Philippines: decentralized approach shows results

In the Philippines several steps have been taken to meet the challenge of increasing population growth. Commencing with the Republic Act 6365, known as the Population Act (1971) program directives focus on achieving and maintaining population levels most conducive to the national welfare. In 1978 a Special Committee was constituted by the President to review the population program. Pursuant to the Committee's findings certain changes were adopted. The thrust is now towards longterm planning to ensure a more significant and perceptible demographic impact of development programs and policies. Increasing attention is paid to regional development and spatial distribution in the country. The 1978-82 Development Plan states more clearly the interaction between population and development. The National Economic and Development Authority, the central policy and planning agency of the government, takes charge of formulation and coordinating the broader aspects of population policy and integrating population with socioeconomic plans and policies. At present the National Economic and Development Authority (NEDA) is implementing a project known as the Population/Development Planning and Research (PDPR) project with financial support from the UN Fund for Population Activities (UNFPA). This project promotes and facilitates the integration of the population dimension in the planning process. It does this by maintaining linkages and instituting collaborative mechanisms with the different NEDA regional offices and sectoral ministries. It also trains government planners in ways of integrating population concerns into the development plan. PDPR promotes the use of population and development research for planning purposes and policy formation. The Philippine Development Plan, 1978-82, recognized that an improvement in the level of 1 sector reinforces the performance of the other sectors. Since the establishment of the National Population Program 12 years ago, population and family planning have been successfully integrated with various development sectors, notably, labor, health, and education. Through the policies of integration, multiagency participation, and partnership of the public and private sectors, the Commission on Population uses existing development programs of government and private organizations as vehicles for family planning information and services and shares the responsibility of implementing all facets of the population program with various participating agencies in the government and private sector.     

Future population growth: researchers in three countries quantify causes and propose policies

This article discusses Population Council analyses conducted by social scientists from India, Kenya, and the Philippines. These scientists agreed that population momentum would continue to increase population size, and that governments must strengthen and create a range of economic, health, and social programs and policies to slow population growth. Multiple approaches will be needed. John Bongaarts is credited with being the first to identify the key role of population momentum and to decompose growth into unwanted fertility, high desired fertility, and population momentum. Unwanted fertility is responsible for about 19% of projected population growth in India, 26% in Kenya, and 16% in the Philippines. High wanted fertility accounts for 20% of future growth in India, 6% in Kenya, and 19% in the Philippines. Population momentum can account for under 50% or over 90% of growth. Unwanted fertility can be addressed by fulfilling unmet need and increasing knowledge of methods, reducing the fear of side effects and disapproval, and eliminating poor service. Family planning programs need to be strengthened and integrated with maternal and child health services. Preferred and actual family sizes can be reduced by lowering infant mortality by means of increasing infant and child health services and girls' educational attainment. Population momentum can be addressed by delaying age at marriage and childbearing through improving social conditions. Investments in human development through education, training, and income generation can create the conditions for slowing population growth. Countries should decompose population growth into its components of unwanted and high wanted fertility and population momentum as a means of distributing resources most effectively.     

Population Policy in a Prosperous City‐State: Dilemmas for Singapore

Singapore has achieved one of the highest levels of per capita income in the world, through sound economic planning and a stress on building its human capital. Yet its enviable living conditions are at risk of being enjoyed by fewer citizens, and indeed themselves placed in jeopardy, by the continued very low fertility levels. Ultra‐low fertility and growing reluctance by citizens to accept an increasing share of foreign‐born pose difficult dilemmas for population policy, given the planning scenario of reaching a resident population of 6.5 million. A range of pro‐marriage and pronatalist policies has failed to raise fertility substantially, while past success in modifying population trends and structure through migration has now encountered the twin problems of political constraints on the volume of immigration that is acceptable and a possible increase in emigration of Singapore citizens.     

Indonesia; World Bank assists Second Population Project

Indonesia's First Population Project, funded jointly by the International Development Association and UNFPA, was started in 1972 and provided for construction of service and training facilities, equipment, research and evaluation studies, education, and communication activities. The national family planning program has made progress in the last 20 years. Acceptor and family planning personnel statistics are given. The World Bank has recently awarded Indonesia a loan to fund its Second Population Project, to aid in reaching the goal of a 50% reduction in fertility by 2000.     

Redefining family planning programs

The Population Council's issue paper entitled Reconsidering the Rationale, Scope, and Quality of Family Planning Programs calls on family planning programs to focus only on reducing unwanted fertility by helping people meet their own reproductive goals safely and ethically. Many family planning programs have been wrongly handed the extra responsibility of reducing wanted fertility. They have therefore used inappropriate means (e.g., incentives, quotas, and coercion) to boost contraceptive prevalence. If programs do focus on reducing unwanted fertility, they will foster reductions in overall fertility and population growth as well as improvements in clients' health and well-being. A new framework has emerged from this shift in rationale. It sets the stage for expanding the scope, improving the quality, and assessing the impact of family planning programs in terms of client choice, health, and well-being. A program needs to determine the range and quality of family planning services it provides at the local level. Local program managers, policymakers, and consumer interest groups should establish minimum or achievable standards of service based on the local health care capacity. Program items that should be assessed include choice of methods, information for clients, technical competence, interpersonal relations, mechanisms to encourage continuity of care, and appropriate constellation of services. The Population Council has conducted rapid appraisals of the quality of care of family planning services to help local program managers to evaluate the strengths and weaknesses of their programs. The HARI (Helping Individuals Achieve their Reproductive Intentions) Index measures a program's success in helping clients safely prevent unwanted or unplanned pregnancy. Program managers can conduct a self-assessment that revolves around answering four questions. Family planning services are an important social investment and are essential to development.     

Population growth,economic development and family planning

This report discusses research conducted to determine whether reduction in population growth rates contributed to the rapid economic growth of Indonesia, South Korea, Japan and Thailand. The 5-year research projects, jointly sponsored by the UN Fund for Population Activities, the Nihon University Population Research Institute, and the East-West Population Institute, concluded that development and family planning programs contributed substantially to fertility decline in these countries. The project examined 3 factors that influence the long-term productive capacity and growth of the 4 Asian economies: savings, the size of the labor force, and the quality of labor (measured by educational attainment). Available evidence indicates a strong positive contribution of population decline toward growth of savings, a growth in labor force concurrent with a decline in fertility rates which enables per capita income to rise, and an increase in 2ndary education enrollment ratios as fertility is lowered. Development factors by themselves explain no more than 1/2 of the decline in fertility observed, suggesting that family planning programs particularly in Thailand, South Korea and Indonesia since 1976 have had an important impact on fertility and economic development.     

1980 ASEAN programme roundup: a model in the making

Association of Southeast Asian Nations (ASEAN) experts and heads of national population programs held their 4th meeting in Singapore from November 24-28, 1980. Program heads resolved to take steps to link their national activities in the population field with those of the ASEAN Population Program and carry out studies and a joint programming exercise in 1981. Progress reports on the following Phase 1 projects were given: 1) integration of population and rural development policies and programs in ASEAN countries including Indonesia, Malaysia, Philippines, Singapore, and Thailand; 2) development of an inter-country modular training program for personnel in population and rural development; 3) multi-media support for population programs in the context of rural development in ASEAN countries; 4) utilization of research findings in population and family planning for policy formulation and program management in ASEAN countries; and 5) migration in relation to rural development. Phase 2 projects approved by ASEAN country participants were also discussed: 1) institutional development and exchange of personnel, 2) women in development, 3) developing and strengthening national population information systems and networks in ASEAN countries, 4) population and development dynamics and the man/resource balance, 5) studies on health and family planning in ASEAN countries, 6) population migration movement and development, and 7) development of ASEAN social indicators.     

After the demographic transition: policy responses to low fertility in four Asian countries

In the low fertility countries of South Korea, Taiwan, Singapore, and Thailand, policy-makers are concerned about the consequences of low growth. In South Korea, a family planning (FP) program was instituted in the early 1960s, and fertility declined to 1.6 by 1987. Rural fertility is still higher at 1.96, and abortion rates are high. 32.2% of fertility reduction is accomplished through abortion. South Korean population will not stabilize until 2021, at 50.6 million people. The elderly are expected to increase and strain housing, energy, and land resources. Government support for FP is being reduced, while private sector services are being enhanced. Government sterilization programs have been reduced significantly, and revisions in the Medical Insurance Law will cover part of contraceptive cost. Integrated services are being established. Many argue for an emphasis on birth spacing, child and family development, sex education, and care of the elderly. In Taiwan, replacement level fertility was reached in 1983. Policy in 1992 recommended increasing fertility from 1.6 to 2.1. The aim was to stabilize population without pronatalist interventions. Regardless of policy decisions, population growth will continue over the next 40 years, and the extent of aging will increase. In Singapore since the 1960s, the national government focused on encouraging small families through fertility incentives, mass media campaigns, and easy access to FP services. Fertility declined to 1.4 in 1988. Since 1983, government has established a variety of pronatalist incentives. In 1989, fertility increased to 1.8. The pronatalist shift is viewed as not likely to succeed in dealing with the concern for an adequate work force to support the elderly and economic development. In Thailand, fertility declined the fastest to 2.4 in 1993. The key factors were rapid economic and social development, a supportive cultural setting, strong demand for fertility control, and a successful FP program. The goal is to reduce fertility to 1.2 by 1996. Replacement level may be reached in 2000 or 2005. Future trends are not clear.     

Mayors accept the population challenge

The Commission of Population (Popcom), together with the Philippine Ministry of Local Government ond the National Economic and Development Authority devised a multiagency project entitled "Population, Local Development and Local Administration." Expected to improve the capabilities of mayors in fulfilling their new roles, the project called for holding consultative conferences with town mayors as participants. From March to november 1985, the sponsoring agencies conducted 12 consultative conferences for 281 municipal mayors and 13 representatives throughout the country. Mayors learned that they are empowered to implement the local population program and that the population workers, being local coordinators of the population program, should be reporting to them. The mayors' feedback given at the conferences made some officials realize that there are local government units that may not be able to fully absorb the full-time outreach workers. To help implement population programs, the mayors suggested fiscal reforms. Overall, the conferences gave the mayors a sense of importance.     

The Philippines: country statement prepared for the International Conference on Population,Mexico City,August 1984

This statement, prepared for the 1984 International Conference on Population, summarizes the demographic situation in the Philippines, the Philippine position regarding implementation of the World Population Plan of Action, and current population policies. In 1980, the population of the Philippines stood at 48.1 million. The country's current population growth rate reflects the interplay between decreasing mortality and still high but declining fertility. The 1984-87 Philippine Development Plan aims to achieve sustainable economic growth, equitable distribution of the gains of development, and personal development. A net reproduction rate of unity by the year 2000 is sought, and preschool-age children, youth, premarriage-age groups, and married couples of reproductive age have been targeted for special outreach efforts. The national population program will concentrate on developing a network of public and private community-based organizations, strengthening the capacity of local government and community organizations to plan and manage the population program, developing community capacity to finance family planning services, upgrading the quality of natural family planning practice, continuing the promotion of effective contraceptive methods, developing a population data bank, and upgrading the technical and management capabilities of population program personnel. Increasing attention is being paid to regional development and spatial distribution. The average annual population growth rate is expected to decline from 2.8% in 1970-75 to 2.2% by 1987. The crude birth rate is expected to drop from 34/1000 in 1980 to 31/1000 in 1987. To help achieve this goal, the contraceptive prevalence rate should increase from 34% in 1983 to 41% in 1987 and 50% by 1993. In addition, attempts will be made to reduce the proportion of women marrying below the age of 20 years and to improve women's access to educational and employment opportunities.     

ASEAN projects reviewed

The ASEAN Population Expert Group met in Manila and was followed by a meeting of the ASEAN heads of population programs, during the period November 5-10, 1979. Heads of population programs from Indonesia, Malaysia, Singapore, Thailand, and the Philippines attended. The meetings were held to review progress-to-date on phase 1 projects and to consider the development of an expanded population program. 5 projects funded by UNFPA are reviewed in tabular form with the project, the sponsoring country, date of implementation, data analysis, and date of completion. Suggestions were made for improving and extending these projects and it was also suggested that all projects being developed and proposed should include a section on use of research. 7 new projects were proposed as phase 2 projects. The 1st, sponsored by Malaysia, deals with women in development; project 2, lead by Thailand, will investigate population movement and its effect on development; project 3, led by the Philippines, will develop and strengthen national population information systems and networks in ASEAN countries; project 4, led by Indonesia, is directed towards institutional development and exchanges of personnel; project 5, led by the Philippines, will examine population and development dynamics and the man/resources balance; project 6, led by Thailand, will develop ASEAN social indicators; and project 7, led by Indonesia and Malaysia, will make a comprehensive analysis of existing medical/health care and family planning systems. It was recommended that an executive director of the proposed ASEAN population coordination unit should be appointed to expedite the recommendations of the meeting related to preparation and submission of phase 2 project proposals.     

New perspective in population assistance

The United States Agency for International Development (AID), in a proposal to Congress, has suggested that before assistance is extended to developing countries, its impact on the country's population growth should be considered and development projects accepted that contribute directly to fertility declines. Foreign development projects will be examined for their direct and indirect impact on population growth. Some projects related to education, employment and economic development may be found, by their very nature, to encourage fertility decline and emphasized as a result of the impact examinations. Other projects may be changed to stress the features that are conducive to slowing population growth. The population impact examination proposal has been included in this year's legislation to authorize the continuation of United States development assistance programs for the fiscal year 1978.     

The Philippine population program under the Aquino administration

3 views of the Philippine Population Program under the Aquino government are presented: the first states the government's position on population programs and the next 2 criticize that position. Issued by the Commission on Population (POPCOM) in early 1987, the first statement establishes the government's stance on population programs. It explains that the 1987 Philippine Constitution reaffirms the government's commitment to the ultimate goal of the Population Program: the improvement of the quality of life in a just and humane society. The statement explains the constitutional guarantees, policy principles, and policy strategies concerning population. The next view presented is an excerpt from Alejandro N. Herrin's paper entitled "Population, Health and Education: Policy Initiatives Under the Aquino Administration." In it, Herrin explains that after 1 year of silence, POPCOM finally issued a policy statement. The statement, however, is marked by ambiguity, avoiding an explicit mention of a policy to moderate fertility. Furthermore, the statement fails to clarify the government's position on 2 basic issues: whether or not an acceptable economic and social development can be achieved within a reasonable time without a moderation of the current high fertility and population growth, and whether or not the government is justified in sponsoring a program to moderate fertility and population growth. The 3rd view presented in the document is that of Virginia A. Miralao. In her essay "Population Policies, Family Planning Programs, and Women's Reproductive Rights," Miralao explains that the current population program -- which directly affects the lives of women -- has virtually excluded women in its planning. Moreover, since Aquino came into power, the Catholic church has gained great influence and has opposed family planning programs.     

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.     

New strategies for slowing population growth

Growth of world population over the next 100 years, until the year 2100, will produce an estimated 11.5 billion people. The past focus on reducing rapid population growth exclusively through family planning has not been sufficient. Population policy needs to be broadened to include health care, education, and poverty reduction. The population policy recommendations of Population Council Vice-President John Bongaarts and Senior Associate Judith Bruce were to reduce unwanted pregnancies by expanding services that promote reproductive choice and better health, to reduce the demand for large families by creating favorable conditions for small families, and to invest in adolescents. The Population Council 1994 publication "Population Growth and Our Caring Capacity" outlined these issues. Another similar article by John Bongaarts appeared in the journal "Science" in 1994. In developing countries, excluding China, about 25% of all births are unwanted; 25 million abortions are performed for unwanted pregnancies. The provision of comprehensive family planning programs will go a long way toward achieving a reduction in unwanted pregnancies. In addition, changes are needed in male control over female sexuality and fertility and in cultural beliefs that are obstacles to use of contraception. Stabilization of population at 2 children per family will not occur unless there is a desire for small families. In most less developed countries, large family sizes are preferred. Governments have an opportunity to adopt policies that reduce economic and social risks of having small families. This can be accomplished through the widespread education of children, a reduction in infant and child mortality, improvement in the economic and social and legal status of women, and provision of equitable gender relations in marriage and child rearing. The rights of children to be wanted, planned, and adequately cared for need to be supported. These aforementioned measures will help to reduce fertility, provide support for small families, and justify investment in social development. Population momentum will keep population growing for some time even with replacement level fertility. Investment in adolescents through enhancement of self-esteem and promotion of later childbearing can lengthen the span between generations and slow population momentum. Population policies will be more effective when human rights are protected.     

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.     

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.     

Backing seen of population policy in AID

Congress is almost certain to agree to use of U.S. funds to motivate reduced population growth in developing countries but funding for sterilization abroad emerged as a political issue in the House. In the proposed U.S. AID budget, which in the past has been about 10% funded for direct population programs, a total concern with literacy for women, higher educational levels, and other developmental programs which increase motivation for family planning has been proposed. Zero Population Growth has sent telegrams to Congress supporting this basic development policy. The controversy over sterilization is the result of India's compulsory sterilization legislation. An amendment refusing to allow any U.S. funds to be used for sterilization programs was rejected, but in rejecting it, the members of the House of Representatives expressed their concern that any and all sterilization programs be completely voluntary. In a letter, AID Deputy Administrator Robert Nooter assured Congress that AID has no goals to sterilize any certain number of women around the world and it is not the main purpose of the AID program to to emphasize sterilization as a method of family planning.     

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.     

The Philippine population program: a stocktaking

Summarizes findings of the Special Committee to Review the Philippine Population Program, created by the Commission on Population to evaluate population related programs and recommend program directions for the future. The Committee conducted a 2 part study: an indepth review and analysis of existing policies and programs, evaluation of their effectiveness, and identification of organizational, statistical and policy or program related gaps and bottlenecks; and recommendations on policy and program thrusts for the next 5 years. Along with specific recommendations on program operations, service delivery, and research, the Committee made a number of important policy recommendations. Chief among these were a call for the development of a broader popultion policy, not focused only on growth but encompassing demographic, manpower, and welfare components; recognition of the need for the program to advocate an ideal family size and a desirable age for marriage; and redesign of the program on a broad scale to integrate it fully with national development plans.