Population Policy at National and State Level Shiv Chandra Mathur

Population Policy at National
and State Level
(A case of India and Rajasthan)
Shiv Chandra Mathur
Professor and Head
Preventive & Social Medicine
Medical College, Kota 324 005
Rajasthan, India
Why this presentation?
India with a population of more than one billion
scattered in 26 states and 8 union territories
provide a unique ground for studying population
programs management. There is a paradigm
shift in population management from exclusive
contraceptive delivery to concurrent dealing of all
issues in the framework of reproductive
health.The steps initiated under the influence of
new philosophy at country and state level may
give certain clues to many other countries,
struggling for betterment of their population
programs.
Shiv Chandra,2001
Objectives
This presentation aims at:
1. Illustrating the definition of policy;
2. Steps involved in policy cycle;
3. Defining the population policy;
4. Imparting knowledge on common
elements of population policies.
Shiv Chandra,2001
Objectives (cont.)
5. Document the Process of
Formulating Population Policy at
State level in a Federal Country;
6. Review the content of National
Population Policy, India 2000;
7. Review the National v/s State
Population Policy.
Shiv Chandra,2001
What is a Policy?
Set of Ideas or Plans that is used as a
basis for decision making;
Attitude and actions of an organization
regarding a particular issue;
General Statement of understanding
which guide decision making.
Shiv Chandra,2001
What is a Policy
It is more than mere statement of
goals:
How the stated goals can be achieved?
Who will carry out the tasks?
In what manner?
Shiv Chandra,2001
Basis for Policy
Set of Values
Commitments
Assessment of current situation
Image of a desired future situation.
Shiv Chandra,2001
Four stages of Policy Process
Problem Identification and Issue
Recognition
Policy Formulation
Policy Implementation
Policy Evaluation
Shiv Chandra,2001
Policies related to Health Sector
National Health Policy
Nutrition Policy
Women Policy
Training Policy
Population Policy
Shiv Chandra,2001
What is Population Policy?
 Measures formulated by a range of social
institutions including Government which may
influence the size, distribution or composition of
human population (Driver,1972).
 A deliberate effort by a national government to
influence the demographic variables like fertility,
mortality and migration (Organski &
Organski,1961)
 A set of Coordinated laws aimed at reaching some
demographic goal (Biurgeois-Pichat,1974)
Shiv Chandra,2001
Types of Population Policies
 Explicit : Document by a national
government announcing its intention to
affect the population growth and
composition
 Implicit : Directives not necessarily issued
to influence the population growth and
composition but may have the effect of
doing so.
Shiv Chandra,2001
Elements common to
Population Policies
Rationale : demographic analysis
Objectives and Goals
Targets :
time bound level of fertility
Program Measures
Shiv Chandra,2001
Process of Population
Policymaking
 Developing the Constituency in favor of
Population Policy
 Identifying the arguments favoring population
policy
 Addressing the issues to a right place
 Visualizing the form a policy should take
 Recognizing the most advantageous time
Shiv Chandra,2001
Observations on National
Population Policy(NPP)India-2000
3
Objectives
 4 New Structures
 12 Strategic Themes
 14 National Socio-demographic Goals (2010)
 16 Promotional and Motivational Measures
 150 Interventions
Shiv Chandra,2001
National Population Policy-2000,
India aims at
 Short Term : fulfill unmet need for contraception,
strengthening the health infrastructure, integrating
the services for Reproductive and Child Health.
 Medium Term :effective implementation of intersector strategies to substantially reduce the TFR
by 2010.
 Long Term : to sustain the economic growth,
social development and eco-conservation, stabilise
the population by 2045.
Shiv Chandra,2001
Demographic Targets of NPP2000 India (2010)
 Fulfilling the Unmet Need for RCH
 Free and compulsory education for children under-fourteen
 Reducing the school dropout between boys and girls to 20







percent
Bringing IMR < 30
Bringing MMR < 100
Increasing Immunization against VPDs to 100 percent
Encouraging the increase in average age at marriage of girls
Increasing Institutional Deliveries to 80 percent
> delivery by trained hands to 100 percent
Making contraceptive of choice available to 100 percent
population
Shiv Chandra,2001
Demographic Targets of NPP2000 India (2010) Cont.
 Enhancing the IEC coverage for RTI/STI/AIDS to
cent percent population
 Integrating allopathy with ISM for betterment of
RCH services
 Encouraging the small family norm to
substantially reduce TFR
 Coordinating the activities of social sector
development to make family welfare program
public oriented
Shiv Chandra,2001
Strategies for NPP-2000, India
 Decentralise the Plan and Program
Implementation
 Convergence in services at delivery points
 Women Empowerment to mitigate
nutrition/health problems of females
 Strengthening child survival
 Meeting the unmet need for FW
 Special services for slums
 Attending Adolescents
 Increasing Male Participation
Shiv Chandra,2001
Structures to be created for
NPP-2000,India
 National Population
Commission under the
chair of Prime Minister
 Population Commissions
in each state under the
chair of Chief Ministers
 Coordination Cell in
Planning Commission at
country level
 Creating Technology
Mission at national level
Shiv Chandra,2001
Population Program
Promotional Measures
 providing fertility regulating information/services
 furnishing family life/sex education information
 improving the status of women
 improving health and nutritional status
 providing incentives and disincentives
 improving research and evaluation
 carrying out specific legal reforms to influence
internal and international migration
Shiv Chandra,2001
Population Policy at State level
 India is a federation of 26 states and 6 union territories with
varying development status. While Kerala in south have
exemplary demographic indicators, the situation in northern
states is dismal.
 Although Population Management falls in the concurrent
list of activities envisaged in the constitutional framework
of India but with other issues of social development like
Health, Education and Women development being in the
state list of activities, state governments own the
responsibilities to a large extent. Thus a new phenomena of
policy formulation at state level has begun which may
reintensify the efforts of Union Government.
 Since population growth and quantum influence the
development of the country at large, union government has
consistently interacted with states on this subject.
Shiv Chandra,2001
Rajasthan-a large state of India
 Rajasthan located in north-west India has a land area of 3.2





million sq km with a population of 54 million(2001). It is
scattered in 200 urban agglomerations and more than 33000
inhabited villages.
The State has one of the highest decadal population growth rate
and one of the lowest literacy rate (particularly female literacy)
in the country. Sex Ratio is 913 females per 1000 males.
Its growth rate has consistently remained above the national
average. It is 28.2 percent for the period between 1ast two
census(1991-2001)
The average age at marriage is less then 18 although a law
exists to not to marry girls before they attain adulthood.
The involvement of male in managing the fertility and
Shiv
reproductive phenomena is minimal.
Chandra,
The state has one of the highest infant mortality rate.
2001
Trends in Population Growth
of Rajasthan
 With the existing TFR
First 10 million
1898
4.4, CPR 40 %, IMR 86 Second 10 million 1961 63 years
and decadal Growth Rate
Third 10 million
1977 17 years
of 28 %, the State’s
population would reach Fourth 10 million 1988 11 years
to 98.8 million by 2041 Fifth 10 million
1996 8 years
A.D
Sixth 10 million
2003 7 years
 State’s Population Policy
aims to achieve TFR 2.1
by 2016 through raising
Shiv Chandra,2001
CPR to >65%.
Policy Changes Proposed in the
Sate of Rajasthan
 From Medical to
 Specific
Social Engineering
Interventions:
Behavioral Change
Informed Choice
Participation
Sustainability
Girl Child
Education/Female
Literacy;
Gender Equity;
Family Life Education;
Legislative Measures;
Enhancing Age at
Marriage;
Male Participation, and
Strengthening IEC.
Shiv Chandra,2001
Policy Interventions In State’s
Population Policy of Rajasthan 2000
 From Quantity to
 Integrated Services
Quality
for
Upgradation of Skills
Static Centres for
Steriliz’ns
Improved access to
services
Upgradation of
facilities
Operations Research
Spacing Method
Antenatal Care
Deliveries
Post-natal Care
Immunization
RTI
Child Care
Shiv Chandra,2001
Institutions to be created for Policy
Implementation in Rajastahan-India
 State Population
Council
 Pop’n Resource
Centre
 District Level
Committee
 Block Level
Committee
 Village Level
Committee
Shiv Chandra,2001
Summary
 It has been a unique event in the history of
Public Health in India that in the year
2000that the Population Policies have been
released at the country and state level with
the goal of stabilizing Population in a large
subcontinent which currently constitutes
one-sixth of world’s population. It is now
for students of Health Management to see,
how the proposed interventions work in the
Shiv Chandra,2001
coming time.