A sound population program

A sound population program must respond to real human needs, must be rooted in values, must generate results, must be administered in an integrated manner, must be based on the ethic and goal of self reliance and on the belief that it must operate and grow on its own steam, and must release human resources for productive economic endeavors. To make any sense at all, population must be linked to the gut level needs of the individual. People should not be viewed as demographic statistics, and the word human should be used in the basic sense of hunger and poverty. If the goal is to bring about lasting change in the way that Filipinos manage their lives and their living, it is necessary to probe their values. If social change is the goal, tradition must be challenged. In the area of family planning, persons who can communicate the fact that the program seeks to enrich life more than prevent birth must be chosen. There has been some criticism that the population/family planning program is "too contraceptive oriented" and too mechanistic in the approach to population. Contraception is behavior, a good measure of acceptance and an effective measure of commitment. The delivery of welfare must be horizontally integrated. Thus it is necessary to learn to work in teams, teams of development workers. The value of self determination and the conscious practice of planning and shaping one's life is the very logic of family planning. The program needs to implant the values of family planning firmly in the community, or, more accurately, in the small face to face primary groups where social norms are set and where change must take place if it is to last. The answer to how to achieve a sound population program lies less in what is done than how it is done.     

Effect of development of rural commodity economy on family planning]

The paper discusses the effects of the changes of rural income level on family planning practice based a survey of 200 rural families in a affluent vegetable producing area of suburban Beijing. In 1984, 99.7% of child birth followed the local birth planning, and 99.1% of families with one child received One Child Certificates. The annual per capita income of the 200 families was 1,092 yuan (1 US$ = 3.7 yuan) in 1984 even higher than the community average. The number of children was negatively associated with the per capita income and per capita consumption except families with 4 children, most of whom have grown up. The rural mechanization in the community has greatly increased the need for skills and technology rather than strong laborers. The provision of community welfare programs and the increased living standard changed the value of children and also changed people's perception in favor of gender equality. Among families with 1 or 2 children, most preferred to have girls. And among families with more children, the preferred family size is smaller than the actual size, which shows a tendency towards favoring a small family. Among 1 child families, 58.7% considered 1 boy and 1 girl to be ideal, and 37.7% was happy with the only child. As the community becomes richer, both the community and individual families increased their investment in education. The spending on education per child was over 2 times as high in 1 child families than the families with more children. The educational status of parents is positively associated with the exception of children's future education and current spending on education. The concern of parents over children's education is an important factor in improving the quality of labor force. Women of higher education status are more acceptable to contraception and family planning policy. The relatively high level of education of the community has been conducive to it fertility decline.     

A tentative discussion on problems of enhancement of population quality in China]

Population quality is an undeniable fact. It means people's scientific and cultural literacy, their ability to work, and their physical health condition. Population quality is influenced by sociological and physiological factors. Population quality improves as society and production power improve. Industrialization and rapid development in science and technology in western countries required workers with higher levels of education and physical concentration. In order to change the poor economic situation and achieve the "Four Modernizations" in China, a great number of people possessing knowledge of modern science and technology to manage modern production is needed. Agricultural and meat production need to be improved, thereby improving the people's physical health condition. The importance of population quantity control must be realized. In order to lower the population growth rate we can increase the economic development and improve people's educational level and physical health. To improve population quality we should continue nationwide family planning programs, change our educational structure (increase vocational training and utilize the electronic media and correspondence courses), improve the physical health of children and youth, expand our social welfare system, and emphasize research on genetics and eugenics.     

Philippines: Association of Population Correspondents formed in the Philippines

2 major decisions were reached at the December 1979 National Workshop for ESCAP Population Correspondents in the Philippines. The first was to set up an Association of Population Correspondents in order to enhance sharing population information at the national level. A newsletter was identified as a priority. The second decision was to set up a task force under the leadership of the Executive Secretary of the Commission on Population. The task force will be responsible for the preparation of a project proposal to establish a national population information clearing-house. Associated tasks will be the organization of a baseline study of the existing agencies, their capabilities and potential roles in the future national clearing-house. Participants stated specific needs for information. Information is needed from Thailand on community-based family planning programs and Indonesia on community participation and evaluation studies on contraceptive technology. The special needs of each member nation should be identified and then fed back to them for obtaining the required information. Participants requested a list of trainers for community-based programs; listing of specific linkages between private and government agencies involved in population work; and listing of international funding agencies on research and action programs.     

From Bucharest to Mexico: a decade of changing perceptions

The 2nd International Conference on Population held in Mexico City in 1984 had 3 main objectives: 1) to adopt the plan to changing demographic situations, 2) to enlarge the plan's scope so it can consider new views that have emerged since Bucharest, and 3) to reinforce the plan's operational aspects so that the plan can be applied more effectively. The Mexico conference had significant differences with the Bucharest gathering: 1) greater participation of developing countries, 2) clarification of the role of population and family planning in development, and 3) recognition of the status of women in development. Governments of many developing countries argue that they cannot wait for their countries to modernize sufficiently enough to stabilize their population levels. Participants in the Mexico conference agreed that family planning programs have been successful in reducing fertility at relatively low cost. The goal of a development-oriented population policy is to improve the people's standard of living by lowering fertility rates, improving health conditions and life expectancy, improving population distribution, and adopting sound economic policies. The overall objective of population policy should not be confined only to growth, distribution, and other demographic aspects; it is imperative that human life and human dignity be upheld.     

Fertility survey in the rural areas of Hubei Province]

In July, 1981, the staff of the Population Research Section of the Economics Department of Wuhan University and family planning personnel at the local level conducted a survey on fertility in the rural areas of Hubei Province. The survey was conducted in the forms of public opinion polls and individual conversations with the local people. The results of this survey can be summarized as follows: (1) Marriage Question -- the average age for first marriage is 22.54. The marriage rate is 5.3/1,000 for age 18, 35.5/1,000 for age 19, 54.2/1,000 for age 20, 171.9/1,000 for age 21, 393.5/1,000 for age 22, 717.8/1,000 for age 23, 886.3/1,000 for age 24, and 965.3/1,000 for age 25. (2) Birth Question -- average time between first marriage and first child is two years. Women between the ages of 25 and 29 average 2 children; women between the ages 20 and 24 average 1.3 children. Figures show that an unlimited population growth is already under restraint, and the fertility rate shows some obvious decline. (3) Ideological Question -- traditional beliefs favoring more children and favoring boys to girls are still strong in the minds of the people. In general, young males and females still contemplate an early marriage and wish to have two children. In order to correct the people's ideology and match it with national population policy, more work is needed in family planning.     

Redefining family planning programs

The Population Council's issue paper entitled Reconsidering the Rationale, Scope, and Quality of Family Planning Programs calls on family planning programs to focus only on reducing unwanted fertility by helping people meet their own reproductive goals safely and ethically. Many family planning programs have been wrongly handed the extra responsibility of reducing wanted fertility. They have therefore used inappropriate means (e.g., incentives, quotas, and coercion) to boost contraceptive prevalence. If programs do focus on reducing unwanted fertility, they will foster reductions in overall fertility and population growth as well as improvements in clients' health and well-being. A new framework has emerged from this shift in rationale. It sets the stage for expanding the scope, improving the quality, and assessing the impact of family planning programs in terms of client choice, health, and well-being. A program needs to determine the range and quality of family planning services it provides at the local level. Local program managers, policymakers, and consumer interest groups should establish minimum or achievable standards of service based on the local health care capacity. Program items that should be assessed include choice of methods, information for clients, technical competence, interpersonal relations, mechanisms to encourage continuity of care, and appropriate constellation of services. The Population Council has conducted rapid appraisals of the quality of care of family planning services to help local program managers to evaluate the strengths and weaknesses of their programs. The HARI (Helping Individuals Achieve their Reproductive Intentions) Index measures a program's success in helping clients safely prevent unwanted or unplanned pregnancy. Program managers can conduct a self-assessment that revolves around answering four questions. Family planning services are an important social investment and are essential to development.     

A Population Policy Rationale for the Twenty‐First Century

I propose that the primary goal of twenty‐first‐century population policies should be to strengthen the human resource base for national and global sustainable development. I discuss the shortcomings of the three dominant twentieth‐century population policy rationales: acceptance of replacement‐level fertility as a demographic goal; realizing a “demographic dividend” from the changing age structure; and filling the “unmet need” for family planning. I demonstrate that in all three cases the explicit incorporation of education into the model changes the picture and makes female education a key population policy priority. Population policies under this new rationale could be viewed as public human resource management. I argue that 20 years after the Cairo ICPD the international community needs a new rationale for population policies in the context of sustainable development and that a focus on human capital development, in particular education and health, is the most promising approach.     

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.     

The Philippines: country statement prepared for the International Conference on Population,Mexico City,August 1984

This statement, prepared for the 1984 International Conference on Population, summarizes the demographic situation in the Philippines, the Philippine position regarding implementation of the World Population Plan of Action, and current population policies. In 1980, the population of the Philippines stood at 48.1 million. The country's current population growth rate reflects the interplay between decreasing mortality and still high but declining fertility. The 1984-87 Philippine Development Plan aims to achieve sustainable economic growth, equitable distribution of the gains of development, and personal development. A net reproduction rate of unity by the year 2000 is sought, and preschool-age children, youth, premarriage-age groups, and married couples of reproductive age have been targeted for special outreach efforts. The national population program will concentrate on developing a network of public and private community-based organizations, strengthening the capacity of local government and community organizations to plan and manage the population program, developing community capacity to finance family planning services, upgrading the quality of natural family planning practice, continuing the promotion of effective contraceptive methods, developing a population data bank, and upgrading the technical and management capabilities of population program personnel. Increasing attention is being paid to regional development and spatial distribution. The average annual population growth rate is expected to decline from 2.8% in 1970-75 to 2.2% by 1987. The crude birth rate is expected to drop from 34/1000 in 1980 to 31/1000 in 1987. To help achieve this goal, the contraceptive prevalence rate should increase from 34% in 1983 to 41% in 1987 and 50% by 1993. In addition, attempts will be made to reduce the proportion of women marrying below the age of 20 years and to improve women's access to educational and employment opportunities.     

Full-time workers reach out to the villages

The Philippine Commission on Population (Popcom) has fielded 2721 fulltime outreach workers (FTOWs). The FTOWs are the outcome of a shift from a clinic-based, motivation-oriented family planning effort to the Rural Outreach Program which is part of the new Total Integrated Development Approach (TIDA). Organizationally, the workers are under local government supervision and their purpose is to make the family planning program more responsive to community needs. This article profiles the average FTOW, describes recruitment and training procedures and discusses problems of the program -- funding, transportation, inadequate training, lack of educational materials, shortage of contraceptive supplies -- and possible solutions.     

Radio: a strategic tool for development

Every country should recognize the need to fully involve media leaders in the planning and implementation of population and family planning programs. Broadcasters are the best equipped to understand the "mind-set" of the mass audience and what is needed to bring about changes therein. If there is to be involvement of the media, particularly radio professionals, in the design, development and implementation of population and family planning programs, attention must be given to the inmplications of this in terms of implementing the World Population Plan of Action. Strategies for population communication using radio as the central medium include the following: 1) development of an adequate in-country support structure; 2) development of a sound, well-researched population communication program; 3) on-air programming in the form of instruction rather than entertainment; 4) provision for substantial and continuous feedback from the audience; 5) frequent broadcasts at a prime time of day; and 6) a program commitment of from 5 to 6 years. Radio needs to be recognized as a strategic tool for development; it should be used professionally and should receive sufficient priority by funding agencies.     

“三关爱”与建设计划生育文明

长春市人口计生委率先提出的人性关爱、人情关爱和人文关爱,即“三关爱”理念,体现了一种自外而内、从下到上的追求,勾画出了计划生育文明的思路框架。人性关爱体现了权利本位的思想,尊重群众,理解群众。人情关爱体现了服务本位的思想。人文关爱体现了文化本位的思想。“三关爱”化解矛盾、创造和谐、促进发展。“三关爱”对政府的工作提出了全新要求,体现了管理型计划生育向服务型计划生育的历史转轨,重民权、合民情、贴民心,构成抓好人口计生工作、提升人口计生工作质量的新动力,是新时期人口计生工作值得关注的重要导向。     

城市流动人口计划生育管理的社区服务模式

我国目前对流动人口实行的防范式行政管理方法,在实际中不易落实,且易引起流动人口的排斥抵触情绪。因此必须针对流动人口的特点,采用计生社区服务模式为主的工作方式,转交流动人口的传统生育观。流动人口计生社区服务模式应着重:以经常性的宣传教育服务为宗旨;以生产、生活、生育服务为主线;注重社区服务的福利性质;以促进城市居民与流动人口沟通为目的。流动人口计生社区服务对于流动人口本身和社区计划生育而言具有很多优势,是以后流动人口计划生育管理服务的发展方向。     

New strategies for slowing population growth

Growth of world population over the next 100 years, until the year 2100, will produce an estimated 11.5 billion people. The past focus on reducing rapid population growth exclusively through family planning has not been sufficient. Population policy needs to be broadened to include health care, education, and poverty reduction. The population policy recommendations of Population Council Vice-President John Bongaarts and Senior Associate Judith Bruce were to reduce unwanted pregnancies by expanding services that promote reproductive choice and better health, to reduce the demand for large families by creating favorable conditions for small families, and to invest in adolescents. The Population Council 1994 publication "Population Growth and Our Caring Capacity" outlined these issues. Another similar article by John Bongaarts appeared in the journal "Science" in 1994. In developing countries, excluding China, about 25% of all births are unwanted; 25 million abortions are performed for unwanted pregnancies. The provision of comprehensive family planning programs will go a long way toward achieving a reduction in unwanted pregnancies. In addition, changes are needed in male control over female sexuality and fertility and in cultural beliefs that are obstacles to use of contraception. Stabilization of population at 2 children per family will not occur unless there is a desire for small families. In most less developed countries, large family sizes are preferred. Governments have an opportunity to adopt policies that reduce economic and social risks of having small families. This can be accomplished through the widespread education of children, a reduction in infant and child mortality, improvement in the economic and social and legal status of women, and provision of equitable gender relations in marriage and child rearing. The rights of children to be wanted, planned, and adequately cared for need to be supported. These aforementioned measures will help to reduce fertility, provide support for small families, and justify investment in social development. Population momentum will keep population growing for some time even with replacement level fertility. Investment in adolescents through enhancement of self-esteem and promotion of later childbearing can lengthen the span between generations and slow population momentum. Population policies will be more effective when human rights are protected.     

Papua New Guinea: first population policy declared

In its 2nd year after achieving political independence, Papua New Guinea declared a general population policy in October 1976, and inaugurated a population research program to guide policy formulation. Population affairs of the country, which has a population of 2.75 million, have been vested with the Ministry of Environment and Conservation. The research program will be implemented in cooperation primarily with the Institute of Applied Social and Economic Research (IASER) and the University of Papua New Guinea, as well as the Central Planning Office, Department of Public Health, Bureau of Statistics, and Office of Information, among other agencies. The priorities for research will initially fall under 5 main concerns: 1) fertility and population growth, and the causes of local differentials; 2) socioeconomic influences on growth trends; 3) interrelation between population and land resources; 4) internal migration; and 5) individual attitudes regarding family planning practice. The research program is designed to become an integral part of national development planning. However, the Government has declared that both policy and research programs must concur with the needs and desires of the people, to pave the way for successful implementation of development plans.     

The International Parliamentary Assembly on Population and Development held in Mexico City

The International Parliamentary Assmebly on Population and Development took place on August 15-16, 1984, with the participation of more than 300 parliamentarians from 60 countries. The aim was to promote an exchange of views on population programs and policies among parliamentarians, and to support the recommendations adopted by the UN International Conference on Population. The assembly held discussion in 3 subcommittees on the subjects of 1) policies of population and development; 2) the legal and social status of women; and 3) the improvement of family planning service. On population policy, parliamentarians generally agreed that policy formulation is the prerogative of each sovereign country, stressing that such policies and programs should be integrated with social and economic development. The developing countries stronly demanded that a new international economic order be established and international aid increased to help them in solving the popultion problem. Concerning the status of women, the assembly unanimously agreed that both men and women should not only be legally equal, but should also have de facto equality for employment, education and social life. Attention should be given particularly to the rights and status of rural women. Examples of how the status of Chinese women has improved were offered by Chinese representative and were appreciated by the assembly. On improving family planning services, participants urged provision of information about birth control to people of marriageable age and of access to contraceptives to eligible couples; moreover, they advocated the strengthening of medical care for women and children and the lowering of infant and maternal mortality rates. Dr. Qian Xinzhong described the priorities and goals of family planning programs in China. Finally, the assembly unanimously adopted the "Action Plan," whose contents embody independence, respect for national sovereignty, and the spirit of cooperation and conformity to the interest of the international community, particularly the developing nations.     

Basic policies of the Philippine Population Program

This history of the Philippine Population Commission, which was created in 1969, is summarized. In 1970 President F.E. Marcos defined the government's task in this area as: 1) educating the people on the urgent need for population control; 2) disseminating knowledge on birth control techniques; and 3) providing facilities, especially in rural areas. Funding began in 1971. The 4 basic policies are noncoercion, integration, multiagency participation, and the partnership of the public and private sectors. The noncoercion policy means that all birth control techniques are offered and couples are free to use or reject whatever they wish. This has probably slowed the spread of family planning, but has also minimized opposition. Family planning has never been the domain of 1 agency but has been implemented through many agencies working together. Now it is being implemented through total community development plans, of which family planning is merely 1 component. This approach puts irrigation workers, agricultural development workers, and many others on the family planning team. private agencies have also had an important role to play in the development of the total program. For the past 5 years these have been mainly voluntary sociocivic and health associations whose interests are very close to or naturally related to family planning. Now the entry of business into the Population Program through the commercial contraceptive marketing program has enlarged the role of the private sector in the diffusion of family planning products and services. It is possible that the partnership between the public and private sectors may soon be based on segmentation of the target population with government agencies going deep into rural areas while private organizations concentrate on urban and adjacent rural areas.     

"Taking full responsibility" should be emphasized in the control of population growth]

Since the establishment of a responsible production system in the countryside, the living standard of the general public has risen constantly, but a new problem in family planning has also occurred. A great many people believe that more male children will eventually provide more labor and thus more income. Consequently, there has been a gradual rise in the birth rate. A crucial problem which needs an immediate solution is how to match the population growth and agricultural production. As a responsible production system is established, an appropriate family planning system should also be established. Married couples of childbearing age should sign contracts concerning family planning and should follow regulations outlined in the contract. Contract violators should be punished with fines, and thoas who follow the contract should be offered economic rewards. Cadres and responsible officials should take full responsibility for reaching the goals set for their respective county, district, commune or brigade, and their people should be rewarded or punished according to their performance. Special care should be given to the old, handicapped, orphans and widows and those who suffer from illness. Households with only one child should be awarded and encouraged with additional benefits. Taking full responsibility is a concept which should be used extensively in agricultural development, production management, and family planning.     

Comrade Mao Ze-dong's contribution to Marxist theory on population--in commemoration of the 60th anniversary of the birth of the Chinese Communist Party]

Is it good or bad to have a large population in China? Comrade Mao Ze-dong said "it is good and it is also bad." Our population is an asset, and we should use this asset and wisdom in our nation's "Four Modernizations" program. On the other hand we should control the population growth and reduce the resulting burden. Marxism recognizes 2 types of production, material production and human production. Both are interrelated, mutually dependent, and beneficial. Comrade Mao criticized concepts and practices that disregard the interrelationship of these 2 types of production. According to Comrade Mao both types of production should be included in the national economic plan, and the proportions of material production and human production should be the basic proportions of our socialistic economic development. Comrade Mao mentioned that population growth should be planned to fit and benefit social development. He suggested establishment of a series of family planning offices or committees to study and implement the family planning program, to develop a longterm plan, to consider the people's wishes in family planning, to meet the people's requirements and desires, to educate people about family planning, and to recommend government funds for the program.