In India the measures taken by the Community Health Services to eradicate diseases have been largely responsible for the population growth, and the only acceptable way of controlling this population growth is by conception control. The contraceptive methods must be simple, highly acceptable, cheap, preferably nonrepetitive, and reliable. The prerequisite for acceptance of family planning is the sense of security that the children born will live a good life span. Thus, any program designed to control the rate of population growth must include child and maternal health services. Such services were developed in the beginning of the 20th century to provide a standard of prenatal, natal and postnatal care, but the available services do not satisfactorily meet the needs. The Community Health Service has to deal with the following identified health problems in the community if a national population policy is to succeed: 1) care of pregnant women during pregnancy, delivery, and following delivery; 2) motivating and sustaining the motivated couple in contraceptive practice; 3) care of the infant; 4) care of the toddler until 5 years; 5) care of the school age child; 6) care of adolescents; 7) care of tuberculosis and leprosy cases; and, 8) environmental factors. The presence of these problems in the community depend among other factors on the cultural habits, religious beliefs, family traditions, social customs, economic status, and educational level of the population in the community. The present trend is to provide an entire population with at least minimal services; these include elementary health care, health education, and identification of high risk groups who need more than minimal attention. To provide these services a wide network of auxiliaries work closely with professional medical staff as well as with community leaders. It is most important to develop an organizational pattern which considers the available resources and the additional resources that are needed.
Health scientists have focussed mainly on controlling the environment and eliminating the pathogenic agents in their efforts to improve community health. "Host factors" must be taken into account also. To eradicate most communicable diseases and establish a healthy community, the cooperation of the people is necessary. A knowledge of demographic factors is necessary in getting community support on health programs. Demography should be included in population courses taught in schools and colleges.
With 2.4% of the worlds area and 2% of the world income, India supports 14% of the total world population. The family planning program which stated in 1952 is organized at the centra, state, district, and block level. The central government family planning department handles communication, financing, and supplies for the national program. Innovative projects can be tried at the state level. Some of the program's weaknesses are: 1)population education at any level is not included; 2)professional consultation for the program is needed; 3)population services in rural areas are lacking; 4)family planning should be integrated with maternal and child health programs; 5)the IUD program failed because follow-up care was lacking; and 6)more family planning training is needed. More attention needs to be paid to the program at the local level. Voluntary organizations could be useful in the following ways: 1)mass communication and education; 2)research; and 3)creation of favorable public opinion on the local level. Incentives and disincentives to establish the small family norm are recommended. Any new population policy must include more attention to general socioeconomic development of the country.
Medical colleges in India have been urged to increase the quality and quantity of teaching on population dynamics and family welfare planning since 1957. The recommendations of the Deans and Principals Conference of August 1967 and the directive of the Medical Council of India issued in August of 1968 outline a syllabus and present many suggestions about the ways in which a number of departments should contribute to the teaching of these subjects during the years of the undergraduate medical curriculum. The Preventive and Social Medicine (P and SM) department is involved in teaching these subjects. In order to determine to what extent the recommendations and directives were being implemented, a questionnaire was sent to the head of the department of P and SM in each of the 93 medical schools in India to ask what that department had done in the 1968-1969 academic year. It was determined that the departments of P and SM were devoting an average of 10.8 holrs of lecture or class discussion to teaching family welfare planning and population dynamics. Many departments said they needed more books in the field. About 40% were conducting research on 1 or more related topics. Questions on the subjects were included in examinations by 90% of the departments in their college exams and 75% said that questions on these topics appeared on the written University examinations. 73% of the departments used A-V aids in their teaching of family welfare planning and the same proportion utilized seminars. 1 department required students to insert an IUCD. However, in the internship, 17 departments required women to do so and 7 required men to do 1 or more insertions. 2 departments made it a requirement during the final year to assist tubectomy operations, and 9 departments did so during the internship. 1 department required final year students to do a vasectomy. During internship, 16 required men to do 1 or more vasectomies, and 7 required women to. Shortage of staff was the most frequent difficulty mentioned for implementing the suggested syllabus. The most frequent suggestion for improving teaching was the development of more adequate teaching family welfare planning clinics. It was concluded that compared with departments of P and SM in other countries, the ones in India were devoting a significant, and perhaps an adequate, amount of time to the teaching of family welfare planning and population dynamics.
