Family planning and fertility decline: a global overview

Family planning and development policy concerns are not incompatible. The emphasis on development policies at the 1974 World Population Conference at Bucharest did not mean that world governments had lost interest in the population and family planning issue. Although worldwide attitudes toward family planning have become more and more favorable, this has not yet meant great impact on world demographic trends. The "inertia factor," i.e., the effects of high birthrates in the previous generation, will camouflage declining birthrates for some time to come. The trend of fertility reduction which was perceptible only among small populations a few years ago is also becoming manifest in larger Third World countries. Mortality rate declines have slowed down but there is no rising mortality due to starvation in any country. At present, food demand exceeds availability for 80% of the Third World population. It is predicted that the food deficit will increase 70% by the year 2000.     

Social change,population policies,and fertility decline in Colombia and Venezuela

This paper takes a comparative case-study approach to examine the social and policy correlates of fertility decline. The analysis compares fertility behavior across a mature and young cohort of women in Colombia and Venezuela, two countries that experienced rapid demographic change under dissimilar socioeconomic and population policy conditions. Based on the distinction between birth-spacing and birth-stopping behavior the analysis tests several propositions derived from the adaptation and innovation explanations of fertility decline. Results show that fertility regulation at low parities was largely absent among mature women in both countries, representing an innovative behavior among younger women. The introduction of fertility control, however, was highly dependent on women's socioeconomic position, particularly their educational and occupational characteristics. The strong family planning programs in Colombia resulted in a more rapid extension of contraceptive use, particularly female sterilization, and stopping behavior after two children relative to Venezuela. Results highlight the diversity of conditions under which fertility can decline in developing countries and the importance of family planning and other policy initiatives to understanding the different pathways towards lower fertility.     

Controlling population growth in Sri Lanka: perceptions,policies and strategies

Sri Lanka has been an oft-cited example in the demographic literature of developing countries over the past 4 decades. Despite its low level of per capita income, Sri Lanka has managed to achieve the lowest level of fertility in South Asia. Sri Lanka's population policies, especially with regard to fertility, have been rated as strong by some writers. The evolution of policies on population growth in Sri Lanka is described in the following sections: the problem of population growth, strategies for controlling population growth, the period of indirect government participation from 1948 to 1965, policy change during 1965-77, 1977 as the beginning of a new era of increasing government commitment to domestic population polices, and strategy changes from 1989 onwards. During this current, most recent, phase of population policy in Sri Lanka, the government has focused upon satisfying the demand for various family planning methods, demand which has been created by a well-promoted fertility control program during the preceding phases of policy implementation. Greater emphasis is simultaneously being given to improving reproductive health.     

计划生育政策的人口效应

文章试图估计计划生育政策使我国少生了多少人。利用1980~2008年世界140多个国家的数据来模拟在没有计划生育政策影响下经济社会变量与人口变量的相关关系,并据此对中国无计划生育条件下的总和生育率进行测算。将测算出来的无计划生育条件下的总和生育率和中国实际总和生育率分别代入模型进行人口模拟,比较无计划生育条件下和现实条件下人口增长的不同过程和结果。研究表明:无计划生育条件下,我国2008年生育率水平的预测值大概在2.5左右。1972~2008年间,排除经济社会发展的影响,单纯由于计划生育的作用,中国少生了4.58亿人。     

Case study: fertility decline in Iran

Iran has experienced one of the most successful family planning programs in the developing world, with 64 percent decline in total fertility rate (TFR) between 1986 and 2000. This paper focuses on Iranians’ unique experience with implementation of a national family planning program. Recognition of sensitive moral and ethical aspects of population issues resulted in successful collaboration of technical experts and religious leaders. Involvement of local health workers, women health volunteers and rural midwives led to great community participation. Demographic and Health Survey (DHS) data in 2000 indicated a TFR of 2.0 births per women and 74 percent contraceptive use among married women. This case study will help policy makers and researchers in Moslem countries and other developing countries with high fertility rate to consider a successful family program as a realistic concept with positive impacts on nation’s health and human development.     

Economic development and fertility decline: lessons from Asia's newly industrialized countries

The general thesis that economic development and fertility decline are interrelated is substantiated in literature that discusses the successes of the newly industrialized countries of Hong Kong, Korea, Singapore, and Taiwan. When countries are developing rapidly, family planning accelerates the rate of fertility change, particularly among the poor uneducated rural population. Relying on economic and social development is not enough. National policy in Hong Kong, Singapore, Korea, and Taiwan recognized that population growth drains resources and the family planning programs operating since the 1960s contributed to a drop from 5 children/woman to 2 by 1988, and 70% of married couples used contraception. Coupled with this, age at marriage rose, contraception became more available, and educational and employment opportunities increased. Economically, the growth rate in the 1980's was 6-10% annually, with growth in the manufacturing and service sectors and export trade. Close economic ties evolved between governments and private sectors. Social development programs had been fully funded and gains evident in education, living standards, health care and nutrition, and life expectancy. The success of family planning is attributed to encouraging contraceptive awareness and use. Fertility reduction may occur with social and economic development, but no developing countries have reduced fertility without family planning. The relative importance of family planning may change over time, and reducing the cost through government sponsored family planning programs and encouraging the acceptability of contraceptive usage.     

Population growth and poverty in the developing world

The links between rapid population growth and the absolute poverty currently affecting 780 million people in the developing countries (excluding China and other centrally planned economies) were examined. Absolute poverty is defined as having less than the income necessary to ensure a daily diet of 2150 calories per person ($200 per person a year in 1970 United States dollars). Focus is on poverty and demography in the developing world (defining poverty; income, fertility and life expectancy; demographic change and poverty), effect of poverty on fertility, family planning programs and the poor, and the outlook for the future. Rapid population growth stretches both national and family budgets thin with the increasing numbers of children to be fed and educated and workers to be provided with jobs. Slower per capita income growth, lack of progress in reducing income inequality, and more poverty are the probable consequences. Many characteristics of poverty can cause high fertility -- high infant mortality, lack of education for women in particular, too little family income to invest in children, inequitable shares in national income, and the inaccessibility of family planning. Experience in China, Indonesia, Taiwan, Colombia, Korea, Sri Lanka, Cuba and Costa Rica demonstrate that birthrates can decline rapidly in low income groups and countries when basic health care, education, and low-cost or free family planning services are made widely available.     

New perspectives on population: lessons from Cairo

The lessons from the 1994 World Population Conference in Cairo, Egypt, are summarized in this publication. The topics of discussion include the evolution of population policies, the changing policy environment, demographic trends, and solutions in the form of gender equity, provision of reproductive health services, and sustainable social and economic development. The program of action supported by 180 governments and targeted for 2015 articulated the goals of universal access to a full range of safe and reliable family planning methods and reproductive health services, a specified level of reduction in infant and child mortality, a specified level of reduction in maternal mortality, an increase in life expectancy to 70-75 years or more, and universal access to and completion of primary education. Other features include goals for improving women's status and equity in gender relations, expansion of educational and job opportunities for women and girls, and involvement of men in childrearing responsibilities and family planning. Steps should be taken to eliminate poverty and reduce or eliminate unsustainable patterns of production and consumption. Population policy must be integrated within social and economic development policies. About $22 billion will be needed for provision of family planning and reproductive health services by the year 2015. Costs will increase over the 10-year period due to the increased population to be served. Per person user costs for family planning alone are higher in countries without infrastructure and technical skills. Actual costs vary with the cost of contraceptive supplies, patterns of use, and efficiency of delivery systems. Although the plan offers 16 chapters worth of advice and recommends 243 specific actions, countries will have to be selective due to cost limitations. The 20/20 Initiative is proposed for sharing social service costs between international donors (20%) and host countries (20%). A separate UN projection of need is for 33% of support from international donors for family planning and related programs. The constraints to the implementation of the action plan are identified as the rate of demographic change, the extent of public support for population limitation and provision of family planning services, and potential conflicts of interests and funding between cooperating agencies. The World Bank has developed guidelines for policy development according to a country's identification as an emergent, transitional, or advanced country.     

Why the silence on population?

The tripling of the world’s population growth since 1960 has received little public attention the past decade. Six reasons for the silence around this subject constitute a “perfect storm”. The first five are: visibility of actual fertility decline in the developed countries as well as a number of the developing ones; well justified attention to the impact of high levels of consumption on the environment; an implicit welcome by conservative political and religious forces to reduced needs for family planning; the tragedy of AIDS dominating international health concerns; and the 1994 Cairo conference’s focus on examples of coercive family planning while nearly ignoring the coercion of women forced into unwanted childbearing. These five relatively new developments have been supported by standard demographic theory containing an assumption that couples naturally want many children, making it difficult to see the many barriers blocking women’s options to manage their own childbearing.     

Family planning and population control in developing countries

This essay aims at a critical analysis of the major assumptions of the family planning movement and their implications for population and development policy in the less developed countries. A neo-Malthusian perspective, in which a reduction of the current high rates of population growth is considered to be a necessary condition for economic development in the less developed countries, is dominant among professionals in family planning. Population control has come to be regarded as a kind of“leading sector” in the development process. The position taken in this paper is that the contention that fertility reduction is crucial to short term economic development is not substantiated empirically and represents a distorted view of the economic development process. Nor is there good evidence that demographic modernization can move far ahead of other aspects of modernization. Skepticism about the success of family planning tends to lead to advocacy of alternative methods of population control which are generally beyond the economic, administrative, and political capacities of the less developed countries and are sometimes repressive in tone. The family planning movement, in overstressing the independent contributions of fertility reduction programs, has tended to underplay conditions such as improved health, lowered mortality, and altered opportunity structure which make these contributions possible at all.     

Thinking about several problems of the research of our family planning strategy]

On the basis of 1982 census data, it is estimated that from 1987-1997 13 million women will enter the age of marriage and child-bearing each year. The tasks of keeping the population size around 1.2 billion by the year 2000 is arduous. Great efforts have to be made to continue encouraging one child/couple, and to pursue the current plans and policies and maintain strict control over fertility. Keeping population growth in pace with economic growth, environment, ecological balance, availability of per capita resources, education programs, employment capability, health services, maternal and child care, social welfare and social security should be a component of the long term development strategy of the country. Family planning is a comprehensive program which involves long cycles and complicated factors, viewpoints of expediency in guiding policy and program formulation for short term benefits are inappropriate. The emphasis of family planning program strategy should be placed on the rural areas where the majority of population reside. Specifically, the major aspects of strategic thrusts should be the linkage between policy implementation and reception, between family planning publicity and changes of ideation on fertility; the integrated urban and rural program management relating to migration and differentiation of policy towards minority population and areas in different economic development stages. In order to achieve the above strategies, several measures are proposed. (1) strengthening family planning program and organization structure; (2) providing information on population and contraception; (3) establishing family planning program network for infiltration effects; (4) using government financing, taxation, loan, social welfare and penalty to regulate fertility motivations; (5) improving the system of target allocation and data reporting to facilitate program implementation; (6) strengthening population projection and policy research; (7) and strengthening training of family planning personnel to improve program efficiency.     

The evaluation of China's population policy]

China's population policy has had tremendous effects on the reduction of fertility. The impact of the population policy is manifested in the following aspects. 1) Reducing the size of the total population by 200 million in 17 years. If the population growth rate had remained at its 1970 level of 2.6/1000, the total population would have been 1.28 billion in 1987. 2) The implementation of the population policy accelerated the process of demographic transition. The mortality decline which began in the early 1950s initiated the demographic transition. The Fertility decline began after the birth control policy was implemented and shifted the transition to a low population growth stage even before the socioeconomic conditions which are considered to be the determinants of fertility decline appeared. The fertility decline, in turn, promoted the socioeconomic development of the country. 3) Solving the problem of food; feeding 21.6% of the world's population on 7.1% of the world's farm land is no easy task. The success of population control, no doubt, played an important role in lowering the population growth rate so that the growth of food production could keep pace with the needs of the population. 4) A decline in the dependency ratio is a favorable condition to socioeconomic development. China's dependency ratio of 59.7 is among the lowest in developing countries and is close to the level in developed countries. Therefore, more production output can be used in investment rather than consumption. 5) The fertility decline facilitated a balanced economic growth. The ratio of population growth as compared to the growth of major economic indicators should be considered an important issue in maintaining macroeconomic control. The population policy made it possible for economic growth to surpass population growth.     

The threshold hypothesis: evidence from less developed Latin American countries, 1950 to 1980

Historical research among European countries finds large differences in the level of social, economic or demographic development among countries, or regions within countries at the time marital fertility rates began their decline from traditional high levels. This research tests a threshold hypothesis which holds that fertility will decline from traditional high levels if threshold levels of life expectancy and literacy are surpassed. Using a pooled regression analysis of 1950, 1960, 1970 and 1980 crude births rates (CBRs) in 20 less developed Latin American countries, in conjunction with 10-year lagged measures of social, economic and family planning program development, analyses reveal statistically significant effects of passing Beaver's (1975) threshold levels of 1950 literacy, or 1950 life expectancy, that are independent of levels of lagged literacy (or lagged life expectancy), economic and family planning program development, as well as measures that control period effects.     

Politics and fertility: a new approach to population policy analysis

This paper aims to explain why divergentpopulation policies and programs arise in otherwisesimilar countries and to clarify how such policiesrelate to fertility decline. An analysis wasundertaken of demographic and policy change over a 30year period in four pairs of developing countries: Algeria and Tunisia; Bangladesh and Pakistan; thePhilippines and Thailand; and Zambia and Zimbabwe. Insome countries, popular demand for family planningfacilitated changing policy. In others, independentfactors, such as economic crisis or internationalpressure, pushed policy makers into action onpopulation policy, often in the absence of populardemand. In these countries, governments whichidentified a coherent rationale, usually economic, forreducing population growth, tended to develop moresuccessful policies. Strong and financially securecoalitions of policy elites were important in sharingthe political risk associated with such policies. Analysis of these processes has lessons for policymakers and researchers interested in expeditingimplementation of new approaches to population andreproductive health.     

Determinants of national family planning effort

In light of recent research demonstrating a substantial impact of family planning programs on fertility, we develop and estimate a multivariate model of the determinants of national differences in family planning program effort (FPPE). The framework that guides the specification of this model identifies three broad classes of factors—those that create demand for family planning, those that facilitate the initiation and expansion of family planning programs, and finally those that encourage or inhibit program development. The results from multiple regression using 84 less developed countries indicate that demand for family planning, facilitating infrastructure, and certain demographic and geographic factors are important determinants of program effort. These results suggest that popular demand for family planning is helpful, but that policy makers must perceive the adverse consequences of high fertility and have the infrastructure necessary to develop an effective organized family planning program. Current U.S. policies relevant to reducing birth rates are discussed and found to reflect quite well research on determinants of fertility declines among LDCs. U.S. policy also balances the often competing claims of family planners and their opponents by encouraging support to both developmental projects as well as direct aid to family planning program activities.     

The objectives of government policies on fertility control in Eastern Europe

Although demographers from the communist countries continue to maintain that overpopulation in the Malthusian sense Is possible only under capitalism, some East European demographers now concede that a form of overpopulation may, at times and under certain conditions, exist In a communist society. In this connection the ideological framework for an optimum population policy under communism has been developed, and demographers have been given the task of determining what the optimum population is and how it is to be attained. There has been considerable ferment on the Issue of fertility control in both the literature and action programmes of Poland, Chechoslovakia, and Hungary. The latter two countries have conducted surveys on family planning, including the use and effectiveness of contraceptives, and have established demographic journals.

All the communist countries of Eastern Europe except Albania and East Germany have relaxed laws restricting abortions and conducted campaigns for the spread of contraceptives. At the same time family allowances have been continued. These paradoxically divergent policies can be rationalized as attempts to sustain existing families while providing the basis for regulating future fertility to achieve an optimum population in relation to the resources of the respective countries.     

Policy options when population growth slows: The case of Thailand

Thailand reached replacement-level fertility almost a decade ago, although there has been a lag in measuring and recognising the implications of this benchmark event. Fertility could well sink still lower. The momentum of population growth will ensure substantial further increase before the population levels off, but this is not true in all regions. For example, earlier and faster fertility decline in the North, and net outmigration, have led to a situation where some geographical and age segments of the North's population are decreasing. Population policy in Thailand since 1970 has had two major planks: to reduce fertility through an active family planning program, and to distribute population away from the large primate city of Bangkok. The paper discusses whether these policies may need to be modified as a result of the major demographic and socio economic changes that have been taking place. It also discusses the limits to population policy in terms of the likely efficacy of various measures that could be adopted, based on both an assessment of the Thailand situation and the experience of other low-fertility countries.     

Family planning and deforestation: evidence from the Ecuadorian Amazon

Despite an abundant literature exploring the relationship between population growth and forest cover change, comparatively little research has examined the forest cover impacts of family planning use—a key determinant of population growth rates in many developing countries. Using data from a panel survey of farms in the Northern Ecuadorian Amazon, this paper explores whether family planning use affects changes in forest cover. After controlling for household life cycle effects, family planning use among female heads of farm households did not have an independent effect on deforestation, reforestation, or net forest loss between 1990 and 2008. Rather, shorter-term drivers of forest change tend to be associated with household life cycles and shifts in production and consumption. However, family planning will continue to improve development and health outcomes for women by reducing unwanted fertility and may offer longer-term environmental benefits.     

Demographic change and response: Social context and the practice of birth control in six countries

This paper expands on Kingsley Davis’s demographic thesis of change and response. Specifically, we consider the social context that accounts for the primacy of particular birth control methods that bring about fertility change during specific time periods. We examine the relevance of state policy (including national family planning programs), the international population establishment, the medical profession, organized religion, and women’s groups using case studies from Japan, Russia, Puerto Rico, China, India, and Cameroon. Some of these countries are undergoing the second demographic transition, others the first. Despite variations in context, heavy reliance on sterilization and/or, abortion as a means of birth control is a major response in most of these countries. The key roles of the medical profession and state policy are discussed, along with the general lack of influence of religion and of women’s groups in these countries.     

Population and environment in the twenty-first century

In the past 50 years global population grew by 3.7 billion. There is a large unmet need for family planning and wherever women have been given the means and the information to decide if or when to have the next child, then family size has fallen, often rapidly. However, since the UN 1994 Cairo conference on population and development, support for international family has collapsed and fertility declines in many of the poorest countries have stalled. Amongst some of the most vulnerable groups family size has risen. The investment made in voluntary family planning will largely determine whether, in the next 50 years, the global population grows to something less than 8 billion or to over 10. The trajectory taking us to the higher figure could jeopardize any possibility of transitioning the global economy to a biological sustainability. Much precious time has been lost. Almost all the additional growth in population will take place in the world’s poorest countries, and it is imperative that the international community act to improve access to family planning in those countries, within a human rights frame framework.