CM10.6-7 | CM10.6-7 | Family Planning and Family Welfare Programme — Summary & Reflection

KEY TAKEAWAYS

India's TFR reached 2.0 (NFHS-5), just below replacement level of 2.1; unmet need is 9.4%. mCPR is 56.5%, dominated by female sterilization (37.9%) — method mix imbalance is a programme quality concern. Temporary methods: COC (93% typical-use, estrogen suppresses lactation — WHO MEC 3 breastfeeding <6 months), POP (91%, safe breastfeeding, must be taken in 3-hour daily window), DMPA/Antara (96%, IM every 12-13 weeks, delayed fertility return), Cu-T IUCD (99.4%, 10 years), PPIUCD (must insert within 48 hours of delivery), LAM (98% when all three conditions met — exclusive breastfeeding + amenorrhoea + infant <6 months), emergency contraception levonorgestrel 1.5 mg within 72 hours (85% efficacy). Permanent: female sterilization by laparoscopy (Falope ring/Filshie clip) or minilaparotomy (Pomeroy technique); NSV for males (0.3% mCPR — grossly underutilised). WHO MEC Category 4 for COC: age ≥35 + smoking ≥15 cigarettes/day. Programme: cafeteria approach since 1996, GATHER counselling, Antara (DMPA delivery), Mission Parivar Vikas (146 high-TFR districts).

REFLECT

Your PHC's HMIS shows the following monthly family planning acceptors: female sterilization 18, male sterilization 0, IUCD 2, Antara injectable 3, OCP 1, condom 4. Total mCPR in your catchment (from last NFHS-5 district factsheet) is 48%, with unmet need at 16%. Analyse the method mix at your PHC: which two programme actions would most effectively reduce unmet need in your catchment, and what role would you assign to the ASHA in implementing each action?