Sterilization 22 million (later raised to 24 million) IUD 7.9 million CC Users 11 million in the terminal years 1984-85
Effective couple protection 36.6 percent
11.59 Strategy for the Sixth Plan: Limiting the growth of
population was one of the main objectives of the Sixth Plan. This had
to be achieved through education of the people to adopt a small family
norm voluntarily, backed by apporpriate programmes of supplies and
services. The family planning and welfare programmes had to be made a
part of the total national effort at providing a better quality of
life. The Plan sought to make a massive attack on the problems of
unemployment and poverty through specific programmes directed towards
the weaker sections of society. Special attention had to be paid to
the education and employment of women to liberate them from dependence
and insecurity, thus improving their social status, and at the same
time changing their attitudes.
11.60 The Sixth Plan emphasised that the family planning and
welfare programme must rise above all controversies and should be
accorded high priority. It was reiterated that the programme would
not be the sole responsibility of any one department of the Government
but the responsibility of Government as a whole. The role of
extension education, motivation and involvement of official and
voluntary agencies was stressed. Health, Family Welfare and Nutrition
programmes directed towards the vulnerable populalation-mothers and
children-were vigorously pursued.
11.61 Performance during the Sixth Plan: Against a target of
24 million sterilisations by the end of the Sixth Plan, little over 17
million sterilisations had been carried out. Against the target of
7.9 million IUD insertions about 7 million IUP insertions were done.
Against a target of 11 million CC users during the year 1984-85 about
9.31 million CC users were enrolled in the programme during the year
1984-85.
11.62 A critical analysis of the above performance highlights
the following features:
(i) Achievements fall short of the targets,
particularly in the sterilisation programme. The
performance in respect of IUD insertions and CC users
reached a high level around 80 per cent and above.
(ii) The effective couple protection acheived by March
1985 with the above performance is of the order 32 per
cent which means that the effective couple protection
has been raised by 10 percentage points, i.e., from 22
to 32 per cent but it is still below the Sixth Plan
target of 36.6 per cent.
(iii) In the first two years of the Sixth Plan, couple
protection rose roughly by 0.5 per cent and 1 per cent,
respectivelly, whereas during the last three year of the
programme, the couple protection has steadily risen by
about 2.5 per cent each year.
11.63 The Performance analysis also reveals that the national
averages are substantially lowered because of the relatively poor
performance in the States of Uttar Pradesh, Bihar and Rajasthan. It
may be mentioned here that these three States which account for a
sizeable population of the country have a couple protection rate of
less than 20 per-Uttar Pradesh 16.7 percent, Bihar 16.8 per cent and
271
Rajasthan 19.3 per cent against the national average of 32 per cent.
Madhya Pradesh and West Bengal have a couple protection rate of 29 per
cent. Special efforts for raising the couple protection rate are,
therefore, necessary in these five States.
11.64 The Family Welfare programme is integrated with the
Health programme, especially Maternal and Child Health (MCH). The
performance of the MCH programme during the Sixth Plan, particularly
in the field of immunization and ante-natal care, is far from
satisfactory. Measures for strengthening the programme and increasing
the child survival rate are essential for the success of the
programme.
11.65 The highlights of the Family Welfare programme are:
(i) It is estimated that the crude birth-rate has
declined by about 8 points in about 17 years-from 41 per
1000 population in 1966 to 33 in 1982, i.e., 0.5
percentage point average decline per year.
(ii) The programme seems to have averted 60 million
births since its inception until end March 1983. It is
estimated that the programme implemented in 1983-84
might avert 11 million potential future births.
(iii) By the end of 1984-85 about 32 per cent of all
eligible couples were effectively protected by family
planning methods.
11.66 Most of the State/UTs showed better family planning
performance than before the Sixth Plan. The pick up was, however,
uneven among the States. Among the major States, the effective couple
protection rate increased by 17.9 percentage points in Punjab, by 12.2
percentage points in Maharashtra and 9.9 percentage points in Haryana
during the first four years of the Sixth Plan (1980-84). All these
are much above the national average increase of 6.6 percentage points.
The increase in Madhya Pradesh (5.9 percentage points) and West Bengal
(6.0 percentage points) was a little below the national average. The
major States showing an increase in couple protection rate (CPR) of
less than 4 percentage points during this period are Assam (1.7),
Bihar (3.5), Tamil Nadu (3.5), U.P. (3.6) and Andhra Pradesh (3.8) of
the other States, Tripura (-0.5) and Meghalays (-0.9) registered a
decline in CPR. Among Union Territories, the performance of Dadra and
Nagar Haveli, Chandigarh, Pondicherry and Andaman & Nicobar Islands
was quite satisfactory. The increase in the couple protection rate in
Lakshadeep (1.2) and Delhi (1.7) was rather poor.
11.67 The shortfalls in the achievements under the programme
could be attributed to:-
(i) Lack of infrastructure facilities;
272
(ii) relatively high targets;
(iii) less than optimal use of available resources;
(iv) political, social, economic and cultural
constraints;
(v) high infant mortality rate, which has declined
only moderately from around 125 during the 70's to 114
in 1980; it is still to high for couples to feel
confident of survival of their children; and
(vi) the levels of maternal and child mortality are
still very high compared to that in other countries.
11.68 Against the Sixth Plan allocation of Rs. 1078 crores
(inclusive of Rs. 68 crores transferred from the Health Sector for
Village Health Guides Scheme), the likely expenditure in the Sixth
Plan is around Rs. 1448 crores.
Seventh Plan Programmes and Perspective
11.69 In the light of the progress made in the initial years
of the Sixth Plan, the health policy targeted a net reproduction rate
of 1 by the year 2000 AD- a review, however, indicated that this goal
would be reached only by the period 2006-2011. The Family Welfare
Programme envisages the following goals for the year 1990:
(i) Effective couple protection rate 42 per cent
(ii) Crude birth rate per thousand population 29.1 per cent
(iii) Crude death rate per thousand population 10.4 per cent
(iv) Infant mortality rate per 90 per cent thousand population
(v) Immunisation Universal coverage
(vi) Ante-natal care 75 per cent
11.70 To reach the above targets, particularly 42 per cent
cuple protection, the Seventh Plan stipulates 31 million
sterilisations by its close 21.25 million IUD insertions and, during
the terminal year, 14.5 million CC Users.
Seventh Plan Targets for Family Planning Methods
11.71 The target of 42 per cent CPR by the end of the Seventh
Plan can be reached provieded the rate of increase in CPR of 2
percentage points annually is maintained. This is an enormus task in
view of the increasing number of eligible couples and the need to
compensate for the increasing number of cases of attrition amongst the
past acceptors. On an average, 3 million couples are expected to join
the reproductive group every year. Determined efforts will,
therefore, be necessary to keep the CRP rising. The targets to be
reached regard to different methods in the Seventh Plan are given in
Table 11.2
11.72 Taking into consideration the realities of the
situation, different sets of targets have to be fixed for different
States, both in terms of level of CPR to be attained and in terms of
the method-mix of the acceptors. The year by which NRR of 1 to be
attained by different States is shown in Table 11.3.
TABLE 11.2
Required Acceptors of Family Planning Methods
(Numbers in lakhs)
1985-86 55.0 32.5 105 Form 32 Per cent
1986-87 60.0 37.5 115 in April
1987-88 62.5 42.5 125 1985 to
1988-89 65.0 47.5 135 42 percent in
1989-90 67.5 52.5 145 March 1990
TABLE 11.3
Date of reaching NRR 1 State-wise
1 2 3 4 5 6
Andhar Pradesh 53.35 Assam 19.90 Bihar 69.91
Gujarat 34.09 Karnataka 37.14 Jammu and 5.99 Kashmir
Haryana 12.92 Madhya Pradesh 52.18 Rajasthan 34.26
Himachal Pradesh 4.28 Orissa 26.37 Uttar Pradesh 110.86
Kerala 24.45 West Bengal 54.58 Manipur 1.42
Maharashtra 62.78 Andaman & 0.19 Meghalaya 1.34 Nicobar Islands
Punjab 16.79 Dadra and Nagar 0.10 Nagaland 0.77
Tamil Nadu 48.41 Haveli Sikkam 0.32
Chandigarh 0.45 Goa,Daman and Diu 1.09 Tripura 2.05
Delhi 6.22 - Arunachal Pradesh 0.63
Pondicherry 0.60 Mizoram 0.49 Lakshadweep 0.04
Seventh Plan Family Welfare and MCH Strategies
11.73 For attaining the long-term goal of reaching NRR= 1 by 2000
AD, a suitable strategy of implementation of the programme must be
designed taking into account the differential CPR achieved by
different States, with attention being concentrated on those where it
is low, particularly the group "C" States in the above table which
account for about 33 per cent of the total population.
11.74 Targets for family planning, particularly sterilisa-
tion, are being achieved by special drives and camps. There is need
to develop the programme on a sustained and continued basis.
Laparascopic sterilisation has become very popular and availability of
laparascops and trained personnel has to be stepped up. Much greater
effort will have to be mobilised for implementation of the programme
relating to IUDs, oral pills and conventional contraceptive users.
Imaginative and innovative measures will have to be adopted for
spreading the use of conventional contraceptives and oral pills and
steps need to be taken to make them freely and widely available,
through an effective social marketing mechanism.
11.75 To achieve the national long-term demographic goals,
educating and enlightening people on the benefits of late marriage and
its social enforcement will have to be greatly emphasised. Special
programmes and incentives oriented towards eligible couples,
particularly in the younger age-groups, are needed. Incentives for
attracting coupls with two children and younger age-groups are
necessary.
11.76 Inter-sectoral coordination and cooperation and the
involvement of voluntary agencies in the programme will be necessary
in this programme to an even greater extent than in health. Community
participation is essential for the voluntary acceptance of the Family
Welfare programme. Identification and active involvement of non-
governmental organisations and of informal leaders in the community
and imparting to them the necessary training to motivate and to
participate in the programme are important aspects of efforts in this
field.
11.77 For the achievement of the "two child" norm, it is essential
that the child survival rate in our country is
273
enhanced. The infant mortality rate of 114 per 1000 is staggeringly
high and unacceptable. Here also, there are wide inter-State
differences, with some States having done remarkably well, e.g.,
Kerala in lowering infant mortality, while others lag far behind,
e.g., UP and Bihar. As more than half of the infant mortalities are
in the neo-natal period, the maternity and child health programme
(MCH) will have to be considerably strengthened. The MCH component of
training of medical and paramedical needs to be carefully planned and
implemented. The associated areas of child immunisation, nutrition
and control of communicable diseases in infants will need special
attention and strengthening. For immunisation, the 'cold chain's till
poses a big problem, which needs to be solved. Diarrhoeas are still
among the major causes of infant child mortality and ORS therapy needs
to be used in more effective manner. Acute respiratory infections too
constitute a major risk, and they also require to be tackled.
11.78 Vigorous steps will have to be taken to reduce maternal
mortality. More than two-thirds of the women in the rural areas are
still being attended to at childbirth by untrained Dais and there is,
therefore, need to augment the Dais training programme.
11.79 Activities and aspects in the Family Planning programme
on which stress will be specially needed in the Seventh Plan are the
following:-
(i) The efficiency and effectiveness of the programme
infrastructure will have to be improved.
(ii) Within the overall framework, greater flexibility
will have to be provided to each State with respect to
programme inputs.
(iii) Greater emphasis will be needed on spacing methods
of increasing the couple protection rate, especially of
the younger age-group.
(iv) Special Information, Education and Communication
(IEC) campaigns would need to be organised to remove the
bias against girl children.
(v) Efforts will be made for propagation and enforce-
ment of the law relating to the minimum age of marriage.
(vi) States which have the lowest couple protection
rate would need special attention. Similarly, within
States, areas and groups with lower acceptance rate will
have to be given particular attention. The programme
would have special focus on urban slums, backward and
tribal areas, as well as the rural poor.
(vii) A special programme will have to be undertaken for
cities with population over 10 lakhs in order to achieve
a much higher couple protection rate.
(viii) Involvement of voluntary organisation in the
programme has played a significant, though limited, role
so far. There is need to provide
274
greater support and encouragement to such voluntary
effort. The existing schemes for providing assistance
to voluntary organisations will, therefore, be
strengthened and continuous efforts will be made to
streamline the mechanism for implementing these schemes.
More innovative schemes would be developed to secure
further involvement of voluntary organisations. For
this purpose, substantially enhanced allocations have
been made. There is also need to give more support and
encouragement to voluntary organisations in rural areas.
Success of these schemes requires close interaction
between the Government and voluntary organisations.
Therefore, special cells would be created at the Central
and State levels of coordinate with voluntary
organisations. An Advisory Committee representing non-
govermental organisation (NGOs) may be attached to the
Ministry of Health and Family Welfare so that the
involvement of NGOs could be developed and further
promoted.
(ix) Experience has shown that involvement of women's
groups and youth groups in some common social and
economic activities is quite useful in promoting the
family welfare programme. Village Health Committes and
Mahila Mandals would be actively involved in family
planning programmes in all villages. Some initial
financial assistance could be given to them to implement
their schemes. This will prove to be a very effective
step in making this a people's programme.
11.80 Some State Legislatures have passed unanimous
resolutions in support of the family welfare programme. This form of
political commitment enhances the credibility of the programme and
boosts the morale of those engaged in the family planning field. It
is desirable that similar resolutions be adopted in the remaining
State Legislatures.
11.81 The network of programme services has been expanded
considerably in different Five Year Plans, but it has not yet reached
close enough to the people. Several studies have shown that these
facilities have not been optimally utilised for various reasons such
as ignorance, inaccessibility and lack of credibility of services.
There is, therefore, an urgent need not only to expand and strengthen
the programme infrastructure but also to enlarge its acceptability.
The following actions will be taken towards this end:-
(i) The pripheral infrastructure upto the sub-centre
level will be completed and made effective operational
by training and retraining of the workers.
(ii) Priority will be given to the training and
placement
275
of village health guides, multi-purpose workers and
training of all types of birth attendants.
(iii) All primary health centres will be made fully
operational by filling all vacancies and through
provision of important facilities such as accommodation
and transport to workers. The entire expenditure
connected with the construction of all building, such as
sub-centres and quarters for workers will be an
earmarked budgeted item in the Seventh Plan as State
outlays.
(iv) As of March, 1984, 554 postpartum centres (PPC)
have been sanctioned in medical colleges, district
hospitals and maternity hospitals. Another 400 centres
have been sanctioned for subdivisional hospitals. More
sub-divisional level postpartum centres will be
establised during the Seventh Plan. Provision will be
made for financing additional beds, and supporting
facilities for such centres which get upgraded.
(v) The scheme of financial support for sterilisation
beds reserved for voluntary organisations will be
extended to municipal corporations and local bodies.
(vi) The scheme of assisting private nursing homes for
family planning work will continue.
(vii) The scheme of revamping urban family welfare
infrastructure will be accolerated to cover the low
income segments of urban areas.
(viii) Special infrastructural requirements will be
provided for cities with population of 10 lakhs and
above to enable them to achieve the goal of 60 per cent
couple protection by the year 1990.
(ix) Each major State will have at least one centre of
excellence for recanalisation. For large States, more
than one centre can be provided. Persons requiring
recanalising will be provided with all facilities such
as travel, boarding, lodging etc., at Government
expense.
(x) It is proposed to replace about 10 per cent of
existing vehicles in the primary health centres every
year during the Seventh Plan.
(xi) Since spacing methods will have to receive
emphasis in the Seventh Plan, the supply line of oral
contraceptives. IUDs and Nirodh has to be kept on
stream. This calls for innovative and flexible methods.
11.82 Incentives do play an important role in the promotion
of the family welfare programme. During the Seventh Plan, the
following suggestions can be activised:-
(i) The present pattern of payment of compensation
money to States and individual acceptors is considered
cost-effective and satisfactory and will, therefore,
continue.
(ii) There is also the need to provide some concrete
incentives for programme officers. These need
necessarily be monetary incentives. National awards can
be given in recognition of outstanding and meritorious
contribution.
(iii) It is recommended that donations to family plan-
ning and MCH activities be tax-exempt.
Programme Management
11.83 The efficiency and capabilities of the existing
infrastructure can be greatly enhanced through certain managerial and
administrative interventions which may be relatively inexpensive.
Some of the major deficiencies are non-availability of service
personnel in rural areas (due to reluctance, shortage of manpower or
for some other reason), relative inadequacy of monitoring and
supervisory mechanisms, occurrence to unexpected difficulties, and
inadequacies in the existing procedural systems to cope with such
unforseen circumstances, etc. With a view to removing such
deficiencies, the following measures are proposed to be implemented
during the Seventh Plan.
(i) A sizable percentage of admissions to postgraduate
courses in Government Medical Colleges would be reserved
for doctors who are borne on the State Health Service
and have put in at least three years of service in rural
areas.
(ii) Facility or rent-free accommodation in rural areas
would be provided and where such facility is not
available, house rent allowance would be given in lieu
thereof.
(iii) To meet the shortage of trained para-medicals,
particularly female multi-purpose workers, local women
with lower educational qualifications may be recruited
for training. In addition, the sandwich type of course,
being followed in the State of Maharashtra, would be
adopted.
(iv) All medical students would be given training in
vasectomy, minilap tubectomy, MTP and IUD insertions so
that they are capable of contributing to the programme
as soon as they graduate.
(v) "Reorientation and continuing education" would be
a regular part of training activitives. For this
purpose, adequacy and efficiency of different types of
training centres like those for female multi-purpose
workers, and of health and family welfare training
centres would be assessed. The Central Training
Institutes would develop functional linkages with such
training centres to improve their capabilities.
(vi) Managament and Information, Education and
Communication (IEC) skills of various categories of
personnel would be suitably upgraded. For this purpose
training needs of different personnel would be
identified. Capabilities of various institutes at the
State, regional and Central levels
275
would be ascertained and suitably strengthened. At the
national level there will be a consortium of premier
management institutions with National Institute of
Health and Family Welfare as a focal point to
coordinate, plan and undertake training activities.
(vii) Allocation of funds for IEC activities would be
regulated in an appropriate manner and not be only
confined to agencies like the Ministry of Information
and Broadcasting, and Directorate of Audo-Visual
Publicity. The strategies and,channels would be
diversified for better and more effective educational
coverage. State would be allowed flexibility for
adopting innovative approaches.
(viii) The "Monitoring, Evaluation and Reserach "
activities at the Centre and in the States will be
suitably strengthened.
(ix) To strengthen "Inter-Sectoral Coordination", all
Ministries and Departments, both at the Central and
State levels, concerned with socioeconomic development
programmes would identify concrete areas of tackling
population problems and action plans for such
departments would be clearly spelled out.
(x) "Demand Generation" activities under the programme
will be vigorously implemented during the Seventh Plan.
Research and Technology Development
11.84 Greater emphasis would be placed on "Operational
Behavioural Reserach" with a view to popularising the existing family
planning methods, increasing their acceptability and removing or
reducing the complications or inconveniences associated with various
methods of family planning.
11.85 Research related to new methods of family planning
which have been found efficatious and safe for their introduction into
the national programme would be completed expeditiously, e.g., long-
acting injectables and subdermal implants will be introduced
progressively in the Seventh Plan. The methods which have been found
safe and effective elsewhere and have been approved by the competent
authorities abroad may be introduced in the programme on a pilot basis
as an operation research scheme and then gradually expanded in the
programme.
Policy Thrust Areas for Maternal and Child Health (MCH) in the
Seventh Plan
11.86 The major thrust of MCH in accordance with the National
Health Policy in the Seventh Plan would be directed as follows:
(i) Recognising the close relationship that exists
between high birth rate and high infant mortality, high
priority will be given to the MCH programme.
276
(ii) Preventive, promotive and educational aspects of
MCH services will be given the highest priority.
(iii) A close linkage of health and health-related
sectors with MCH activities will be developed.
(iv) Health care for mothers and children will be
strengthened through the primary health care approach,
which includes integrated, comprehensive MCH care and
suitable strengthening of referral services.
(v) Increased emphasis will be laid on people's
participation in MCH activities by supporting voluntary
organisations, NGOs, village health committees, women's
organisations, women's clubs and traditional birth
attendants.
11.87 The implemention of the MCH programme would be along
the following lines:
(i) MCH services would be provided on the basis of
'high risk' approach.
(ii) Health and family planning services would be
assessed and, depending upon the needs, adequate beds
would be provided for women and children.
(iii) A sizeable proportion of new beds in the Seventh
Plan would be for women and children.
(iv) Logistic, technical, consultative and referral
support for primary health care will be provided at the
secondary level in community medicine, obstetrics,
gynaecology, paediatrics and management.
(v) In order to bring more women and children within
the easy reach of MCH services, the primary health
infrastructure would be strengthened.
(vi) Efforts would be made to maximise the use of ICDS
infrastructure for the enhancement of MCH programmes.
(vii) Special IEC campaigns would be organised to
educate women on the advantages of prolonged breast-
feeding.
Programme Outline for MCH
11.88 The health of mothers and, in particular maternal
mortality, is significantly affected by induced abortions performed by
unqualified persons under unhygienic conditions. The Medical
Termination of Pregnancy Act (1971), (MTP) is a legislative measure
for improving maternal health through the stipulation of conditions
under which pregnancies may be terminated. By the end of the Seventh
Plan period, it is anticipated that MTP services would be provided at
all primary health centres. In urban areas it would be available in
all maternity homes and centres. MTP services would be an integral
part of maternal and child health services and would be closely linked
with the MCH programme. Training programmes would be conducted for
improving the delivery of services. An intensive education and
publicity programme making use of all available facilities would be
undertaken for improved services utilisation.
276
Health care for Woman
11.89 In addition to service provided through the general health
care system, this programme will aim at raising health consciousness
among women. A comprehensive, field-based information, education and
communication programme will be developed. Women would be organised
around available economic activities to enable them to actively
participate in the entire process of socioeconomic development
including health.
Care of Pregnant and Nursing Mothers
11.90 Pregnant and nursing women are a vulnerable segment of
the population. (Maternal Mortality rate is estimated to be about 4-5
per 1000 live births. Abortion handled by quacks and anaemia are some
of the important causes of maternal mortality. Services for the
health care of mothers during ante-natal, intra-natal and post-natal
period will be strengthened. Efforts will be made to cover all
mothers by prophylaxis against anaemia. Services of obstricians and
gynaecologists would be provided at community health centres, and at
subdistrict and district levels.
Care of the New Born
11.91 About half of infant deaths occur during the first
months of life and a large number of these occur during the first week
of life. Some of the causes of these deaths are low birth weight,
inadequate ante-natal and intra-natal care of the mothers, poor care
of the neborn soon after birth (resulting in deaths due to asphyxia
etc.,) and indaequate levels of care. The importance of prevention
and promotive aspects of newborn care are well recognised. During the
Seventh Plan, neo-natal services will be expanded and extended at
appropriate levels.
Care of the Young Child
11.92 The infant mortality rate in India is still very high,
and deaths in the pre-school age is responsible for half the total
mortality. The major causes of death are infections (such as
respiratory diseases, diarrhoeal disease and others), dehydration and
malnutrition. Most of these are preventable.
11.93 Reduction in deaths due to diarrhoea, respiratory
infections and malnutrition could be brought about by training multi-
purpose workers and traditional birth attendants in the recognition of
these problems, administering primary care, as well as in referral of
selected patients. Facilities for secondary level care will have to
be created. Support facilities and supply of drugs at primary and
secondary levels of care will have to be augmented.
11.94 Additional paediatricians will have to be trained to
provide the required services for the Seventh Plan period. Facilities
for training doctors from primary health centres, as well as
paramedical personnel, in aspects related to delivery of MCH service
would be strengthened. Training centres for trainers of multi-purpose
workers in the delivery of child health service will be established.
Expended Programme of Immunisation (EPI)
11.95 A significant part of high morbidity and mortality among
infants and children can be attributed to a few common communicable
diseases which can be prevented by immunisation. Under the expanded
programme of immunisation, vaccination against these diseases is pro-
vided. The objectives of the immunisation programmes during the
Seventh Plan will be to reduce the incidence of diptheria, whooping
cough, tetanus, poliomyelities, childhood tuberculosis and typhoid
fever, by making veccination services available to all eligible
children and women by 1990. Efforts would be directed to achieve
self-sufficiency in the production of vaccines; their quality control
and distribution will also be ensured. Measles immunisation will be
included in the EPI.
11.96 In order to achieve the objective of universal
immunisation, it will be essential to augment the inputs of trained
manpower, 'cold chain' equipment, transport facilities and other
essential supplies and equipment. Immunisation services will be
privided through all health institutions and health care camps and
teams, and the cold chain' will be suitably strengthened for vaccine
storage. The epidemiological pattern of diseases will form the basis
for programme operations. Surveillance of diseases would be suitably
strengthened to document the impact of services. Information
dissemination and health education will be promoted to raise the
health consciousness of people as well as to provide support to health
workers.
Health Services for School-Age Children
11.97 The health care programme for school-age children (4-
16) will emphasise the detection of correctable disabilities which
will prevent major handicaps later. The multiplier effect of
education of children and of child-to-child extension are important
aspects of the comprehensive child health care programme. Appropriate
programmes of health services for children both in schools and in the
community will be organised.
11.98 There is need to develop a National Institute of
Maternal and Child Health to develop and coordinate various aspects of
MCH.
Indian System of Medicine (ISM) and Family Welfare
11.99 There are over 500,000 practitioners of ISM in India
employed in the public sector as well as in private practice.
Practitioners of the ISM are mostly functioning in far-flung rural
areas. They have a long tradition of acceptability among the people.
This vast resources would be gainfully used in promoting family
welfare, MCH
277
and the expanded programme of immunisation. They can play a very vital
role in extension education, supply of contraceptives, etc.
Community Participation
11.100 In the success of the Family Welfare and MCH programmes,
the most important single factor is the active participation and
involvement of the people, non-Government organsations and community
organisations. The role of Mahila Mandals, Youth Clubs and Village
Health Committees is of paramount importance.
Seventh Plan Outlays
11.101 The outlays for the family welfare programme are being
stepped up to Rs. 3,256 crores. Details are given in Annexure 11.4
278
ANNEXURE- 11.1
Seventh Plan Outlays Health Sector
(Rs. crores)