COUNSELLING FOR FAMILY WELFARE AND

RECENT ADVANCEMENT IN CONTRACEPTIVE

DEVICES

BY
PRATIBHA SINGH
M.Sc. 1st year
 OBJECTIVES:

• INTRODUCTION
• CONCEPT OF FAMILY WELFARE PROGRAMME
• AIMS AND OBJECTIVE OF FAMILY WELFARE PROGRAMME
• GOALS OF THE FAMILY WELFARE PROGRAMME
• CRITERIA OF FAMILY WELFARE PROGRAMME COUNSELLING
• DIFFERENT ROLE OF COUNSELLOR
• RECENT ADVANCEMENT IN CONTRACEPTIVE DEVICE
 INTRODUCTION
Family welfare includes not only planning
of birth, but they welfare of wholes family by
means of total family health care. The family
welfare programme has high priority in India
because its success depends upon the quality of
life of all citizens.
Family planning means planning by
individual or couples to have only the children
they want, when they want them, this is
responsible parenthood
 CONCEPT OF FAMILY WELFARE
PROGRAMME

• The concept of welfare is basically related to quality

of life.
• it include education, nutrition, health
employment ,women's welfare and right, shelter, safe
drinking water all vital factors associated with the
concept of welfare.
• It is centrally sponsored programme. For this,
the states receive 100% assistance from central
government.
• The emphasis is on child family.

• Also, emphasis is on spacing methods along with

terminal methods.

• The current policy is to promote family planning

on the basis of voluntary and informed acceptance
with full community participation.

• The services are taken to every doorstep in order

to motivate families to accept the small family norm.
 AIMS AND OBJECTIVE OF FAMILY
WELFARE PROGRAMME
The Government of India in the Ministry of Health
and Family Welfare has started the operational aims
and objective of family welfare programme as
follows-
• To promote the adoption of small family size
norm, on the basis of voluntary acceptance.
• To promote the use of spacing method.
• To arrange for clinical and surgical service so as to
achieve the set target.
• To ensure adequate supply of contraceptive to all
eligible couple within easy reach .

• Using the means of mass communication and

interpersonal communication to overcome the
social and cultural hindrance in adopting the
programme or extensive use of public health
education for family planning

• Participation of voluntary organization/local

leaders/local self government, in family welfare
programme at various level.
 GOALS OF THE FAMILY WELFARE
PROGRAMME
• Reduction of death rate from 10(in 1992) to 9per
1000.
• Raising couple protection rate from 43.3(in 1990)
to 60%.
• Reduction in average family size from 4.2(in 1990)
to 2.3
• Decrease in infant mortality rate from79 (in 1992)
to less than 60 per 1000 live birth.
 CRITERIA OF FAMILY WELFARE
PROGRAMME COUNSELLING
DURING COUNSELLING SHOULD FOCUS ON:
• INTEGRATION WITH HEALTH SERVICE:
family welfare programme has been integrated with
other health service instead of being a separate service.
• INTEGRATION WITH MATERNITY AND CHILD
HEALTH:
family welfare programme has been integrated
with maternity and child health. Public are motivated for
post delivery sterilization, abortion and use of
contraception
• CONCENTRATION IN RURAL AREA: family welfare
programme are concentrated more in rural areas
at the level of subentries and primary health
center. This is in addition to hospitals at district,
state and central levels.
• LITERACY: There is a direct co-relation between
illiteracy and fertility. So stress and priority is given
for girl’s education, fertility rate among educated
female are low.
• BREAST FEEDING: Breast feeding is encouraged. It
is estimated that about 5 million birth per annum
can be prevented through breast feeding.
• RISING THE AGE FOR MARRIAGE:
Under the child bills (1978), the age of
marriage has been raised to 21 year for male and18
year for female. This has some impact on fertility.

• MINIMUM NEED PROGRAMME: It was launched

in 5th year plan with an aim to raise the economical
standards. Fertility is low in higher income groups.
so fertility rate can be lowered by increasing
economical standard.
• INCENTIVE:
Monetary incentive has been given
in Family Planning Programme, especially for poor
classes. But these incentives have not been very
effective. So the programme must be on voluntary
basis.

• MASS MEDIA:
Motivation through radio, television, cinema,
news paper, puppet shows and folk dance is an
important aspect of this programme.
DURING COUNSELLING SHOULD
EXPLAIN THE DIFFERENT ROLE
 ROLE OF COMMUNITY HEALTH NURSE
IN FAMILY WELFARE SERVICES
Community health nurse has a vast role in family
welfare service:
• SURVEY WORK:
• Collecting demographic facts.
• Making list of homes and finding out housing
location.
• Collecting information about pregnant mother,
eligible couples, and infants.
 EDUCATIONAL FUNTION AND MOTIVATION:

Explaining the importance and necessity of family

planning to masses:
• Using various techniques of teaching and
communication to propagate the message of
family planning to common man.
• Motivating the eligible couple to use contraceptive
and educating them about its uses.
• Motivating people for family planning operation
or permanent contraception.
 MANEGERIAL FUNCTION :
1. Conducting clinics-
• Deciding the date and place of clinics.
• Arranging equipments and other resources at
clinics.
• Arrangement and distribution of contraceptives.
• Insertion and removal of IUD.
• Organizing family planning camps
• Arranging family planning operatio(sterilization) of
male and female through special camps.

• Making arrangements at the camps and follow

aseptic techniques for the operation.

• Motivating eligible couple and preparing them for

the operation.

• Assisting the doctor in operation

Maintaining the records-
• Keeping the eligible couple register update.

• Maintaining the register of sterilization cases,

contraceptives user, and pregnant mothers.

• Maintaining other records related to family planning.

• Liaison work

• Soliciting the co-operation of NGOs/voluntary

organization.
RECENT ADVANCEMENT IN
CONTRACEPTIVE DEVICE:
 ANTARA
• To help improve the supply and distribution of
contraceptives, the Ministry had recently
launched a new software, Family Planning
Logistics Management Information System
(FP-LMIS), designed to provide robust
information on the demand and distribution
of condom
What is Injectable contraceptive (MPA)
• Injectable contraceptive (MPA) is a hormonal contraceptive method
for women that prevents pregnancy for three months
How does it work
• It prevents monthly ovulation, thickens cervical mucus thus blocking
sperms from meeting eggs
• Makes implantation of fertilized egg difficult.
How is it used
• Get an injection every 3 months
• It can easily be administered in the arms, thighs, buttocks
• The date of subsequent dose may be remembered from MPA card
provided.
Why injectable is the right choice
• It is a long term effective , reversible method of contraception
• Suitable for breastfeeding women ( after 6 weeks of childbirth)
• Does not require daily attention.
• Ensures user privacy
 CHHAYA(CENTCHROMAN)
What is Chayya
• Chhaya is a non-hormonal, non-steroidal, once
a week contraceptive pill
How does it work
• Chhaya prevents implantation of fertilized egg
in the uterus.
How is it used
• Take one pill twice a week for the first 3 months
• From 4 month take pill once a week on the first pill day.
• The first pill can be taken on the first day of the menstrual
cycle or any other day provided pregnancy has been ruled
out.
• After finishing one pack take first pill from next pack on
scheduled day.
• Why Chhaya is the right choice
• Chhaya is an effective reversible method of contraception.
• It is safe for women of all age groups.
• It is safe for breastfeeding women, even immediately after
childbirth Return to fertility on stopping the pills is
prompt.
• Sino- implant II
the sino-implant is available at more than
60% less than the price of the other implants
available on the market. It is registered in china,
Indonesia, serria and Kenya. More than 7 million
implants have been distributed, and
11published clinical trials show that this new
device is safe and effective
• SILCS Diaphragm:
This new product ,women can comfortably
insert the device themselves at home with the
assistance of written instructions. An effectiveness
and safety study of new diaphragm began in 2008
United States. Evidence collected suggests that the
majority of women can insert this device safely
and position it correctly, suggesting that it will
meet the criteria for OTC marketing.
• NES/EE contraceptive vaginal ring (CVR):
This new CVR can be used for upto 13 cycles or
one year, reducing costs and increasing user
convenience. The NES/EE CVR is currently undergoing
phase III clinical trials to determine if it is safe and
effective, and to assess cycle control, return to fertility
and side effects. Preliminary findings suggest this new
device is highly effective in preventing pregnancy and
has a safety profile that is similar to other
contraceptives.
.
 ORTHO EVRA

• It is a contraceptive skin patch containing a

combination of female hormones (ethinyl estradiol
and norelgestromin) that prevent ovulation (the
release of an egg from an ovary). This medicine
also causes changes in your cervical mucus and
uterine lining, making it harder for sperm to reach
the uterus and harder for fertilized egg to attach to
the uterus. Ortho Evra skin patches are used as
contraceptionprevent pregnancy
 You should not use Ortho Evra if you have:
• abnormal vaginal bleeding history of heart attack, stroke, or blood
clot
• an inherited blood-clotting disorder that causes your blood to clot
more than normal;
• untreated or uncontrolled high blood pressure;
• problems with your eyes, kidneys or circulation caused by diabetes;
• a history of hormone-related cancer such as breast or uterine
cancer;
• liver disease or cancer severe migraine headaches (with aura,
numbness, weakness, or vision changes), especially if you are older
than 35.
•MALE HORMONAL
CONTRACEPTIVES
• Testosterone undecanoate is used in androgen
replacement therapy. It is specifically approved
only for the treatment of hypogonadism. As an
intramuscular injection, it is administered at a
dosage of 1,000 mg once every 12 weeks.
Conversely, oral testosterone undecanoate must
be taken two or three times a day with food.
• This medication is given by injection into the
buttock muscle as directed by your doctor. After
the first dose, it is usually given 4 weeks later,
then every 10 weeks.
 17 alpha Methyltestosterone
• Methyltestosterone is a man-made form of testosterone,
a naturally occurring sex hormone that is produced in a
man's testicles. Small amounts of testosterone are also
produced in a woman's ovaries and adrenal system.

• Methyltestosterone is used in men and boys to treat

conditions caused by a lack of this hormone, such as
delayed puberty or other hormonal imbalances.
Methyltestosterone is also used in women to treat breast
cancer that has spread to other parts of the body.
TESTOSTERONE ENANTHATE :
• It is a naturally occurring sex hormone produced
in a man's testicles. Small amounts of
testosterone are also produced in a woman's
ovaries and adrenal system.

• Testosterone Enanthate is used in men and boys

to treat conditions caused by a lack of this
hormone, such as delayed puberty, impotence, or
other hormonal imbalances. This medicine is not
for use in treating low testosterone without
certain medical conditions or due to getting older.
You should not be treated with this medicine if
you are allergic to testosterone, or if you have:

• male breast cancer

• prostate cancer
• serious heart problems
• severe liver disease;
• severe kidney disease
• allergy
• This medication is given by injection into the
buttock muscle as directed by your doctor,
usually every 1 to 4 weeks. Do not inject this
medication into a vein. Dosage is based on
your medical condition, testosterone blood
levels, and response to treatment.
 ADJUDIN NON HORMONAL METHOD

• Adjudin (AF-2364) is a drug which is under

development as a potential non-hormonal
male contraceptive drug, which acts by
blocking the production of sperm in the
testes, but without affecting testosterone
production.
•SUMMARY
• EVALUATION
 ASSIGNMENT
• Explain in detail about recent non-hormonal
contraceptive device.
 BIBLIOGRAPHY
• Basavanthappa BT, Community Health Nursing 1st Edition, 1998,
JaypeeBrothers, Delhi, Page no. 319-321.

• Chalkey A. M., A Textbook for the Health Worker, 1st Edition, 1985,
N.A.I. Limited, Publisher, New Delhi, Page no. 330-340.

• Kumari Neelam, Essentials of Community Health Nursing, 1st Edition

2011, PV books Jalandhar, Page no. 225-226

Dutta D.C, Textbook of obstetrics ,8 TH Edition,Jaypee ,the health

sciences, Page no. 185-206.

Dutta D.C,Textbook of gynecology, 7th edition , Jaypee ,the health

sciences, page no.35