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.     

Prospective study of birth interval dynamics in rural Bangladesh

Abstract A group of 209 married, fecund women in rural Bangladesh were studied prospectively for 24 months from 1969 to 1971 to define some of the biological and sociological factors relating to fertility performance. These women were selected from a larger study population of 112,000 that had been followed with a daily house-to-house vital registration programme since 1966. The selected women were interviewed bi-weekly and were asked questions about menstruation, pregnancy, lactation, husband's occupational absences, and monthly urine tests for pregnancy were taken. The results for 193 non-contracepting women revealed that the seasonal pattern of births previously observed in this population could be associated with a corresponding seasonal pattern of conceptions and that this was due to a seasonal trend in fecundability. The highest conception rates were in the coolest months of the year. Post-partum lactational amenorrhoea was very prolonged, averaging 17 months for women with a surviving child. The appearance of the first post-partum menstrual flow (onset of ovulation) also had a seasonal trend which could not be adequately explained. The median waiting time to conception, once menstruation had resumed was eight months. This interval was influenced by seasonal fluctuations, as well as by the age of women and by husbands' absences. The foetal wastage rate was 15·0 per 100 conceptions, with 62 per cent of the foetal losses occurring during the second month of gestation. Overall, the average birth interval was 33 months, with the prolonged lactational amenorrhoea accounting for almost 45 per cent of this interval. From the Department of Population Dynamics, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland 21205.     

Prospective study of birth interval dynamics in rural Bangladesh

A group of 209 married, fecund women in rural Bangladesh were studied prospectively for 24 months from 1969 to 1971 to define some of the biological and sociological factors relating to fertility performance. These women were selected from a larger study population of 112,000 that had been followed with a daily house-to-house vital registration programme since 1966. The selected women were interviewed bi-weekly and were asked questions about menstruation, pregnancy, lactation, husband's occupational absences, and monthly urine tests for pregnancy were taken. The results for 193 non-contracepting women revealed that the seasonal pattern of births previously observed in this population could be associated with a corresponding seasonal pattern of conceptions and that this was due to a seasonal trend in fecundability. The highest conception rates were in the coolest months of the year. Post-partum lactational amenorrhoea was very prolonged, averaging 17 months for women with a surviving child. The appearance of the first post-partum menstrual flow (onset of ovulation) also had a seasonal trend which could not be adequately explained. The median waiting time to conception, once menstruation had resumed was eight months. This interval was influenced by seasonal fluctuations, as well as by the age of women and by husbands' absences. The foetal wastage rate was 15·0 per 100 conceptions, with 62 per cent of the foetal losses occurring during the second month of gestation. Overall, the average birth interval was 33 months, with the prolonged lactational amenorrhoea accounting for almost 45 per cent of this interval.      

The evolution of family planning in an African city: Ibadan, Nigeria

Summary Data drawn from a 1973 probability sample of 6,606 Yoruba females, 15-59 years of age in Ibadan City, Nigeria, are employed to analyse changing family planning practice over time. Usage and method rates are calculated for broad age groups from 1930 to 1973. Contraceptive practice is shown to have increased rapidly during the 1960s and early 1970s, from a very low initial base with a doubling period for the proportion of contraceptors of about four years, so that by 1973 one-sixth of the women had practised contraception and one-ninth were currently doing so. The major determinant of contraceptive practice is education. Oral contraceptives and IUDs account for an ever larger proportion of all contraception over time and together made up over 50 per cent by 1973. The Ibadan data give strong support to a suggestion emanating from scattered findings elsewhere that there is a special pattern of sub-Saharan contraceptive use: it begins with use in pre-marital and extra-marital relationships; then is increasingly employed as a substitute for post-marital sexual abstinence, and only later becomes the means for limiting the size of the family. Hence, the success of a family planning programme is indicated by rising average parity among the acceptors. Most couples in Ibadan will probably be practising contraception at some time in the 1980s, but even then such rates will probably still be low in rural areas.     

Family planning achievements as suggested by changes of total fertility and party birth rate]

The dynamic characteristics of China's 5 distinct stages of population development since the People's Republic of China was established in 1949, namely, 1950-1958, 1959-1963, 1964-1970, 1971-1981, and 1982-present, are outlined and discussed. By tracing both the overall rate of population growth and age-specific fertility rates for women aged 15-45 (5-year groups), a clear pattern emerges which indicates that the rates of early and late fertility (ages groups 15-19 and 30-45) are significantly declining. This is interpreted as a key factor in the overall decline in fertility rate. Annual statistics showing the number of children per woman of childbearing age and interval between 1st marriage and 1st birth are compared and discussed. It is concluded that the overall decline in birth rate and fertility rate since the 1970's is attributable to China's successful family planning campaign.     

Methods for estimating the number of the Cryptomeria red mite, especially with the removal by solutions

Summary We compared the removal by solution, the represented count-area method and the beating, for the purpose of estimating the number of the Cryptomeria red mite. Among them the solution procedure provided the smallest standard error as per cent of the mean. 0.25 per cent unheated solution of sodium hydroxide is used for the summer generation, and also 0.25 per cent boiling one for the winter eggs. The mean proportion removed±standard error for the summer eggs and the winter eggs were 0.8770±0.0316 and 0.7920±0.0281 respectively, while 0.9894±0.0050 for the mites.     

The changing influence of religion on U.S. fertility: Evidence from rhode Island

Traditionally one of the indisputable generalizations in demography has been that Catholics have higher fertility than Protestants and Jews (Freedman, Whelpton, & Campbell 1959; Ryder & Westoff 1971; Westoff, Potter, & Sagi 1964; Whelpton, Campbell, & Patterson 1966). Recently, however, doubts have been raised about the continued validity of this longstanding and heretofore widely accepted generalization.     

A Family planning survey in four Delhi villages

A family planning attitude survey was conducted in four villages near metropolitan Delhi. Information was obtained through questionnaires from 455 currently married females of reproductive age: Of the women interviewed, 50 per cent were aware of family planning, 19 per cent had knowledge of a method and only 3 per cent used birth control methods. The method most commonly practised was prolonged lactation. Of the women interviewed, 253 were willing to learn about family planning; they said there was little opposition from their family members. These women thought that a family should have four children, and spacing between them should be roughly four years.     

Change of marital fertility in China from 1964 to 1981]

In 1982 the Chinese National Family Planning Commission conducted a nationwide (excepting Taiwan and Tibet) .001 random sampling of the total population to gather data on the fertility and age structures of married women. In comparing general marital fertility and standardized fertility, findings show that from 1964 to 1970 both rates averaged 225.1/1000. When family planning work began on a wide scale in 1971, the rates steadily declined, reaching 116.7/1000 in 1980. However, in 1967-68 the standard fertility rate rose by 21.34% due to the chaos of the Cultural Revolution, and in 1980-81 the rate increased by 13.2%, indicating that problems still remain in family planning. The total marital fertility rate dropped 2.84/1000 from 1964 to 1981. The rate of decline in rural areas was greater than in the cities, but the cities had a larger percentage decline than the countryside. In the 5-year periods of 1965, 1970, 1975, and 1980, marital fertility rates tended to decline in 1970 and 1975 among women aged 30-40 years because during those periods greater control was placed on women having multiple children. For 1980 and 1975, combined total rates for 15-19 year olds dropped 17.1%, but the combined total rates of 30-49 year olds dropped by 61.2%, indicating that in recent years the drop in marital fertility is mostly among those over 30 years of age.     

The role of contraceptive supply and demand in Mexican fertility decline: evidence from a microdemographic study

This paper uses retrospective life history data to assess the impact of family planning services on contraceptive use in a rural Mexican township. Between 1960 and 1990 contraceptive use rose and fertility declined dramatically. Both contraceptive supply and demand factors were influential in these trends. The start of the government-sponsored family planning programme in the late 1970s was associated with a sharp rise in female sterilization and use of the IUD. However, once we controlled for the changing socio-economic and demographic characteristics of the sample, the presence of family planning services had no significant effect on the likelihood that women used modern reversible methods compared to traditional methods. Men and women expressed concerns about the safety of modern methods such as the pill and the IUD. Efforts to increase modern contraceptive use should place greater emphasis on communicating the safety of these methods and improving the quality of services.     

The Role of Contraceptive Supply and Demand in Mexican Fertility Decline: Evidence from a Microdemographic Study

This paper uses retrospective life history data to assess the impact of family planning services on contraceptive use in a rural Mexican township. Between 1960 and 1990 contraceptive use rose and fertility declined dramatically. Both contraceptive supply and demand factors were influential in these trends. The start of the government-sponsored family planning programme in the late 1970s was associated with a sharp rise in female sterilization and use of the IUD. However, once we controlled for the changing socio-economic and demographic characteristics of the sample, the presence of family planning services had no significant effect on the likelihood that women used modern reversible methods compared to traditional methods. Men and women expressed concerns about the safety of modern methods such as the pill and the IUD. Efforts to increase modern contraceptive use should place greater emphasis on communicating the safety of these methods and improving the quality of services.     

Family planning in choiseul province,Solomon Islands

The results presented are from a rural prevalence survey on family planning in Choiseul Province, Solomon Islands. Married women aged 15–49 years with at least one living child and married men whose wife met the same criteria, provided data on knowledge, attitudes and practices of contraceptive use. Fifty one per cent of the female sample were using some form of contraception, 26 per cent reversible and 25 per cent non-reversible methods. Sixty-five per cent of men claimed that they or their spouse were using a method of family planning. Tubal ligation was the most common currently used method (25 per cent in the female survey). Desired family size was four for both males and females. Knowledge and approval of family planning was high, with 83 per cent of females and 81 per cent of males knowing of at least one method. Problems in accessing information and services for family planning include cultural and logistical constraints. Religious affiliation was the major variable affecting knowledge, use and approval of contraceptive methods. Nearly a quarter of the sample lived further than two hours travel time from the nearest health clinic supplying contraceptive methods. These clinics often have only an intermittent availability of supplies. A strong interest in family planning was demonstrated by both respondents and service providers.     

Mothers' Education and Survival of Female Children in a Rural Area of Bangladesh

In this paper it is investigated whether the positive effect of mothers' education on child survival is similar for boys and girls in Matlab, Bangladesh. The study is based on follow-up of 7,913 live births that occurred in the study area during the whole of 1982. The five independent variables included in the analysis are: sex of children, mother's education, mother's age at the time of birth, household economic condition, and health programme block. Hazard analysis shows that the positive effect of mother's education on child survival is different for boys and girls. For boys, a change in mother's education from no schooling to 1–5 years resulted in reducing the predicted risk of death by 45 per cent, while for the girls the reduction came to only seven per cent. Similarly, a change in mother's education from no schooling to six or more years of schooling resulted in a reduction of risk of 70 per cent for boys, while for girls it was only 32 per cent.     

Population activities of the United States government

The editor's comment in this issue of the journal cites 5 overlapping phases in the evolution of population and family planning programs in the United States. The phases are 1) collecting census data and vital statistics, 1790-, 2) family planning assistance to developing nations, 1963, 3) family planning assistance to the U.S. "disadvantaged," 1964-, 4) overpopulation as a national concern, 1969-, and 5) the multiple action phase, 197? (phase including diverse steps to limit population growth and occurring after basic attitudes toward human reproduction have changed). The issue of the journal focuses on total population size and rates of population increase rather than on the distribution of population, and on federal action rather than on the activities of state and local governments. The editor's comment is followed by an extensive discussion of population activities of the United States government, especially since 1963. Topics discussed include demographic data, international programs, research, federally subsidized family planning services, medical care programs, educational and international programs, national growth policy, and the roles of the legislative and executive branches of government. A directory listing federal agencies with substantial and identifiable programs concerned with population and family planning is appended.     

Effect of declines in mortality on the birth rate and related measures

In December 1961, the government of the Republic of Korea adopted a programme of family planning as part of its public health services. In 1962 a pilot research project was begun, under university auspices, with the object of demonstrating and assessing what can be achieved through intensive family planning education and services. Wondang Myun near Seoul, with a rural population of 9,000 in seven villages, was chosen for the study. A baseline survey covering attitudes and practices related to family planning was made of the population under study, as well as of a similar population in the control area of Kimpo Myun. This report outlines the design, the programme of education and services, and some of the preliminary results of the study. After eighteen months of the programme, acceptance of birth control measures increased fourfold among the married women in the fertile age range. Acceptance was highest among the 25–39 age group, and among high-parity women. Economic considerations were foremost among the reasons given for adopting family planning. Among the traditional methods offered, the condom was the favoured method of choice, indicating that husbands were taking the initiative in contraceptive practice. A decline in the crude birth index was observed; whether the decline was due more to contraceptive practice or to abortion, at least an increase is reflected in the effective desire for family limitation. The high failure rate among Users should be investigated further. Continued effort is needed to provide more information and detailed instruction to users, and to develop social circumstances that support the practice of family planning. Along with an effort to achieve more effective use of traditional methods, other methods, including intra-uterine devices, deserve trial.     

Family planning in Malta

Abstract The crude birth rate has dropped dramatically in Malta(1) over the post-war period, from 36·0 per 1,000 population in 1948 to 17·1 in 1971. A drop of this magnitude is not uncommon(2) although it rarely occurs so fast.     

The trends of contraceptives of people in Shanghai since early 1980s

Shanghai has had the lowest fertility rate in China for many years. Shanghai had a negative rate of natural growth during 1990-95. During 1980-93, fertility dropped continuously. In 1982, contraceptive use among married women included 29.47% using IUDs, 29.33% using oral pills, 23.44% using female sterilization, and 10.48% using condoms. Contraceptive prevalence declined slightly from 98.6% in 1982 to 92.29% in 1993. By 1993, method use changed. Oral pill and female sterilization use declined to 8.04% and 7.22%, respectively, among married women of reproductive age. IUD use increased dramatically to 72.2% in 1993. Condom use declined to 8.83% of total users. Despite reduced contraceptive prevalence, the birth rate declined from 18.51/1000 population in 1982 to 6.50/1000 population in 1993. The proportion of women accepting the one-child certificate increased from 53.32% of all married women of reproductive age in 1984 to 70.13% in 1993. The shift use of contraceptive methods means reliance on long-term reversible methods.     

Cagayan de Oro taps own resources to cope with population problem

In 1972, the Model City Population Planning Project (MCPPP) was begun in the Philippine city of Cagayan de Oro. The MCPPP was an attempt to encourage family planning on the community level. Funding was provided by the Ford Foundation for the program in 1974, for 2 years. There were 5 main objectives of the program: to provide family planning information to parents, to test small scale projects which could be applied elsewhere in the country, to actively involve local government, to reduce the birthrate, and to facilitate, coordinate and strengthen population and family planning services of the different agencies of Cagayan de Oro. While the MCPPP's efforts to reduce the birth rate were mostly concerned with coordinating and facilitating prexisting family planning services, evaluators of the project credit it at least partially, for the cities' declining birthrate. In 1971, the birthrate was 36.5 per 1,000 and in 1975, it had dropped to 29 per 1,000. In mid 1976 the program was incorporated into the nationwide Outreach Program. Although some evaluators felt that private citizens were not sufficiently involved with it, the program has been judged successful in demonstrating a city's capacity to work toward solving it's own problems. Particularly successful were efforts at educating the population and dissemination of family planning information.     

The end of population growth in Asia

This paper presents probabilistic population projections for five regions of Asia (South Asia, Central Asia, China region, Pacific OECD and Pacific Asia) and Asia as a whole. Over this century, Asia will experience very heterogeneous demographic development: Central Asia is expected to almost double in population and South Asia will become by far the world’s most populous region, rapidly surpassing the China region. Simultaneously, the Pacific OECD countries are likely to shrink in population size and experience extreme population ageing. The proportion of the population aged 60 and above in these countries (with Japan having the greatest weight) is expected to reach 50 per cent of the total population (with the 95 per cent uncertainty interval ranging from 35 to 61 per cent). The China region will experience a more rapid speed of ageing, with the proportion aged 60 and above expected to increase by a factor of four from 10 per cent in 2000 to 39 per cent in 2100.     

On some characteristics of China's population--analysis of the ten percent sampling tabulation of the 1982 third national population census

Advance results from the 1982 census of China are presented based on a 10 percent sample. Sections are included on age distribution, centenarians, marriage patterns, educational status, and the labor force. Several characteristics of China's population are described in this article, based on a 10% sampling tabulation of the production teams and resident groups of the whole country. Data are included for 100,380,000 people. The proportion of the population aged 0-14 is 33.60%, which marks a decline from figures in the 1964 census (40%). This decline is attributed to family planning and population control efforts. The median age is 22.91 years, which is 2.71 years older than that in the 1964 census. The % of the population aged 15-64 rose from 55.7% in 1964 to 61.5%. The dependency ratio dropped from 79.4% (1964) to 62.6%. There were 3,765 centenarians as of July, 1982; the overwhelming majority live in villages, and most (94.77%) are illiterate or semiliterate. The number of female centenarians is 2.4 times that of males. Marriages are comparatively stable in China. 63.6% of the population aged 15 and over are married, and .59% are divorced. The % of the population remaining single after age 50 is .21% for females, 2.97% for males. The average 1st marriage age is 22.80 years for females and 25.49 years for males. 60.35% of the people have had primary education or above; .44% are college graduates. In 1964, 33.58% of the population illiterate or semiliterate. At present, among people aged 12 and over, 31.90% are illiterate or semiliterate. The rural illiteracy rate is more than twice the urban rate. 51.94% of the total population is employed. Of these, 92.08% are engaged in manual labor. Males exceed females in all professions and occupations. The median age of the employed population is 30.84 years. The level of education among the employed is relatively low: 28.26% are illiterate or semiliterate, and 34.35% have had primary education only.