Population planning in Asia in the 1970s

Summary To what extent is family planning integrated with broader population planning in the countries of East Asia and South Asia? To what degree do these countries combine population planning with economic and social planning in their development plans? An attempt to answer these questions suggests that, despite variability from country to country in development goals and policy implementation, family planning has been largely separated from economic planning, and birth control programmes have often been substituted for intermediate and long-range population planning. Demographic factors have been treated as exogenous variables rather than as integral parts of social-economic-demographic plans. Such comprehensive planning is difficult for both technical and political reasons, but in any case is unlikely to be achieved so long as family planning and population planning continue to be confused.     

A components method for measuring the impact of a family planning program on birth rates

One of the major goals of family planning programs worldwide has been to reduce the level of fertility in hopes of slowing the rate of natural increase and promoting social and economic development. Such programs have now been in existence for sufficient lengths of time to have had an impact on fertility levels. In general countries with organized family planning programs, marked declines in fertility levels have been observed. The extent to which such declines may be credited to organized programs has not been rigorously measured because an appropriate research methodology has been lacking. This paper describes one method of directly linking declines in fertility levels to the contraceptive protection experienced by a population. The contribution of organized family planning programs is estimated by decomposing the amount of total contraceptive protection into within-program and outside-program sources.     

Status of National Family Planning Programmes of Developing Countries in relation to demographic targets

Abstract Having arisen within the context of social and economic development plans, demographic targets associated with family planning programmes in developing countries stipulate levels deemed desirable or necessary to implement economic goals. Since an optimum fertility path for economic development is open to conjecture, targets tend to be vague or arbitrary, and generally imply a fertility decline that goes beyond family limitation based on health considerations. While on the one hand, programme administrators have assumed responsibility for these targets, on the other hand they have structured their programmes toward health, not demographic, goals. As a result, they have minimized rather tham maximized the contribution of the programmes to the targets. of the 24 countries with programmes designed to reduce birth rates, the demographic variable is on target in seven; in six, review is premature; five cannot be evaluated because targets are non-quantifiable or vital data are too uncertain; and in six, including India and Pakistan, progress has been poor, at least in relation to targets. The demographic target is only one of many models and techniques for programme evaluation, although many require data not often available in developing countries. An estimate of births averted based directly on programme activities is not only complex but speculative. However, in contrast to the target criterion, cost benefit analyses involving the estimated return for an averted birth indicate that the programmes are a highly profitable investment.     

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.     

A comment on ‘social and economic factors in Hong Kong's fertility decline’ by Sui-Ying Wat and R. W. Hodge

The recent article by Wat and Hodge appears to make incorrect inferences about the relation of certain social and economic indicators (infant mortality, employment opportunities for women, and education) to Hong Kong's fertility decline, based on a multiple regression of these variables to the crude birth rate of Hong Kong for 1951–1967. Such modernization measures probably have at least a long-run causal relation to fertility decline. It is also possible that the family planning programme ofHong Kong may have added little to the effects, as the authors suggest. However, I do not believe that their multiple regression analysis establishes these conclusions.     

A comment on 'social and economic factors in Hong Kong's fertility decline' by Sui-Ying Wat and R. W. Hodge

Abstract The recent article by Wat and Hodge appears to make incorrect inferences about the relation of certain social and economic indicators (infant mortality, employment opportunities for women, and education) to Hong Kong's fertility decline, based on a multiple regression of these variables to the crude birth rate of Hong Kong for 1951-1967. Such modernization measures probably have at least a long-run causal relation to fertility decline. It is also possible that the family planning programme ofHong Kong may have added little to the effects, as the authors suggest. However, I do not believe that their multiple regression analysis establishes these conclusions.     

Family planning in Taiwan, Republic of China: Progress and prospects

Abstract The family planning programme in Taiwan is considered to have been most successful and has been systematically evaluated. In the light of some expressed scepticism, however, its impact on fertility will have to be carefully reviewed. The present article discusses six specific problems : How many women have accepted the Lippes loops or pills offered in the programme ? How long will the loop stay in utero ? What proportion of married women is currently wearing the loops ? What changes have occurred in the knowledge-attitude-practice (KAP) of family planning among the target population ? How many births have been prevented by the IUD programme ? And finally, How much has fertility declined ? The fertility decline in Taiwan has been accelerating since the programme started in 1964. Approximately 40% of the decline in the birth rate, from 36.3 in 1963 to 27.7 in 1969, or 8.5 points per 1,000 in six years, however, was due to changes in age structure and delayed marriage. An increasing proportion of girls of marriageable age and a possible increase in the fecundability of the population will work against the programme's objective. Concerted efforts and heavier investment are essential for the final success of the programme.     

The relation of economic class and fertility: An analysis of some Indonesian data

Summary Many recent fertility studies in developing societies put forward the hypothesis of a negative relation between economic class and fertility. Data showing a positive relationship are frequently dismissed a priori as resulting from the reporting errors of illiterate women. This study draws on data from Indonesia's 1971 Census, a 1973 sample survey of fertility and mortality, and an intensive community study in Java, to argue that an observed positive relation between class and fertility is real, and is related to differences in patterns of marital disruption, postpartum abstinence, and fecundity. The positive relation may be reversed in the future as changes in these patterns, and the impact of the national family planning programme, affect the family structure of each class differently. Had the positive relation in this context been attributed offhand to reporting errors, these important socio-economic changes would have been misunderstood, and possibly ignored.     

基层民主自治进程中乡村计划生育政策落实的困境及出路——基于基层治理中“不出事逻辑”的分析视角

本文对基层民主自治进程中乡村计划生育政策落实的困境及出路进行了探讨。基层民主自治是我国的一项基本政治制度,实行基层民主自治是发展中国特色社会主义民主政治的重要内容。但是在乡村推行基层民主自治的过程中,乡村计划生育政策的落实陷入一些困境,这些困境集中表现为计生政策与村民生育愿望、与村委会选举、与社会保障体系、与利益导向机制及与其它相关部门和政策的冲突与矛盾。鉴于此,本文相对应地提出了加强宣传教育、完善村民自治、健全社会保障体系、健全舆论导向机制以及加强政策的同向性与协调度等对策建议,以期推动计划生育政策在乡村进一步落实。     

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.     

Socialist system creates favourable social environment for fertility decline in China

The Chinese experience suggests that the socialist system can create more favorable conditions for a decline in fertility than the capitalist system. This is related to 5 factors: 1) changes in the traditional functions of the nuclear family; 2) popularization of education and the transmission of culture; 3) improvements in the status of women; 4) rapid decreases in mortality, especially infant mortality; and 5) social security for the aged. In addition, the structure of social organizations and the widespread dissemination of information about birth control methods have facilitated family planning practice. The impact of theswe structural factors has been intensfied by the Chinese social environment, which has changed individual attitudes toward family size. Overall, the social environment has created attitudinal change while implementaton of the national family planning policy has made the fertility decline in China possible.     

The child survival hypothesis

Summary Because of current interest in the child survival hypothesis, we have reviewed available evidence bearing upon the relationships of infant and child mortality to fertility and contraceptive behaviour. The evidence is drawn from time series data for local and national vital events, from special in-depth studies of the infant mortality-fertility relationships in family formation, and from service statistics from health and family planning programmes. As a result of this review, we suggest five clarifications which should be made in redefining the child survival hypothesis and assessing its potential programme implications. The child survival hypothesis states that improved child survival will contribute to increased family planning motivation and consequent fertility decline. The evidence presented here suggests that the effect is not automatic and probably not a necessary pre-condition for fertility decline. There is certainly not a reflexive one-to-one replacement, but a partial effect may still be important. In the clearly demonstrated reduction in inter-pregnancy intervals after a child death, the major component is undoubtedly the removal of the biological protection of lactational amenorrhoea. A separate but somewhat smaller effect has been demonstrated in situations where lactation did not seem to have been the explanation. It is expected that increased child survival will contribute to fertility decline mainly in countries experiencing rapid mortality decline and population growth. The replacement of children who die is probably not so much 'volitional' as a result of alterations in sub-conscious expectations. It is apparent that in traditional agrarian populations, few direct and manipulable means of influencing motivation for fertility limitation are available, and, therefore, it must be stressed that integrated health and family planning programmes do provide opportunities for immediate programme development. By making parents aware of improved changes of survival through health services in which they develop confidence, the spontaneous linkages between mortality and fertility can presumably be reinforced. Family planning services must be provided as an essential initial step in programme development, but they can be made more effective, as well as politically more acceptable if appropriately integrated with maternal and child health and nutrition services.     

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.     

Theoretical explanation of rapid decline in China's fertility]

China's fertility decline is widely acknowledged. The 1982 census and a random survey of 1/1,000th of the nation's population set the total fertility rate at 2.6%. Bureau of statistics data collected in 1984 showed the nation's birth rate as 1.7% and total fertility rate 1.94%. Friendly observers call this a miracle; others blame the decline on forced government family planning policy. Scientific pursuit of the causes for the decline is an issue of practical and realistic value. First, favorable conditions for fertility decline have been fostered by the socialist system and are deeply rooted in the country's economic development. China's industrialization and urbanization have brought new lifestyles and liberated individuals and families from the constraints of traditional family life. Couples have chosen to limit the number of children, to enhance the quality of life and education potential of their children, thus altering the traditional high fertility in China. Education of women has played a role in raising women's consciousness; a 1982 census placed the fertility rate of women with high-school level education or above, lower than that for less or uneducated women. Neonatal mortality rate decline is also related to the spontaneous decline in fertility rate, as high fertility has historically been intended to compensate for high child mortality rates. Welfare and social security systems for the elderly have also helped change the traditional mentality of having many children as assurance of life support in old age. Social organizations have accelerated knowledge and methods of planned fertility. Later marriages are also a factor: in 1970 the average marriage age was 19 - 20 and had increased by 1976 to 22 - 23. Other favorable social factors include free birth control and the view of population planning as an essential part of national welfare.     

Adolescent sexuality in Asia: new focus for population policy

As the age at marriage continues to rise in East and Southeast Asia, the fertility behavior of unmarried teenagers is receiving more attention from population policymakers. In addition to fertility reduction through family planning, Asian societies today consider population planning strategies in relation to national needs and social goals, including such matters as the population's growth rate, age structure, educational quality and skills. The number of single youth in Asia is growing much more rapidly than the total youth population. By the year 2010, for example, India is projected to have nearly 70 million single teenagers, aged 15-19, 188% more than in 1980. In many developing countries today, such as the Philippines and Korea, the rising age at marriage has combined with rapid urbanization, improved status for women, and more educational opportunity to alter both the behavioral norms of young people and the traditional means of social control over youth. Studies of contemporary adolescent sexuality have been conducted in 4 Asian countries. In the Philippines an overt independent youth homosexual culture was found to exist in urban and to some extent rural areas. In Thailand research revealed little conservative resistance to family planning or to contraceptives for young unmarried people. Surveys in Taiwan indicate that behavior related to dating and choice of spouse has become more liberal, and a survey in Hong Kong revealed a higher level of premarital sex and use of prostitutes among Chinese men than expected. Population policy perspectives that need to be considered in these changing times include: 1) issues of access to family planning services by unmarried people below the legal age of maturity; 2) the development of social institutions, such as exist in Thailand and the Philippines, to guide adolescents' behavior; 3) more extensive study of adolescent sexuality; 4) establishment of the scope of family policy.     

Assessment of family planning programme effects on births: Preliminary results obtained through direct matching of birth and programme acceptor records

Abstract In order to match birth and family planning acceptance records and thereby to obtain estimates of pre- and post-acceptance fertility, use is made of seven-digit national identity card numbers, issued to all adult West Malaysians. These unique numbers are recorded on live-birth records and national family planning programme acceptor records of West Malaysian women. The application and preliminary results of this method of direct computer matching of these sets of records for assessing the effects of a family planning programme on fertility are described. Pre- and post-acceptance fertility rates are presented in terms of contraceptive methods used, and the key characteristics of race and age of programme acceptors, and are discussed in terms of marital duration and number of children at the time of acceptance.     

The Bangladesh fertility decline: an interpretation

The claim has been made, notably in a 1994 World Bank report, that the Bangladesh fertility decline shows that efficient national family planning programs can achieve major fertility declines even in countries that are very poor, and even if females have a low status and significant socioeconomic change has not occurred. This article challenges this claim on the grounds that Bangladesh did experience major social and economic change, real and perceived, over the last two decades. This proposition is supported by official data and by findings of the authors' 1997 field study in rural southeast Bangladesh. That study demonstrates that most Bangladeshis believe that conditions are very different from the situation a generation ago and that on balance there has been improvement. Most also believe that more decisions must now be made by individuals, and these include decisions to have fewer children. In helping to achieve these new fertility aims, however, the services provided by the family planning program constituted an important input.     

Pakistan's population growth: the need for action

Despite the existence of a national family planning program that dates to 1965 Pakistan has not seen a reduction in the fertility rate. One of the poorest countries in the world, Pakistan has 1 of the highest population growth rates in the world at about 3.0% annually. For over 2 decades, the average woman in Pakistan has given birth to more than 6 children. At the current fertility rate, the country's current population of 120 million will increase to over 150 million by the year 2000, and it will increase to 280 million by 2020. And even if today every woman were to begin having only 2 children, the population would still reach 160 million before leveling off. But reducing fertility in Pakistan will prove difficult. One of the leading obstacles is the low status of women. Few women in Pakistan have advanced education or professional jobs. Only 1/4 of those women without education or who are not working have any knowledge concerning contraception. Family size and composition also fuel the high rate of fertility. On the average, women desire 5 children (the fact that women average more than 5 suggests an unmet need for contraception). And due to social, cultural, and economic conditions, Pakistanis generally prefer male offsprings. Islamic opposition to family planning has also contributed to the continued high rates of fertility. Finally, administrative and management weaknesses have hindered Pakistan's family planning program. In order to overcome these obstacles, Pakistan will have to enlist the commitment of political, religious, and community leaders. The status of women will have to be improved, and the attitudes of people will need to change.     

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.     

论计划生育政策对实现福利适度人口的意义

我国人口问题十分严重,人口因素很难自发地与社会其他要素相适应,不利于社会经济的全面协调与可持续发展,对社会福利目标的实现构成了一定阻碍。我国计划生育政策的实施,解决了生育率与死亡率不对称性的矛盾,解决了物质资料再生产与人类自身再生产不平衡性的矛盾,解决了家庭生育计划与社会适度人口不一致性的矛盾,促进了人口因素与其他社会因素的协调与可持续性发展。