NATIONAL FAMILY

WELFARE
SERVICES.

By
bhavani babu,
b.sc (n) iv yr,
saveetha college of nursing.
FAMILY WELFARE SERVICES
DEFINITION:
Family welfare includes not planning of births, but the
welfare of whole family by means of total family health care.
AIMS AND OBJECTIVE OF FAMILY WELFARE PROGRAMME:
 To promote the adoption of small family size norm on basis of voluntary
acceptance
 To promote the use of spacing methods
 To ensure adequate supply of contraceptives to all eligible couples within easy
reach
 To arrange for clinical and surgical services so as to achieve the set targets
 Participation of voluntary organization/local leaders/local self government, in
family welfare programme at various levels
 Using the means of mass communications and interpersonal to overcome the
social and cultural hindrance in adopting the programme or extensive use of
public health education for family planning
IMPACT OF FAMILY WELFARE PROGRAMME:
Awareness of one or more methods of contraception
 Increases in contraception use over years
 Increase in use of condoms
 Knowledge of female sterilization
 Increase knowledge about contraceptive pills
 Fertility rate low among educated women
 Fertility rate low among higher income group

ROLE OF NURSE IN FAMILY WELFARE SERVICES:

 Survey work
 Collecting demographic facts
 Collecting information about pregnant mothers, eligible couples, infants and
children below the school going age.
 Education functions and motivation:
 Explaining the importance and necessity of family planning to mass
 Using various techniques of teaching and communication to propagate the
message of family planning to common man
 Motivating the eligible couple to use contraceptive
 Motivating people for permanent contraception
 Managerial functions:
 Conducting clinics
 Organizing family planning camps
 Maintaining the records
 Liaison work- soliciting the co-operation of NGO’s /Voluntary organization
 NATIONAL FAMILY
WELFARE PROGRAMME

INTRODUCTION
India launched the National Family Welfare Programme in 1951 with
the objective of "reducing the birth rate to the extent necessary to
stabilize the population at a level consistent with the requirement of
the National economy. The Family Welfare Programme in India is
recognized as a priority area, and is being implemented as a 100%
Centrally sponsored programme.
Definition:
Family planning means planning by individual or couples to have only
the children they want them , this is responsible parenthood.
Family welfareincludes not only planning of birth , but they welfare of
wholes family by means of total family health care. The family welfare
programmes has high priority in india.

EVOLUTION OF FW PROGRAM

The approach under the programme during the First and Second Five
Year Plans was mainly "Clinical" under which facilities for provision
of services were created. However, on the basis of data brought out by
the 1961 census, clinical approach adopted in the first two plans was
replaced by "Extension and Education Approach" which envisaged
expansion of services facilities along with spread of message of small
family norm.

In the IV Plan (1969-74), high priority was accorded to the

programme and it was proposed to reduce birth rate from 35 per
thousand to 32 per thousand by the end of plan. 16.5 million couples,
constituting about 16.5% of the couples in the reproductive age group,
were protected against conception by the end of IVth Plan.

The objective of the V plan (1974-79) was to bring down the birth rate
to 30 per thousand by the end of 1978-79 by increasing integration of
family planning services with those of Health, Maternal and Child
Health (MCH) and Nutrition, so that the programme became more
readily acceptable. The years 1975-76 and 1976-77 recorded a
phenomenal increase in performance of sterilisation. However, in view
of rigidity in enforcement of targets by field functionaries and an
element of coercion in the implementation of the programme in 1976-
77 in some areas, the programme received a set-back during 1977-78.
As a result, the Government made it clear that there was no place for
force or coercion or compulsion or for pressure of any sort under the
programme and the programme had to be implemented as an integral
part of "Family Welfare" relying solely on mass education and
motivation. The name of the programme also was changed to Family
Welfare from Family Planning.

In the VI Plan (1980-85), certain long-term demographic goals of

reaching net reproduction rate of unity .
The Family Welfare Programme during VII five year plan (1985-90)
was continued on a purely voluntary basis with emphasis on promoting
spacing methods, securing maximum community participation and
promoting maternal and child health care. The Universal Immunization
Programme (UIP) was launched in 1985 to provide universal coverage
of infants and pregnant women with immunization against identified
vaccine preventable diseases and extended to all the districts in the
country

The approach adopted during the Seventh Five Year Plan was
continued during 1990-92. For effective community participation,
Mahila Swasthya Sanghs(MSS) at village level was constituted in
1990-91. MSS consists of 15 persons, 10 representing the varied social
segments in the community and five functionaries involved in women's
welfare activities at village level such as the Adult Education
Instructor, Anganwari Worker, Primary School Teacher, Mahila
Mukhya Sevika and the Dai. Auxiliary Nurse Midwife(ANM) is the
Member-Convenor. From the year 1992-93, the UIP has been
strengthened and expanded into the Child Survival and Safe
Motherhood (CSSM) Project. It involves sustaining the high
immunization coverage level under UIP, and augmenting activities
under Oral Rehydration Therapy, prophylaxis for control of blindness
in children and control of acute respiratory infections. Under the Safe
Motherhood component, training of traditional birth attendants,
provision of aseptic delivery kits and strengthening of first referral
units to deal with high risk and obstetric emergencies were being taken
up.

To impart new dynamism to the Family Welfare Programme, several

new initiatives were introduced and ongoing schemes were revamped
in the Eighth Plan (1992-97). Realizing that Government efforts alone
in propagating and motivating the people for adaptation of small
family norm would not be sufficient, greater stress has been laid on the
involvement of NGOs to supplement and complement the Government
efforts.

Reduction in the population growth rate has been recognized as one of

the priority objectives during the Ninth & Tenth Plan period. The
strategies are:

i) To assess the needs for reproductive and child health at PHC level
and undertake area- specific micro planning.

ii) To provide need-based, demand-driven, high quality, integrated

reproductive and child health care reducing the infant and maternal
morbidity and mortality resulting in a reduction in the desired level of
fertility.
 CONTRACEPTIVES

The National Family Welfare Programme provides the

following contraceptive services for spacing births:

a) Condoms

b) Oral Contraceptive Pill

c) Intra Uterine Devices (IUD)

It was decided in the national health policy that 1983, and then the net
reduction of reproduction rated
should be one by the year 2000.

CONCEPT OF FAMILY WELFARE PROGRAMME:

The concept of family welfare is basically related to quality of life.
 As such it includes education, nutrition, health employmrnt, womens
welfare and right, shelter, soft drinking water all vital factors associated
with the concept of welfare.
 It is centrally sponsored programme . for this , the states receive to 100%
assistance from central government.
 The emphasis is on child family.
 The services are taken to every doorstep in order to motivate families to
accept the small family norm.

IMPACT OF FAMILY WELFARE ACTIVITIES:

Nearly 98%of women and 99% men in the age group 15 and 49 have a
good knowledge about one or more methods of contraception.

Over 97% of women and 95% of men aare knowledgable about female
sterilization.
STRATEGIES OF FAMILY WELFARE PROGRAMME:
 Integration with health services,
 Family welfare programme has been integrated with other health
services instead of being a separate service.
 Integration with maternity and child health,
 Family welfare programme has been integrated with maternity and
child health. Public are motivated for post delivery sterilization,
abortion, and use of contraception.

CONTRACEPTIVES:

Whereas condoms and oral contraceptive pills are being

provided through free distribution scheme and social marketing scheme,
IUD is being provided only under free distribution scheme. Under
Social Marketing Programme, contraceptives, both condoms and oral
pills are sold at subsidized rates. In addition, contraceptives are
commercially sold by manufacturing companies under their brand names
also. Govt. of India does not provide any subsidy for the commercial
sale.
COPPER-T

Cu-T is one of the important spacing methods offered under the

Family Welfare Programme. Cu-T is supplied free of cost to all the
States/UTs by Govt. of India for insertion at the PHCs, Sub-centres
and Hospitals by trained Medical Practitioners/trained Health
Workers.

The earlier version of Cu-T 200 ‘B’ (IUDs) has been replaced by
Cu-T 380-A from 2002-03 onwards which provides protection for a
longer period(about 10 years) as against Cu-T 200 ‘B’ which
provided protection for about 3 years only.

EMERGENCY CONTRACEPTIVE PILL (ECP) was introduced

under Family Welfare Programme during 2002-03. The
emergency contraceptive is the method that can be used to prevent
unwanted pregnancy after an unprotected act of sexual intercourse
 (including sexual assault, rape or sexual coercion) or in
contraceptive failure. Emergency Contraceptive is to be taken on
prescription of Medical Practitioners.

TERMINAL METHODS

Under National Family Welfare Programme following Terminal/

Permanent Methods are being provided to the eligible couples.

A) TUBECTOMY.
Mini Lap Tubectomy

i) Lapro Tubectomy

Laparoscopic sterilization is a relatively quicker method of female

sterilization.

B) VASECTOMY

i) Conventional Vasectomy

ii) No-Scalpel Vasectomy

It is one of the most effective contraceptive methods available for

males. It is an improvement on the conventional vasectomy with
practically no side effects or complications. This new method is now
being offered to men who have completed their families. The No-
Scalpel Vasectomy project is being implemented in the country to
help men adopt male sterilization and thus promote male
participation in the Family Welfare prograMME.

ROLE OF NURSE IN FAMILY WELFARE SERVICES:

SURVEY WORK:
  Collecting demographic facts

 Making list of homes

 Collecting information about pregnant mother , eligible couples,

and infants.

EDUCATIONAL FUNCTION AND MOTIVATION – explaining the

importance and necessity of family planning to masses

 Using various techniques of teaching and communication to propogate

the message of family planning to common man.

 Motivating the eligible couple to use contraceptive and educating them

about its uses.

MANAGERIAL FUNCTION:

 Conducting clinics
 Arranging family welfare operation
 Making arrangements at the camps and follow aseptic techmiques for the
operation.
 Motivating eligible couples,and preparing them for operation.
 Assisting the doctor in operation.
 Maintaining the records.
 Keeping the eligible couple register update.
 Maintaining the other records related to family planning.
 Liasian work
 Soliciting the co operation of NGO’S / voluntary organization.