The availability of family planning does more than enable women and men to limit family size. It safeguards individual health and rights and improves the quality of life for individual women, their partners and their children.

1.To understand the link of use of family planning methods and effect on fertility and unmet and met need.

2.To discuss the specific goals and strategies for fertility reduction as mentioned in the National Population Policy

Contextual Framework of Family Planning:

The National Family Welfare Programme in India has traditionally sought ‘to promote responsible and planned parenthood through voluntary and free choice of family planning methods best suited to individual acceptors’ (Ministry of Health and Family Welfare, 1998a). In April 1996, the programme was renamed the Reproductive and Child Health Programme and given a new orientation to meet the health needs of women and children more completely. The programme now aims to cover all aspects of women’s reproductive health throughout their lives. With regard to family planning, the new approach emphasizes the target-free promotion of contraceptive use among eligible couples, the provision to couples of a choice of contraceptive methods (including condoms, oral pills, IUDs, and male and female sterilization), and the assurance of high-quality care. An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births (Ministry of Health and Family Welfare, n.d.).

The National Population Policy, 2000 (NPP 2000) adopted by the Government of India affirms the commitment of the government towards voluntary and informed choice and consent of citizens while availing of reproductive health care services and continuation of the target free approach in administering family planning services. The NPP provides a policy framework for advancing goals and prioritizing strategies during the next decade, to meet the reproductive and child health needs of the people of India, and to achieve net replacement levels (TFR) by 2010. It is based upon the need to simultaneously address issues of Child Survival, Maternal Health and contraception, while increasing outreach and coverage of a comprehensive package fo RCH services by Government, industry and the voluntary non-Government sector, working in partnership.

Of the 14 goals mentioned in the NPP document, three specific goals focus on family planning. These are:

1. Address the unmet needs for basic reproductive and child health services, supplies and infrastructure

2. Achieve universal access to information /counseling and services for fertility regulation and contraception with a wide basket of choices

3. Promote vigorously the small family norm to achieve replacement levels of Total Fertility Rate.

In addition, the NPP document also states twelve strategic themes, identified to address these goals:

	Decentralised Planning and Programme Implementation
	Convergence of Service Delivery at village level
	Empowering women for improved Health and Nutrition
	Child Health and Survival
	Meeting the Unmet needs for Family Welfare Services
	Underserved Population Groups
	Diverse Health Care Providers
	Collaboration with and commitments from Non-Government Organization and the Private Sector
	Mainstreaming Indian System of Medicine and Homeopathy
	Contraceptive Technology and Research on RCH
	Providing for the older population
	Information, Education and Communication
	National Commission on Population

About one fifth of India’s population is in the adolescent age group and yet to begin their reproductive lives. It is expected that this age group will continue to grow. All children in the age group of 10-19 years are adolescents. Focusing on this age group is critical for ensuring the health of future generations, and to achieve demographic transition and population stabilization in India. Furthermore, adolescents are more flexible to behavior change, and targeting this group can assist in changing future patterns of health problems and epidemics such as HIV/AIDS. Fostering and more importantly, sustaining an environment for gender equality and the empowerment of women is not possible without examining the attitudes and behavior of adolescents, especially adolescent boys. Adolescents are important as a target and as potential partners in population development planning and implementation. It has also been recognized that the health needs of adolescents are different and require separate attention.

Situation analysis of adolescents in India

Lack of education (low literacy levels among girls, % drop out from schools among boys and girls)

SRH is a taboo subject at home, school and in community settings

Low awareness and knowledge regarding SRH

Misconceptions and misinformation about SRH

Lack of skills to deal with peer pressure

Under pressure from parents and elders to marry young

Undernourished and underweight- fall prey to illness very often

Early marriage (before the legal age of marriage both for girls and boys)

Early pregnancy and childbirth

Unsafe sexual practices

Unsafe abortions

Repeated abortions

Lack of knowledge on family planning usage

Exposure to substance abuse and drugs

Risk of exposure to RTI / STD and HIV / AIDS

Brainstorming on Adolescent Health needs and related interventions. The period of adolescence is very exciting part of a person’s life.

üThe body undergoes physiological changes due to puberty, resulting in changes in the reproductive system, gaining in height and weight.

üAt the same time, there is also an urge to try experimenting with different activities and take risks.

üTheir curiosity is also aroused and peer pressure and negative influencers easily mislead many adolescents.

üThis is further compounded by the fact that they lack Sexual health education.

üPeople often label this as ‘growing up’ and ignore the adolescent.

üMany adolescents adopt high risk behavior due to the numerous myths and there is a near total absence of credible resources to carry out the task either in the school system or in the community as such.

üAdolescents have a poor access to reproductive health information and services and mainly rely on peers- who themselves may be poorly informed- and the media to gain health related information.

Any individual can become infected with a sexually transmitted infection (STI) or reproductive tract infection (RTI), regardless of age, background, or socioeconomic class. The World Health Organization (WHO) estimates that there are more than 340 million new cases of curable STIs each year, and UNAIDS calculates that in the year 2000 alone, 5.3 million people became infected with human immunodeficiency virus (HIV). RTIs that are not sexually transmitted are even more common.

In proportion to their prevalence and the suffering they cause, sexually transmitted infections (STIs) are practically ignored in public health research, interventions, and services.

Non-HIV STIs constitute the second major cause of disease burden (after maternity-related causes) in young adult women in developing countries. Untreated STIs are thought to account for 10–15 percent of fetal wastage and 30–50 percent of antenatal infections and are linked to cervical cancer and ectopic pregnancy. Furthermore, untreated STIs are associated with a significant increase in the rate of HIV infection—by as much as three to five times. Preventing and treating STIs can therefore be an effective means of reducing reproductive morbidity and can be expected to make a major contribution in reducing HIV infection.