteritis, diarrhoea, infective hepatitis and enteric fever
etc.. The habit of open defecation further compounds the
problem of water and soil pollution. Large resources are
required to provide safe and potable drinking water for which
liberal Central assistance is required.
IV. ROLE OF THE MEDIA, NGOS, PRIVATE SECTOR, PANCHAYATI
RAJ INSTITUTIONS AND PEOPLE’S PARTICIPATION IN THE
NATIONAL EFFORT TO STABILIZE POPULATION.
Though media has played a significant role in raising awareness
level, its benefit has not been available to vast rural population
due to various factors. However, AIR has maximum reach in
the State through which health programmes are being
disseminated.
The private sector and NGOs have so far played only marginal
role in the State so far. However, the State has constituted a
State level coordination committee for NGOs participation
especially in health, education and sanitation programmes.
State has decided to constitute a committee at Panchayat level in
order to implement all health programmes. Awards are also
being given to Panchayats who show best results in
implementation of Family Welfare programmes every year.
SOME
IMPORTANT
PRADESH;
-
POLICY
SUGGESTIONS
FROM
HIMACHAL
The National Population Policy should
lay
greater emphasis to reward such States which
perform well in terms of arresting population
growth.
The design
for devolution of
resources
through
the
Finance
Commission,
Planning
Commission
and
various
centrally
sponsored
schemes should be made more favourable for such
States which stand out as significant performers
for population control and providing better
quality of health services.
-
Financial norms for provision of services linked
to
population
control
should
be determined
keeping
climate
in view the topography, severtiy of
and
fact
that
administering
health
services
Himachal
costs much more in hill States like
Pradesh. Adequate allowance should be
made in the norms for hill States and devolution
should
provide
for
factors
like
difficult
topography and related issues.
-
A new approach has been initiated in locating
projects for health interventions under which the
district is being taken as a unit. We would like
to strongly favour this approach and emphasise
that preference should be given to such districts
which have performed well in terms of population
control
as
also
in
terms
of
immunisation
converage and health indicators. Such an approach
could lead to a higher success rate of the
programmes and become a good demonstration point
for encouraging competition.
4a
To integrate the spirit of population control
into our process of democratic decentralisation/
we have enacted a law under which candidates
having more than
two children will not be
eligible to contest elections to PRIs. We have
also introduced the new schemes of incentives to
Panchayats
under
which
one
panchayat
in
each
Assembly Constituency will be given a cash award
of Rs.1.00 lac for local developmental works. The
panchayat which records lowest birth rate, lowest
infant mortality rate and highest immunisation
coverage shall get this award in each Assembly
Constituency every year.
Our experience reveals that districts which had
high female literacy and a high sex ratio of
females per thousand males tended to perform
better
on all health
indicators as compared
State or National averages.
recorded
the
lowest
to
Such districts also
population growth
rates
as
well (Kangra, H^-mirpur, Bilaspur, Una and Mandi).
Recongnising the lead role of female literacy,
the Government of Himachal Pradesh has made
education for girls free upto University level.
We emphasise that female education should become
the focus of population control efforts.
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SR
8
GOVERNMENT OF KARNATAKA
SPEECH
OF
SHRI S. M. KRISHNA
HON’BLE CHIEF MINISTER OF KARNATAKA
ON THE
OCCASION OF THE FIRST MEETING
OF THE
NATIONAL COMMISSION ON POPULATION
NEW DELHI
22nd July 2000
Hon’ble Prime Minister and Chairman of the
National Commission on Population, Hon’ble
Deputy Chairman of the Planning Commission
and Vice Chairman of the National Commission,
Hon’ble Union Ministers,
Leader of the
Opposition in Parliament, Hon’ble Chief
Ministers, Deputy Chairman, Rajya Sabha,
Distinguished Members, Invitees, ladies and
gentlemen,
It gives me great pleasure to address this
august gathering, at this first meeting of the National
Population Commission, on behalf of the five crore
people of Karnataka,
H
The 21st century has begun for India with
hope for the future. The world has sat up to take
note of a new, emerging power, the fifth largest
economy in terms of purchasing power parity, a
new leader in information technology and the
largest, the most vibrant democracy in the world.
And our billionth citizen Astha, as the representative
of what that future holds for us, has demanded that
the trust reposed by the people in their leaders, to
make their world a better place, must be redeemed
in full measure.
2
I must, at the outset, welcome the efforts of
the Government of India at formulating a new
National Population Policy and in setting up this
Commission. The issues raised in the policy
document, the goals and the strategies will be
debated today and in future meetings of the
Commission. I hope that this body remains active
and vibrant, as much work has to be done over the
next few years for the larger benefit of our people.
Let me spend a minute on the position in our
State, in the area of population stabilization.
Karnataka deserves pride of place in the annals of
the family planning programme in India. In June
1930, the first birth control clinics in the world
were started in Karnataka, one in Bangalore and
the other in Mysore, to advocate small families and
provide maternal health care services. Today, through
our 8143 sub centres, 1676 primaiy health centres,
249 community health centres, 103 post partum
centres and 87 urban family welfare centres, we
provide facilities well above the national norms. Arid
what have we achieved ? A crude birth rate of 36.9
in 1971 came down to 22 in 1998, the crude death
rate declined from 14.9 to 7.9 in the same period.
Our total fertility rate is now 2.13, which already
approximates the national goal for 2010. The effective
couple protection rate has reached 60 per cent.
But what do cold statistics imply? In our
State we are looking at improving the overall quality
of life of our people, not just restricting our numbers.
We do not believe that population stabilisation
measures can be taken without improving the overall
health and nutritional standards of our people. We
feel that the integration of health and family welfare
services are absolutely essential. After all, these
services merge at the level of the PHC, why then
should there be two wings for healthcare at higher
levels? We would hope that the policies of the
Union Government would permit sufficient
coordination between the two departments to obviate
any difficulties in this regard.
In Karnataka, we have taken up a major
initiative to improve our health systems with tire
setting up of a fourteen member task force to advise
the Government on necessary reforms in the sector.
This task force, with Dr. Sudarshan, who is a
member of this Population Commission, as the
Chairperson, is working on a comprehensive health
policy that will also include a population policy for
the State. Perhaps for the first time, such a task
force of outside experts has also been given the
responsibility of overseeing the implementation of
reforms, at least in the initial stages.
4
The question of unmet need is a vexatious
one. While the national policy of institutional
deliveries for the safety of the mother and the child
is laudable, it would be unwise to turn a Nelson’s
eye to the fact that even in our State, about half the
deliveries are outside the formal institutional
framework. Even today, the poor pregnant mother
has no means, both financial and physical, to travel
miles at the time of delivery. We need to go back,
therefore, to the traditional midwife, but in a modem
environment. We are retraining them, giving them
modem kits and facilities, and are even examining
the possibility of giving them an assistant for the
actual delivery; after all, at the time of birth, both
the mother and the child are vulnerable, and the
dai cannot easily look after both. Attention to safety
issues at the time of birth would improve both MMR
and IMR at the same time. We need the support of
the Union Government in this effort.
In our State, wherever we have a shortage of
auxiliary nurse midwives, we are asking our
anganwadi workers to perform the non-clinical
duties of the ANMs. On the lines of the Government
of India pattern of PHCs with two doctors, we have
decided to provide the extra doctor in all PHCs in
certain backward districts of the State.
5
This brings me to an important area of
concern. While some States, particularly the southern
States, have done well in our population stabilisation
efforts, there are regional imbalances within’the
States which need to be rectified. For example, most
parts of northern Karnataka need to be treated on
a special footing in all sectors of development.
Karnataka's district-wise HDI analysis indicates that
there are districts which are as underdeveloped as
the worst in any other part of the country. I would
recommend that our population stabilisation
strategies include a special, intensive efforts for
backward regions even within otherwise developed
areas.
We consider the reproductive health of rural
women to be of prime importance. To provide better
menstrual hygiene, which would reduce STI and
RTI problems in rural women, we are embarking on
a path breaking pilot project of educating teenage
school girls and providing personal hygiene kits at
a cost of up to Rs. 18 crores to our own exchequer.
There is another, related, area of concern. And
that is of the pernicious HIV virus. Along with our
sterilisation campaign, which is the main focus of
our stabilisation programme, there is need to put in
6
an increased effort at condom promotion. This
could perhaps become the most important plank, of
our population programme in the future.
In Karnataka, we believe that the main
determinants of good health lie outside the health
sector in sanitation, water supply and literacy. We
are, naturally, placing an emphasis in this direction.
Though our literacy rate is about 63%, we are
concerned at the low levels of female literacy and
have made education for girls upto the pre-university
level completely free. A major initiative towards a
comprehensive village sanitation programme has
been started this year. We acknowledge that the
nutrition needs of children, particularly in the zero
to two age group need to be addressed for reducing
IMR and we are working on a combined health,
nutrition and population project. However, we feel
that a much larger initiative from the Centre with
regard to these sectors would be necessary in the
coming years.
A word about the role of the voluntary sector.
In Karnataka, we have encouraged NGOs to run our
primary health centres on behalf of Government.
Two such are being run by NGOs in tribal areas,
with great success; we are presently discussing with
7
the FPAI for them to take over a few more and we
are mandating that each of our medical colleges
should provide rural service by “adopting” a few
PHCs each for primary health care. We believe that
the empowerment of the people can be better achieved
with the involvement of the voluntary and the
private sector. They also have their own skills and
expertise which the Government is trying to tap.
I welcome the present initiative of the Centre.
But as I said at the beginning of my speech, the
effort cannot stop at a few plenary meetings of this
nature, however much they are also necessary. I
would recommend that a smaller representative
group of Chief Ministers, State Health Ministers,
Health Secretaries and experts should meet
periodically and report to this apex body about the
progress in our population stabilisation efforts.
And finally, I must point out that the small
and happy family must include the man of the
house and he must be urged to be a part of the
population programme. Men seem to be indifferent
to most population stabilisation measures and
leave family welfare efforts to women. This must
change. The man must be made an integral part of
our programme and a major media initiative is
8
required in this direction. As a symbolic but
significant gesture, the father must find a place in
the logo of the national RCH programme, along
with the happy mother and child.
I thank you, Mr. Prime Minister, for giving me
this opportunity to intervene.
NATIONAL POPULATION COMMISSION
FIRST MEETING
NEW DELHI
22.07.2000
Address of
DR. KALAIGNAR M. KARUNANIDHI
Hon’ble Chief Minister
of
Tamil Nadu
Delivered by
Thiru Arcot N.VEERASWAMI
Hon’ble Minister for Health and Electricity
Government of Tamil Nadu
ADDRESS BY Dr. KALAIGNAR M. KARUNANIDHI,
HCN’BLE CHIEF MINISTER OF TAMILNADU
AT THE FIRST NATIONAL POPULATION
COMMISSION MEETING.
Hon’ble Prime Minister Thiru Atal Behari Vajpayee,
Hon'ble
Union Minister of
Health and Family Welfare
£)r. C.P. Thakur,
Hon'ble Union Minister of State for Health and Family Welfare
Tmt. Rita Verma,
Hon’ble Chief Ministers of States and Union Territories,
Hon’ble Ministers of Health and Family Welfare from States
and Union Territories,
Secretaries to Government of India,
State Secretaries of Health and Family Welfare and other
officials,
1.
Let me first congratulate the Hon'ble Prime Minister and
the Government of India for constituting the National
Population Commission. At the outset, I would like to
appreciate the effort of Government of India in framing the
National Population Policy 2000 which not only spells out
goals but has
also
identified strategic themes and
operational strategies. I would also like to thank the Hon’ble
Prime Minister for providing an opportunity to the States
and Union Territories to share their experiences and
express their views on issues relating to population
stabilisation. I am sure that the deliberations of this council
will help the States and Union Territories and
thereby the
country in achieving the national population policy goals.
2.
I would like to use this opportunity to share with this
august body the success story of Tamilnadu’s Family
Welfare programme. Realising that family planning is now
•
a critical input for development, our Government has been
taking keen interest in population stabilisation measures.
Major initiatives have therefore been launched in this
direction by the State. This has resulted in improving the
quality of care, bridging the gaps in the health care
delivery system, thereby meeting to a large extent, the
unmet needs of the rural and urban population.
It has
also brought Tamiinadu to the forefront of the family welfare
programme.
Recently,
a
State
Level
Population
Commission has been constituted under my chairmanship.
Our impressive record of achievements is as follows:
eCrude Birth Rate (CBR):National Goal:21
India’s achievement : 26.5
Tamilnadu’s achievement : 19.2
Infant Mortality Rate (IMR)
National Goal: 60
India’s achievement : 72
Tamilnadu’s achievement : 53
: 2 :
Total Fertility Rate (TFR)
National Goal: 2.1
India’s achievement : 3.3
Tamilnadu’s achievement : 2
With 100 percent immunisation coverage, more than 84 percent
institutional deliveries and 100 percent antenatal registration,
Tamilnadu has emerged as a model state for family welfare and
health care.
3.
Tamilnadu’s progress in the family welfare is the outcome
of several factors including the general development of the
economy. However, one of the most important factors has
been the high level of political commitment for the
programme and strong political will to implement it.
Long
before government of India introduced the Family Planning
Programme in the country the great social reformer Periyar
Ramasamy created a strong social movement in the
&
state to increase the age of marriage for women and
acceptance of the small family norm. This movement has
been carried forward by Arignar Anna and now by the
present Government. This tradition has continued along
with the formal family planning programmes launched
nationally. Almost all social and political leaders and even
prominent administrators talk forcefully about family planning
and the small family norm at any opportunity they get to interact
: 3 :
with the people both in public meetings and social functions.
This, along with specific IEC programmes has resulted in
creating a 99 percent awareness of the small family norm
in Tamilnadu.
In order to provide health care facilities to the people of
the state, Tamilnadu has systematically created health
infrastructure as per Govt, of India norms in respect of
Health subcentres, Primary health centres, Government
hospitals etc. As a result, we have at present 8682 Health
subcentres,
1410 Primary health centres,
160 Taluk
hospitals, 67 non-taluk hospitals, 26 district hospitals and
After the present
11 teaching medical institutions.
Government came to power in 1996, it was decided to
improve the infrastructure facilities by providing own
buildings for all the Primary Health Centres. Hence, 652
Primary Health Centres were built at a cost of Rs.51
crores purely from the state funds. On date, 94 percent of
PHCs are functioning in their own buildings, the balance is
under various stages of construction. Similarly 64 percent
of the Health Subcentres are functioning in their own
buildings.
600 are being constructed.
through community participation.
400 of these are
This is
a
unique
experiment, which Tamilnadu is carrying out. To ensure 24
: 4 :
maintenance, provision of equipment etc. So far 69 PHCs,
5 HSCs, 24 Government hospitals have been adopted by
51 industrial houses and their contribution is about Rs. 1.5
crores.
7.
|
The State has also drawn up a standard equipment list for
PHCs and HSCs. Equipments are now provided and
supplied as per this list. All First Referral Units have now
been equipped with ultra sonograms apart from other
emergency and essential obstetric and newborn care
equipments.
8.
Realising that infrastructure cannot be optimally utilised
without adequate training of manpower, the physical and
academic infrastructure of training institutions in the state
have been strengthened. The curricula have been revamped
to focus on development of skills, management, and gender
motivation and community mobilisation to improve the
quality of care given by the providers.
9.
Apart from training and sensitisation of all health providers
in the State including the state level functionaries like
Director of Health and Family Welfare Departments, training
is now given to all Medical Officers on their induction in
the PHCs. The training includes familiarisation with the
ongoing Family Welfare Schemes in the State, reorientation
: 6 :
of technical, management as well as administrative skills.
Here, I would like to mention, about a unique mobility
training, the state gives to its grass root level functionaries
the Village Health Nurses(VHN), Sector Health Nurses(SHN)
and Community Health Nurses(CHN). These female field
health functionaries are the backbone of the health care
delivery system, and their mobility is critical to better
delivery of outreach activities. Sensitive to the ground
reality that mere provision of funds and sanction of moped
loans were not sufficient to make them mobile, 3 day
residential camps are being organised for imparting
training in moped riding.
The response for this was
overwhelming and there is a distinct improvement in the
field level management of health services.
In order to effectively manage the health care delivery
system, constant monitoring of inputs and outputs is
required. For doing this, state has been conducting, since
1996 a vital events survey involving a huge sample of 9
million persons.
More comprehensive than the sample
registration system-this generated estimates of vital data
gender wise, district wise and place of residence wise.
It
also sensitised the entire health system personnel to issues
of Public Health in general and Maternal and Child Health
in particular.
11.
To monitor the performance of Primary Health Centres, a
format compatible for reading and feeding into the
computer by using an Optical Mark Reader (OMR) has
been developed.
Thus concurrent monitoring of the
institutional activities of all PHCs like outpatient, inpatient,
number of deliveries conducted is being done regularly.
I
As a result of this close monitoring the utilisation of the
institutional services is steadily increasing.
I2.
In order to bring down the IMR and MMR a critically
important monitoring tool has been adopted by the state
called the maternal death audit and infant death audit.
A Medical Audit team has been formed for each revenue
district with the District Health Administrator, Obstetrician
and Chief Medical Officer of the First Referral Units as
members.
A Maternal death protocol has also been
developed for prompt reporting and investigation of maternal
deaths. The objective of these is to determine the medical
and non-medical causes of each maternal death.
The
team gives the report after detailed investigation which
includes the viewpoints of the relatives as well as the
service providers of the deceased within 15 days of the
occurrence of death.
The aim of this verbal autopsy is
fact finding and sensitising service providers to take
corrective action on systemic failures.
: 8 :
13.
Our Government has introduced recently a new scheme of
comprehensive free health checkups and treatment camps
in rural areas called “Varumun Kappom”. This scheme
is the first of its kind in the country. During the camps
more than 15 specialist doctors from the government
hospitals screen the rural
people with sophisticated
equipments like ECG and Ultra sonogram etc. treat them
and if required refer them to higher medical institutions for
special treatment for which transport services are also
provided by the government. Health awareness, health
promotion and knowledge of avoidance of ill health are
also to be imparted in these camps. So far more than
4334 camps have been held in the villages. The average
attendance per camp is around 916.
By December, 10
million people i.e. one sixth of the population of the state
will be covered by these early detection camps.
These
camps have generated a massive data on morbidity
patterns
making
it
easy to
draw
up
area
wise
epidemiological profiles for the whole state. This will also
act as a major input in planning and designing preventive
and curative health care.
This is a unique programme
aimed at providing services at the doorstep and improving
the quality of life for the rural poor.
: 9 •
14.
Similarly the School
health
programme
“Vazhvoli
Thittam” has been intensified during 1999. School children
from first to twelfth standard are screened, treated and if
required referred to a higher medical institution by a team
of medical and para medical staff of the PHC based on a
fixed plan of visits for schools.
72 lakh school children
have been screened during 1999-2000.
15.
In order to give a new thrust to the Family Welfare
Programme,
“State Population Policy 2000” is under
preparation. A special drive to shift the exclusive burden
of the programme from that of women and bring about
active male participation through intensive IEC activities is
under way. We are also taking initiatives for ensuring that
the future generation is healthy and strong, by launching
an iron supplementation programme and rubella vaccination
programme for our future mothers - i.e. adolescent girls.
16.
With all these initiatives the state is steadily marching
forward.
The natural growth rate of the state has
fallen below that of Kerala and now stands at 10.7
compared to 11.9 of Kerala.
7.
We
have also achieved
reproduction rate of one.
the
replacement level net
India will require another 5
years to achieve this if the current tempo is maintained.
Our vision is to bring about the stabilisation of the
: 10 :
population of Tamilnadu at 7.2 crores by 2010 and
we are sure we will achieve it.
18.
However, we have an apprehension in our mind which the
Hon’ble Prime Minister and the government of India have to
dispel.
Tamil Nadu has 39 Members in the Lok Sabha. At
the moment, we have an assurance from the Hon'ble Prime
Minister and the Government of India that consequent on
'
reduction in population, our representation in the Lok Sabha
will not get reduced.
I am sure the Hon’ble Prime Minister
and the Government of India will take immediate and
appropriate measures by way of suitable amendment to the
Constitution to ensure that Tamil Nadu and other States
which have implemented Family Welfare Programmes
enthusiastically and successfully to contain and stabilise the
population are not penalised by a reduction in the number of
their representatives in the Lok Sabha.
In view of the fast
approaching deadline of the year 2001, it has become
imperative that the issue is addressed at the earliest and the
freeze on the existing number of Lok Sabha seats allocated
to the State extended till 2025 A.D. as recommended in the
'National Population Policy, 2000’.
I am sure we will have the very valuable support and
mcouragement of the Hon’ble Prime Minister and Government of
ndia in realising our population stabilisation goals.
Thank you, Vanakkam.
: 11 :
The National
Population Policy
2000
-s
V ational Population Policy
2000 aims at improving the quality of
life that people lead, to enhance their
wellbeing and to provide them with
opportunities and choices to become
productive assets in society. Though
India was the first country to launch
a national programme in 1952 aiming
at stabilising the population at a level
consistent with the requirement of
national economy,
sharp decline in
death rate were not accompanied by
a similar drop in birth rate.
This document is brought to you by the ■
Ministry of Health and Family Welfare,
Government of India and
Voluntary Health Association of India (VH Al)
.
However the country has seen some demographic achievements through the
National Family Welfare Programme and they are related to the reduction of:
vvervicw
Crude Birth Rate (CBR)
from 40.8 in 1951 to 26.4 in 1998
Infant Mortality Rate (IMR)
from 146/1000 live in 1951 to 72/1000 live births in 1998
Crude Death Rate (CDR)
from 25 in 1951 to 9.0 in 1998
Life Expectancy at Birth
increased from 37 to 62 years
Total Fertility Rate (TFR)
from 6.0 in 1951 to 3.3 in 1997
Despite these Government initiatives and achievements, population growth
in India today continues to be high. On I I May, 2000 India’s projected
population crossed I billion mark (100 crore), i.e. 16 percent of the world’s
population living on 2.4 percent of the globes land area. If current trends
continue, India may overtake China in 2045, to become the most populous
country in the world. While global population has increased threefold during
this century, from 2 billion to 6 billion, the population of India has increased
nearly five times from 238 million (23 crores) to I billion in the same period.
India’s current annual increase in population of 15.5 million is large enough
to neutralize efforts to conserve the resource endowment and environment.
If the trend continues, Population of India will be I0I2.4 million in 2001,
1178.9 million in 201 I and 1268.5 in 2016. Thus stabilizing population is an
essential requirement for promoting sustainable development with more
equitable distribution. However, this is as much a function of making
reproductive health care accessible and affordable to all, as of increasing the
provision and outreach of primary and secondary education. This would also
include, extending basic amenities including sanitation, safe drinking water and
housing, besides empowering women and enhancing their employment
opportunities, and providing transport and communication.
The National Population Policy 2000 (NPP 2000) declares the commitment
of Government towards providing voluntary and informed choices and seeking
jjjgglpErent of citizens. It also popularises the use of reproductive health care
Wices and the continuation of a target free approach in administering family
anning (FP) services. It addresses the fact that apart from making
productive health care services accessible and affordable to all, it is also
iperative to increase the outreach of education, basic amenities like
nitation, safe water and housing. Empowering women through awareness
d enhancing their employment opportunities is also essential.
e
Objectives of National Population Policy 2000
The Immediate Objective of the NPP 2000 is to address the
unmet needs for contraception, health care infrastructure and
health personnel and to provide integrated service delivery of basic
reproductive and child health (RCH) care to all sections of the
population. It is based on a strategy of developing partnerships
within government departments and with industries and the
voluntary sector.
Its Mid-term Objective is to bring the Total Fertility Rate down
to replacement levels by 2010 through vigorous implementation of
inter-sectoral operational strategies.
Its Long term Objective is to achieve a stable population by
the year 2045 at a level that is consistent with the socio-economic
and ecological requirements at that time.
The NPP 2000 envisages to address these issues by aiming to attain its mid
term objective by increasing access to quality health and reproductive services,
making school education upto 14 years free and compulsory. Reducing the
IMR and Maternal Mortality Rate (MMR), achieving universal immunisation for
all children, promoting delayed marriages for girls, achieving I OQ% registration
of births, deaths, marriage and pregnancy, developing infrastructure to promote
safe deliveries, setting up counselling and FP service centres, containing the
spread of HIV/AIDS, RTFs and STD’s, preventing and controlling communicable
diseases, integrating Indian Systems of Medicine’s v/ith reproductive and child
health services; promoting vigorously the smaj|<zfamily norm .and developing
the family welfare programme as a people c
(
If the NPP 2000 is fully and successfullyJ[jfflPt§BiWt , the population is j
d of the
anticipated to be 1107 million in 20IO ins
ently projected 1162
million, the CBR will be 2I.0, IMR will
30 apd the/TFR will be 2.1.
O W V iC W
[■Decentralised Planning and Programme Implementation
The Panchayati Raj Institution (PRIs) are an important means of realising the
socio-demographic goals of the NPP 2000. With the 73rd and 74th amendment,
greater authority in matters of health, family welfare and education has been
placed onto the panchayat; however further delegation of administrative and
financial powers is necessary to facilitate the effective functioning of PRI s. It
is envisaged that these empowered PRI’s will identify area specific needs and
prepare need based socio-demographic plans for the village aiming at
developing a people centred reproductive and child health programme (RCH
programme). Those panchayats that succeed in doing so will be nationally
honoured. Also elected women panchayat members are expected to play a
pivotal role in developing a gender sensitive, multi-sectoral local agenda for
population stabilisation.
□Convergence of Service Delivery at the Village Levels
I
Efforts at population stabilisation will be effective only if we direct an effective
package of essential health services at the village and household levels.
Currently there are many inadequacies in health infrastructure below the
district level; lack of supervision, trained personnel, communication skills and
motivation to work in rural areas has lead to obvious gaps in the coverage
and effectiveness of RCH services.There is a need for a flexible intersectoral
approach that would build partnerships with the voluntary and non
governmental sector in extending RCH services to all the areas of the country
including hilly, inaccessible and forested areas.
In this aspect since health and education has been decentralised to the
panchayats, a one stop integrated service delivery system needs to be
developed at the village level for providing basic RCH services. For this it
is necessary to set up equipped maternity huts, register births, deaths,
marriage and pregnancies and developing a task force of TBA’s, community
mid wifes, village health guides, teachers and aganwadi workers who will
work towards increasing the coverage, outreach and effectiveness of the
RCH initiative.
□Empowering Women for Improved Health and Nutrition
Due to the discriminatory behaviour women are subjected to in India, most
of them suffer from under nutrition and micro nutrient deficiency that
becomes crucial to a woman’s wellbeing and that of her child during pregnancy.
The extent of maternal mortality is an indicator of disparity and inequity and
it is safe to say that a women’s health is always at risk in India; from childhood
neglect, lack of education, poor nutrition early child bearing due to early
marriages, frequent and unsafe pregnancies, unsafe abortions, RTI’s and STD’s
- all these combine to keep the MMR in India among the highest in the world.
The NPP 2000 addresses this by calling for an intersectoral holistic approach
where in the non-governmental and private corporate sector collaborate with
the government in committing to provide RCH services, education and
employment opportunities to women. In addition the NPP 2000 has also
called for strengthening the safe motherhood, immunization, child survival,
women’s nutrition, RTI and STD control initiatives by further integrating them
into the RCH programme.
□Child Health and Survival
Infant mortality, Under 5 mortality and neo-natal mortality are some of the
primary causes for high fertility rates in India. Inadequate child care, asphyxia,
premature birth, low birth weight, respiratory infections, lack of immunization,
nutritional deficiencies have all hindered child survival in India for a long time
now. Government child survival interventions have made a small difference
but due to a decline in standards, outreach and quality of services, significant
improvements have not been made.
The NPP 2000 prioritises the need to intensify neo-natal care as primary by
calling for the setting up of a National Technical Committee which would set
perinatal audit norms, strategise on quality development and monitoring and
suggest that medical and nursing education be provided to all perinatal health
providers. NPP 2000 also calls for extending the ‘baby friendly hospital
initiatives’ to all hospitals and clinics at the district level which would also
include upgrading the skills of TBA’s in order to improve new born care
practices.
□ Meeting the Unmet Needs for Family Welfare Services
The NPP 2000 indicates that there is still .a paucity of contraceptives,
equipment, man power and comprehensive FP information and informed health
providers in both rural and urban areas. It is essential to strengthen these
initiatives in all areas and also a need to improve the system of referral
transportation and develop innovative social marketing schemes for affordable
products and services.
0 Under Served Population Groups
Currently slums account for high maternal and child mortality due to a
lack of proper health services and facilities. There is an urgent need to
provide basic and primary health care and RCH services in slums and to
strengthen water and sanitation facilities in these areas. In addition health
promotion and education facilities also need to be strengthened.
•
It is a realised fact that populations in remote and hilly areas do not even
have access to basic health care which attributes to the high level of
mortality in these areas. NPP 2000 maintains that these communities need
special attention in terms of health, awareness and RCH services in order
to address IMR, MMR and high fertility rates in these neglected areas.
overview
•
Due to the rise in cases of unsafe abortions, STD’s, HIV/AIDS, adolescents
constitute a group whose needs must be addressed. Approachable RCH
services providing education, counselling, FP information can go a long way
in addressing their unmet needs.There is also a need to enforce the child
marriage restraint act of 1976 more stringently.
•
Menfolk need to constitute an integral part in any population control
programme. We can not deny that men play a critical role in family welfare
in India. Their active involvement is called for in planning families,
supporting contraceptive use, helping pregnant women, helping in arranging
safe deliveries and in child care. There is an urgent need to re-popularise
vasectomies and focus on men in information and education campaigns
to promote the small family norm.
□ Diverse Health Care Providers
The health infrastructure run by the government is rendered inadequate in
light of the magnitude of demands made by the population. The RCH needs
of the population are also unmet due to this paucity.There is a need to involve
private doctors in providing these services and a need to revive the system
of licensed medical practitioners in collaboration with the Indian Medical
Association.
EJ Collaboration with and Commitments from Non-government
S Organisations and the Private Sector
Understanding the magnitude of demands placed on the governments health
services, it is apparent that a sustainable and efficient RCH effort will only
be possible if partnerships are built with the non-government and private
sector. Though these sectors have an impressive pool of expertise and
resources, mobilizing them is no easy task as motivating them to address public
health goals raises various issues of governance that need to be carefully
addressed.
H Mainstreaming Indian Systems of Medicine
and Homeopathy (ISMH)
The traditional systems of medicine which are affordable, accessible and
effective and have addressed the health needs of a large portion of the
population for ages needs to be revived. Their utilisation in basic RCH care
will expand the pool of effective health providers, optimise utilisation of local
remedies and promote low cost health care. There is a need to orient and
train ISM medical practitioners in aspects of woman and child health and utilise
their services at sub-centres and PHC centres. Guidelines also need to be
evolved to regulate and ensure standardisation, efficacy and safety of ISM drugs.
I
[0 Contraceptive Technology and Research on Reproductive and
I Child Health
The government must constantly advance, encourage and support medical,
social science, demographic and behavioural science research on maternal, child
and reproductive health care issues. There is a need for consultations and
frequent dialogue by government with existing research institutions in all
sectors. The strengthening of the management information system (MIS) for
ascertaining the impact and outcomes of government programmes through
district surveys and facility surveys by the department of family welfare has
been a positive step in this light.
HJ Providing for the Older Population
Improved life expectancy has lead to an increase in the number of older people
in the population. When this is viewed in the context of significant weaknesses
in health systems, one finds that the elderly are increasingly vulnerable and
need protection. It is necessary to build in geriatric health concerns within
the population policy by sensitising, training and equipping rural and urban
health centres to provide geriatric health care. The voluntary sector can be
involved in implementing schemes that make the elderly economically self
reliant and a system of tax incentives to encourage grown ups to care for
their parents can be developed.
jH Information, Education and Communication
There is a need for large scale dissemination of IEC messages to all parts of
the country. Locally relevant, clear and focussed RCH/IEC material will go a
long way in popularising and sensitizing RCH issues within communities.
Government departments, NGO’s and the panchayats need to be deeply
involved in this endeavour and proper use of mass media tools like radio and
television needs to be made.
Promotional and Motivational Measures for
Adoption of the Small Family Norm
Certain promotional and motivational measures for adoption of small family
norm have been suggested. Under this for exemplary performance in
universalising the small family norm, acheiving reduction in IMR, TBR, and
promoting literacy, Panchayats and Zila Parishads will be rewarded. Cash
incentive of Rs. 500 will be awarded at the birth of the girl child and to
mothers who have their first child after nineteen years of age. For couples
having 2 children and undergo sterilisation would become eligible for health
insurance upto Rs.5000. Couples who have their first child after the mother
reaches 21 will be rewarded. Creches will be opened, and facilities for safe
abortion will be expanded. There would be provision for wider choice of
contraceptives, and soft loans will be encouraged to those who run ambulance
services and ensure mobility of ANMs.
;
Conclusion
The NPP 2000 which will largely be implemented and managed at the
panchayat and nagarpalika level in coordination with state administrators has
highlighted clearly the need to understand and look at population stabilization
as a multidimensional concept and thus realize that it can only be achieved
when government departments collaborate with each other and with the
private and voluntary sector in holistically looking at population issues.
The NPP 2000 has called for the setting up of State and National Commissions
on Population which will be presided by the Prime Minister, include Chief
Ministers, members from concerned ministries and members of the civil
society who will oversee and review the implementation of the NPP 2000 in
States and Union Territories.The Planning Commission will have a coordination
cell to facilitate inter-sectoral collaboration between ministries in order to
enhance the performance of States particularly those which have adverse
demographic and human development indicators.
In aspects of funding, priority will be given to developing health care
infrastructure at the community, primary health care, sub-centre and the village
level. Critical gaps in manpower will be remedied through re-deployment and
referral links will be improved. It is foreseen that in order to implement
immediately this action plan , it would be necessary to increase the annual
budget of the Department of Family Welfare.
As the NPP 2000 has rightfully indicated, population stabilization while being
an intersectoral approach needs to be pursued as a national movement based
on the essence of participation and sustainability. Greater financial resources
need to be allocated in this regard if we are to assure the success of this
policy. Finally it is important to realize that if the full potential of the NPP
2000 is realized then the cherished dream of providing health for all may
become a reality and the vast number of people in India will be able to live
healthier, better and economically productive lives.
J Action Plan
1
Convergence of Service Delivery at Village levels
Operational strategy :
•
to utilise village self help groups for RCH.
•
to implement at village level a coordinated health service delivery
package.
•
to provide a wider basket of contraceptive services.
•
to organise and strengthen community midwives, TBAs, aganwadi
centres, practitioners of ISMH, retired school teachers and ex-defence
personnel
Empowering Women for Improved Health and Nutrition
2
Operational strategy will include -
u
•
to create an enabling environment for women and children
•
to open more child care centres in rural areas and urban slums
•
social afforestation
•
to reward energy saving devices
to facilitate access to fuelwood and fodder
•
to improve district, sub-district and panchayat health centres
•
to ensure adequate transportation at all levels
to improve technical skills of maternal and child health providers
to improve accessibility to maternal and child health services.
to monitor performance of health personnel
to support community activities such as dissemination of IEC
to develop a comprehensive programme including nutrition, STD/RTI/
HIV, family planning, convergence of various programmes and providing
quality care.
to develop a health package for adolescent
to expand the availability of safe abortion care at all levels
to develop maternity health centre at sub-district levels and at
community health centres as FRUs for complicated and life-threatening
deliveries.
•
to formulate an enforced standard for clinical services
•
to focus on distribution of non-clinical methods of contraception.
•
to create a national network of public, private and NGO centres.
3
Child Health and Survival
Operational Strategy will be -
•
4
to support community activities from village level upwards and to
monitor early and adequate Ante Natal Care and Post Natal Care
•
to set up a National Technical Committee on neo-natal care
•
to pursue compulsory registeration of birth in coordination with the
ICDS Programme
•
to provide counselling and advocacy about contraception after birth
of a child
•
to improve capacities and basic mid-wifery services and essential neo
natal care
•
to sensitise and train health personnel in the integrated management
of childhood illnesses
•
to strengthen critical interventions aimed at bringing about reductions
in maternal malnutrition, morbidity and mortality
•
to pursue rigorously the pulse polio campaign to eradicate polio
•
to ensure 100 percent routine immunisation for all vaccine preventable
diseases, especially tetanus and measles
•
to explore promotional and motivational measures for couples below
the poverty line
•
to give focussed attention to children from vulnerable groups
•
to explore the feasibility of national health insurance for children
below 5 years of parents who have adopted small family norms
•
to expand the ICDS to include children between 6 to 9 years of age
•
to provide professional training for girls
Meeting the Unmet Needs for Family Welfare Services
Operational Strategy will be -
•
to strengthen health infrastructure at the village sub-centre and the
primary health centre levels
•
to address different unmet needs on priority basis
•
to formulate and implement innovative social marketing schemes
•
to improve facilities for referral transportation at panchayat, zilla
parishad and primary health centre levels
•
to encourage local entrepreneurs at village and block levels to start
ambulance service
•
to provide special loan scheme for opening chemist shop for basic
medicines and first aid at village level
Under-Served Population Groups : Urban Slums, Tribal Communities,
5
Hill Area Populations, Displaced and Migrant Populations,
Adolescents and Diverse Health Care Providers, Older Population
Operational Strategy for Urban Slums
•
to finalise a comprehensive urban health care strategy
•
to facilitate service delivery centres in urban slums
•
to promote networks of retired government doctors and para-medical
and non-medical personnel
•
to strengthen social marketing programmes for non clinical family
planning products and services
•
to initiate specially targeted IEC campaigns
•
to promote inter-sectoral coordination
•
to streamline the referral systems and linkages between the primary,
secondary and tertiary levels of health care
•
to link the provision of continued facilities for observance of small family norms
Operational Strategy for Tribal Communities, Hill Area Populations, Displaced
and Migrant Populations
•
to provide information and counselling in respect to infertility
•
to encourage the NGO sector to formulate and implement a system
of preventive and curative health care
•
to encourage Indigenous System of Medicine
•
to sensitise health care providers to adopt “burden of disease” approach
Operational Strategy for Adolescents
•
to ensure access to information counselling and services including RCH services
•
to provide a package of nutritional services under ICDS programme
•
to enforce the Child Marriage Restraint Act, 1976
•
to provide integrated intervention in pockets with unmet needs
overview
Operational Strategy for Diverse Health Care Providers
•
to maintain blockwise database at district and sub-district
levels for private medical practitioners whose credentials
may be certified by Indian Medical Association (IMA)
•
to revive the earlier system of the licensed medical
practitioners
•
to involve the non-medical fraternity in counselling and
advocacy
•
to modify syllabi and curricula of medical, nursing and para
medical education in consultation with appropriate bodies
•
to ensure the efficient functioning of First Referral
Operational Strategy for
Units
Providing for the Older Population
•
to sensitise, train and equip rural and urban health centres
and hospitals towards providing geriatric health care
•
to encourage NGOs and voluntary organisations to
formulate and strengthen a series of formal and informal
avenues that make the elderly economically self-reliant
•
to explore the possibility of providing tax benefits for
children to look after their aged parents.
Due emphasis will be laid on
❖
Collaboration with communities and Non-Government
Sector
❖
Collaboration and commitments from the Industry
❖
Mainstreaming Indian System of Medicine and Homeopathy
♦
Contraceptive Technology and Research on RCH
Information, Education and Communication
This document is brought to you by the
Ministry of Health and Family Welfare,
Nirman Bhawan, New Delhi 110 011 and
Voluntary Health Association of India, New Delhi 110 016
For further information contact:
Ministry of Health and Family Welfare,
Nirman Bhawan, New Delhi 110 01 I
and
Voluntary Health Association of India
40, Qutab Institutional Area, New Delhi 110 016
Phone: 6518071, 6518072, 6965871, 6962953
Fax: 01 1-6853708, Email: vhai@vsnl.com
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This document is brought to you by the
Ministry of Health and Family Welfare,
Nirman Bhawan, New Delhi 110 011 and
Voluntary Health Association of India (VHAI)
For further information contact:
Ministry of Health and Family Welfare,
Nirman Bhawan, New Delhi I IO Ol I
Voluntary Health Association of India
40, Qutab Institutional Area, New Delhi I IO 0I6
Phone: 6518071. 6518072, 6965871, 69$2953
Fax: Ol I-6853708, Email: vhal@vsnl.coqt
VHA of Karnataka
No. 60, Rajini Nllaya, 2nd Cross
Gurumurthy Street,
Ramakrishna Mutt Road, Ulsoor
Bangalore 560 008, Karnataka
Phone: 080-5546606
2001 : &&3o2od
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A
CENSUS OF INDIA QOOI: HOUSEHOLD SCHEDULE
Use only Arabic Numerals as indicated below :
EEEnSHHZEE]
Part I - Location particulars :
Name of Stale/ UT
Confidential when filled
Schedule number
Name of District.
Name of Tahsil/ Taluk/ P.S./
Dev. Block/ Circle/ Mandal etc.
Name of Town/ Village.
Number and/ or Name of Ward
Part II - Individual particulars :
Serial number of household
(to be copiedfrom column
of the Abridged Houselist)
.Code No
Enumeration Block Number.
■Code
Type of household:
(give appropriate Code number)
I------ 1
Normal-1 / Institutional-2 / Houseless-3
GENERAL AND SOCIO-CULTURAL CHARACTERISTICS
QI
Name of the person
Q.M
Relationship to head
last birthday
(record the relationship
in full)
Q.8
QI
Q.9
Religion
If Scheduled Caste,
If Scheduled Tribe,
(write name of the religion write name of the Scheduled write name of the Scheduled
Caste from the list supplied Tribe from the list supplied
in full)
(in completed
For following religions, also (Scheduled Castes can be
give Code number in box
only among Hindus, Sikhs
and Buddhists)
Hindu
I
Muslim
2
Christian
3
Sikh
‘I
Buddhist
5
Jain
6
Q. 10
Mother tongue
Q.ll
Other languages known
(enter upto two languages in
order ofproficiency)
(Scheduled Tribes can be
from any religion)
Q. 13
Highest educational level
attained
(for diploma or degree
holder, also write the subject
ofspecialisation )
Q.I5
If the
person is
physically/
mentally
disabled,
give
appropriate
Code
number
from the
list below
For other religions,
write name of the religion in
full but do not give any
Code number
Persons
ITEM-1
[For Item-3,
[refer column M I
Total of I's
[for sex and
Females Females (0-6) [column 5 for
'age for counting
Total of 2's ®children in
[age-group 0-6
Males (0-6)
ITEM-2 ITEM-3
Notes for striking Page Totals :
I. Count the number of persons from column 2 and give total in the box provided for Item-1.
2. Stnke 'Page Totals' for Items- 2 to 12 in respect pf males and females separately below
Questions 3,4,12,16 and 17(i).
Code numbers for Q. 5
(Marital status)
Name of the Respondent
Never married
Relationship to head
Currently married.
Widowed.
Divorced or
Separated
i
Code numbers for Q. 15
(Type ofdisability)
Literates (Total ol Is) ®
Dated signature or thumb impression
of the Respondent
Dated signature of the Enumerator
Dated signature of the Supervisor
ITEM-H
Illiterates (Total ofO's)^
ITEM-5
In Seeing
In Speech
in Hearing
In Movement.
Mental
L
CENSUS OF INDIA 2001: HOUSEHOLD SCHEDULE
confidential whenjuied
Position: 442 (8 views)