مددكاري اجتماعي

Ocean – 17 countries. Total 205 countries

 

Summary: 82% of world’s population is living in the developing countries of Asia, Africa and Latin America, India has the second largest population in the world.

 

Birth & Death rate: The world’s B.R. fell below – 30 for the first time around 1975 has declined to 27.3 during 1980-85 has further declined to 22 during 2003.

                Outstanding examples are Singapore and China

Reasons: change in the attitude of government towards growth

                The spread of education

                Increased availability of contraception

                Extension  of services offered thro family planning program

                Marked change in the marriage pattern

 

Growth rate: When crue death rate is substrate from the crued birth rate, the net residual is the current annual growth rate, exclusive of migration.

 

Relation between growth rate 4 population

 

Population growth rates like railway trains are subject to momentum. They start slowly and gain momentum. Once in motion, it takes time to bring the momentum under control.

 

 

·          The growth rate is not uniform in the world.

·          There are countries (European countries and North America) where the growth rate is less than 0.5% per year

·          Approximately 95% of the growth is occurring in developing countries (less developed)

·          World population is most likely to near 9 billion in 2050 and reaching 20.7 billion and century later

·          World population is growth at 176 per minute, 10,564 per hour, 2,53,542 per day, 9,25,42,000 year

·          The rampant population growth has been viewed as the greatest obstacle to the economic and social advancement of the majority of people in the developing world.

 

Characteristics of India’s population

A)      Age: is like a pyramid with broad base and tapering top (large base of children and small base of elderly) < 15 years – 36%, > 65 years – 4%

B)       Sex: Sex ratio is defined as the number of female per 100 male

 

·          The sex ratio in India has been generally adverse to women that is the number of women per 1000 men has been less than 1000.

·          Apart from being adverse to women, the sex ratio has been declined over the decades. 1901 – 972 : 1000, 1991 – 9.27:1000

·          Kerala is the only state with a sex ratio favorable to female (1030 for 1000 per male)

 

Density of population: the number of persons living in per square mile. 842/square mile

 

Family size

                Fertility rate refers to the average number of children born to a woman during her life time.

                The family size depends are:

·          Duration of married life

·          Education of couple

·          The number of line births

·          Living children

·          Preference of male children

·          Desired family size

 

Urbanization: Growing urbanization is a recent phenomenon in developing countries

Urban population: 1901 – 10.84%

                                                1981 – 23.34%, 1991 – 25.72%, 2003  - 28%

 

Reasons: Natural growth (through birth)

                Migration from village – PUSH and PULL factor

                Migration effects the quality of life of people

Vitality – Number of children a woman have during reproductive span of life.

 

Literacy: A person is deemed as literate if he/she can read and write with understanding in any language.

                The literacy rate has increase during the decade 1981-91 crossing the 5% mark. Still literacy level is very low among female. The literacy rate have certainly improved but the total number of illiterates has continued to increase.

 

Life expectancy in India: at a given age is the average number of years which a person of that age may expect to live according to the mortality pattern prevalent in that country.

                It is the best indicator of a country’s level of development and of the overall health status of its population.

 

 

Process

1.  Fertility

* By F we mean actual bearing of children.

* A women’s reproductive is roughly from 15 to 45 years of 30 years

A woman married at 15 & living till 45 with her husband is exposed to the risk of pregnancy of 30 years and may give birth to 15 child – but this maximum is rarely achieved.

                Studies indicate that an average woman gives birth to an average of six to seven children in her married life is not interrupted.

 

Factors influencing fertility

                High F in India is attributed to monarchy starting status of mouth.

                Sub countries in most village, state district H, taluk , sub centre is to see that all people are covered by PHCs. Preventive, primitive and therapeutic services at every PHC is managed by 2 workers for general and family planning provide door step. Para medical care, 98% can be cured in PHCs. Doctor will provide complete health care, education H at taluk level PHCs in India novel concept in 1945 prior to independence, comprehensive more and more treatment centres.

 

·          Implementation of National health (NHP) programmes: blindness, TB, Cancer and major problems, NHP sponsored by Central Govt. funds only.

·          Improvement in the food supply: Grow free crops food production increased a rendition brought with use of modern method and pesticides

·          International aid in several ways: ICDS program by UNICEF, WHO provides finance to HIV, AIDS from UNESCO, World Bank, foreword provided for health.

·          Development of social conscious among people: very careful preserving health. They have awareness about primary level itself. Periodical health check up to the students, basic about health everybody knows.

 

Further decline in M rate not possible in the near future. Enemy to India is birth rate, we almost reached accurate in M rate.

 

Other issues like

·          Environment sanitation and nutrition major problems in India

·          Communicable disease like cancer, diabetes, HIV need to avoid

 

a) Universality of marriage

b) Low age of marriage

c) Duration of married life      

10-25% of birth occur within 1-5 years of married life

50-55 eyras of birth within 5-15 years

Birth after 25 years of married life and very few

d) Spacing of children

e) Low level of literacy

f) Poor level of living – economic status – eco. Devt. Of the best contraceptive

g) Caste & Religion: Rural & Urban

h) Nutrition: all well feed societies have low fertility and poorly fed societies have high fertility.

* The effect of nutrition on fertility is largely indirect

i) Use of contraceptive : an important factor in fertility reduction

j) Place of women in society: value of children

* Widow remarriage

* Breast feeding practice

* Urbanisation & industrialization

* Customs and beliefs

* Better health condition

* Tradition way of life

 

2) Mortality: refers to death presently 9.5 per 1000 able to achieve much progress on par with developed countries.

 

Reasons for declining M. rate in India

·          Absence of natural calamity: floods, cyclone, epidemics, tsunami

·          Mass control of diseases; able to eradicate small pox, leprosy, cholera, plague, malaria

·          Advances in medical sciences: using pesticides, antibiotics, insecticides, chemotherapeutics

·          Better health care facilities: Primary health care

Bhore Committee introduced in India 1^st, estd. Of PHCs to cattle the needs of people all over India.

 

Migration

                Migration is not important factor. Those who meet out and in it will effect structure, composition.

 

·          M is the 3^rd component of population change the other2 being fertility and mortality.

·          F & M are biological variables and M is affected to a great extent on the wishes of people, except in few cases. M is not a major variable. M is 2 factor push and pull factors. Factor which will drive the people move off. Push of drought, pull factor refers to attraction urban fm rural in migration and out M. M means is one of the few terms which denote different meanings to different people. M is a form of geographical mobility between one geographical unit and another, generally involving a change in the residence from the place of origin to the place of destination. It is a permanent M.

 

Immigration and emigration             

                Indians setting in Vs.(or immigrants to U.S. and emigrants from India) permanently is immigrants.

                Migratory movements are a product of social, cultural, economic, pollution or physical circumstances in which industrial and societies find themselves.

 

Sources of data

                Main source regard M is census definite question in performa.

Survey and population registers note down place of birth and residence.

 

Questions to be asked for measuring M

·          Place of birth, duration of residence, place of last residence, place of residence at a fixed prayer date.

·          Marriage: Many M are not registered, now it is compulsory. Advantages b Supreme Court, definitely improve the status of women and can avoid child marriage, marriage appear population like child marriage not directly, indirectly.

·          Social mobility: Movement of people forms one status to another status: ex low to high. It will only effect the quality of population. It will not affect population

 

Family Planning

                FP is making great progress during the past several decades we have moved ahead in many ways.

 

a) Family planning is now seen as a human right basic to human dignity people and government around the world understand this.

b) Early everyone now knows about family P most people also know of some F.P. methods

c) E.P. has community support, people expect that most others in their practice F.P. and they approve

d) Most people use FP. At any one time, more than half of the world married couple are FP users.

e) FP providers offer more choices to more people, people can use FP more effectively and more safely.

g) Couples now can choose from more methods. These include injectables, implants, female and male sterilization, oral contraception, condoms, various spermicides

h) We have learned that almost everyone can use modern FP methods safely

For most methods, most clients do not require physical examination or lab test.

i) We have discovered important health benefits of some FP methods, besides preventing unintended pregnancies. Ex: combined oral contraceptives help stop anemia help prevent several types of cancer.

j) Condoms help prevent STD and other infections, especially when used every time.

k) Many different types of the people now provide F>p. supplies services and information.

l) We are doing a better job telling people about F.P. and helping then make reproductive health decisions. We are helping to make informed choices. We do this in face to face discussions and counseling thro’ radio, TV and newspapers and in community events.

m) We are making it easy for people tog et FP and other reproductive health care. We are removing unnecessary barriers of all kind. The barriers includes lack of information, not enough service points, limited hours, few methods not enough suppliers.

 

Family planning: FP is a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of the family and this contribute effectively to the social development of a country (WHO definition)

               

                Another expert GP of WHO defined and described FP as

                FP refers to practices that help indicts or couples to attain certain objection.

 

Basic human right

                The U.N. recognized long ago that FP is a basic human right. The plan action is that all couples and individuals have the BHR to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do.

 

                The world conference of the International Women’s year in 1975 also declared the right of the women to decide freely and responsibly on the number and spacing of their children to have access to the information and means to enable them to exercise that right.

 

                During the past few decades, F.P. has emerged from whispers in private quarters to the focus of international concern as a basic human right and a component of family health and s. welfare.

 

F.P. helps everyone

                FP provides can be proved of their because FP helps everyone. There are some of the ways.

 

Women: FP helps women protect themselves from unwanted pregnancies.

                Many women lives have been saved from high risk pregnancies or unsafe.

                Many FP methods have other health benefits for some hormonal helps prevent certain cancers and condom women space births.

MEN: FP helps men & women care for their families. Men around the world say that planning their families helps them to provide a better life for their families.

 

Families: FP improves family well being. Couples wish fever children are better able to provide them with enough food, clothing, housing and schooling.

 

Nations: FP helps nations develop

                In countries where women are having far fewer children than their mothers did peoples economic situations are improving faster than in most other countries.

 

The Earth of couples have fewer children in the future, the world’s current population of 6 billion people will avoid doubling in less than 50 years. Future demands on natural resources such as water and fertile soil will be less. Everyone will have a better opportunity for a good life.

 

 

CHINA’s Experiment

·          China implemented its one child policy in 1979

·          One child norm lead to children never learned to share

·          They were called SHANGAI little emperors and nobody ever said no to them

·          20-30 yrs of propaganda has yielded results. But will these children have 2 or 3 kids or no kids at all?

 

Scope of FP services

·          FP is not synonymous with birth control. It is more than mere birth control.

·          A WHO expert committee has stated that f includes

a)        The proper spacing and limitation of births

b)        Advice on sterility

c)        Education on parenthood

d)        Screening of pathological conditions related to reproductive system

e)        Sex education

f)        Genetic counseling

g)        Premarital consultation and examination

h)       Carrying out pregnancy test

i)         Marriage counseling

j)         Preparation of the couples for the arrival of their 1^st child

k)       Providing services for unmarried mothers

l)         Teaching home economics & nutrition

m)      Providing adoption services

 

These activities vary from country to country according to national objections and policies with regard to family planning. The above is the modern concept of FP.

 

Family planning services: FP is associated with numerous misconceptions

Misconceptions: 1) FP means sterilization

2)       FP means birth control

Family is reorganized as ‘welfare’ and is basically related to quality of life

The term FP is renamed as family welfare

 

Small Family norms: Small differences in the family size will make big differences in the birth rate. The differences of only one child per family over a decade will have a tremendous impact on the population growth.

 

                The objective of F welfare program is that people should adopt the small family norm to stabilize the population symbolized by the inverted red-triangle, the program initially adopted the model of the 3-child family.

 

                In the 1970s, the slogan was Do Va Teen Bs

In the 1980s the campaign advocated the 2-child norm

Genetic disorder this from parents

Genetic pre-disposition problem comes if parents has diabetes chance

 

                The current emphasis is on 3 themes

                Sons or daughters: two will do

                Second child after 3 years

                Universal Immunization

 

All efforts are being made through mass communication that the concept of small family norm is accepted, adopted and woven into life style of the people.

 

Eligible couples: this refers to currently married couples wherein the wife is in the reproductive age, which is generally assumed to the between the ages of 15 & 45.

 

Target couples: In order to pin point the couples who are a priority within the broad definition of eligible couples. The term target couple was coined the term target couple was applied to couple who have had 2-3 living children and family planning was largely directed to such couples.

 

                The definition has been gradually enlarged to include families with one child or even newly married couples. With a view to develop acceptance of the idea of FP from the earliest possible stage.

 

                The term has lack its original meaning and not preferred

 

Counseling: C is crucial

Through C providers help client market is carried out their own choices about reproductive health and FP

 

                Good C makes clients more satisfied. Good counseling also helps clients use family planning longer and FP men prosperity, well being more successfully.