Physician and the Family Welfare Concept

This working paper owes its origin to a paper presented by the author at the first Regional Conference on the theme of Population Problem and Family Planning Effort, held at Ahmedabad in November 1980. The genesis of the problem is traced to the overall macro-level planning orientation and in particular a belated recognition of the population problem. In qualitative terms the situation was further aggravated by a strong association of family planning at its initial stages with sterilization. The concept of family welfare emerged as late as 1977. The paper examines and projects the role of physicians in the family welfare effort of a community or nation. The definition of physician is a broad-based one and is not confined largely to Allopathic practitioners as in the case of the series of seminars and conferences held on the subject starting with the Stockholm Conference in 1974. Special attention is given to the role of physician, according to this broad definition, can play in the process of communication. The issues of particular relevance in the context of Indian environment are the age of marriage and the child bearing age. The expectations of the community and the family groups become quite dominant in the decision regarding the family size as well as the time to start the family. This is strongly reflected in a large number of child births at an age which is below the newly stipulated age of marriage for women according to the Child Marriage Restraint (Amendment) Act of 1978. The role of the physicians is projected as that of an effective opinion leader and communicator by virtue of the professional standing and respect enjoyed by them from most sections of the Indian society. This role can be played by the marginal extension of the professional aspect. No less important is the question of social obligation of a physician. Of the various forms of education, medical education depends much more on the society not only for financial and other infrastructure resources but also on availability of human resources as experimental material at times. Potential acceptors of family planning are more likely to be convinced of the welfare aspect, if it is presented to them in an individualized form of communication rather than generalized. That is where the limitation of the mass media comes in. A physician cannot only reassure the target couple/family unit about the worthwhileness of Consumption Guidance, but also prompt them or guide them to select a suitable method. The success of the family welfare programme in India depends a great deal on the voluntary acceptance of the concept and that is where physicians as well as para-medical practitioners and community health workers can be effective in creating substantial motivation amongst the target couples for achieving the overall goals of the nation.