Family planning is the concept that allows individuals and couples to have
their desired number of kids and to decide the spacing they want between their
children. This can be achieved through certain methods like contraception,
sterilization, natural methods, etc. Family planning provides a choice to women
to decide whether she wishes to have kids or not. With a variety of strategies
for avoiding or expelling a conception while having a normal sex life, a woman
can control the time, spacing, and frequency of pregnancy.
Another part of
family planning is adoption. Birth spacing technology has advanced to the point
that safe and effective contraceptive options are now widely available at a fair
cost in both developed and developing nations. Family planning is one of the
substantial public health attainments of the 21st century as it plays a vital
role in improving the health of newborns, women, children, and families. Family
planning can therefore help to prevent undesirable and untimely pregnancies,
reducing the consequences of excessive population growth.
In general family
planning services include:
- Pregnancy testing and counselling which includes a proper laboratory
test, examining adequate history in order to come by any pregnancy symptoms and
appropriate education whenever necessary.
- Contraceptive methods which apart from pregnancy prevention reduces the
risk of certain reproductive cancer, sexually transmitted diseases like HIV, HPV
and can prevent induced abortion and hence reduce the majority of these deaths.
- Providing required counselling, education and testing of Sexually
transmitted infection and HIV in order to get over of the myths people have
related to these types of diseases. And let them know that it is a curable
disease which is transmitted only by anal or vaginal sex, or by sharing of
syringes, or other equipment used for drug injection, and not all HIV positive
individuals develop AIDs.
- Breast and screening of cervical cancer.
Family planning is crucial as fortuitous pregnancy can have a number of negative
consequences for women, which includes:
- Increased risk of maternal depression,
- An Increased risk of physical abuse during pregnancy,
- Delays in starting prenatal care
- Reduced chance of breastfeeding
The negative consequences of unwanted birth are more acute on teen parents and
their children. Pregnancies between the ages of 15 and 19 account for 82 percent
of all pregnancies.
There can be a number of negative consequences on teen
pregnancy like:
- They will be less likely to complete their high school.
- They will receive twice the federal aid which will indirectly affect the
economy of the country.
- They will earn less in comparison to those who wait childbearing until
their 20s.
Women with the lower level of education faces certain barriers in use of family
planning services. Furthermore, men are less likely to have access to the family
panning services in comparison to women.
The barriers for both men and women in
family planning services are:
- Inadequate services for men
- Limited access to funded services provided by the government.
- Limited access to insurance coverage
- Locating of family clinics in remote areas where it may take hours to
reach
- Lack of awareness to the family planning services among the people where
it is hard to reach like that of a rural area.
- Lack of friendly services for teenagers.
- Lack of services for men
- Lack of transportation to rich clinics or healthcare services.
Family planning programmes in India and tracing their history
India became the first nation in the world to implement a national family
planning programme in 1952. The Programme has seen significant changes since its
initiation in 1952 in terms of its implementation. There was a gradual change in
the approach to this programme from clinical to reproductive and child health.
The National Population Policy in 2000 introduced a broad and open mission for
access to fertility reduction.
In 1976, when political and institutional pressure was used to force family
planning. Just waiting for the economic and educational progress of the country
in order to reduce fertility was not a viable alternative, according to the
strategy. Because the clock was ticking and the threat of population expansion
was so great, the government had no choice but to launch a frontal attack as a
pledge to break the vicious cycle.
So accordingly, the minimum age of marriage
was decided to be 18 years for girls and 21 years for boys as per the National
Population Policy 1976. Apart from this special emphasis was given to raising
the quality of women's education, allowing state legislatures to pass
legislation for mandatory sterilisation in the exercise of their own powers; and
providing incentives to government workers for the adoption of small family
planning across the country.
In the year 2000, the 2nd population policy was launched. The immediate goal of
the National Population Policy 2000 was to meet healthcare infrastructure,
unfulfilled contraceptive, and health-care staff needs, as well as to contribute
to unsegregated reproductive and child healthcare services. The strategy assumes
that by using the mentioned measures population stabilisation may be achieved by
the year 2045.
The policy is first if it's kind that had mentioned about the
need for the basic child and reproductive health services. Under the policy free
and compulsory education was given to until the age of 14 so that dropout rates
at primary and secondary levels can be reduced for both boys and girls.
The
policy aims to provide counselling for fertility regulation, preventing and
controlling the spread of AIDS and promoting greater integration for the
governance between RTI and sexually transmitted infections and RTI and the
National AIDS Control Organization and 100% registration of births, marriage,
pregnancy and marriage can be registered.
On 11 May 2000, India's population surpassed one billion. The Prime Minister
announced the foundation of the National Population Commission on that day, with
him as Chairman and the Vice Chairman of the Planning Commission as Vice
Chairman. The Commission's mandate is to: analyse, observe, and provide proper
direction for the growth of a National Population Policy in order to achieve
Population Policy's goals; and promote harmony between different programmes for
education, environment, health in order to accelerate population stabilisation.
The Two-Child Policy
A two-child policy has been implemented in some Indian states. Persons having
more than two kids are not allowed to serve in government, according to the
regulations. Assam enacted the most current policy in 2017. Some states have
rescinded policies; for example, Chhattisgarh enacted a policy in 2001 that was
later removed in 2005.
These measures have been criticised for limiting the number of women in
government and encouraging sex-selective abortions.
As of 2014, 11 Indian states had adopted the two-child policy with the aim of
reducing the number of kids per family.
The policy was aimed mostly at prospective and aspiring politicians who wanted
to keep their family size to two or fewer children. Those who hold political
positions have harsher restrictions for the goal of setting a good example for
society; for example, if a person has more than two children while working, they
will be fired. Non-politicians may also suffer repercussions if they have more
than two children. If they have more than two children, the government may begin
withholding health care, government privileges, jail time, and taxes.
National Family Welfare Programme
As per National Family Welfare Programme in India broadly 2 methods are used for
family planning - Spacing methods and permanent methods.
- Spacing Method- Spacing Techniques:
These are reversible contraceptive
methods that couples who would like to have kids in the future can use.
These
are some of them:
- Oral Contraceptive Tablets (OCPs):
These are the pills which make changes
in hormones and must be taken by a woman on a regular basis, preferably at a set
time. During the hormonal pill-free days, the strip additionally contains extra
placebo/iron tablets to be ingested. Majority of the women can use the procedure
once it will be certified by professionals.
At the moment, ASHA has a plan in place to distribute OCPs to recipients'
doorsteps for a little fee. At all public healthcare institutions, the brand "MALA-N"
is offered for free.
- Condoms:
Condoms are barrier contraceptive devices that prevent undesired
births while also preventing the transfer of sexually transmitted Disease like
HIV. The "Nirodh" brand of a condom is provided free in government health care
facilities and are even delivered at home at a lower price by ASHA.
Copper-containing intrauterine contraceptive devices are quite successful in
birth spacing for a long term. They should not be used by women with, active
PID, uterine abnormalities, or those who are at elevated risk of Sexually
transmitted diseases.
- Permanent Procedures:
These methods are typically regarded as
irreversible and either of the couple can use it.
- Female Sterilization (A) There are two methods:
- Minilaparotomy:
This procedure entails creating a tiny cut in the
abdomen. The fallopian tubes are taken to the cut and either cut or plugged.
Only a skilled MBBS doctor can conduct this procedure.
- Laparoscopic:
An extensive narrow tube with a lens is inserted into the
belly through a tiny cut in laparoscopy. The doctor can use this laparoscope to
examine and block the fallopian tubes in the belly. Only a qualified and skilled MBBS doctor or expert may do this procedure.
- Male Sterilisation:
The provider pinpoints both the two tubes that carry
sperm to the penis through a puncture or small cut in the scrotum and clogs it
by cutting and stitching it closed or by using Permanent Methods. It normally
takes around 15 minutes and is performed under local anaesthesia, which means
you are aware but not in discomfort.
Male Sterilisation may be divided into two categories:
- Traditional vasectomy performed with a scalpel (surgical knife:
A local anaesthetic is used to numb your scrotum before the procedure. The tubes that
transport sperm out of your testicles are then reached through two tiny slits in
the skin upon every side of your scrotum. A little portion of each tube is taken
off. The tubes' ends are then sealed, either through tying them or using heat to
seal them. The wounds are sewn together, generally with dissolvable threads that
fade away in approximately a week.
- Vasectomy with no scalpels:
The doctor will initially use a local anaesthetic
to numb your scrotum. To get to the tubes, they cut a tiny puncture hole in your
scrotum's skin. This implies they won't have to use a knife to cut the skin. The
tubes are subsequently tied or sealed in almost the same way as a traditional
vasectomy is done.
With this treatment, there is minimum bleeding and no need for sutures. It's
supposed to be a little less painful than a traditional vasectomy and far less
likely to produce problems.
India has a lengthy history of attempting to manage population concerns through
policies and initiatives that have failed to achieve the desired outcomes. In
terms of population, India is now ranked second in the world and is on the path
to outstrip China, the world's most populated country, in the near future. There
is an essential legal element of population dynamics and family planning that
has yet to be fully addressed.
The Indian legal system was unable to gather all
of the country's family planning regulations in a systematic manner. Various
legislation, administrative directives, and judicial declarations are frequently
strewn among the overall body of law. The importance of law in facilitating
family planning is that it aids the State in ensuring the Constitutional promise
of socio-economic equity for the Indian people.
To overcome these issues the
state must be obligated to create a comprehensive, effective, and easily
available family planning framework to support people in adopting their
preferred family planning techniques. Parents with a small family who have
willingly undergone sterilisation should be eligible for certain benefits.
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