Increasing contraceptive use in Bangladesh: The role of demand and supply factors

This article analyzes the determinants of contraceptive use in Bangladesh, focusing on the roles of demand for additional children and of family planning service supply. Data from the Matlab Family Planning Health Services Project are used to examine the contributions of these factors to the difference in prevalence of modern contraceptive use between the project area and a control area served by the government family planning and health programs. Results of multivariate analysis deriving from the Easterlin synthesis framework show the importance of family planning supply factors in reducing psychic and resource costs of fertility regulation and in activating latent demand for contraception. Demand for birth limiting and for birth spacing emerge as important explanatory factors; demand for birth spacing is greater in the project area, and both demand measures exert a stronger effect on contraceptive behavior in that area.     

The western fertility decline: Reflections from a chronological perspective

The study of recent fertility trends in the West has been dominated by examinations of Europe. A better perspective on twentieth-century fertility movements can be gained by giving an equal emphasis to trends in the ‘Offshoots’ (USA, Canada, Australia and New Zealand). This paper focuses on the periods of rapid fertility decline and to a greater extent on the intervening periods of near-equilibrium. It is suggested that the ‘late twentieth century compromise’ is more stable than is suggested by reports on its internal strains, and that only massive government intervention could raise fertility.     

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.     

Retrospective evidence of a decline of fertility and child mortality in Bangladesh

A detailed analysis of survey data collected in 1961–1962 for a sample of 4200 families in central East Pakistan produced consistent and reasonable estimates of birth and death rates for the preceding decade. Extremely high levels of infant and child mortality declined noticeably in the period 1952–1961. Age-specific birth rates to married women also decreased in the decade for women over the age of 19, while a small increase was recorded for married women aged 15 to 19. During the 1950s total marital fertility declined about one-fifth. Birth rates remained high in 1960 according to these estimates, but there is reason to anticipate further reductions in birth rates, particularly among older women. To improve understanding of the determinants of fertility and to aid in the formulation of policy to cope with population trends, statistical analysis must increasingly consider information on families over time. Retrospective household survey data may provide the empirical base for this line of inquiry.     

Fertility differentials as evidence of incipient fertility decline in a developing country

Abstract Age data from the 1960 and earlier censuses of Ghana allow the construction of child-woman ratios which appear to indicate the existence of a substantial urban-rural fertility differential. Plausible assumptions of urban-rural mortality differentials increase the apparent fertility differential. In this paper recently published data for Statistical Areas in the country's larger towns are used to demonstrate that one explanation for the fertility differential is almost certainly the enumeration of some females in the towns, while one or more of their surviving children were enumerated outside. Nevertheless, in 1960 the four largest towns exhibited birth levels which are likely to have been about 11% below those of the population in the surrounding regions. Roughly half the differential can be attributed to a general urban-rural differential and half to socio-economic differentials within the towns. It is shown that most fertility reduction within the towns may be explained by delayed female marriage, and that such delay is associated with extended education. It is also shown that amongst the higher socio-economic status groups a small part of the reduction can probably be attributed to the prevention of pregnancy within marriage, and that the making of such attempts is positively associated with extended education, urban birth, participation in first and monogamous marriages, Protestantism, and the holding of views about the harmful effect of high population growth rates on attempts to raise living standards. It is argued that these fertility differentials are evidence of some fertility decline among key groups in the population and that such declines are likely to become more widespread.     

Emigration and fertility decline: The case of Barbados

This paper examines the role of emigration in the recent fertility declines which have occurred on the island of Barbados. Barbados with a history of over two centuries of out-migration has experienced in the period 1951–1970 very significant migration loss. In the period 1960–1970 and up to the present fertility has been declining. An important question is what part has this net migration loss of 32,600 had on the reduction of the crude birth rate from 33.6 in 1960 or from 31.5 in 1956 to 20.5 in 1970? Using officially published net migration loss figures and supplementing them with data on Barbadians living overseas, we calculated the crude birth rates which would have occurred had there been no migration loss. We also calculated the numbers of births to be expected if certain age-specific fertility rates were maintained and compared these with the births to residents plus the calculated births to Barbadians overseas. We conclude that in both cases emigration is a very significant contributor to the fertility declines which have occurred and are still underway.     

The South African fertility decline: Evidence from two censuses and a Demographic and Health Survey

Inadequate data and apartheid policies have meant that, until recently, most demographers have not had the opportunity to investigate the level of, and trend in, the fertility of South African women. The 1996 South Africa Census and the 1998 Demographic and Health Survey provide the first widely available and nationally representative demographic data on South Africa since 1970. Using these data, this paper describes the South African fertility decline from 1955 to 1996. Having identified and adjusted for several errors in the 1996 Census data, the paper argues that total fertility at that time was 3.2 children per woman nationally, and 3.5 children per woman for African South Africans. These levels are lower than in any other sub-Saharan African country. We show also that fertility in South Africa has been falling since the 1960s. Thus, fertility transition predates the establishment of a family planning programme in the country in 1974.     

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.     

A couple analysis of micro-level supply/demand factors in fertility regulation

Demographic research in developing countries has traditionally neglected the role of male input into reproductive decision making. This has contributed significantly to the general inability to resolve the fertility problem in sub-Saharan Africa. The principal aim of this study is to apply a joint- or couple-model to the analysis of one such population problem in order to illustrate the potential avenues that emerge when the input of male spouses is considered. The 1988 Ghana Demographic and Health Survey is used to examine the need for supply- and demand-side policy in achieving fertility declines. The data indicate that, although there is some evidence of the benefit of family planning programs, it appears that there is much room for further success. Also, there is a strong indication that the demand side of the fertility equation must be addressed more, by tackling the issue of individual motivations, particularly of males, for childbearing.     

Social networks and changes in contraceptive use over time: evidence from a longitudinal study in rural Kenya

The impacts of social networks on changes in contraception in rural Kenya are investigated using special data from a longitudinal household survey. An analytic model, informed by detailed knowledge of the setting, yielded estimates that indicate that (1) social networks have substantial effects even after unobserved factors (e.g., homophily) that may determine social networks are controlled; (2) controlling for these unobserved factors may substantially alter the estimated effects of networks (these controls were not used in previous studies); (3) network effects are important for both men and women; and (4) network effects are nonlinear and asymmetric, suggesting that networks provide information primarily through social learning, rather than by exerting social influence.     

The decline of fertility: Innovation or adjustment process

Abstract In Western society the process of fertility decline is often regarded as an innovation process. The assumptions behind this approach seem rather questionable, and the diffusion lags or gradients of limited importance. Both Swedish and other European data are used as illustrations. It is suggested that the decline be treated within the wider sociological perspective of a time-consuming adjustment or change process, not necessarily starting from a position of completely uncontrolled fertility within marriage. The situation in to-day's high fertility populations is briefly discussed against this background.     

The determinants of early fertility decline in Texas

This study examines the determinants of fertility control in a frontier population made up largely of German-Americans during the years from 1850 to 1910. The analysis employs a complex register of population constructed from census enumerations, civil and ecclesiastical vital registration, and tax assessment rolls. The article begins with a series of bivariate analyses with cohort of mother’s birth, religion, ethnicity, and husband’s occupation determining marital fertility. The second half of the paper presents a multivariate model of the determinants of fertility using these and other demographic characteristics as independent variables. The conclusions emphasize the importance of the overall trend toward fertility decline in the United States, as well as the role of religion and of occupational differences, in determining changes in fertility behavior in the population of Gillespie County, Texas.     

The causal relationship between female labor supply and fertility in the USA: updated evidence via a time series multi-horizon approach

The purpose of this paper is to investigate the causality between female labor supply and fertility in the presence of auxiliary variables such as education, female wages, and male relative cohort size. We employ annual time series data spanning the period 1948 to 2007 for both an aggregate and an age-specific group. Our econometric specification follows closely the concepts and procedures proposed by Dufour and Renault (Econometrica 66(5):1099–1125, 1998) and Dufour et al. (J Econom 132:337–362, 2006) in that we conduct multi-horizon causality tests that allow for direct and indirect effects to take place. The sign and economic importance of our results is assessed via the estimation of impulse response functions. Our results establish bidirectional indirect causality between female labor supply and fertility and suggest interesting causal chains among the system variables. Causality effects are stronger for the age-specific group.     

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.     

Fertility and desired fertility: Longitudinal evidence from Thailand

Summary The validity and usefulness of 'desired additional children' and 'ideal family size' as predictors of fertility are analysed in this paper on the basis of longitudinal survey data from Thailand. First, the extent of measurement error in these variables is considered, and it is concluded that the error variance and the true variance are of similar orders of magnitude. Secondly, the changes in attitudes subsequent to births and deaths of children are investigated. It is found that the number of additional children desired is decreased by births and increased by deaths, but less than would be expected if 'desired additional children' represented an unchanging target family size. 'Ideal family size' is almost unaffected by births and deaths. Thirdly, the contribution of attitudinal variables to behavioural models is examined. It is found that desired fertility is explained no better than fertility in a standard economic model. A birth function separating desired children from identifiable physiological factors as explanatory variables indicated that the former was just significant. A model of contraceptive acceptance also found desired fertility to be a significant determinant. Thus, desired fertility can be successfully integrated into behavioural models. But on the whole, its explanatory power was weak, and it was concluded that the independent use of this variable does not significantly improve on models which relate fertility to socio-economic variables directly.     

Women's lives and rapid fertility decline: Some lessons from Bangladesh and Egypt

The recent experiences of Bangladesh and Egypt show thatfertility can sustain impressive declines even when women's lives remain severely constrained.Since the late 1970s, rural and urban areas in both countries have experienced steadydeclines in fertility, with recent declines in rural Bangladesh similar to those in ruralEgypt, despite lower levels of development and higher rates of poverty. This paperprovides an in-depth exploration of the demographic transition in these two societies andaddresses three basic questions: (1) have measurable improvements in economic opportunities forwomen been a factor in the fertility decline?; (2) can preexisting differences in gender systemsexplain the more rapid fertility decline in Bangladesh, despite the more modest economicachievements?; (3) can the development strategies adopted by the governments ofBangladesh and Egypt, be seen as additional factors in explaining the similar rural fertilitydeclines despite dissimilar economic circumstances? The paper concludes that neither gender systemsnor changes in women's opportunities appear to have contributed to declining fertility.Indeed, low levels of women's autonomy have posed no barrier to fertility decline in eithercountry. However, there is a case to be made that Bangladesh's distinct approach to development,with considerable emphasis on reaching the rural poor and women and a strong reliance onnongovernmental institutions, may have played a part in accelerating the transition in thatenvironment and in helping women to become more immediate beneficiaries of that process.

     

HIV and fertility in Africa: first evidence from population-based surveys

The historical pattern of the demographic transition suggests that fertility declines follow mortality declines, followed by a rise in human capital accumulation and economic growth. The HIV/AIDS epidemic threatens to reverse this path. We utilize recent rounds of the demographic and health surveys that link an individual woman’s fertility outcomes to her HIV status based on testing. The data allow us to distinguish the effect of own positive HIV status on fertility (which may be due to lower fecundity and other physiological reasons) from the behavioral response to higher mortality risk, as measured by the local community HIV prevalence. We show that although HIV-infected women have significantly lower fertility, local community HIV prevalence has no significant effect on noninfected women’s fertility.