Since the 7^th Five Year Plan, Family Welfare programmes have been focusing on the health needs of women in reproductive age groups and of children below the age of 5 years. In the 8^th Plan, all the MCH programmes were brought under Child Survival and Safe Motherhood (CSSM) programme. The main objective of this was to improve health status of women & children and reduction of child morbidity and mortality rates. It envisaged the provisions of :

1. Universal coverage with TT vaccine and Iron & Folic acid tablets.
2. Timely detection / referral of obstetric complications
3. At least 3 antenatal check ups.
4. Clean and safe delivery by trained personnel
5. Promotion of institutional deliveries & propagation of birth spacing
6. Universal Immunisation Programme
7. Acute Respiratory Infection Control
8. Oral Rehydration Therapy for diarrhoea control among children
9. Prevention and control of Vitamin A deficiency among children

    In 1966, the practice of fixing targets for individual contraceptives was given up. But the utilisation of various contraceptive methods continues to increase. Some o the performance figures (in million) are:

    As a result of continued efforts, nearly 24.2 crore births have been averted till March 1999 with couple protection rate of 45.4 per cent in 1997 and 45.1 per cent for the year 1999-2000. The total fertility rate has been reduced to 3.3 (1997) from 6.0 of 1951.

    In the 9^th Plan, a new comprehensive programme for child and mother was launched under the name, Reproductive & Child Health programme (RCH), which includes child survival interventions and safe motherhood programmes (CSSM), issues related to STDs and reproductive tract infections, gender issues and family planning.

    The new RCH programme provides for an integrated approach towards mother and childcare. Interventions under this include child survival interventions and safe motherhood interventions as under CSSM, ii) institutional developments and training package, iii) modified Management Information Systems (MIS), iv) Information, Education, Communicatin (IEC) activities and counselling on health, sexuality and gender, v) urban and tribal areas RCH package, vi) reproductive tract facilities at PHCs, viii) community participation through Panchayat, women groups and NGOs and ix) adolescent health and reproductive hygiene.

IMMUNISATION

    The Universal Immunisation Programme (UIP) aimed at reduction in mortality and morbidity among infants, younger children and pregnant mothers was started in 1985-86. Under this programme, vaccines are administered to infants and pregnant women for prevention of vaccine preventable diseases among infants and reduction in neo-natal tetanus and other diseases among pregnant women. The impact of the programme is reflected in significant drop in the infant mortality rate from 129 in 1976 to 72 in 1998 per 1000 live births. Child mortality (0-4) rate has declined from 26.5 in 1991 to 23.9 in 1996.

    The immunisation coverage (% of targets) is given below:

    Pulse polio immunisation programme for eradication of polio was launched in 1995-96. As a result of its implementation, the number of cases have come down from 4320 cases in 1998 to 2810 cases during 1999. In order to accelerate the efforts for polio eradication the PPIs, four national rounds, 2 additional rounds have been conducted in 8 states of Assam, Bihar, Gujarat, Madhya Pradesh, Orissa, Rajasthan, Uttar Pradesh and West Bengal. Four national rounds have been completed. The effort during these rounds was reach every child even if he/she is living in remote/inaccessible areas. Panchayats, NGOs and community have been fully involved in this effort. The reported coverage on 27.2.2000 and 26.3.2000.

    As a result of various programmes implemented by the Government of India, the infant mortality rate has declined from 104 during 1984 to 72 in 1998. There are, however, wide inter-state variations with a range of 16 in Kerala to 98 in Orissa. The States of Orissa (98), Madhya Pradesh (98), Rajasthan (83), Uttar Pradesh (85) and Assam (76) continue to be above national average of 72. Efforts are being made to strengthen the programme in these States also to accelerate the decline in IMR and child mortality.

    National Population Policy has been approved by the Government in February, 2000. It has been laid on the table of both Houses of Parliament during the Budget Session of Parliament, 2000. The policy aims at the following objectives :-

Short term:

    The immediate objective of the National Population Policy is to address the unmet needs of contraception, health infrastructure, health personnel and to provide integrated service delivery for basic reproductive and child health care.

Medium term:

    The medium term objective is to bring the total fertility rates to replacement level by 2010, through vigorous implementation of inter-sectoral operational strategies.

Long term:

    The long-term objective is to achieve a stable population by 2045, at a level consistent with the requirements of sustainable economic growth, social development, and environmental protection.

    The Constitution (79^th) Amendment Bill, 1992 which aims at disqualifying a person from being chosen as a Member of Parliament or Legislature of a State, if he has more then two children was cleared by the Standing Committee of Parliament on Human Resource Development for consideration and passage, is pending since December, 1992, for want of Political consensus.

    State Governments have established statutory implementation mechanisms under the Pre-natal Diagnostic Techniques (Regulation & Prevention of misuse) Act, 1994 to ensure the pre-natal diagnostic tests are done only for detection of genetic abnormalities. Testing of gender of foetus is punishable under this Act.