Contraceptive prevalence: the influence of organized family planning programs.

Estimates of contraceptive prevalence for the period 1977-1983 are presented for 73 less developed countries. Socioeconomic conditions are associated with much of the variance in prevalence, but organized family planning programs strengthened this association significantly. The average percent of couples in the reproductive ages practicing fertility regulation is 26, with the range from 4 to 55 percent between the low and high socioeconomic groups of countries, and from 7 to 59 percent between groups of countries with very weak (if any) to strong family planning program effort.

Family planning program: world review 1974. Introduction.

PIP: The 1974 Population Conference at Bucharest was marked with controversy between developed and developing countries, with the latter strongly critical of aid for population control but less for social and economic development. The Plan of Action which was finally approved emphasized the importance of social and economic factors in relation to population growth while recommending that couples in all nations should have access to family planning information. Different regions of the world, however, have widely divergent population policies and goals. The Asia-Pacific region of the developing world, which has 3/4 of the population of the developing world, has articulated a strong stance in favor of reducing birth rates at Post-Bucharest Consultation. Government-supported family planning programs are seen as a high priority item to reduce rapid population growth. Rapid population growth is not seen as a high-priority problem in most African, Arab, and Latin American countries. Population problems will be solved with economic and social advancement. There is more concern in Latin America for family planning as a "human right" issue than to promote demographic goals. Latin America was also concerned with migration/urbanization issues. All of the Regional Consultations after Bucharest favored a greater emphasis on population in development planning, concern for the problems caused by migration and urbanization, improvement in the status of women, and support for the reduction of mortality levels. Some 74 countries containing 93% of the population of the developing world, supported family planning, with only 4 populous countries -- Burma, Ethiopia, Peru, and North Korea not in support. More than 98% of the population of Asia lives in countries which support family planning; the figures are 94% for Latin America, 90% for the Middle East and North Africa and 64% for Sub-Saharan Africa. The governments of 39 countries with a combined population of 2.3 billion have stated that rapid population growth is detrimental to the rapid attainment of social and economic development; 35 additional developing countries favor family planning as a basic human right, to improve the status of women, and for health reasons. There is a wide range of acceptance rates for contraceptives among the developing countries with gains shown for most countries between 1972 and 1974. There is a strong pattern of fertility decline in 11 East Asian and Latin American countries plus Mauritius. Induced abortion countries to be a major means of birth control even in countries where it is illegal. Legal access to abortion on broad grounds is available in China, North Vietnam, Tunisia, Singapore, India, Zambia, and Hong Kong. It seems likely that liberalization of abortion laws will occur in more developing countries in the near future for health reasons as well as for demographic reasons.^ieng

Fertility reduction in an MCH/family planning program: a model for projection.

One of the important questions in an integrated maternal and child health/family planning program is the likely effects on fertility rates if given proportions of a stated target population can be reached and provided with family planning services. The question is easy, but the process of obtaining viable estimates of potential fertility decline from this type of program is complicated. First of all, the number of women in the target population must be estimated. Next, it is necessary to make various assumptions and estimates concering the types of contraceptives accepted, the age distribution of acceptors, the sets of continuation rates that go with each age/method specific group of women, and a variety of other factors. This article describes and illustrates a procedure for estimating potential fertility declines with an integrated maternal and child health/family planning program.

A program for family planning based on maternal-child health services.

PIP: The Population Council set up as a reference framework for a study an organizational model postulating the number of doctors, midwives, and field workers, the type and number of Maternal/Child Health (MCH) centers needed for given units of population. An extrapolation cost of providing MCH services with family planning was about 1 billion dollars for the women in the developing world. Six projects have been developed in a number of countries. Principles of operation for the delivery of family planning from an MCH base include: 1) integration of family planning with MCH; 2) size and location of project areas; 3) the target population; 4) subdivisions of target groups; 5) replicability; 6) evaluation. Evaluation of the project should provide answers to: 1) success of the program in delivering specified services, 2) results of the program in terms of health and fertility, 3) effectiveness of the program as a family planning delivery service. Programs are proposed for Indonesia (Java), Turkey (Yozgat), the Philippines (Bohol), Egypt (Behlira Governorate), Brazil (Rio Grande do Norte), and Bangladesh.^ieng

Population policies in the Maghreb.

PIP: The population policies of 3 North African countries are reviewed: Morocco, Algeria, and Tunisia. There are about 15.5 million persons in Morocco, 14.2 million in Algeria, and 5.2 million in Tunisia, with current growth rates over 3% in the 2 larger nations, and probably 2.7% in Tunisia. The population policies of the 3 countries are quite different. In Tunisia there has been considerable social progress for women plus a vigorous and open concern with population growth. There exists a definite and expanding family planning program. In Morocco there is government policy to reduce population growth via family planning, but the efforts to fulfill this policy are weak. In Algeria research and study are being carried out to obtain more and better data on population growth and related subjects. There is also an avowed policy of economic development as the solution to lower fertility. None of the countries proclaims as policy that it does not have enough people and should seek to increase fertility or in-migration. The author believes that the organized family planning effort began in Tunisia at about the right time. Morocco, however, may have started its family planning program too early, with the result that not only is there very slow program development, but maybe the long-term goal of reduced fertility is pushed a bit further into the future by what might be termed a semi-false start. The author suggests that it would be unwise for the Algerian government to begin an organized family planning program now and even more unwise for outside agencies and organizations to urge it to do so. In the Maghreb, the 2 countries with organized family planning programs want them, and the 1 country without does not want one. The author ends with the question of what and whose criteria are to be utilized in cases in which external agencies are asked for population program assistance once a government decides that it wants a program for its people.^ieng