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Demography and Family Planning

Demography and Family Planning. Dr. Pracheth R, Assistant Professor, Community Medicine, Yenepoya Medical College. Outline. Demographic cycle Birth and death rates Growth rates Sex ratio Age pyramids Dependency ratio Urbanization Fertility and related statistics

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Demography and Family Planning

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  1. Demography and Family Planning Dr. Pracheth R, Assistant Professor, Community Medicine, Yenepoya Medical College

  2. Outline • Demographic cycle • Birth and death rates • Growth rates • Sex ratio • Age pyramids • Dependency ratio • Urbanization • Fertility and related statistics • Population explosion

  3. Maximum carrying capacity

  4. Population explosion • India: 1,210,193,422 • Projected: 2025> China • Sudden, rapid increase : population size • Two main causes • Birth rate> death rate • Fertility rate falling but still higher> developed

  5. Social factors: population explosion • Early marriage, universal marriage • Poverty, illiteracy • Male bias • Beliefs • Illegal migration

  6. Effects of population explosion • Unemployment • Manpower utilization • Decreased production, increased costs • Burden: health care services

  7. Population doubling time and population pressure • Time required for a population to double itself • The population pressure is due to: • Dramatic increase in population • High densities in different parts of the world This gives rise to disparity in resource availability 15% of the population controls resources of 85% of world’s population

  8. Demography meaning • Scientific study: human population • Changes in population size • Composition of population • Distribution • Census, vital events registration

  9. Demographic cycle • First stage- High stationary • High birth rate, death rate • Cancel ; stationary • India: in this stage-1920 • Second stage-Early expanding • Death rate decline, birth rate unchanged • South Asia, African countries

  10. Continued….. • Third stage-Late expanding • Death rate declines further • Birth rate tends-fall • Birth>death-population grows • India • Fourth stage-Low stationary • Low birth, death rate • Stationary population- zero population growth • US, UK, Austria, Denmark, Sweden

  11. Continued….. • Fifth stage-Declining • Birth rate less than death rate • So declines • Germany, Hungary

  12. Birth and death rates • Crude birth rate: 20/1,000 population • Crude death rate: 7/1,000 population • Birth rates decline: • Government attitude • Education • Contraception services • Change in marriage patterns

  13. Continued…. • Death rates decline: • Infant and child mortality reduced • Immunization • Diarrhoea, ARI treatment

  14. Growth rates • CDR-CBR • Excludes migration • Railway trains • Slow, motion-time to bring: control • Mass and inertia=age distribution, marriage customs, cultural, social factors • 95%: developing countries • One-third: < 15-enter reproductive age group

  15. Sex ratio • Number of females/1,000 males • Sex ratio at birth-India: 943, child: 919 • Female deficit syndrome

  16. Causes: declining sex ratio • Male-child preference • Female infanticide, foeticide • Girl child neglect: higher mortality • Maternal mortality • Male bias: counting population • Easy availability: sex determination, abortion services • Solution??

  17. Population/age pyramid • Graphical illustration :distribution of various age groups in population • 2 back-to-back bar graphs, with the population plotted : X-axis, age :Y-axis • Males, females in 5 year age groups

  18. India • India: broad base, tapering top

  19. Switzerland • Bulge in middle, narrower base

  20. Dependency ratio

  21. Dependency ratio • Proportion: people above 65 years and children below 15 years • Young age, old age • Use: study demographic burden • Decreases: early stages development-rapid decline: fertility • Rapid decline: child dependency-key factor: development

  22. Continued…. • Demographic bonus: • Ratio declines: decline in fertility • Begins to rise: increased longevity • Lead to development • Invest: health care, education in this period- maximum advantage-high economic growth

  23. Demographic bonus

  24. Demographic burden • Increase total dependency ratio in any period • Mostly : old age dependency ratio • Inevitable: demographic transition

  25. Urbanization • Causes: • Industrialization • Social factors: better quality of life, standard of living, education • Employment • Rural-urban transformation

  26. Positive effects • Employment • Transport, communication • Education • Standard of living

  27. Adverse effects • Slums- diseases • Cost of living • Disintegration : joint families • Crime rates • Stress • Pollution

  28. Fertility • Actual bearing of children • 15-45/49 years • High in India: • Universality : marriage • Lower age : marriage • Low literacy • Limited use contraceptives • Beliefs

  29. Factors influencing fertility • Age at marriage • Duration: married life • Spacing of children • Education • Economic status • Family planning • Others: customs, beliefs, status: women, industrialization

  30. Fertility indicators • Birth Rate: • Simplest • Unsatisfactory • General Fertility Rate (GFR): • (No live births: area, 1 year/ MY female population (15-49 years) same area, year) X 1,000 • Better: denominator • Weakness: not all women-birth

  31. Continued…. • General Marital Fertility Rate (GMFR): • (No live births/ MY married female population 15-49 years) X 1,000 • Age Specific Fertility Rate (ASFR): • (No of live births: particular age group/ MY female population: age group) X 1,000 • More precise • Highlights fertility pattern • Age groups eg: 15-19 years, 20-24 years

  32. Continued…. • Age-specific Marital Fertility Rate (ASMFR): • (No of live births: particular age group/ MY married female population: age group) X 1,000

  33. Continued…. • Total Fertility Rate (TFR): • Average number: children-woman have • Passes through reproductive years bearing children at same rates as women now in each age group. • Sum ASFR X 5/1,000

  34. Continued…. • Total Marital Fertility Rate • Gross Reproduction Rate (GRR): • Avg no girls would be born to woman • If experiences: current fertility pattern-reproductive span • 5X ASFR for female births/1,000

  35. Continued….. • Net Reproduction Rate (NRR): • No of daughters a newborn girl bear in lifetime • Assuming fixed age-specific fertility and mortality rates • NRR=1: small family

  36. Family Planning

  37. Outline • Definition • Objectives • Scope • Health aspects • Small family norm • Eligible, target couples • Couple Protection Rate

  38. Definition Expert Committee 1971: • Way of thinking, living-adopted voluntarily • Upon basis : knowledge, attitude, responsible decisions by individuals, couples • To promote health and welfare of family • Overall social development of country

  39. Objectives • Avoid unwanted births • Bring wanted births • Regulate intervals between pregnancies • Control time in which birth occurs in relation to parents age • Determine number of children in family

  40. Scope of family planning services • Proper spacing, birth limitation • Advice on sterility • Education for parenthood • Screening –pathological conditions related to reproductive system (cervical cancer) • Genetic counselling

  41. Continued…. • Premarital consultation, examination • Carrying out pregnancy tests • Prepare couples for arrival of first child • Provide services-unmarried mothers • Provide adoption services • Teach nutrition, home economics.

  42. FETAL HEALTH WOMENSHEALTH INFANTS AND CHILDHEALTH Health aspects of family planning

  43. Health aspects of family planning • Women’s health: • Pregnancy damages mother’s health • Risk increases after 3-4 children • Family planning improves health through: • Avoid unwanted pregnancies • Limit number of births and proper spacing • Timing of births

  44. Continued… • Foetal health: • Congenital anomalies (Eg: Down’s syndrome): increasing maternal age • Avoided: timing births in relation to mother’s age • Quality of population improved : avoiding unwanted births

  45. Continued… • Child health: • Child mortality: • Repeated births , rapid succession • Birth intervals: 2 to 3 years-reduce child mortality • Birth spacing, family size:

  46. Small family norm • Small differences in family size: big difference in birth rate • Objective in India: stabilize population -1,533 million : 2050 • 1970s: Do Ya Teen Bas • 1980s: 2-child norm

  47. Current emphasis

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