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June 2004
by
edward
—
last modified
17-08-07 22:17
:: 1 June 2004-Newsletter ::
From: Populationfirst
[newsletter@populationfirst.org]
Sent: Tuesday, June 01, 2004 3:05
PM
To: bobby.sista@populationfirst.org
Subject:
Newsletter-June 2004
| A
Communications Initiative for Sustainable Human Development in
India |
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| E-NEWSLETTER |
Second Issue 1 June 2004 |
Are NPP2000 Goals Beyond
Reach
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As the new government settles
in office at the centre, it must soon turn its attention to where India
stands on issues related to health and population. It was four years ago
that country got its first rights based National Population Policy, now
popularly known as the NPP2000. But while NPP2000 set the national goals,
the country now faces glaring demographic differences across its various
regions, most notably the gap between some achievements in the Southern
States against stubborn fertility rates in the Northern States.
As
the Secretary for Family Welfare Mr. Prasanna K Hota recently noted:
[Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan, Chattisgarh,
Jharkhand., Uttaranchal, Orissa] will in total account for 56% of
population increase in this [1996-2016] period. Family planning and health
services in these States will have to be strengthened on a priority basis.
The population scenario of India shall largely depend on fertility
reduction in these States. [Full speech at http://www.iipsindia.org/hota.pdf ] |
If programmes and
services are not delivered to these States on a priority basis,
there remains a real danger that India might miss the NPP medium
term objective of bringing Total Fertility Rate to replacement
levels by 2010 and population stabilisation by 2045.
Certainly, there is a school of thought that India might
indeed have to rewrite these timelines.
In a key note
address at a symposium organised earlier this year on the role of
Private Sector in Population Stabilisation, Mr. Robert Clay Director
Population, Health & Nutrition at the United States Agency for
International Development [USAID], said: If the current trend
continues, it is expected that an Indian couple would have only
about two children by 2020. In other words, India would reach
replacement level fertilityten years later than the goal envisaged
in the NPP Therefore, given the current trend, Indias population
is expected to stabilise around 2055-2060, which is about 10-15
years later than what is envisaged in the NPP. [See box] The basis
for Mr. Clay statement appears to be the continuing high fertility
in the Hindi belt and the Herculean task of improving the coverage
and quality of family planning services in the Hindi belt.
However, not all agree that the goals have been missed
already.
Said Dr. Ramakrishna Reddy, an award winning
surgeon who has worked on population programmes: There is no cause
for alarm. As a technical expert, I can say that we can achieve
Replacement Level Fertility even earlier, by 2008 or 2009, provided
we have a definite direction for implementation
Dr. Reddy
cites the examples of Tamil Nadu, which reached Replacement Level
Fertility in three years from 1982 to 1984, and Andhra Pradesh,
which did the same from 1995 to 1997 through sheer political will.
These states have been successful in mopping up the demand for
contraceptive services through effective family planning programmes
and were able to achieve the goals of replacement level fertility
earlier.
According to Dr.Reddy, the last two years have seen
many a State and the Centre caught in election mode, and so
programmes were deprived of the zeal and political push that was
required to make them work beyond the regular, administrative level.
Dr.Reddy believes that the pace has been positive but not
enough all along. m optimistic. But if we slip now, we get
into trouble, he said.
Political determination to implement
the family planning programmes efficiently, filling up the
infrastructure shortfalls and providing appropriate technical
support to the programmes are the three essential inputs, according
to Dr. Reddy. |
The
following is an excerpt from an address by Mr.Robert
Clay, Director Population, Health & Nutrition at
the United States Agency for International Development
[USAID]
. An agency of the US Government, USAID has been
supporting important health and population programmes in
India.
This was part of Mr.Clays keynote
address to the Symposium on Population Stabilisation:
Role of Civil Society organized earlier this year in
New Delhi by the Confederation of Indian Industry, or CII
In
order to accelerate the pace of the demographic
transition in India, it is imperative to note the
wide variations that exist within the country. Due
to various factors including higher female
literacy, greater exposure to mass media,
concerted efforts to expand access to quality
services and strong political commitment, the
southern states have made far greater progress in
fertility decline than their northern
counterparts.
If the current trend
continues, it is expected that an Indian couple
would have only about two children by 2020. In
other words, India would reach replacement level
fertility, the level of fertility at which a
couple has only two children to replace
themselves, by 2020, ten years later than the goal
envisaged in the National Population Policy.
However, due to a large young population base,
even after India reaches replacement level
fertility, the population will continue to
increase as the cohorts of young people will pass
through childbearing. As a result, it will take an
additional 35 to 40 years for the population of
India to stabilize after reaching replacement
fertility. Therefore, given the current trend,
Indias population is expected to stabilize around
2055-2060, which is about 10-15 years later than
what is envisaged in the National Population
Policy.
Today, there are about 170 million
married couples in the reproductive age group in
India. The family planning needs of 27 million
couples are not being met especially in the four
large states of Bihar, Uttar Pradesh, Rajasthan
and Madhya Pradesh. If the unmet need for
contraception was adequately addressed, India will
reach replacement fertility, i.e. each couple will
have only two children.
Another issue,
although current use of contraception has
increased, there is need for considerable
improvement in the coverage and quality of family
planning services, especially in the Hindi belt.
In order to accelerate the pace of the demographic
transition, it is imperative to reach out to the
couples whose family planning needs are not being
currently met and provide choices to have the
desired number of children. This requires a
Herculean effort.
The government cannot
alone meet this challenge; the private sector has
to shoulder equal responsibility, for increased
progress towards population stabilization and
fulfilling Indias dream of smaller, healthier
families with better-educated children having
expanded opportunities. I strongly believe that
the public-private partnership is critical to the
task of achieving population stabilization. |
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However, it may be noted that
while the Southern States have achieved Replacement Level Fertility, they
fare poorly on other related indicators like Infant Mortality Rate and
child nutrition status which are significant for improving the quality of
life. The specific needs and focus required in these States will be
different from the inputs needed for the Northern States and the gap is
something that a pan all population policy might not be able to address.
There is, therefore, an urgent need to reframe the population policies in
these states to address quality of life issues while not slackening the
contraceptive service delivery.
While TFR is an important goal of
NPP, it should not be the sole criterion that drives the population
programmes. As Mr. A R. Nanda, India former Health Secretary observed: population stabilization is not merely about numbers; it has to be looked
at in the context of wider socio-economic development. It does not matter
if in the process we dont stabilize by 2045; it could be achieved by 2050
or 2060. But what is of greater concern is how we approach the issue of
population stabilisation. [http://www.india-seminar.com/2002/511/511%20a.r.%20nanda.htm
]
Clearly, this is a critical time which will decide whether
we meet or fall short of NPP2000 goals. The challenge before the new
government would be to meet demographic goals without compromising on
other health and social indicators. To do this, there must be a re-look at
the path already traversed, and agreement on benchmarks that would help us
navigate the future. After all, how can we talk of bringing Total
Fertility Rate to replacement levels by 2010 without having a year by year
progress chart to understand just how well we are walking the chosen path
to population stabilisation.
|
| As New
Ministers Take Charge, A Re-look At The Manifesto They Must
Implement |
Dr. Anbumani Ramdoss
India's new Minister for
Health & Family Welfare |
Dr. Anbumani Ramdoss, a
suave 36-year-old doctor is India new Minister for Health &
Family Welfare. My aim is that no life should be lost for want of
medical care, Mr.Ramdoss said soon after taking charge on May 25.
In an interview, he said Bihar, Uttar Pradesh, Madhya Pradesh,
Jharkhand, Uttaranchal and Chattisgarh would receive his special
attention for population programmes.
His junior Minister is
Ms.Panabaka Lakshmi, Minister of State for Health & Family
Welfare, from the Congress party which leads the new coalition
government at the Centre.
Dr. Ramdoss is not from the
Congress party but should have no difficulty in working to implement
the Congress party manifesto in so far as health and population
issues are concerned. While the government works on a Common Minimum
Programme, we do not expect much of a tussle over the goals and
programmes of the ministry for health and family welfare. |
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| Here is what the Congress
promised on health and population in its manifesto document: |
- The Congress will raise public spending on health to at least 2-3%
of GDP, with the focus on primary health care over the next five years
and to around 5% of GDP over the next decade.
- on present reckoning, four-five states of India will be unable to
reach TFR of 2.1 by 2010. The Congress will take the lead in replicating
the success of other states in those states where population growth
continues unabated.
- A sharply targeted mobilization effort will be mounted in the
150-odd districts that still have unacceptably high levels of fertility.
- Nutrition programmes, for the girl child particularly, will be
expanded on a significant scale.
- A national cooked nutritious mid-day meal scheme will be introduced
in primary and secondary schools across the country. The Integrated
Child Development Services (ICDS) will be universalized to provide for a
functional anganwadi in every settlement and full coverage, especially
children below age of six.
- A national scheme of health insurance for families living below the
poverty line will be proposed.
- The Congress will introduce a new community anchored health worker
scheme and implement it with the involvement of peoples organizations
and panchayati raj institutions.
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The Congress party manifesto
also includes the partys stand on various other issues which have a
bearing on health and population programmes:
- raise public spending in education to at least 6% of GDP with at
least half of this amount being spent in primary and secondary schools.
A cess will he proposed on all central taxes to finance the commitment
to universalize access to quality basic education.
- Special schemes (under PDS) to reach food grains to this section
through panchayats will be launched. Antyodaya cards for all households
at risk of hunger will be introduced. Grain banks in chronically food-
scarce areas will he established.
- Stern measures will be taken to ensure the elimination of female
foeticide and infanticide.
- Marriage registration will be made mandatory.
- Village women and their associations will be empowered to assume
responsibility for all development schemes relating to drinking water
supply, sanitation, primary education and health, nutrition, biogas,
maintenance of water pumps and bore wells and farm forestry.
|
COMMUNITY
MOBILISATION WORKSHOP
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Population First works
at the grass roots along two aspects. One is to help improve service
delivery by working with health service providers and building their
capacities to provide quality service. |
| On the other hand, we
also work at the community level wherein we seek to empower the
communities to address the health issues and also demand quality
health services form the State health system an essential
ingredient for efficient health service delivery. |
|
Community mobilisation is
undertaken through participatory micro planning processes, under which the
facilitators help the community members identify and assess the problems,
and help find solutions through association or networking at the village
level. By forming coordination committees at the village level, the entire
process from the initiative to responsibility for implementation as well
as the credit for success, lies with the community.
The first
pilot community mobilisation workshop began in Nandgaon village of
Kinhavali PHC area on May 25. The five day workshop will involve house to
house survey, village mapping, focus group discussions and development of
action plans. The workshop seeks to involve and impact the entire village
population of around 800 people. The focus is on maternal and child
health, adolescent sexual and reproductive health, hygiene and sanitation.
A second workshop is scheduled for early June in the Dolkhamb PHC
area. More.... |
| Response
to the cover story in the May newsletter, which discussed the then Deputy
Prime Minister Lal Krishna Advanis suggestions that India should have a
two childnorm. |
| George Jacob writes Mr.Advani is making impractical suggestionsWhat exactly does he mean by Public Offices? If he means a peon in the Community Development Office,
it is cruel to throw a poor man out of his familys livelihood, just
because he did not observe the DPMs norm. The norm is violated where
women are not educated and are not in a position to contribute to the
family expenses except through household work and bearing heirs to her
husband. |
Until this is set right,
fascist methods will only cause infanticide. Given the unenviable record
of our home ministry in keeping corrupt policemen from top to bottom, not
one case will surface. Let the inept government not take its frustration
out on innocent just born infants. The need is to improve the root cause,
educate your women and create the right kind of employment |
| POPULATION
FIRST |
| Population First is a
communications based initiative that embraces the government objective of
achieving population stabilisation by the year 2045. Working to support
the governments programmes, Population First builds the
communication foundations for partnership between government, civil
society, the corporate sector and the media, creating a common ground for
the sharing views and perspectives that will help lead change in society.
The whole idea evolves around the belief that empowering women to exercise
their rights |
helps achieve social
development and provides a refreshing and appropriate framework for
addressing issues related to health and population. A focus area of the
organisation is reproductive health, which is closely connected with
decisions on family size and must be seen within the context of equal
rights for women and children. In this endeavour, Population First
counts on the responsible participation of the community, a response which
we hope to kick start at least in part by our communications initiatives.
More.... |
Copyright é 2004, Population First
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