Demography and Family Planning Social Pharmacy Notes
Chapter 2 Social Pharmacy Notes 2.1 Demography and Family Planning, 2.2 Mother and child health, 2.3 Importance of breastfeeding, 2.4 Ill effects of infant milk substitutes and bottle feeding 2.5 Overview of Vaccines, 2.6 Types of immunity 2.7 Immunization 2.8 Effect of Environment on Health 2.8.1 Water pollution 2.8.1.2 Importance of safe drinking water, waterborne diseases 2.8.2 Air pollution 2.8.3 Noise pollution 2.8.4 Sewage and solid waste disposal 2.8.5 Occupational illnesses 2.8.6 Environmental pollution due to pharmaceuticals 2.8.7 Psychosocial Pharmacy: Drugs of misuse and abuse – psychotropics, narcotics, alcohol, tobacco products.
Definitions:
i) Demography: is the scientific study of the human population. It is mainly concerned with (1) Changes in population size, (2) The distribution of population. 3) composition
ii) Fertility: Is defined as the ability to bear the children. OR The ability to produce offspring or children.
iii) Family planning: is a way of living and thinking that is adopted voluntarily upon the basis of knowledge, attitude and responsible decisions by individuals and couples in order to promote the health and welfare of the family group and thus contribute effectively to the social development of the country.
iv) Contraceptive: is an agent used to prevent conception i.e. pregnancy.
Demographic cycle:
Demographic Cycle: It comprises of following 5 stages –
- First Stage: (High Stationary Stage): The feature of this phase is both natality i.e. birth rate and mortality i.e. death rate are very high. Both cancel each other keeping the population steady. India was in this phase till 1920. (Stationary/constant) ( BR & DR same)
- Second Stage: (Early Expanding Stage): Here mortality (death rate) starts falling down but birth rate remains same i.e. higher. As a result, the population starts increasing (expanding). At present African and South Asian countries are in this phase. (BR same, DR falls)
- Third Stage: (Late Expanding Stage): Here mortality continues to fall but birth rate also starts decreasing. But yet Natality remains higher than Mortality. So, the population continues to increase. China, India, Singapore are at this stage. (BR falls, DR further falls)
- Fourth Stage: (Low Stationary Stage): It is also called Zero Growth stage as Natality equals Mortality and both are lowered. So net population growth is zero. Many developed countries have reached this stage in the last 20 years. (BR equals DR)
- Fifth Stage: (Negative Growth Stage) (Declining stage): Here Mortality is higher than Natality. So, there is a decline in population size. Reasons behind are advancement in medical science and facing problems of population increase. Germany and Hungary are presently at this stage. (BR falls further than DR)
What is family planning
Family planning (according to WHO in 1971) is defined as “the way of living and thinking that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples in order to promote the health and welfare of the family and thus contributes effectively to the social development of a country.” OR Family planning is the way to decide the number and timings of children in the family. so it is the way of life adopted by married couples to promote the health and welfare of their families. and later it has been renamed as “Family Welfare Programme”.
It is the basic human right it refers to the practices that help individuals or couples to attain the following objectives.
Objectives of family planning:
- To avoid unwanted birth.
- To bring about a wanted birth.
- To regulate the interval between pregnancies.
- To control the time at which birth occurs in relation to ages of parents.
- To determine the no. of child’s in the family.
Scope of family planning :
family planning has a wide scope and includes the following activities:
- Proper spacing and limitation of birth.
- Investigations and advice on sterility.
- Education for parenthood.
- Sex education.
- Screening of the reproductive system for pathological conditions.
- Premarital consultation and examinations.
- Marriage counselling.
- Providing services for unmarried mothers, their care and adoption services.
- Carrying out pregnancy tests.
- Providing nutrition guidance.
Only a couple can decide about the size of the family they would like to have which includes the number of children and spacing between the children married couples can avoid unwanted pregnancies and can regulate the proper spacing by adopting family planning measures. Contraception is only one of these measures.
Methods of contraception :
Following are the methods of contraception available at present –
A) Temporary Methods
1. Barrier methods:
(a) Physical methods: i) Condom ii) Diaphragm iii) Vaginal sponge
(b) Chemical methods: i) Foams ii) Creams iii) Suppositories iv) Soluble films
2. Intra – uterine device (IUDs):
(a) First generation Non-medicated IUDs: Loops as Lippes loop
(b) Second generation Medicated IUDs:
i) Metal containing IUDs: Copper- 7, Copper T – 200, T. Cu- 380 A or Ag
Third Generation Hormone containing IUDs: Progestasert
3. Hormonal methods:
(a) Hormonal pills:
- Combined pill: Mala –N, Mala –D
- Progestogen only pill (POP)
- Post coital pill: Tab. Unwanted 72, Tab. I pill 72
- Once a month pill
- Male pill
- Saheli ( Centchroman)
(b) Slow release preparations:
- Injectable: DMPA ( Depot – medroxyprogesterone acetate )and NET-EN (norethisteon enantate )
- Subcutaneous implants: Norplant
- Vaginal rings
4. Post conceptional methods
(a) Menstrual regulation
(b) Menstrual induction
(c) Abortion (MTP)
B) Permanent Methods:
1. Male sterilization (Vasectomy)
2. Female Sterilization (Tubectomy).
C. Miscellaneous methods
- Behavioural methods
(a) Abstinence
(b) Coitus interruptus
(c) Safe period use method
(d) Vaginal washing method
- Natural family planning method :
(a) Basal body temperature
(b) Cervical mucus method / Billing’s method
(c) Prolonged Lactation method / LAM Method (lactational amenorrhea)
(d) Symptothermic method.
Each of the contraceptive methods have their own advantages and disadvantages, so the adoption of a particular method amongst the given is purely a matter of individual couples preference.
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