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.     

人口现代化"和"生育现代化":人口发展与计划生育工作的根本目标

人口现代化和生育现代化是人口发展与计划生育工作的根本目标。计划生育就是为了实现生育的现代化,进而来推进人口的现代化。如果说人口现代化是人口发展的战略目标,那么生育现代化就是计划生育事业的战略目标。从政策的角度探讨两大命题的现实意义,在此基础上提出了稳定低生育水平的"三合一"工程。     

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.     

Below-replacement fertility of ethnic Indians in Fiji: a decomposition analysis of the components of changes in the total fertility rate

The population of Fiji consists of two major ethnic groups, Fijians and Indians; it also comprises other groups, such as Europeans, Chinese and other Pacific Islands. The 2007 Census showed that there were 56.8 % Fijians and 37.5 % Indians, with the remaining 5.7 % consisting of other groups. This paper examines ethnic variation in fertility using current fertility estimated directly from the census data. As the Fiji census continued to gather information on the relationship of mothers with their own children, this information has been used to estimate fertility trends over the past 15 years preceding the census by the application of the own-children method. Fiji has recently undergone a spectacular decline in fertility but with a marked variation between Fijians and Indians. The total fertility rate (TFR) among Indians dropped to 2.8 in 1986 and 2.5 in 1996. It continued to decline further, approaching below the replacement fertility of 1.9 in 2007. By contrast, Fijian fertility reached 3.9 in 1996. As with that of Indians, Fijian fertility also fell sharply, to 3.2 in 2007. This paper uses a decomposition analysis technique to determine the components of changes in the TFRs due to marital structure and marital fertility among Fijians and Indians, covering the intercensal periods, 1966–1976, 1976–1986, 1986–1996 and 1996–2007.     

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.     

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.     

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.     

中国生育现代化问题的定量研究

本文主要对我国生育现代化进行了一些定量研究 ,构造了生育现代化综合指数 ,在历史及省际比较的基础上认为我国生育现代化自建国以来呈波浪形上升演进过程 ,省际差异大而且生育现代化内部各方面发展不平衡。     

Evolution of fertility and mortality

Historical and current fertility trends in both Quebec and Canada as a whole are surveyed. While fertility among French Canadians was higher than that in neighboring provinces until the mid-20th century, in 1968 Quebec's crude birthrate was the lowest in Canada, and in 1972 it was 13.8 vs. 15.9 (the national birthrate). This reversal is explained in terms of the demographic transition theory, the declining influence of organized religion, and new opportunities for social mobility for minority groups. The birthrate throughout Canada is also declining. Although recent cohort studies are incomplete because women have not yet finished their reproductive years, it appears that completed family size will be lower than at any time in Canadian history. The period total fertility rate indicates an average family size of 1.8 children in 1976, but it is unclear whether this represents an actual reduction in family size or the postponement of childbearing. The sharpest fertility decline has been among women aged 35-49, but peak fertility rates have shifted from the 20-24 age group to those aged 25-29. Fertility is negatively related to education, and the lowest fertility is found among the intermediate income groups. Since the 1969 lifting of the ban on contraceptive sales and advertising, family planning activities have been stepped up. Also removed was the total ban on abortion. In 1975 there were 14.9 therapeutic abortions per 100 live births, but it has been charged that abortion standards are being applied inequitably from hospital to hospital.     

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.     

非政策因素对我国生育率影响的量化分析

以西方生育率变动理论为依据,利用中国第五次人口普查的省区截面数据,采用路径分析法对影响中国生育率的非政策因素进行量化分析。目前对生育率直接效应最大的非政策因素是社会经济发展水平,妇女的受教育状况次之,避孕节育对生育率的影响已经减弱;同时还发现社会经济发展水平主要是直接或通过教育因素间接对综合生育率产生影响,而教育对综合生育率的影响除了直接或通过避孕节育间接发生作用外,还有一些影响是通过模型以外的其他要素来发生作用的。     

Health as a context for social and gender activism: female volunteer health workers in Iran

Having reversed its pronatalist policies in 1988, the Islamic Republic of Iran implemented one of the most successful family planning programs in the developing world. This achievement, particularly in urban centers, is largely attributable to a large women-led volunteer health worker program for low-income urban neighborhoods. Research in three cities demonstrates that this successful program has had a host of unintended consequences. In a context where citizen mobilization and activism are highly restricted, volunteers have seized this new state-sanctioned space and successfully negotiated many of the familial, cultural, and state restrictions on women. They have expanded their mandate from one focused on health activism into one of social, if not political, activism, highlighting the ways in which citizens blur the boundaries of state and civil society under restrictive political systems prevalent in many of the Middle Eastern societies.     

An analysis of major proximate determinants of our fertility]

The sample survey of fertility, in Shanghai city and Shanxi and Hebei provinces of China in 1985, provided plentiful data about fertility, marriage, contraceptive usage and breastfeeding in terms of The World Fertility Survey Model. The data, along with Bongaarts' model, was utilized to analyze the relation between several proximate determinants and fertility changes. When comparing these three geographic areas, the largest difference was breastfeeding and the smallest one was non- contraceptive usage. It was very different from the results of The World Fertility Survey in developing countries in 1977. The difference of marriage indexes among three areas was close to that of breastfeeding; but for the effects on induction of fertility, marriage index surpassed breastfeeding. There were two models showing effective efficacy on fertility decline. One was the Shanghai model, in which much more effect came from marriage delay, accounting for 71%; another was the Hebei model, induction of fertility was caused by contraceptive usage, about 53%. Both indicated that the major factor affecting fertility decline was the family planning program. Otherwise, it seemed to indicate that different factors such as social, economic development indirectly decreased fertility through family planning programs.     

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.     

Fertility trends in Taiwan: Tradition and change

Fertility rates have been falling In Taiwan for several years. The declines appear to be general throughout the island, and are occurring mainly in the age groups above 50, as would be expected if there are beginnings of family limitation. There are indications that the fertility rates are negatively correlated with indices of modernization In local areas. Several pilot studies indicate a consensus in the population on the desirability of a moderate number of children, the desirability of the Idea of family planning, a positive valuation of such traditional Chinese values as the joint family and support of parents by their children In old age. In one urban area studied, a substantial minority of wives 25–29 years old have used a family planning method already. The “pre-pregnancy health program” of the Provincial Health Department has been quite successful in providing service to interested couples, and among these couples the programme is demonstrably effective in reducing birth rates. Data from the various sources are consistent with the speculation that Taiwanese couples want to use modern family planning methods to maintain elements of the traditional Chinese family in a modern setting.     

Womens education and diffusion of the fertility transition: The case of Egypt 1960–1996 in 4905 administrative subdivisions

Egypt comprises thousands of small geographic units. Total fertility rates are reconstructed for the 4905qism, qarya, medina, markaz andshiyakhat covering non-desert Egypt at the 1960, 1976, 1986 and 1996 censuses. This fine spatial scale reveals that heterogeneity across subdivisions increased during the fertility transition, illustrating the rapidity of change. Spatial patterns appear in the fertility upsurge of 1974–85, which is accompanied by a large but temporary reduction in heterogeneity. Fertility varies greatly between subdivisions and geographic differentials underlie the expected and observed association between fertility, literacy, family transfers and industrialization. Cairo led the decline of fertility, but that decline is counterbalanced by rapid economic growth and persistently high levels of illiteracy. A similar pattern of fertility change is observed for the chief city of the Muhafaza and its surrounding area. Egypt presents an archetype of demographic transition as improved economic and educational status diffuses across the country, moderated by its specific geography.     

Republic of Korea. Country feature

The Government of Korea's 5th 5-Year Economic and Social Development Plan (1982-86) seeks to reduce the population growth rate from its 1982 level of 1.58% to 1.49% by 1986; it is assumed that the population replacement level of fertility (total fertility rate, 2.1) will be attained in 1988. The task of achieving these demographic targets is expected to be made more difficult by factors such as the impact of the 1950s baby boom and widespread son preference. New population control policy measures announced in 1981 call for improvements in the current family planning program management system; a new social and institutional support system to inculcate the small family size norm; strengthened information, education, and communication activities for family planning; and establishment of coordination among the government organizations involved in population-related activities. Numerous social support measures have already been put into effect, including income tax exemptions for up to 2 children, inclusion of population education in the school curriculum, priority in alloting public housing to sterilization acceptors with 2 or fewer children, and provision of IUD services through the medical insurance system. The number of contraceptive acceptors in the government program increased 78.3% from 1981-83, from 614,000 to 1,094,600. Sterilization and menstrual regulation services have shown particularly sharp increases. Program achievement for 1983 was equivalent to 19% of eligible women ages 15-44 years. The total fertility rate stood at 2.7 in 1982. Major efforts now must be directed toward eradicating the strong parental son preference and ensuring better family planning program efficiency and effectiveness.     

再论“四二一”结构:定义与研究方法

"四二一"结构是中国低生育率背景下家庭结构与代际关系的一种特殊表达,既反映了20世纪70年代以来计划生育政策广泛推行对中国家庭的深刻影响,又揭示了中国现阶段婚姻家庭乃至未来人口发展的特点与趋势。目前这一领域的研究虽然已经取得一系列的进展,但在概念界定与使用的方法上仍缺乏共识,导致研究结论的分歧和研究拓展的迟滞。在中国社会剧烈变动的形势下,"四二一"结构是研究中国的计划生育政策、独生子女问题,以及家庭结构与代际关系变动的一个良好的载体和切入点。     

Fertility in botswana: The recent decline and future prospects

Recent estimates of fertility in Botswana suggest a rapid decline of more than two births per woman between 1981 and 1988. This paper proposes that the baseline fertility was overestimated but that nonetheless fertility declined by about one birth per woman during the 1980s. The decline in fertility was linked to a deterioration in social and economic conditions caused by a major drought in the early 1980s and to the increased availability of family planning services in the same period. Fertility apparently began to rebound in the late 1980s in response to improved conditions, which came about as a result of a successful drought relief program. Future declines in fertility depend on the continued success of the family planning program, particularly in rural areas.