Population Education and Family Welfare

What to remember

• Population education teaches people why population size, growth and structure matter, so that they choose a small, healthy family; the Family Welfare programme gives the services (contraception, safe motherhood, child health) to make that choice possible.
• India started the world's first official family planning programme in 1952; the replacement-level fertility is a Total Fertility Rate of about 2.1.
• Know the vital-rate definitions (birth rate, death rate, IMR, MMR, TFR, sex ratio) and the main contraceptive methods: spacing methods versus terminal (permanent) methods.

Basic population ideas

Demography is the study of population: its size, growth, density, composition and distribution.

• Census: a count of the whole population, held every ten years in India. The Registrar General and Census Commissioner conducts it. The first complete (synchronous) census was in 1881 and the first after independence was in 1951.
• Population growth depends on births, deaths and migration. Natural increase = births minus deaths.
• Density of population: persons per square kilometre.
• Age structure: proportion of children (0 to 14), working age (15 to 59 or 64) and elderly. The dependency ratio compares dependants (children and elderly) with the working-age group.
• Sex ratio: in India, the number of females per 1,000 males.
• Literacy: ability to read and write with understanding.

Vital statistics (standard definitions)

Demographic transition: populations move from high birth and high death rates (stage 1) to falling death rates with high birth rates (rapid growth, stage 2), then falling birth rates (stage 3), then low birth and death rates (stage 4). Thomas Malthus (1798) argued that population grows geometrically while food grows arithmetically, which leads to checks such as famine and disease. Population momentum means that growth continues for years even after fertility falls, because there are many young people entering the reproductive age.

Causes and effects of rapid population growth

Causes: high birth rate, falling death rate through better health care, early marriage, illiteracy, poverty, preference for sons, low use of contraception, and lack of women's empowerment.

Effects: pressure on food, water, land, housing, health and schools; unemployment; poverty; pollution and loss of forests; slums; poor nutrition; and low quality of life.

Benefits of small families: healthier mothers and children, better schooling, savings, and higher status for women. The slogan "Hum do, hamare do" (we two, our two) promotes the small family norm.

Population education

Population education is an educational programme that helps people understand population processes and the effects of population change on the family, society, the environment and the economy, so that they can make responsible choices.

• It is not only sex education and not only family planning propaganda. It covers population growth, family size, health, nutrition, environment, status of women and quality of life.
• Objectives: knowledge about population, a positive attitude to the small family, delayed marriage and responsible parenthood, respect for the girl child, and concern for the environment.
• Where it is given: school curricula (in India an NCERT-led project started in the early 1980s with UNESCO and UNFPA support), adult and non-formal education, anganwadi counselling, mass media, folk media and community groups.
• Methods: discussion, role play, posters, songs, drama, case studies, survey of the village, charts of the growth of the village.
• Adolescence Education Programme: life skills and reproductive health education for adolescents in schools.

Family welfare programme in India

• 1952: India launched the National Family Planning Programme, the first in the world.
• 1977: renamed the Family Welfare Programme to show that it covers the health of the whole family, not only birth control.
• Reproductive and Child Health (RCH) programme started in 1997 and RCH-II in 2005; the National Rural Health Mission started in 2005 and is now part of the National Health Mission.
• National Population Policy 2000: immediate aim to meet the unmet need for contraception and strengthen health services; medium aim to bring the TFR to replacement level; long-term aim to stabilise population in the middle of the century in line with sustainable development.
• Janani Suraksha Yojana (2005): cash help to encourage institutional delivery for poor women. Janani Shishu Suraksha Karyakram (2011): free delivery, drugs, diet, transport and care for the sick newborn.
• Mission Parivar Vikas (2016): intensive family planning in districts with high fertility. Family Planning Logistics Management ensures supply of contraceptives.
• Beti Bachao Beti Padhao (2015): to improve the sex ratio and girls' education.
• PCPNDT Act 1994 (amended 2003) bans sex determination before birth.
• World Population Day: 11 July.

Family planning methods

Counselling points for couples: wait until the wife is at least 18 and the husband at least 21 to marry; delay the first child until after about 21 and then space children three years apart or more; stop at two children; use contraception in postpartum period; breastfeeding alone is not enough after six months or when periods return.

Medical Termination of Pregnancy (MTP) Act, 1971: allows abortion by registered doctors in approved centres under specified conditions. The 2021 amendment allows termination up to 20 weeks on one doctor's opinion and up to 24 weeks for specified categories of women, with later termination allowed on medical-board advice in cases of substantial foetal abnormality.

Role of the Anganwadi worker

• Maintain a register of eligible couples and pregnant women; counsel on small family, delayed marriage, birth spacing and contraceptive choice.
• Motivate couples for services and link them to the ANM and Primary Health Centre.
• Promote institutional delivery, antenatal check-ups, breastfeeding, immunization and exclusive nutrition for the girl child.
• Distribute condoms and pills where permitted, and refer for IUCD, injectable and sterilisation.
• Use village meetings, mothers' groups and Village Health and Nutrition Days to give population education.

Population and development in brief

A smaller, healthier population helps a country invest more in each child's schooling, health and nutrition. Women's education and employment, a lower infant mortality rate, and easy access to family planning services all help to lower fertility. When parents are confident that their children will survive, they are more willing to choose a small family. Therefore child survival programmes, immunization and breastfeeding are closely linked to population stabilisation. Better status of women, delayed marriage and respect for the girl child also have a strong effect on the birth rate. Population education also builds awareness of migration, urbanisation and ageing of the population as new issues.

Exam traps

• Family planning programme started in 1952; it was renamed Family Welfare in 1977.
• IMR is per 1,000 live births; MMR is per 100,000 live births.
• Replacement-level TFR is about 2.1, not 2.0 or 3.0.
• Condoms protect against STIs; pills and IUCD do not.
• Vasectomy is simpler than tubectomy and is not castration.
• Emergency pill is not a regular contraceptive.
• Malthus: population geometric, food arithmetic.
• Copper-T 380A lasts longer than Copper-T 375.
• Janani Suraksha Yojana is about institutional delivery, not sterilisation.
• Sex ratio in India is counted as females per 1,000 males.

One-liners

• 1. India launched the first national family planning programme in 1952.
• 2. Family Planning was renamed Family Welfare in 1977.
• 3. Replacement-level fertility is about 2.1.
• 4. MMR is per 100,000 live births.
• 5. The census is held every ten years.
• 6. National Population Policy was announced in 2000.
• 7. Janani Suraksha Yojana began in 2005.
• 8. World Population Day is 11 July.
• 9. Copper-T 380A works for about ten years.
• 10. The emergency pill is taken within 72 hours.
• 11. Antara is an injectable contraceptive given every three months.
• 12. Population education covers more than family planning.

Practice questions

1. India launched the world's first national family planning programme in

   1. 1947
   2. 1977
   3. 2000
   4. 1952
   Answer

   D. 1952

   The National Family Planning Programme started in 1952.

2. The census in India is conducted once in every

   1. 10 years
   2. 8 years
   3. 12 years
   4. 5 years
   Answer

   A. 10 years

   The decennial census is held every ten years.

3. The infant mortality rate is expressed per

   1. 100,000 live births
   2. 1,000 live births
   3. 10,000 population
   4. 100 live births
   Answer

   B. 1,000 live births

   IMR is infant deaths under one year per 1,000 live births.

4. Replacement-level fertility (TFR) is about

   1. 3.0
   2. 2.1
   3. 1.5
   4. 1.0
   Answer

   B. 2.1

   A TFR of about 2.1 lets a population replace itself.

5. World Population Day is observed on

   1. 11 July
   2. 5 June
   3. 8 March
   4. 1 August
   Answer

   A. 11 July

   World Population Day is 11 July.

6. The maternal mortality ratio is expressed per

   1. 10,000 live births
   2. 1,000 live births
   3. 1,000,000 live births
   4. 100,000 live births
   Answer

   D. 100,000 live births

   MMR is maternal deaths per 100,000 live births.

7. The Family Planning Programme was renamed the Family Welfare Programme in

   1. 2005
   2. 1952
   3. 1977
   4. 1985
   Answer

   C. 1977

   The 1977 change showed that the programme covers the health of the whole family.

8. Malthus argued that population grows in

   1. Arithmetic ratio while food grows geometrically
   2. Geometric ratio while food grows arithmetically
   3. A declining ratio
   4. A constant amount
   Answer

   B. Geometric ratio while food grows arithmetically

   Malthus (1798) said population grows geometrically but food only arithmetically.

9. Which family planning method also protects against HIV and other STIs?

   1. Condom
   2. Oral pills
   3. Injectable DMPA
   4. Copper-T
   Answer

   A. Condom

   Only barrier methods like the condom reduce the risk of infection.

10. The emergency contraceptive pill should be taken within

    1. 1 week
    2. 12 hours
    3. 1 month
    4. 72 hours
    Answer

    D. 72 hours

    It works best within 72 hours of unprotected sex.

11. A permanent family planning method for men is

    1. Copper-T
    2. Oral pill
    3. Vasectomy
    4. Condom
    Answer

    C. Vasectomy

    Vasectomy blocks the sperm-carrying tubes.

12. Copper-T 380A remains effective for about

    1. 30 years
    2. 10 years
    3. 1 year
    4. 2 months
    Answer

    B. 10 years

    Copper-T 380A is effective for about ten years.

13. The Janani Suraksha Yojana encourages

    1. Institutional delivery
    2. Pre-school education
    3. Adoption
    4. Sterilisation of men
    Answer

    A. Institutional delivery

    JSY gives cash incentives for delivery in a health facility.

14. The injectable contraceptive Antara is given every

    1. Year
    2. Month
    3. Three months
    4. Week
    Answer

    C. Three months

    Antara contains DMPA and is given every three months.

15. Chhaya (centchroman) is an oral contraceptive taken

    1. Yearly
    2. Monthly
    3. Daily
    4. Weekly
    Answer

    D. Weekly

    It is a non-hormonal pill taken weekly.

16. In India the sex ratio is expressed as

    1. Males per 1,000 females
    2. Males per 100,000 females
    3. Females per 100 males
    4. Females per 1,000 males
    Answer

    D. Females per 1,000 males

    Indian census reports the number of females per 1,000 males.

17. An eligible couple is one in which the wife is aged about

    1. 5 to 15 years
    2. 15 to 49 years
    3. 50 to 70 years
    4. Below 10 years
    Answer

    B. 15 to 49 years

    Eligible couples are those in the reproductive age group.

18. Population momentum means that

    1. Population keeps growing for years because many young people are entering the reproductive age
    2. Population falls immediately when fertility falls
    3. Migration stops
    4. Death rate becomes zero
    Answer

    A. Population keeps growing for years because many young people are entering the reproductive age

    A large young population keeps growth going even when fertility is falling.

19. Stage 2 of the demographic transition is characterised by

    1. Low birth and low death rates
    2. Falling birth rate and falling death rate equally
    3. Falling death rate with high birth rate, causing rapid growth
    4. High birth and high death rates
    Answer

    C. Falling death rate with high birth rate, causing rapid growth

    Better health care lowers deaths while births remain high.

20. The PCPNDT Act of 1994 prohibits

    1. Sex determination before birth
    2. Child labour
    3. Use of IUCD
    4. Early marriage
    Answer

    A. Sex determination before birth

    It bans prenatal sex determination and sex-selective abortion.

21. The slogan Hum do, hamare do promotes

    1. Joint families
    2. The small family norm
    3. Early marriage
    4. Large families
    Answer

    B. The small family norm

    It means two parents and two children.

22. The lactational amenorrhoea method gives protection only when

    1. The baby is two years old
    2. The mother takes iron tablets
    3. The baby is bottle fed
    4. The baby is under six months, exclusively breastfed and periods have not returned
    Answer

    D. The baby is under six months, exclusively breastfed and periods have not returned

    LAM needs all three conditions.

23. In a population of 100,000 there were 3,000 live births in a year. The crude birth rate is

    1. 3
    2. 30
    3. 300
    4. 0.3
    Answer

    B. 30

    3,000 ÷ 100,000 × 1,000 = 30 per 1,000.

24. In a year there were 2,000 live births and 40 infant deaths. The infant mortality rate is

    1. 2
    2. 4
    3. 20
    4. 40
    Answer

    C. 20

    40 ÷ 2,000 × 1,000 = 20 per 1,000 live births.

25. A village has 4,800 females and 5,000 males. The sex ratio is

    1. 960
    2. 1,000
    3. 480
    4. 1,042
    Answer

    A. 960

    4,800 ÷ 5,000 × 1,000 = 960 females per 1,000 males.

26. A group has 300 dependants (children and elderly) and 600 persons of working age. The dependency ratio is

    1. 200 per 100
    2. 150 per 100
    3. 50 per 100
    4. 20 per 100
    Answer

    C. 50 per 100

    300 ÷ 600 × 100 = 50 per 100.

27. If the birth rate is 25 per 1,000 and the death rate is 7 per 1,000, the natural increase rate is

    1. 25 per 1,000
    2. 7 per 1,000
    3. 32 per 1,000
    4. 18 per 1,000
    Answer

    D. 18 per 1,000

    25 − 7 = 18 per 1,000.

28. A young woman wants a reversible method that works for about ten years without daily action. The best choice is

    1. Oral pills
    2. Copper-T 380A
    3. Condoms
    4. Vasectomy
    Answer

    B. Copper-T 380A

    Copper-T 380A is a long-acting reversible method.

29. Mission Parivar Vikas was started to

    1. Control tuberculosis
    2. Provide pre-school education
    3. Intensify family planning services in districts with high fertility
    4. Give free school meals
    Answer

    C. Intensify family planning services in districts with high fertility

    It focuses on districts with the highest fertility rates.

30. The MTP Act as amended in 2021 allows termination up to 24 weeks for

    1. All women without any reason
    2. Only women above 40 years
    3. Only married women
    4. Specified categories of women
    Answer

    D. Specified categories of women

    Up to 20 weeks on one doctor's opinion and up to 24 weeks for specified categories.

31. Population education differs from family planning propaganda because it

    1. Only supplies contraceptives
    2. Teaches about population processes and their effects, not only contraception
    3. Is only for doctors
    4. Is only for old people
    Answer

    B. Teaches about population processes and their effects, not only contraception

    It covers growth, environment, health, status of women and quality of life.

32. Consider the statements. 1. India began its family planning programme in 1952. 2. It was renamed Family Welfare in 1977. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both dates are correct.

33. Consider the statements. 1. A condom protects against sexually transmitted infections. 2. Oral pills protect against HIV. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Pills prevent pregnancy only.

34. Consider the statements. 1. Replacement-level TFR is 4.0. 2. Replacement-level TFR is about 2.1. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    B. 2 only

    Replacement level is about 2.1.

35. Consider the statements. 1. MMR is expressed per 1,000 live births. 2. IMR is expressed per 100,000 live births. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    D. Neither 1 nor 2

    The denominators are swapped: MMR per 100,000 and IMR per 1,000.

36. Consider the statements. 1. Vasectomy is simpler than female sterilisation. 2. Vasectomy needs a long hospital stay. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Vasectomy is a minor procedure with no long hospital stay.

37. Consider the statements. 1. Copper-T 380A is a long-acting method. 2. IUCD is a reversible method. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both are correct.

38. Consider the statements. 1. The emergency pill is meant for regular use. 2. It should be taken within 72 hours of unprotected sex. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    B. 2 only

    It is only for emergencies.

39. Consider the statements. 1. Malthus said food grows geometrically. 2. Malthus said population grows arithmetically. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    D. Neither 1 nor 2

    He said the opposite: population geometric, food arithmetic.

40. Consider the statements. 1. Janani Suraksha Yojana encourages institutional delivery. 2. Janani Suraksha Yojana is a sterilisation scheme. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    JSY gives cash support for institutional delivery.

41. Consider the statements. 1. Population education includes concern for the environment. 2. Population education includes respect for the girl child. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both are aims of population education.

42. Consider the statements. 1. The census is held every five years in India. 2. The first census after independence was held in 1951. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    B. 2 only

    The census is decennial.

43. Consider the statements. 1. The lactational amenorrhoea method is always reliable after six months. 2. The rhythm method is the most reliable family planning method. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    D. Neither 1 nor 2

    LAM is reliable only up to six months and the rhythm method has low reliability.

44. Consider the statements. 1. Antara is an injectable contraceptive containing DMPA. 2. Chhaya is an IUCD. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Chhaya is a weekly oral pill.

45. Consider the statements. 1. An Anganwadi worker maintains a register of eligible couples. 2. She refers couples for IUCD and sterilisation to the health centre. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both are among her duties.