Bangladesh

In Bangladesh the Population Control and Family Planning Division of the Ministry of Health and Population Control has decided to delegate increased financial and administrative powers to the officers of the family planning program at the district level and below. Currently, about 20,000 family planning workers and officials are at work in rural areas. The government believes that the success of the entire family planning program depends on the performance of workers in rural areas, because that is where about 90% of the population lives. Awareness of the need to improve statistical data in Bangladesh has been increasing, particularly in regard to the development of rural areas. An accurate statistical profile of rural Bangladesh is crucial to the formation, implementation and evaluation of rural development programs. A Seminar on Statistics for Rural Development will be held from June 18-20, 1980. The primary objectives of the Seminar are to make an exhaustive analysis of the current availability of statistics required for rural development programs and to consider methodological and operational improvements toward building up an adequate data base.     

Bangladesh: programs geared to meet population goals; communication as a major factor in UNFPA funded projects

The population policy of Bangladesh is aiming for a zero population growth rate at a suitable level of equilibrium. It is hoped that a net reproductive rate of 1.0 will be achieved by 1990, and that by 1985 fertility will be reduced to replacement level. Various measures to attain these goals have been suggested and they include such ones as the integration of family planning programs with other development efforts through a multisectoral approach and the introduction of incentives and disincentives for acceptance of the idea of the small family. Communications by radio and television play a critical role in the program to reduce fertility. UNFPA-funded projects emphasize education, motivation, and communication with the hope of creating a favorable attitude towards family planning and the concept of the small family. Numerous projects in progress are mentioned with regard to their current status. These projects include: rural development cooperatives and population education; pilot projects for family planning motivation and services in industry and on plantations; population education in agricultural extension; strengthening (IEM) information, education, and motivation and training; population awareness for out-of-school youth; a population education program for the Ministry of Education; and a national population information service.     

Bangladesh: progress of the intensive sterilization campaign

The President of Bangladesh announced a governmental population policy which aims at checking the country's population explosion. In line with this newly-announced policy, the national family planning program, aided by the Bangladesh Association for Voluntary Sterilization,, launched an intensive sterilization compaign in mid-1977. In the 1st 3 months of the program operation, 128 doctors were trained at 15 rural health centers. During this same period, more than 50,000 vas and more than 25,000 tubectomies were performed. It is estimated that each of these sterilizations will avert 1.8 births on an average.     

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.     

Major studies on population authorized by United States Congress

The Office of Technology Assessment, acting on a request from the U.S. Congress, will undertake 2 major population studies in the near future. The goal of the studies will be to facilitate U.S. policy formulation over the next couple of decades. The 1st study will attempt 1) to assess the impact of efforts make by national government to alter birth rates between 1960-1980; 2) to predict the effects of population growth utilizing different assumptions concerning family planning; 3) to identify the types of population issues which will emerge in the period 1980-2000; and 4) identify research priorities aimed at clarifying these issues. The 2nd study will 1) investigate current contraceptive technology; 2) attempt to define a perfect contraceptive; and 3) examine the prospects of contraceptive technology between 1980-2000.     

Implementation of China's population policy

On July 1, 1982 China's 3rd national population census reported the population of the 29 provinces, municipalities, and autonomous regions on the mainland at 1,008,175,288, showing a net increase of 460,000,000 or 84% over the 548,000,000 recorded at the end of 1949. At this time China's population is about 1/4 of the world. Its population policy must conform to her national conditions and will be successful only to the extent that it does so. Discussion focuses on the main features of China's population policy. In 1953 the State Council instructed the Ministry of Health to support birth control by providing contraceptives. It also ratified provisions concerning contraception and induced abortions. In 1962 the State Council issued "Instructions on Conscientious Advocacy of Family Planning." China not only advocates and publicized family planning but also takes specific measures. Special administrative organizations were established in 1964 to oversee scientific research, production, and supply of contraceptives and to provide couples of childbearing age with free contraceptives. An all round attack on family planning work in 1966 led to unchecked childbirth resulting in rapid population growth. In 1971 Premier Zhou Enlai reiterated the importance of population control in 1971 and asked that it be incorporated into the 4th Five Year Plan for the development of the national economy. Family planning was incorporated into the Constitution in 1978. China's 20 years of experiences with family planning suggest that a country's population policy becomes effective only with repeated efforts. The 10-year period of turmoil undermined the enforcement of the population policy. Recently the State Family Planning Commission organized a nationwide fertility survey which indicated tremendous successes for China's population control drive. The total fertility rate dropped from 5.29 in the 1950s to 2.63 in the 1980s. The population census shows that the momentum of China's population growth cannot be checked without strict measures because the population is characterized by a huge base figure, a young age composition, and a fertility rate much higher than a population replacement level. China's population policy is formulated in line with her national conditions. Specific provisions for family planning reflect different ways to deal with different people.     

Five levels of family planning progress: lessons from Thailand

The U.S. Agency for International Development (USAID) has developed terms to categorize nations on the basis of their level of modern contraceptive prevalence. Categorization reveals national family planning elements and circumstances common to each level, aiding policymakers in policy projection and appropriate program formulation. At the lowest prevalence level, emergent countries demonstrate less than 8% modern contraceptive prevalence. Launch countries are from 8-15%, growth countries from 16-34%, consolidation countries from 35-49%, while mature countries range from 50% and higher. Related country characteristics according to respective stages are explored in the paper. Thailand's successful progression through these stages is provided as a model example. For developing countries at a more broad level, launch stage countries should emphasize consensus building for family planning, and consider adopting a national family planning policy. Growth stage countries require effective communication programs, while countries in the consolidation phase need to attract groups from outside of the mainstream. Finally, countries in the mature stage should progressively realize greater responsibility in the private sector for service provision.     

1980 ASEAN programme roundup: a model in the making

Association of Southeast Asian Nations (ASEAN) experts and heads of national population programs held their 4th meeting in Singapore from November 24-28, 1980. Program heads resolved to take steps to link their national activities in the population field with those of the ASEAN Population Program and carry out studies and a joint programming exercise in 1981. Progress reports on the following Phase 1 projects were given: 1) integration of population and rural development policies and programs in ASEAN countries including Indonesia, Malaysia, Philippines, Singapore, and Thailand; 2) development of an inter-country modular training program for personnel in population and rural development; 3) multi-media support for population programs in the context of rural development in ASEAN countries; 4) utilization of research findings in population and family planning for policy formulation and program management in ASEAN countries; and 5) migration in relation to rural development. Phase 2 projects approved by ASEAN country participants were also discussed: 1) institutional development and exchange of personnel, 2) women in development, 3) developing and strengthening national population information systems and networks in ASEAN countries, 4) population and development dynamics and the man/resource balance, 5) studies on health and family planning in ASEAN countries, 6) population migration movement and development, and 7) development of ASEAN social indicators.     

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.     

The international family planning movement

Over the past 3 decades, the number of women using family planning has increased 6-fold to over 400 million married women of childbearing age. The evolution of behavior and attitudes toward using birth control among third world couples reflects the goals and hard work of an international network of individuals, governments and organizations. This article follows the progression of this movement, from early opposition in developed as well as developing countries, to the present day, when birth control is practiced by a slight majority of the world's women of childbearing age. Among world regions, contraceptive use ranges from about 17% in Africa to 75% in Asia. In some African countries, however, family planning is still a foreign concept, and fewer than 5% of women use any birth control. International organizations played a crucial role in spread of family planning by providing training for developing country professionals, funding actual family planning programs and helping to evaluate programs. But the success of a country's family planning program also was dependent upon a national commitment, and often on a strong socioeconomic setting. The private sector has had a limited role except in some countries, notably in Latin America, but its involvement is likely to expand in the future. Also, as financial support from the US and international organizations wanes, national governments will cover a larger share of the cost. The worldwide increase in the practice of family planning has led to fertility declines in many third world countries, slowing rapid population growth rates. For individuals, family planning has been a liberating influence, allowing them to participate more fully in the shift from traditional to modern society.     

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.     

Rethinking the effectiveness of family planning in Africa

For the past 50 years there has been a near global consensus that the demands of development necessitate that couples reduce their fertility as a critical act which would jump start economic growth. This consensus heralded the era of the One Child policy and over 90% of least developed states continue to run programs which seek to induce lower fertility rates in their populations. However, a growing body of literature is questioning both the validity and utility of these interventions. This article seeks to contribute to the rethinking of family planning programs. Using new data on family planning scores from forty two African states this article shows that rates of fertility are unlikely to be affected by the strength of family planning programs at lower levels of development. However, at moderate levels of development, family planning programs may contribute to accelerating the decline in fertility initiated by exogenous factors. These findings offer a fresh perspective on the wide spread adoption of family planning policy that permeates the developing world.     

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.     

Prospects for fertility reduction and projections for future population growth in Kenya

In 1979 Kenya's annual rate of natural population growth was 3.8%. Data from the1989 Kenya Demographic and Health Survey indicate that significant decreases in fertility levels were experienced during the 1980s. Factors associated with conditions supportive of high fertility in Kenya are discussed, and progress toward attaining significant fertility reduction thresholds during the 1980s is assessed. Findings from recent fertility surveys are presented, and 1969–1989 national level family planning data are evaluated. Four population projections for 1985–2025 are presented and analyzed. One projection is based on official government growth targets; two are based on estimates provided by the United Nations and the Population Reference Bureau, and a fourth projection is based on the assumption that Kenya will attain an annual natural population growth rate of less than 1% by the year 2025. Each projection assumes that fertility declines will be experienced. Kenya's prospects for reducing the annual population growth rate to 1% within the next sixty years and a cost-sharing development policy are addressed briefly in the concluding section. Recent data suggest that Kenya will probably not complete the demographic transition before the year 2050, but Kenya should continue to move through the transition stage.     

Study findings on evaluation of integrated family planning programme performance

In 1976 the United Nations's Economic and Social Commission for Asia and the Pacific launched a comparative study on integrated family planning programs in a number of countries in the region. In November 1979 the study directors from the participating countries meet in Bangkok to discuss the current status of the studies in their countries. The Korean and Malaysian studies were completed, the Bangladesh study was in the data collecting phase, and the Pakistani research design phase was completed. The meeting participants focused their attention on the findings and policy implications of the 2 completed studies and also discussed a number of theorectical and methodological issues which grew out of their research experience. The Malaysian study indicated that group structure, financial resources, and the frequency and quality of worker-client contact were the most significant variables determining program effectiveness. In the Korean Study, leadership, financial resources, and the frequency and quality of contact between agencies were the key variables in determining program effectiveness. In the Malaysian study there was a positive correlation between maternal and child health service performance measures and family planning service performance measures. This finding supported the contention that these 2 types of service provision are not in conflict with each other but instead serve to reinforce each other. Policy implications of the Korean study were 1) family planning should be an integral part of all community activities; 2) family planning workers should be adequately supported by financial and supply allocations; and 3) adequate record keeping and information exchange procedures should be incorporated in the programs.     

Does family planning work in a Chinese way

The demographic and economic characteristics of China make it necessary to do family planning work in China in a Chinese way. Special characteristics of China and corresponding strategies are detailed 1) China is rather underproductive and underdeveloped, with a huge population, whose growth must be curtailed while industrial and agricultural production is enhanced. 2) In the next 10 years, a large number of young people will center childbearing age, prompting a government policy favoring late marriage and one child per couple. 3) China is large and heterogeneous, and regional authorities should have some population policymaking functions to take sociocultural differences into account. 4) Male child preference ideology in rural areas has been gently combated with a resulting increase in family planning rate from 65.1% to 74.2% from 1979 to 1983. Family planning authorities have made considerable progress, as demonstrated by figures such as a drop of women's total fertility rate from 5.68 in the 60s to 2.07 in the 70s. The task at hand remains large: the population at the end of 1983 was 1,024,950,000. However, family planning is an element of state policy, the marriage law, and the constitution, and mored an more, societal ideology. Government policy equates family planning with child wellness and societal welfare and attempts supportiveness of couples showing positive birth limiting attitudes. An ample system of family planning programs and resource persons furnishes education, a variety of high quality methods are available, and contraceptive research is some of the best in the world.     

A tentative discussion on family planning problems in Xinjiang's minorities]

The Uighur Autonomous region in Xinjiang includes a number of minority groups such as the Uighur, Kazakh and Hui. The question of how to implement family planning in minority areas if of utmost importance. In February 1982, the State Council decreed that family planning policy for minority groups could justifiably be more lax than for the Han people, who comprise a majority of Chinese population. Instead of advocating 1 child per couple, as is the current national policy, urban minority groups are permitted 2 (with exceptions, 3) children per couple and rural villagers are permitted 3 (with exceptions, 4) children. The 1982 National Census showed that the natural rate of growth for Xinjiang was 13.63/1000 (compared to the national rate of 11.45/1000) with individual minority growth rates as high as 20.11/1000. The area's gross output value cannot keep up with this population increase. Over half of Xinjiang's minorities are of the Islamic faith, which teaches that births are not self-willed. It is crucial to inculcate in them that births can indeed be planned. Also, their custom of early marriage (age 15 for girls and 16 for boys) which leads to a high fertility rate, must be changed. Although Xinjiang's land mass is great, only 38.4% is arable, so the common belief that its population can grow without limit is fallacious. When family planning was being implemented nationwide, for minorities it was only propagandistic. After the population growth for the majority Han was under control, the minority groups declared family planning programs would also benefit them. Symposiums were held contraceptive use became voluntary among many women. The birth rate fell from 22.5/1000 in 1981 to 14.09/1000 in 1985. Family planning also received approval from religious leaders. But because population distribution and growth are uneven in Xinjiang, family planning policy must reflect these differences.     

New perspectives on population: lessons from Cairo

The lessons from the 1994 World Population Conference in Cairo, Egypt, are summarized in this publication. The topics of discussion include the evolution of population policies, the changing policy environment, demographic trends, and solutions in the form of gender equity, provision of reproductive health services, and sustainable social and economic development. The program of action supported by 180 governments and targeted for 2015 articulated the goals of universal access to a full range of safe and reliable family planning methods and reproductive health services, a specified level of reduction in infant and child mortality, a specified level of reduction in maternal mortality, an increase in life expectancy to 70-75 years or more, and universal access to and completion of primary education. Other features include goals for improving women's status and equity in gender relations, expansion of educational and job opportunities for women and girls, and involvement of men in childrearing responsibilities and family planning. Steps should be taken to eliminate poverty and reduce or eliminate unsustainable patterns of production and consumption. Population policy must be integrated within social and economic development policies. About $22 billion will be needed for provision of family planning and reproductive health services by the year 2015. Costs will increase over the 10-year period due to the increased population to be served. Per person user costs for family planning alone are higher in countries without infrastructure and technical skills. Actual costs vary with the cost of contraceptive supplies, patterns of use, and efficiency of delivery systems. Although the plan offers 16 chapters worth of advice and recommends 243 specific actions, countries will have to be selective due to cost limitations. The 20/20 Initiative is proposed for sharing social service costs between international donors (20%) and host countries (20%). A separate UN projection of need is for 33% of support from international donors for family planning and related programs. The constraints to the implementation of the action plan are identified as the rate of demographic change, the extent of public support for population limitation and provision of family planning services, and potential conflicts of interests and funding between cooperating agencies. The World Bank has developed guidelines for policy development according to a country's identification as an emergent, transitional, or advanced country.     

Migration, fertility, and state policy in Hubei Province, China

Despite China s one-child family planning policy, the nation experienced a slight rise in the birth rate in the mid-1980s. Many observers attributed this rise to the heightened fertility of those rural-to-urban migrants who moved without a change in registration (temporary migrants), presumably to avoid the surveillance of family planning programs at origin and destination. Using a sequential logit analysis with life-history data from a 1988 survey of Hubei Province, we test this possibility by comparing nonmigrants, permanent migrants, and temporary migrants. While changing family planning policies have a strong impact on timing of first birth and on the likelihood of higher-order births, migrants generally do not have more children than nonmigrants. In fact, migration tends to lower the propensity to have a child. More specifically, the fertility of temporary migrants does not differ significantly from that of other women.