Radio: a strategic tool for development

Every country should recognize the need to fully involve media leaders in the planning and implementation of population and family planning programs. Broadcasters are the best equipped to understand the "mind-set" of the mass audience and what is needed to bring about changes therein. If there is to be involvement of the media, particularly radio professionals, in the design, development and implementation of population and family planning programs, attention must be given to the inmplications of this in terms of implementing the World Population Plan of Action. Strategies for population communication using radio as the central medium include the following: 1) development of an adequate in-country support structure; 2) development of a sound, well-researched population communication program; 3) on-air programming in the form of instruction rather than entertainment; 4) provision for substantial and continuous feedback from the audience; 5) frequent broadcasts at a prime time of day; and 6) a program commitment of from 5 to 6 years. Radio needs to be recognized as a strategic tool for development; it should be used professionally and should receive sufficient priority by funding agencies.     

民主生育论

本文将计划生育村民自治定义为“民主生育”,凸现了计划生育村民自治的民主性。民主生育是指由民作主、群众自治的生育活动,属于政策性自主生育活动。通过“三自四民”,民主生育正在重构基层的社会关系,正在开创人本主义计划生育的新格局。但在实践过程中,民主生育还面临着真民主还是假民主的严峻挑战。捍卫群众的话语权是村民自治的核心任务之一,也是基层民主建设在计划生育公务上的具体体现。     

The Population Program's Medium-Term Plan: a blueprint for welfare

The Population Program in the Philippines initially was preoccupied with the problem of fertility reduction. From 1981-85, the program will be carrying out a 5-year population plan which aims at the reduction of fertility as well as the broader goal of enhancing the well-being of the family and of society. Called the Medium Term Plan, this population plan began to evolve in January 1978 when President Marcos called for a comprehensive review of the population program in the context of the country's overall development plans. The Special Committee to Review the Philippine Population Program, worked from February to June 1978 and focused attention on the policy, program, and research components of the population program. They assessed the achievements of the program, analyzed its limitations, and recommended future policy and program thrusts. In performing its task, the committee observed the following guidelines: 1) the program must be evaluated by taking into account the overall development goals that are directly related to the population problem, 2) the program must be evaluated in its totality, 3) the concept of family planning must be redefined as family planning and welfare, 4) research must be recognized as a vital instrument for program formulation, and 5) the population program must be evaluated with an awareness of the role of financial and institutional support in its implementation. The committee's findings stressed the need to link family planning efforts with the rest of socioeconomic issues outlined in the government's 5-year development plan for 1978-82. The broad objective of the National Population Program is to reduce the population growth rate to levels that promote national welfare and individual well-being. Under the Medium Term Plan the population growth rate should be reduced from an estimated 2.3% to an estimated 2.0% in 1985. To achieve this objective, the program aims to raise the number and quality of protected couples, promote delayed marriage, promote internalization of the small family size norm, and study other development factors. 14 strategies and their objectives are outlined along with action steps.     

Falling fertility in Indonesia: success in national family planning

This publication summarizes the findings of the National Indonesia Contraceptive Prevalence Survey (NICPS), which revealed a rapid decline in Indonesia's fertility rate. This article also describes how the successful Indonesia family planning program is designed and maintained. Since 1975, fertility rates have dropped from 5.5 to 3.3 children per woman. Those practicing contraception during the same period has risen from 400,000 couples to 17 million. Contraceptive education is high (e.g. 95% of all married Indonesian woman are familiar with a modern contraceptive method). The Indonesia family planning program cooperates with other government activities designed to improve people's health and welfare. It emphasizes access to contraceptive methods and promoting the idea small family. The program was structured to us extensive community involvement, and cultural beliefs were incorporated into program policy; Islamic leaders were consulted before program implementation. The program is flexible so that the differing needs of each region can be effectively met by the family planning program. The future main goal will be to contain a potential population boom when the 40% of the present population which is under 15 years of age becomes reproductively mature.     

Planning population development in Pakistan

Population development planning is an effort to reconcile numbers with individual, national, and global needs. The emphasis is on the integral linkage that exists between development planning and people's needs, which is best identified through demographic characteristics. Population development planning should focus on the 40% of those living below the poverty level and the 50% at the subsistence level. Limiting a country's population, or family planning, is not an end in itself; it should be complemented by long-term development. Planners and programmers in education, rural development, trade, social welfare; health, labor, agriculture, or local government should ensure a consonance between the people's aspirations and the nation's needs. Family planning must be joined with efforts to change standards of living. Individual behavior is affected by intermediary areas of association and authority, the extended family, the neighborhoods, and the local community. Government programs will fail if they do not consider the grass-roots, individual, and community needs.     

From Bucharest to Mexico: a decade of changing perceptions

The 2nd International Conference on Population held in Mexico City in 1984 had 3 main objectives: 1) to adopt the plan to changing demographic situations, 2) to enlarge the plan's scope so it can consider new views that have emerged since Bucharest, and 3) to reinforce the plan's operational aspects so that the plan can be applied more effectively. The Mexico conference had significant differences with the Bucharest gathering: 1) greater participation of developing countries, 2) clarification of the role of population and family planning in development, and 3) recognition of the status of women in development. Governments of many developing countries argue that they cannot wait for their countries to modernize sufficiently enough to stabilize their population levels. Participants in the Mexico conference agreed that family planning programs have been successful in reducing fertility at relatively low cost. The goal of a development-oriented population policy is to improve the people's standard of living by lowering fertility rates, improving health conditions and life expectancy, improving population distribution, and adopting sound economic policies. The overall objective of population policy should not be confined only to growth, distribution, and other demographic aspects; it is imperative that human life and human dignity be upheld.     

论稳定低生育水平

中国经济已进入以扩大内需为主的新发展阶段,从可持续发展计,保持经济持续、快速和健康发展,必须把已出现的低生育水平稳定住。我国已经是低生育率国家,但低生育水平还不稳定。从当前和今后的发展来看,稳定低生育水平,必须使人口政策和经济政策协调起来,积极寻求扩大内需与稳定低生育水平的政策结合点,增加计划生育的政府投入,完善计划生育利益导向机制,处理好稳定现行政策与人口与计划生育工作机制改革与创新的关系。     

Research on population theory must be integrated with China's reality]

This article is based upon a speech delivered by the author to a conference on population theory in memory of the centennial celebration of the death of Karl Marx. The conference was organized by the Institute of Population Theory of the Chinese People's University. According to the author, the only correct way to study population theory is to use the Marxist population theory as a guiding principle and integrate it with China's reality, and the format of dogmatism should not be adopted. The work on population theory studies should be established on a political and scientific foundation. The Chinese people should have a clear understanding of the goal of limiting China's population figure to under 1.2 billion at the end of this century. To reach this goal, the general public must be educated and understand to close relationship between family planning and the economic and social development of all of China. Family planning is a absolute necessity for the fundamental interests of China as a nation and as a people. Technical personnel and scientific theorists should be trained and organized in order that their work may satisfy the needs of China's reality. Family planning work should also be handled according to China's current situation.     

Comrade Mao Ze-dong's contribution to Marxist theory on population--in commemoration of the 60th anniversary of the birth of the Chinese Communist Party]

Is it good or bad to have a large population in China? Comrade Mao Ze-dong said "it is good and it is also bad." Our population is an asset, and we should use this asset and wisdom in our nation's "Four Modernizations" program. On the other hand we should control the population growth and reduce the resulting burden. Marxism recognizes 2 types of production, material production and human production. Both are interrelated, mutually dependent, and beneficial. Comrade Mao criticized concepts and practices that disregard the interrelationship of these 2 types of production. According to Comrade Mao both types of production should be included in the national economic plan, and the proportions of material production and human production should be the basic proportions of our socialistic economic development. Comrade Mao mentioned that population growth should be planned to fit and benefit social development. He suggested establishment of a series of family planning offices or committees to study and implement the family planning program, to develop a longterm plan, to consider the people's wishes in family planning, to meet the people's requirements and desires, to educate people about family planning, and to recommend government funds for the program.     

立足改革创新,做好新形势下的人口和计划生育工作

新时期的人口和计划生育工作,法制性、规范性和服务性显而易见。因此,立足改革创新,做好新形势下的人口和计划生育工作具有重要的意义。审时度势,转换脑筋,找准位置,进入角色,依法管理,工作到位,是调整工作思路和方法,适应形势、任务发展需要的关键,也是做好人口大文章,追求计划生育大目标,为全面建设小康社会做出大贡献的根本途径。人口和计划生育部门及其工作人员,必须与时俱进,积极改进工作,跟上时代步伐,用显著的业绩为经济发展和社会进步添砖加瓦,为全面建设小康社会创造条件,提供保证。     

Men and family planning: toward a policy of male involvement

The stated aim of this discussion is to examine the extent of male use of family planning and the nature of men's role in family planning in developing countries. Case studies are presented which are successful examples of strategies for involving men in family planning. Policies that aim to increase male involvement must be sensitive to cultural values, apply to a decentralized government approach toward information and supplies, include adequate political will, and consider the costs and benefits of changing values. A male family planning policy would not always be compatible with all fertility values in developing countries or traditional values of the older population. A policy should stress the value of male individuals contributing as much as possible for their own and others' welfare. Community participation is considered important in order to create a feeling of mutual support. A sizeable investment will be required for mass distribution of contraceptive information. Schools are viewed as an ideal place for educating youth about the problems of high fertility and about use of family planning methods, such as the condom. Religious organizations should be used to educate people about responsible parenthood and to minimize barriers to use of modern contraception. Comic books on how to use condoms are suggested as a good source. Local authorities who are trusted are useful in influencing acceptance among local populations. Local personnel may be trained as information disseminators. Adequate contraceptive information needs to be supplied to a wide audience. Lack of supply and inadequate information are given as two key reasons for insufficient use of male contraception. Condoms should be priced to be affordable to the average person and free to those with no income. Program strategies that proved successful are cited for Thailand's Mechai Viravaidya program and Bali's grass-roots program. The vasectomy program in Bangladesh is also noted for its success. Low levels of condom use are attributed to factors such as price, education, availability, accessibility, culture, religion, and economic conditions. Male sterilization levels can be enhanced with wider availability of clinics and provision of correct information for challenging beliefs that vasectomy is a form of castration.     

Population goal set for China's new five-year plan

China's 7th Five-Year Plan recommends that China's total mainland population be held within the limit of 1.113 billion, with an annual average natural growth rate of about 12.4/1000. As a large number of youths will reach marriage and childbearing age during the course of the 7th Five-Year Plan, the Plan affords a high priority to the family planning program and to the control of population growth. The plan proposes 5 policies and measures to realize its goal: continuous efforts need to be made to give family planning a high priority; late marriage, late childbearing, and the 1-child family should be advocated; ideological and political education should be strengthened; scientific and technological research devoted to family planning should be intensified; and family planning communication and service centers at the county level should be consolidated and strengthened, and the family planning program should be conducted systematically and be ongoing.     

To the barrios] The new course charted by the national population program

In order to reduce the Philippine birthrate to 2% by 1980, the number of rural women practicing contraception must be trebeled. To facilitate such an effort, a large-scale reorganization and reorientation in all areas of family planning activity--delivery, training, research, information, education, and communication--is proposed, shifting the delivery of family planning services from clinics to the 36,000 barrio bases. A goal of 16,000 extension workers in family planning is set for 1976; these workers will be the ones to make the initial contacts with potential acceptors. Then full-time family planning workers will try to make potential acceptors into bonefide ones, giving advice or prescribing the method and providing follow-up. Family planning workers will be supervised by nurses and midwives in health stations, who in turn will be supervised by the physician in the rural health unit. Acceptability among community residents is the most vital characteristic of a family planning worker, with the country's 27,000 hilots (birth attendents) seen as leading candidates. Attracting and training manpower in the field is a major challenge, as is lack of personnel in the area of research. Several possible avenues for the development of research interest and manpower for the population program are explored.     

Selling family planning to the farmer

Dr. Juan M. Flavier of the International Institute of Rural Reconstr uction (IIRR) found medical terms used by family planning teams had little meaning for rural audiences. In addition, the family planners lectured too much and did not truly reach their farm audiences. The Institute developed a series of materials based on agricultural parallels with captions in verse, capitalizing on the rural Filipino's love of balagtasan (debate in verse) and duplo (couplets). The IUD is likened to a stone which prevents a seed from germinating. The ill-effect of frequent childbirth is likened to a citrus tree laden with too many fruit. The program talks about birth control or limitation in number, spacing, and infertility. Dr. Flavier believes it is important to include infertility if only to show that family planning is an aid to all couples. Many times the farm illustration will spark discussion, which allows the group to bring up questions about birth control which otherwise they would not. A 3-year grant to study the IIRR approach found that this adaptive technique, though slower in the beginning, led to greater continuation rates and more confidence in family planning. It could be used in urban poor areas as well because many slum and working-class families have rural backgrounds. Also, the household illustrations (comparing a cervical cap to the lid of a pot which keeps unwanted items out) would be understandable to most women.     

Sub-Saharan Africa: population pressures on development

The population of sub-Saharan Africa, estimated at 434 million in 1984, is expected to reach 1.4 billion by 2025. The birth rate, currently 48/1000 population, continues to increase, and the death rate, 17/1000, is declining. Rapid population growth has curtailed government efforts to provide adequate nutrition, preserve the land base essential for future development, meet the demand for jobs, education, and health services, and address overcrowding in urban areas. Low education, rural residence, and low incomes are key contributors to the area's high fertility. Other factors include women's restricted roles, early age at marriage, a need for children as a source of security and support in old age, and limited knowledge of and access to modern methods of contraception. Average desired family size, which is higher than actual family size in most countries, is 6-9 children. Although government leaders have expressed ambivalence toward development of population policies and family planning programs as a result of the identification of such programs with Western aid donors, the policy climat is gradually changing. By mid-1984, at least 13 of the 42 countries in the region had indicated that they consider current fertility rates too high and support government and/or private family planning programs to reduce fertility. In addition, 26 countries in the region provide some government family planning services, usually integrated with maternal and child health programs. However, 10 countries in the region do not support family planning services for any reason. Unfortunately, sub-Saharan Africa has not yet produced a family planning program with a measurable effect on fertility that could serve as a model for other countries in the region. Social and economic change is central to any hope of fertility reduction in sub-Saharan Africa. Lower infant and child mortality rates, rising incomes, higher education, greater economic and social opportunities for women, and increased security would provide a climate more conducive to fertility decline. Given the limited demand, great sensitivity must be shown in implementing family planning programs.     

Upholding the freedom of couples to use a method of their choice

A recent review of the Philippine Population Program's 5-year plan, ended in December 1982, showed that in 1980, natural family planning (NFP) users were only about 12.5% of couples practicing family planning. This figure doubled by 1982. Based on these responses the decision was made to intensify the NFP program as early as 1982. The 1st step was to put more money into the NFP program. The program includes the modern scientific techniques such as cervical mucus, basal body temperature, and sympto-thermal. The program also will fund the training of doctors and other clinic personnel and the production and distribution of appropriate training and information material. Other family planning methods, such as sterilization, oral contraception (OC) and the condom, also will be promoted. Promotion of NFP will depend on the choice of the family planning practitioners themselves. The program's community based services are being intensified. NFP, together with the other family planning methods such as sterilization and OC, will always be made available to couples in the community based services. All agencies in the population and family planning program will be promoting NFP. Knights of Columbus doctors have been invited to assist the program and share their own training modules for the training of trainers. An agreement has been entered into with the Gabriel M. Reyes Memorial Foundation based in Aklan. The goal is for trainers who need further knowledge and skills in NFP to learn from the foundation's wealth of organized orientation and training techniques in NFP. NFP is emphasized at this time because it is acceptable to a great number of couples.     

The Catholic response to the population problem

A survey of efforts led or sponsored by the Catholic church in response to the population problem in the Philippines. These efforts stem from the Church's belief that population growth is related to the overall picture of development, and that priority must go to social and economic justice. The Catholic Church of the Philippines (to which 85% of the population belong) views it as a problem basically involving care of people, and directs its efforts primarily at internal human sexual control rather than external contraceptive control. Family Life Education began as a program in the church in the 1960s. Efforts by priests, nuns, and lay leaders in Mindanao eventually resulted in counseling in husband-wife relations, marriage commitment, human sexuality, parent-child relations, and responsible parenthood, and to the creation of college courses to prepare teachers in tackling sex education. A program offering natural family planning was also started, initially for employees of a packing firm and later expanding throughout the province. In 1975, the program was launched in Manila, and a year later had 3 family life centers. The ovulation (or Billings) method is offered -- an advantage to low income people because it does not require purchase of a thermometer. Success of this method requires a sense of responsibility on the part of both husband and wife. Widespread international interest in the ovulation method has led to formation of an International Federation for Family Life Promotion, to which the Philippine Federation for Natural Family Planning has applied for membership. The IFFLP is working with the WHO Human Reproduction Unit on 2 projects, part of one of them (a field trial for evaluation) being conducted in Iligan City, Iloilo City, and Manila. Among the concerns of the IFFLP-WHO collaboration is developing a standardized Natural Family Planning curriculum or educational package.     

The participation of non-governmental organizations in the Philippine population program

In 1957 the National Council of Churches in the Philippines (NCCP) established the Family Welfare Center, offering an educational program in family planning; it was subsequently expanded and reorganized into the Planned Parenthood Movement of the Philippines. Since its creation in 1970 the Philippine Population Program has brought together government, private, and religious activities. Under the 1987-92 development plan nongovernmental organizations (NGOs) will be taking a more active role in the implementation of the population program by contributing to the maternal and child health/family planning and the information, education, and communication (IEC) components. There are more than 50 private organizations engaged in such population activities. These include national women's organizations and development NGOs with a mass base. The Family Planning Organization of the Philippines is carrying out a 3-year comparative study of the effectiveness of community volunteers in the acceptance of natural family planning. The Reproductive Health Philippines has completed a follow-up of Depo Provera defaulters in a previous clinical study of Depo Provera acceptors conducted in 1985-87. IEC support from various medical and social organizations also helped advance family planning and population awareness of the program. The Mary Johnston Hospital and Iglesia ni Kristo have been front-runners in sterilization through their mobile teams and regular clinics. On the negative side, funding constraints are threatening the very existence of some NGOs. Even those that do not face such constraints face problems related to cost effectiveness, priority setting, capability building, and staff development. A survey of the Population Center Foundation identified some urgent concerns: sharing experience in self-reliance, enhancement of the managerial skills of staff, and funding problems. NGOs complement the family planning services of the government as well as focus on the smooth flow of IEC activities.     

Massive drive to reenergize the family planning programme

A massive drive has been launched throughout India in an effort to reenergize the family planning program. The Prime Minister has made a special appeal to the nation from radio and television networks and through the press to adopt the small family norm as a way of life. The Chief Ministers and the Health Ministers in the States have made similar appeals to the people and the doctors. The current drive was preceded by 18 months of concentrated efforts to vitalize the family planning program. The change in nomenclature from "family planning" to "family welfare" created some misunderstanding regarding the government's own commitment to the program, but it is now widely understood that while family welfare aims at the total welfare of the family, family planning is an essential part of it. The government has tried to involve all sectors of society in program efforts. The mass media is now focusing attention on "family welfare" almost continuously. In villages, a large-scale program of organizing education camps of opinion leaders is now underway. The rural health scheme, initiated in October 1977, promises to bring about increased participation of the people in village programs. 54,000 community health workers have already started serving the rural population in their areas. In 2-3 years there will be 1 trained community health worker in every Indian village.     

A Population Policy Rationale for the Twenty‐First Century

I propose that the primary goal of twenty‐first‐century population policies should be to strengthen the human resource base for national and global sustainable development. I discuss the shortcomings of the three dominant twentieth‐century population policy rationales: acceptance of replacement‐level fertility as a demographic goal; realizing a “demographic dividend” from the changing age structure; and filling the “unmet need” for family planning. I demonstrate that in all three cases the explicit incorporation of education into the model changes the picture and makes female education a key population policy priority. Population policies under this new rationale could be viewed as public human resource management. I argue that 20 years after the Cairo ICPD the international community needs a new rationale for population policies in the context of sustainable development and that a focus on human capital development, in particular education and health, is the most promising approach.