Which of the Following Does Not Apply to Family Planning Measures Used Now or in the Past in China?
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Recently, commentators in several prominent U.South. publications have alleged that the population explosion is over and concluded that population growth is no longer a serious policy consequence. "The population boom is a bosom," declares one.[2] I statistic commonly cited every bit prove of this is the global pass up in fertility rates (the number of children born per adult female). Information technology is true that fertility worldwide has fallen from most six in 1950 to around three in 1998. Furthermore, betwixt the early 1960s and 1998, fertility rates in the developing world have declined from 6.1 to three.three. The sharpest declines occurred in East asia—from five.ix to i.8—and Latin America—6.0 to 3.0.[iii] United Nations projections propose that the world's population could begin to decline in near fifty years. If global fertility has declined and then sharply, should the U.s. and other donor countries go along to invest in overseas population assistance programs, specially family planning? After all, given these trends, isn't the piece of work of family planning finished?
Not notwithstanding. The world's population is still growing. Although the rate of growth has been declining since the 1960s, global population grows each year by approximately fourscore million people, or the equivalent of the population of a country the size of Germany. About all of this growth is full-bodied in the developing nations of the world (Figure 1), in many of which fertility rates remain high. High fertility can impose costly burdens on developing nations. Information technology may impede opportunities for economic development, increase health risks for women and children, and erode the quality of life by reducing access to education, nutrition, employment, and scarce resources such equally potable water. Furthermore, surveys of women in developing countries suggest that a large per centum—from ten to 40 percent—want to space or limit childbearing but are non using contraception. This finding indicates a continuing, unmet need for contraception. Historically, voluntary family planning programs have been very effective in filling this demand for contraception and by doing and then helping developing nations to moderate high fertility rates.
Figure 1. Population Increments by Decade in Industrial and Developing Countries
SOURCES: United Nations, Section for Economic and Social Information and Policy Analysis, Population Division, World Population Prospects: The 1996 Revision, New York, 1996, and projections using the model in World Depository financial institution, World Development Indicators, Washington, D.C., 1997.
These conclusions emerged from an examination of research on family planning in developing countries by RAND'due south Population Matters project, a program for communicating the policy-relevant findings of demographic enquiry. The work used existing enquiry to look at problems surrounding world population growth and to make up one's mind whether there is show of a standing need for family unit planning programs in developing nations. The work focused on three questions:
- What are current fertility trends in the developing world and what are their consequences?
- How effective are family planning programs in helping to reduce fertility?
- What role take donor nations, particularly the The states, played historically in family planning programs?
Population Growth and the Need for Contraception Are However Major Concerns in the Developing Globe
Proclaiming the cease of the population explosion is premature. Likewise, information technology is mistaken to conclude from aggregate trends and projections that population growth is no longer a serious problem anywhere in the world or that family unit planning programs are no longer needed. There are several reasons why:
1. Fertility rates are still high in many developing nations. Almost of the world's population growth occurs in poor, developing nations, which are to the lowest degree able to support rapid population growth and whose socioeconomic evolution is near likely to exist hindered by high fertility. In almost of these nations, fertility rates remain high. Sub-Saharan Africa in particular has experienced less alter than Asia or Latin America: Its total fertility charge per unit is 6.0, notwithstanding a downtrend in a few countries such as Kenya, Zimbabwe, Republic of ghana, and Zambia. In Nigeria, the continent's most populous nation, the average woman will give nascence to half-dozen.5 children in her lifetime.
Figure ii. Causes of Population Growth in developing Countries
SOURCE: John Bongaarts, "Population Policy Options in the Developing World," Scientific discipline, Vol. 263, No. 5148, 1994, pp. 771–776.
2. Population momentum is strong and will produce big population increases over the adjacent 25 to 50 years. The full population continues to grow for some fourth dimension after fertility stabilizes at replacement level, or the number of births required for couples to replace themselves, which is 2.1 births per woman. This miracle, known as "population momentum," occurs when a big share of the population is young. If a large proportion of women are in their childbearing years, the total number of births tin can remain the same or even increase although the rate of childbearing per woman falls. Momentum is a powerful demographic force and will account for about half of the world'southward population growth over the next 100 years (meet Effigy 2).
3. A sizable population grouping is about to attain childbearing age. By the yr 2000, nearly half a billion women—mostly in developing countries—volition exist in their young adult years, age fifteen to 24. This means that more women volition be of childbearing age than at any other time in history. This number will increase earlier it gets smaller. If women delay childbirth and increment spacing between their children, all the same, the resulting rate of population growth will be much lower.
The populations of developing countries are much younger on average and have a much greater proportion of their population in the reproductive years than those in industrial countries (see Figure iii). Even if couples in this age group have only ii children each, for a number of decades births will outnumber deaths amongst the relatively modest number of older people, and the population will continue to abound.
Figure 3. Age Construction of Population in Developing and Industrial Countries, 1995 (in millions)
SOURCES: World Depository financial institution, World Development Indicators, Washington, D.C., 1997; Earth Banking company, World Development Report 1997, Washington, D.C.,1997.
4. A weakening of family planning programs could tedious further fertility declines. Failing global fertility is in large measure a testimony to the success of family unit planning and related efforts to improve the educational activity of women. Most projections of future fertility turn down assume the continuation of these programs. These declines could wearisome if support for these programs is not maintained.
v. In that location is a widespread preference in developing countries for smaller families. High fertility runs counter to the preferences of over 100 million women in developing countries, who would prefer to limit family unit size or increment spacing betwixt births. This gap between stated preference and actual beliefs is a measure out of what demographers label the "unmet need for contraception." This concept refers to the attitude of women who desire no more children or desire to delay their next pregnancy but face barriers to the use of contraception. The ii barriers women most commonly cite are (1) lack of noesis almost contraceptive methods and availability and (2) concern most health effects. By increasing admission to contraception and to a wider variety of methods likewise every bit promoting wider cognition about proper contraceptive use and low health risks, family planning programs accept helped address these barriers. Reducing unmet demand can also aid to reduce the number of unintended pregnancies. Since these pregnancies are more than likely to stop in abortion, they increase health risks for women.
six. Even in some countries where fertility is low, increased access to contraception is needed to reduce the heavy reliance on ballgame. The fertility rate in Russia, for example, is currently about 1.2 children per woman. I way that Russian women reach such a low fertility charge per unit is by having 1 of the highest rates of ballgame in the globe. Russian women have an average of ii.5 abortions in their lifetime, a figure that has actually dropped from 4.5 in the concluding 20 years.[4]
Increased access to contraception tin can assistance reduce the costly and oftentimes risky reliance on ballgame by preventing unintended pregnancies, which accept a higher likelihood of catastrophe in ballgame. For instance, 30-twelvemonth trend data from Hungary show that abortion declined with increased contraceptive employ, equally practise information from other settings, such as South korea. Evidence from Russia and Kazakhstan also shows declines in abortion in the 1990s equally contraceptive services have expanded. A more than contempo report from People's republic of bangladesh that compared two districts' experiences with family planning showed that the 1 with a more effective family planning program also had a lower rate of abortion.[5]
Family Planning Programs Yield Benefits on Several Levels
Family unit planning programs, which offer a range of contraceptive choices to couples, have led to precipitous increases in the use of contraceptives in the developing world. This trend in turn has had a marked result on fertility rates since the mid-1960s. Controlling for economic growth, which tends to reduce fertility in and of itself, it has been estimated that family planning programs have been responsible for approximately 43 pct of the turn down in earth fertility during the period 1965–1990. Moreover, effective family planning and economic growth together take a synergistic issue in helping to raise contraceptive prevalence and reduce fertility.
Granted, the success of family unit planning programs has not been uniform in all locales. Information technology has depended on several factors, including potent political support, well-designed and implemented programs, the availability of quality services and a wide range of methods, flexibility and responsiveness in adapting to local weather, and adequate funding sources. There are success stories on all continents and in all cultural settings. Much has been learned, in good function through enquiry supported by the U.S. authorities, virtually how to blueprint and operate successful programs, even in what would appear to be unfavorable social and cultural environments.
Reductions in fertility from increased utilise of contraception have in plow been associated with a range of positive outcomes, both for developing countries and for donors. These outcomes are explored in more detail below.
Wellness and Quality-of-Life Benefits
Reduced Risk of Maternal Mortality. Family planning can reduce the run a risk of mortality associated with childbirth. Death in childbirth is almost twenty times as probable for each birth in developing countries as in adult countries. Many successive pregnancies magnify this hazard. At the total fertility rate in sub-Saharan Africa of well-nigh 6.0 children, the average adult female has a 1 in eighteen lifetime risk of dying in childbirth. Reducing fertility by half would also reduce this chance past nearly half.
Effective use of contraception can as well reduce maternal mortality by enabling women to delay first births until age twenty or afterwards, space births at least two years autonomously, and reduce the number of unwanted pregnancies that might otherwise terminate in abortion. Studies in Canada and Scandinavia showed that access to contraception, combined with effective sex education, decreased pregnancies and abortions among young women. Where safe abortions are non available, effective family planning is even more important as a means of reducing mortality associated with unwanted births.[vi]
Improved Health for Children. Lower fertility also produces healthier children. Closely spaced children (less than two years apart), children with many siblings, and children built-in to younger and older mothers are all more mutual at higher levels of fertility, and all face college mortality risks. For example, information bear witness that children built-in less than two years apart are twice as probable to dice in the commencement twelvemonth of life as those born after an interval of at to the lowest degree two years. Furthermore, closely spaced pregnancies are more likely to result in depression-birthweight babies. Finally, shut spacing also interferes with chest-feeding, which has a vital role in kid nutrition and in building the child's resistance against infectious affliction. Family unit planning can assist women achieve optimum spacing between births.[vii]
Improved Life Options for Women. Allowing women more control over their fertility can enhance their status and choices in settings where educational and economic opportunities are expanding. High levels of fertility generally hateful that women become pregnant in their teen years. In some developing countries, this pattern of early on pregnancy is associated with more than a quarter of female school dropouts, beginning equally early as primary school. Furthermore, over their lifetimes, women in these countries may spend the equivalent of 6 continuous years being pregnant and 23 years caring for children younger than six years quondam.
Easing the Burden on Schools. Reducing the proportion of school-age children reduces the burden on schools. Reducing child dependency as well allows families and nations to invest more in education, improving the quality of the hereafter labor force. During the menstruation between 1970 and 1990, fertility levels in South korea brutal from over four children per family unit to less than two. At the same time, net secondary enrollment increased from 38 per centum to 84 percent, while per pupil expenditures more than tripled.
Reduced Pressures on the Environment and Public Services. Lower fertility can besides reduce pressures on the environment and provide a grace period for dealing with other kinds of pressures, such every bit the needs for housing and employment, for public services such every bit health care, and for managing typically limited resources such as h2o.
Economic Benefits
At the macroeconomic level, reduced fertility has helped create favorable atmospheric condition for socioeconomic development in some countries. A prime example of this connection has been the so-chosen Asian Economic Miracle. From 1960 to 1990, the 5 fastest-growing economies in the world were in East Asia: South Korea, Singapore, Hong Kong, Taiwan, and Nihon. Two other Southeast Asian nations, Republic of indonesia and Thailand, were not far behind. During this 30-year span, women in East Asia reduced their childbearing from an boilerplate of 6 children or more to two or fewer in the span of a unmarried generation. Analysis of the experience of E Asian countries suggests that the reductions in fertility in the past decades relieved not simply dependency burdens simply also dependence on foreign uppercase by contributing to high saving rates.
One way in which lower fertility can promote socioeconomic evolution is by reducing the proportion of dependent children in the population. A lower ratio of children to adults tin create a "demographic bonus": With fewer children, families have more dispensable income to salvage or invest. Furthermore, a smaller proportion of children means that a greater per centum of the population is in the working age groups. If expert jobs are available, this situation can contribute to economic growth.
Withal, some caution is in order when drawing connections between lower fertility and socioeconomic development. The "demographic bonus" is not automatic but dependent on appropriate policy in other areas. Furthermore, savings from the "bonus" must be wisely spent or the effects may be negative. For example, the liquidity created by savings in the East Asian countries may actually have contributed to the financial excesses that led to the recent Asian economic crunch.
Benefits for Donor Countries
Developing countries are not the only beneficiaries of family planning programs. Donor countries, which provide approximately one-quaternary of the funds for international family planning programs, also benefit in at to the lowest degree three means.
Boosting the Economic Strength of Potential Trading Partners. Family unit planning is not directly equivalent to strange aid designed to promote exports, but its effects may be wider and terminal longer. If developing countries can achieve lower population growth and improved economies, donor countries stand to benefit considerably from growing markets and expanding export and investment opportunities. In the United states of america, a third of economical growth in the past decade has been generated by exports. Strong economies overseas accept figured prominently in this trend. For case, ii Asian countries that benefited essentially from U.S.-supported family unit planning programs—South Korea and Taiwan—have become major U.S. trading partners.
Improving Stability and Cooperation. In addition, strong economies in developing countries promote political stability and facilitate cooperation on international bug, ranging from security to criminal offense to global warming to uncontrolled migration.[viii]
Achieving Humanitarian Goals. Since the recipient nations tend to exist among the world's most impoverished, support for family planning helps reduce human misery and improve the quality of life for many of the world's poorest people. It is worth noting that developing countries take affirmed their support for family planning at three global conferences since 1974. And as noted above, many women have expressed a desire for limiting or postponing births. Thus, these programs provide services that are actively sought by the countries themselves and many of their residents.
Donor Nations Still Have a Vital Role to Play
Donor nations have played a critical role in the success of family planning. In add-on to providing virtually a fourth of all funding for family planning programs worldwide, donor nations accept provided vital expertise in all the skill areas that are essential to successful family planning programs: medicine, public health, communications, management, demography, and social services.
The chief donor countries are the United States, Federal republic of germany, the Britain, Japan, and nine other members of the Organisation for Economic Co-Performance and Development. Historically, the The states has been the largest contributor to population programs around the world and the most meaning provider of technical aid. However, there are signs that the United States has started to relinquish its part as world leader. In 1996, Congress reduced funds for bilateral international family planning by 35 percent and imposed crushing legislative restrictions that exacerbated these cuts. Although some of this funding was restored the following twelvemonth, the 1997 U.S. Agency for International Development (USAID) funding of $385 one thousand thousand was well beneath its 1995 top of $542 1000000.[9] Furthermore, U.S. back up for the Un Population Fund and other multilateral instruments has been eroding in recent years.
The effect of these declines on the global funding environment is uncertain. It is non clear whether other donor nations are willing or able to make upwardly the difference. Reduced back up for family unit planning risks eroding decades of progress enabled past U.S. support for family planning. According to 1 set of estimates, the effects of reduced funding worldwide for family planning during 1996–1997 could accept dramatic implications:
- More than women will die in pregnancy and childbirth.
- Thousands of infants will dice as the result of increases in high-risk births.
- Several million couples in developing countries will lose access to modern contraceptives, resulting in millions of unwanted pregnancies.
- A substantial fraction of those pregnancies will end in abortion.[10]
Challenges Lie Ahead
Family unit planning programs have enjoyed success in a wide range of political, economic, and cultural contexts and have contributed essentially to welfare in developing countries at a surprisingly small cost: Americans spend about $1.44 per capita per year on USAID support of family planning.[eleven] Notwithstanding, family planning still has much to accomplish. Programs must continue to accommodate to changes in their customer populations. As fertility declines, it becomes concentrated among younger adults. Many pregnancies for women in their teens and early 20s are unintended and could be postponed if contraception were available. Unmet need for contraception is higher among immature adults relative to its levels among older women, and therefore, as the younger cohort increases, unmet need will grow.
Much of the need for contraception amongst this younger population is for delaying or spacing births. Because delaying births can help reduce population momentum, programs need to revamp their goals and approaches accordingly. Farther challenges lie ahead in improving services and quality of care and dealing with sexually transmitted disease, specially HIV/AIDS.
Another critical demand is inquiry to promote advances in contraceptive development and delivery. These advances can increase contraceptive use and reduce unintended pregnancies and abortions, which are sometimes a consequence of contraceptive failure.
Sustainability is another key claiming. As the fiscal surround becomes more constrained, programs may need to develop more diverse sources of financing, possibly including fees from consumers who can beget to pay for services.
Helping developing countries encounter these challenges could prove extremely difficult without donor nation engagement and especially without American expertise. At present is not the time to curtail support for family unit planning programs in developing countries.
Notes
This paper was supported by funding from The William and Flora Hewlett Foundation, The Rockefeller Foundation, and the United Nations Population Fund.
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