Family planning programs: efforts and results, 1982-89
- PMID: 1792675
Family planning programs: efforts and results, 1982-89
Abstract
According to a set of 30 indices that assess the strength of large-scale family planning programs in developing countries, a strong upward shift in effort scores occurred between 1982 and 1989. During that period, many countries established or augmented their family planning programs, and effort scores improved in all developing regions and in all four dimensions of effort--policies and stage-setting activities, service and service-related activities, record keeping and evaluation, and availability of contraceptive methods. By region, the sharpest improvement was not in East Asia, where levels were already high, but in sub-Saharan Africa, where the movement was clearly upward, from a low base. Earlier associations between program effort and fertility declines are reaffirmed, additive to the contribution of socioeconomic improvements. In order to compute scores ranging from zero to 30 for each of the 30 indices, a detailed questionnaire was sent to 4-6 respondents in each of 103 developing countries having more than one million population. Respondents included program staff, donor agency personnel, local observers, and knowledgeable foreigners. The scores indicate that developing countries are continuing to move toward more favorable policy positions and stronger implementation of action programs, with consequent fertility effects. For the fertility decline to match the medium population projections of the United Nations, however, a substantial enlargement in the number of contraceptive users is necessary, not only to compensate for the enlarging base of couples, but also to increase the proportion who use contraceptives.
PIP: A cross-national study of the strength of national family planning programs and the relationship of program strength to fertility change was conducted in 88 countries in both 1982 and 1989. Study data were obtained through detailed questionnaires sent to 4-6 respondents in each of 103 developing countries with over 1 million population. Respondents included program staff, donor agency personnel, local observers, and knowledgeable foreigners who ranked 30 indices along a 0-30 point scale. Many countries having established or augmented their family planning programs over this period, effort scores improved in all developing regions regarding policies and stage-setting activities, service and service-related activities, record keeping and evaluation, and availability of contraceptive methods. Greatest improvement was observed in sub-Saharan Africa where upward movement took place from a low base. Study results reaffirm an earlier association between program effort and fertility declines. They show developing countries to still be moving toward better policy positions and stronger implementation of action programs with corresponding fertility effects. Substantially more contraceptive users are, however, needed in order to meet medium UN population projections. Increases must be sufficient to both compensate for the enlarging base of couples while increasing the overall proportion of users. The indices included in the program effort scale are summarily discussed in the appendix.
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