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It took the US 200 years to go from 7 babies per family to two. "Bangladesh has [nearly] done that in 20. Iran has more than halved its fertility rate in a decade."
Carl Haub - Population Reference Bureau

Before, we didn't know how to control pregnancy, we didn't have the education, and people in the area were having nine or ten children. We have 18 families and no one has more than three children. The health of the children and mothers has improved, and so has the spacing of babies. Everyone understands the importance of family planning now. Vincente Jarrin and Maria Juana Jarrin Malca, Husband and Wife Family Planning Promoters in Pasquazo Zambrano, Ecuador
2005  

The Two Parts of Sustainability Are Consumption and Population   The world could possibly reduce consumption down to a very basic level, but if population keeps growing, eventually that will not be enough. Even today many are living on a sub-sustainable level, due in part to an uneven distribution of resources, but also because, in many regions, population has outgrown essential resources for that region.

When people feel threatened by a hand-to-mouth existence, they are more likely to look towards less-than democratic ways to reduce population, especially if they have the foresight to realize that population growth is like a run-away train, very difficult to slow and stop.

However, more and more evidence is showing that the methods that work the best towards reducing population growth, are the methods established by the principles of the Cairo Conference in 1994 (United Nations International Conference on Population and Development (ICPD) September 1994, Cairo, Egypt), which include: a. Empowering women and girls in the economic, political, and social arenas; b. Removing gender disparities in education; c. Integrating family planning with related efforts to improve maternal and child health; and d. Removal of 'target' family sizes.  

Population Progress.   A United Nations report says poverty perpetuates and is exacerbated by poor maternal health, gender discrimination, and lack of access to birth control. This holistic view has helped slow the increase in world population. The average family has declined from six children in 1960 to around three today. The world's population is expected to grow by 39% over the next 45 years and births in the 50 poorest nations are estimated to rise by 228%. Education and improved health for women and access to contraception are vital. Smaller families are healthier families and improve the prospects of each generation. 201 million couples do not have access to contraception and if they could practice family planning, 22 million abortions, 142,000 pregnancy-related deaths, and 1.4 million infant deaths each year could be prevented. Since 1994 more women have access to education and other rights, and more early-marriage traditions are being opposed. Most countries have laws prohibiting violence against women, female genital mutilation, and other violations of human rights.   October 06, 2004   Boston Globe

What could we, should we actually do about human population growth? Can population trends be altered? If so, can they be altered without violating core human values about the worth of all human beings and the freedom of all to make decisions about their own childbearing? Does the idea of altering population trends lead inevitably to "population control," to walls erected to keep out immigrants, and to coercive policies on childbearing that punish poor women for environment problems that may be the fault of wealthy people living far away? At the United Nations International Conference on Population and Development in Cairo in 1994, some 180 nations agreed with economist Amartya Sen that coercion has no place in any population program, whether it be a one-child policy, sterilization, forced marriage, forced childbearing, or forced sex. The Chinese, to their credit, are turning away from coercion and toward the approach that the United Nations Population Fund is the United Nations Population Fund is demonstrating, and groups such as Population Action International are advocating worldwide. This more democratic and comprehensive approach champions women's education and access to information and to reproductive-health to reproductive-health care. That care ideally includes not only contraceptives but also pre-natal and post-natal care, professional birth attendants, nutritional and child-care counseling, as well as H.I.V./AIDS prevention.   Amy Coen, PAI, Vanity Fair LTE

Meeting the Cairo Challenge.   Policies based on population control are moving towards more people- oriented, reproductive health approaches. Although it takes time for policy and legal changes to benefit women and men at the community and household levels, such changes are a critical first step. Policies and laws are needed to hold health services courts, schools, and other institutions, as well as communities and families, accountable. As such, the policy and legal changes made since 1994 based on human rights, equity, and meeting people's needs--are central to fullfiling the Cairo Mandate.   Family Care International

Call for Europe to Take the Lead in Revitalising Family Planning Agenda in World's Poorest Countries.   A plea is made for a revitalisation of family planning in the poorest countries, as soaring population rates are a bigger threat to achieving the MDGs than HIV. A paper asserts that family planning should have a higher priority than HIV in most poor countries, because it poses a greater threat to international development. Leadership may need to come from European governments and agencies, rather than the US. Family planning promotion is unique in its potential benefits. It reduces poverty, maternal, and child mortality. It contributes to universal primary schooling, empowers women and enhances environmental sustainability. Family planning programmes have raised the use of contraceptives from less than 10% to 60% and reducing fertility in developing countries from six to about three births per woman. But in half the countries contraceptive practice population growth and unmet need for family planning remain high. Investment in family planning should have a higher priority than in HIV prevention and treatment. In Uganda, with a longstanding HIV epidemic, population size is projected to grow from 30 million today to 61 million by 2025, and further to 127 million by the middle of this century. Hopefully, perhaps European countries, the World Bank, or even the Gates Foundation will give leadership. Most poor countries need encouragement to implement population control with conviction and commitment. The keys are high-level political commitment, a broad coalition of support from elite groups, adequate funding, the legitimisation of the idea of smaller families and modern contraceptives.   November 06, 2006   Innovations Report

Women Education and Family Planning.   In almost every country, educated women have fewer children than their uneducated sisters. Since more girls are receiving education in the developing world, the education factor becomes extremely significant. There are 29% more girls and 16% more boys in secondary school than a decade ago. Fertility has gone down in some American countries and experts say, education was responsible. An educated literate woman is far more likely to make use of clinics, post offices or transport systems, because education makes her more confident and less dependent on men. She is more likely to feel that she has control over her life and fertility. Educated women are better able to keep their children alive and healthy. A 1% rise in women's literacy rate is three times more effective in reducing infant mortality than a 1% rise in number of doctors. Four to six years of a education led to a 20% drop in infant deaths. In families where a child had died, parents will tend to produce more children than they wanted. Having children becomes a form of insurance against the risk of no offspring to support you in your old age. If a mother knows that there are certain things she can do to help keep her children alive she will be far more open to controlling the size of her family. Women who are educated get better healthcare. In an ideal world all women would have several years education before they decide to start a family. But in every country in the world one school girl or another is discovering that she is pregnant. In patriarchal societies education may serve to further entrench inequalities. In India for example, educated women improved only the health of their sons.   November 06, 2006   The Tide Online

Reproductive Health of Young Adults in India: the Road to Public Health.   In 1999, with the support of the Bill and Melinda Gates Foundation and unrestricted seed money by the Pathfinder Board of Directors, Pathfinder International launched the first phase of the Reproductive Health of Young Adults in India (RHEYA) Project, a seven-year pilot project to change the attitudes of adolescents and young adults related to reproduction, overcoming the idea that ill health is an act of God or a result of one's fate. RHEYA Project has improved the overall utilization of reproductive health and family planning services primarily by changing popular beliefs and knowledge about early marriage and childbearing and the importance of spacing children to improve their chances of surviving and thriving. In selected areas of the states of Tamil Nadu, New Delhi, Rajasthan, and Madhya Pradesh, Pathfinder partnered with four local nongovernmental organizations to develop effective interventions that reached nearly 22,000 young people from underprivileged communities with adolescent sexual and reproductive health (ASRH) information. The project's goal was to reaching parents, in-laws, and community and religious leaders, as well as the young people themselves - all at he same time. More than 81% of the people of India live on less than $2 per day; despite amazing economic progress, much of the country remains crushingly poor. India is home to 30% of the world's young people - between the ages of 10 and 24.3 - those reaching their reproductive years. Indian women bear an average of 3.0 children, which means the country's population will double in 41 years. Indian women - "like those in many developing countries" bear their children very young. The median age of marriage for girls is 16.75, well below the legal age of 18. Given little knowledge of or access to contraception, their childbearing is telescoped into adolescence and early adulthood. Twenty-eight percent of women give birth before the age of 18, and the median age of sterilization is 25.77. Only 5% of married women between the ages of 15-19, and 21% between 20-24, use modern methods of contraception. In fact, according to a study from NFHS 2, 1998-1999, at least 25.6% of women between the ages of 15-19, and 18.4% between 20-24 would like to space their children further apart but do not have the ability to do so. Access to reproductive health and family planning for these young people could lower birth rates to dramatically slow the population doubling rate. For over 30 years, the government of India aggressively addressed the problem of population, with a dominant focus on promoting small families and the use of sterilization after two or three children. "A small family is a happy family," was the slogan, which led people to believe that the government's goal was to limit the population. They saw contraception as a government need, rather than as something that is to their personal advantage. Pathfinder directly addresses that perception, persuading women and men to understand contraception and the timing of pregnancies as an important means of personal autonomy and improvement in their personal lives. India has a tragically high maternal mortality rate and adolescent girls are twice as likely to die in childbirth as women in their twenties. For those between the ages of 10-14, this risk is five times higher, due to their emotional and physical immaturity and their inability to seek and use adequate health care during pregnancy and childbirth. The children of young mothers are 50% more likely to die than those born to mothers aged 20-29. Child spacing is more important for an adolescent because an adolescent is not fully developed and pregnancy retards her own growth. A child born less than 24 months after a previous birth is nearly three times as likely to die as a child born after a gap of 48 months or more. Unwanted teenage pregnancies often lead to abortions - 16% of maternal mortality in India is due to unsafe abortions. Adolescents are also the age group most vulnerable to Sexually Transmitted Infections (STIs) and HIV/AIDS. In 2005, 32.42% of people living with HIV/AIDS in India were between the ages of 15 and 29. Knowledge about sexuality, reproduction, personal hygiene, and STIs is extremely low, since these are culturally embarrassing topics between mother and daughter, father and son, teacher and pupil, or even between friends. A young girl in a poor village who learns how to control and take responsibility for her reproductive life, will be able to change the course of her life, from delaying marriage and children to acquire education, to making healthy decisions about sexual activity and preventing sexally transmitted diseases. She will be more able to take steps to ensure healthy pregnancies and care of newborn children. In India, and in much of the developing world, the key to reducing maternal and child mortality, the prevention and treatment of HIV/AIDS, empowering women, improving their health, ensuring family well-being, and reducing population growth rates, is an urgent focus on adolescents.   November 06, 2006   Pathfinder

Far Too Many Women Risking Death to Give Life, UNFPA Leader Says, As UN Unveils Progress Report on Development Goals.   UNFPA said we must create a more caring world by doing all we can to prevent millions from losing their lives to pregnancy and childbirth. Today’s report reaffirms that universal access to reproductive health care is the starting point for maternal health and saving women's lives. Maternal health also frees women to pursue opportunities in work and education, giving them power to make decisions to improve lives in their families and communities. Promoting the rights of girls and women, securing their reproductive health and the means to protect themselves from sexually transmitted infections, particularly HIV/AIDS, are the surest ways to realize the development goals of all countries. The risk of death from pregnancy in the developing world would be reduced substantially if all of its women had access to the family planning services they desired. Currently, 200 million women have an unmet need for safe and effective contraceptive services. It is essential for pregnant women to get access to emergency obstetric care centres that must be stocked with drugs, equipment and supplies. Because there is no cure for AIDS, prevention is essential, treatment and care need to be expanded to reach millions who are HIV-positive.   June 17, 2005   UNFPA

World Population Likely to Stabilize in 40 Years.   World fertility is expected to decline and the world population will stabilise in 40 years. Over the last 50 years, the world has slowed population growth, raised life expectancy, lowered mortality and improved quality of life. The last century, had seen the total population more than triple, to 6.1 billion in 2000, growing annually at 1.2%, lower than the 2% in the late 1960s. The number of children per woman came down from 5 in the 1950s to less than 3 currently, and the annual increase of the population fell to 77 million in 2004 from 87 million in 1987. The increase has been falling since the 1980s and is expected to fall to 29 million by 2050, when there wil be stabilization, attributed to lower fertility. When fertility decreases to the replacement level of 2, the birth rate and the death rate will be in harmony. There are 60 countries below that level, but population growth is not yet over and is expected to last 25 to 40 years. Six developing countries, India, China, Pakistan, Nigeria, Indonesia and Bangladesh account for half of the annual increments of the world population, with India making up 21%. South Asia and Africa are the two fastest- growing areas, and there we have to continue family planning services. The challenge of population ageing could be met by extending working age, adjusting social policies and bringing in more migrants, among other policy adjustments.   July 10, 2004   Xinhua General News Service

Poverty and Fertility in Sub-Saharan Africa. Evidence from 25 Countries.   The incidence of poverty in Africa has been stagnating over the last two decades and is unlikely to improve in the near future. Widespread fertility control seems to be the only route to a fertility decline. The hypothesis of fertility decline under poverty runs counter to the classical demographic theory and to the common idea that poverty is a key factor of high fertility. Economic approaches consider high fertility a rational response to poverty and fertility will not decline unless conditions improve. On the other hand, the decline of fertility among the poor is consistent with the innovation diffusion approach which says that fertility decline results from the spread of ideas, values and technology, regardless of their economic status. Evidence of fertility changes in Bangladesh and Nepal are consistent with innovation diffusion, and studies in Latin America support this view. Yet, few studies have documented the relationships between economic status and fertility in Sub-Saharan Africa. It is well-known that female education and place of residence are related to fertility, but few studies have described the relationship between economic status and fertility behaviour. The objective of this paper is to document the relationship between economic status and fertility behaviour in Sub-Saharan Africa. Three questions are addressed. (1) What are the differentials in fertility by economic status? (2)What account for these differentials? (3) Are they explained by women’s educational level and place of residence? We briefly address four questions. (1) In each country, what proportion of fertility change can be accounted for by a shift in economic status? (2) To what extent has fertility changed within economic groups? (3) What accounts for these changes? (4) Can they be related to changes in other the economy? Women from poor households have larger families, almost always in the course of fertility transition. Relationships are less clear-cut in high fertility settings. In a previous literature review on the relationships between economic status and fertility, about 50 such relationships reported in 32 studies but only six of them were on Sub-Saharan Africa. We found a diversity of relationships between economic status and fertility. There was no relationship in Botswana in the 1970s, a slightly positive relationship in Sierra Leone, a slightly negative relationship in Burkina Faso and in a small town in Southern Sudan. Using data from surveys conducted in the 1990s, indicate that, in most countries, fertility decreases with increasing economic status. Fertility by economic status are in all the 25 countries studied, and the poorest women have a larger number of children. These fertility differences are from contraceptive use and age at marriage. The differences by economic status persist after education and place of residence that suggests economic status has the major effect on fertility. Analyses of changes show that fertility has decreased in all the economic groups in these countries that indicates though fertility has declined, poverty does not represent an obstacle to fertility changes, in these countries. Fertility changes are independent from changes in the distribution of the population by economic status. They are little related to educational levels and changes in place of residence. The largest changes, which concern the poorest women, have occurred in Kenya, Ghana, Zimbabwe, South Africa where family planning programmes are more developed. This suggests that better family planning services contribute to reducing fertility among the poorest women. Our results suggest that better-off women are the first to control their fertility and that control spreads to the rest of the population, including the poorest women. The level of child mortality in the countries where fertility has changed most among the poorest women (Ghana, Kenya, South Africa and Zimbabwe) is lower than in other countries. Child mortality is most strongly related to fertility in Sub-Saharan Africa and should be taken into account. The changes in the demand for children by economic status could provide further insight into the mechanisms underlying the relationships between economic status and fertility behaviour.   April 2004   Population Association of America

The Interaction Between Health & Fertility: Evidence from the Ivory Coast.   The UN calculates that developing countries can increase their economic growth by reducing population through lower fertility. In many East-Asian countries, lower fertility led to a lower dependency, that fostered savings and investments for economic growth. The key factors are investments in health, education and gender equality. As fertility declines, the working-age adult population increases and with a lower dependency and investments in health and education, families were able to move out of poverty, that led to economic growth. Though countries have only one chance to take advantage of this effect, many developing countries have yet to reach that stage. Investments in health and education in developing countries take on more importance since their effect on economic growth may be larger than previously thought. For countries to take advantage of this, a better understanding of the effects of investments on economic growth is needed. Studies have established that higher education, awareness of reproductive health services and opening labor market opportunities, lead to lower fertility. Increased education for women does not always leads to greater participation in the labor market, thereby reducing fertility, but allows for more investment in their children in the form of more schooling and better health. This higher investment increases the cost of having an additional child and may lead to a fall in the demand for children. If you are interested in this subject, please follow the link to the entire article as it is not all covered here.   December 05, 2003   Journal of Health and Population in Developing Countries

Forks in the Demographic Road.   What causes birth rates to drop? The short answer is that while there are racks of data that show strong correlations with fertility decline, all of the models fail to establish predictive causality. In short, while there are "theories" about the "demographic transition," there are no hard-and-fast rules, and quite a few important exceptions. John Cleland of the London School of Hygiene and Tropical Medicine has looked at countries with similar socio-economic profiles, for example, and found that many of them have very different track records. Algeria and Tunisia, for example, had comparable proportions of literate people, city dwellers, and the exact same life expectancy in the mid-1980s. Algeria's GNP of $2,360 per head, however, was almost double that of Tunisia. So did Algeria's fertility decline faster than Tunisia's? No. In fact, Algeria's fertility decline started about 15 years later than Tunisia's. Why? The short answer, according to Cleland, is that the Algerian government regarded family planning as a tool of Western oppression, while Tunisia had a more positive attitude towards contraception. While the government of Algeria has since embraced a very successful family planning program, their 15-year delay will have a real cost -- a 2050 population that will be 20 million people higher due to governmental delay. A similar story is told in Bangladesh and Pakistan, two nations that used to be one country. At the time of their 1971 split, Bangladesh was far poorer than its neighbor. So did Pakistan's fertility rate fall faster than that of Bangladesh? No. In fact, Bangladesh's fertility rate fell soon as a direct result of government resources put into meeting the unmet need for contraception in that country. In Pakistan, instead of focusing on family planning and health care, that government focused on saber-rattling and weapons procurement. As a result, Pakistan will have about 150 million more poor people in 2050 than it might have had if it had followed the Bangladesh model. Cleland argues such comparisons show that the link between economic development and smaller families is "much weaker and more variable" than previously believed, and that "the empowerment of women ... will facilitate fertility decline but is not a precondition for it." Ironically, Cleland's theory is challenged by the case of West Bengal, right next door to Bangladesh. The Muslims of West Bengal (which includes the city of Calcutta) have the highest levels of contraceptive use in India -- higher even than that of the Muslims of Kerala. The total fertility rate of West Bengal is expected to hit the replacement rate within the next two years. What's odd here is that the state government of West Bengal "has been quite indifferent to population policy" according to Alaka Basu and Sajeda Amin, writing in the December 2000 issue of Population and Development Review. "West Bengal has never had the kind of aggressive or even efficient family planning campaign or program that many other parts of India have embraced at various times." According to Basu and Amin, both Bangladesh and West Bengal share a common language and a common culture that embraces change -- another element in the matrix of factors that influence the speed of fertility decline. The bottom line seems to be that every country, every culture, and every couple need to be treated as individuals if we are to get to replacement level fertility rates as quickly as possible. While education, economic development, and government support for family planning programs are all important, there is not a single "silver bullet solution" that triggers rapid and sustained fertility decline in every country every time. Instead, the decision to have smaller families appears to be a complex decision that can be encouraged and facilitated by a wide variety of programs, developments and outside forces. The good news is that countries that have been slow to embrace family planning often find that modern contraceptive methods can help to reduce fertility quickly. The bad news is that time lost cannot be regained. Though fertility may fall, the base population will be higher and so too will be the population when it reaches stabilization. For more information, see "The Determinants of Reproductive Change in Bangladesh: Success in a Challenging Environment" published by the World Bank and authored by John Cleland and Sajeda Amin, and; "Conditioning Factors for Fertility Decline in Bengal: History, Language Identity, and Openness to Innovations," Population and Development Review, December 1, 2000 by Alaka Basu and Sajeda Amin. I have appended below the historical and projected (UN Median variant) total fertility rates of the countries discussed:

	ALG.	TUN.	PAK.	BANG.	INDIA
1950-1955	7.28	6.93	6.28	6.7	5.97
1955-1960	7.28	7.04	6.28	6.76	5.92
1960-1965	7.38	7.25	6.28	6.85	5.81
1965-1970	7.38	6.89	6.28	6.6	5.69
1970-1975	7.38	6.21	6.28	6.15	5.43
1975-1980	7.18	5.69	6.28	5.6	4.83
1980-1985	6.36	4.9	6.23	5.25	4.48
1985-1990	5.23	4.12	6.08	4.75	4.15
1990-1995	4.12	3.13	5.83	4.4	3.8
1995-2000	3.15	2.32	5.48	3.95	3.45
2000-2005	2.8	2.01	5.08	3.46	3.01
2005-2010	2.51	1.91	4.62	3.08	2.7
2010-2015	2.28	1.85	4.11	2.75	2.46
2015-2020	2.08	1.85	3.6	2.5	2.28
2020-2025	1.91	1.85	3.14	2.31	2.14
2025-2030	1.85	1.85	2.79	2.16	2.02
2030-2035	1.85	1.85	2.53	2.04	1.92
2035-2040	1.85	1.85	2.34	1.94	1.85
2040-2045	1.85	1.85	2.18	1.85	1.85
2045-2050	1.85	1.85	2.06	1.85	1.85

  August 2003   Patrick Burns

Women's Reproductive Health in the Middle East and North Africa.   Half of the 10 million women who give birth in the Middle East and North Africa (MENA) endure complications and one million suffer from serious injuries due to birth. Women in MENA continue to face complications due to sexual inequality, quality of healthcare and the lack of reproductive healthcare and education. In 1994 the UN International Conference on Population and Development stated a definition for reproductive health that would advance women and go beyond family planning. Currently the majority of maternal deaths occur in four countries: Egypt, Iraq, Morocco, and Yemen. Iraq’s is one of the highest in the world, 300 deaths per 100,000 live births. Morocco is 200 deaths per 100,000 live births. "Maternal deaths are strongly associated with the absence of good medical care before, during, and after delivery." Most maternal deaths occur due to postpartum hemorrhage. Most of the women who do seek healthcare while pregnant prefer to see women physicians, however there are few available. Overall, "reducing cultural, financial, and physical obstacles to reproductive health care service is necessary for improving maternal health." The other cause for maternal death is self-induced abortions of abortions carried out my unskilled practitioners. Over one million unsafe abortions occur in MENA countries every year and 16 percent of all maternal deaths are attributed to this. An otherwise safe procedure can mean death for many where abortion is illegal, unsanitary and unsafe. "MENA’s total fertility rate has declined from an average of 7.0 children per woman in 1960 to 3.3 children in 2002 – still well above the world average of 2.8 children per woman." Sixty percent of married women are using a form of family planning, but many are still not using contraceptives. Some women choose not to use contraceptives because of feared side effects, opposition from husbands and relatives or even trying contraceptives and being unsatisfied with the use. "One study has shown that if no women experienced contraceptive failure or stopped using a method, Egypt and Jordan’s total fertility rates would drop to 2.0 births per woman, Morocco’s to 2.4, and Turkey’s to 1.5." Thus, finding a contraceptive that works well with each individual woman is important for the reproductive health of all families.   February 17, 2003   Population Reference Bureau

Fertility Rates Drop.   by Amartya Sen, author of Development as Freedom, and recipient of the Nobel Memorial Prize in Economic Science in 1998.
Perhaps the most immediate adversity caused by a high rate of population growth lies in the loss of freedom that women suffer when they are shackled by persistent bearing and rearing of children. Global warming is a distant effect compared with what population explosion does to the lives and well-being of mothers. Female illiteracy, lack of female employment opportunity and economic independence contribute substantially to the muffling women's voices in society and within the family. Not knowing about family planning or available family planning facilities is also an important source of helplessness. Cultural and religious factors often force young women toi accept a subservient position and the burden of constantly bearing and rearing children which husband or parents-in-law have placed on them. A long history sanctifies such practices and generates uncritical acceptance. On the other hand, women's empowerment, through employment, education, property rights, etc., can lead to the reduction of the fertility rate. The Indian states of Kerala, Tamil Nadu or Himachal Pradesh have experienced speedy fertility declines which can be linked to the rapid enhancement of female education, employment opportunity, and and other empowerment of young women. The states of Uttar Pradesh, Bihar, and Rajasthan, on the other hand, give few economic and educational opportunities to young women and experience high fertility rates. It is notable that China, where coercive one-child policies were employed, fertility rates fell from 2.8 to 2.0 from 1979 to 1991, while in Kerala, where fertility decline was freely chosen, fertility rates fell much faster, from 3 to 1.8 in the same period. In Kerala, the rate of expansion of female literacy has also been faster than China's, and consequently, Kerala's infant mortality rate has continued to fall fast while it has not in China, where it is now double Kerala's, even though they were roughly even in this respect in 1979. [This is an excellent article and deserves a full read. Unfortunately, it is not on-line. Look for The Nation, No. 4, Vol. 271; Pg. 16 ; ISSN: 0027-8378 at your library.]   July 24, 2000   Nation, The (Thailand)

Tesitmonial.   "As a member of the U.S. delegation to the International Conference on Population and Development, I was involved in the crafting of the program of action. After thirty-five years in this field and work in 12 countries, I don't believe the program of action was flawed." ... "Even before Cairo, we had figured out that by the year 2000 the U.S. government should be contributing 1.2 billion dollars per year to international population and family planning. This budget coming up is about one-quarter of that amount. At Cairo we agreed that developing countries would contribution 2/3 of the money needed to address population growth in their countries. The donor countries promised to contribute 1/3. Five years later the developing countries met their commitment; we had not. It seems that the flaw is in our unwillingness to take seriously the issues related to population. But our biggest flaw is that we citizens have been unable to hold our decision-makers accountable."   1999   Pat Waak, National Audubon Society Population and Habitat Program

Large Acceptance for Family Planning.   Over 95% of the developing world's population lives in countries with policies supporting family planning. In fact, almost three-quarters of funding for family planning services comes from developing country governments and consumers. Nearly 60% of couples or over 380 million women in the developing world (excluding China) want to limit or space their births. Yet over 100 million of these women do not use family planning services mainly because of lack of accurate information and poor access to a variety of good-quality services.   1999   USAID (U.S. Agency for International Development)

Causes of population growth:	Solutions:
Unwanted pregnancies and the unmet need for contraception. About one out of four women wants to prevent or postpone her next pregnancy, but is not using contraception. In sub-Saharan Africa, unmet need is between 30-42%.	Family planning education and availability of contraception and sterilization
Population momentum, which occurs when large numbers of young people enter their childbearing years at once. Population growth peaked in the 1960s, and the children of those people are now having children. Between the ages of 15 and 24, most young women become sexually active, marry and have their first children. Many times, these activities are not the choice of the young lady involved.	Studies estimate that delaying the onset of childbearing by two to five years would ease "population momentum" and reduce the eventual global total. Spacing children will also ease the burden of population momentum. "Raising mothers’ age at first birth from 18 to 23 would reduce population momentum by over 40%." "If they decide to delay their first pregnancy and to have proper spacing between pregnancies, the difference could be something like half a billion to 1 billion people by the year 2015," UN Population Fund Executive Director Nafis Sadik says. Christian Science Monitor, 20 Oct
The desire for large families. In areas where child mortality rates are high, parents choose to have many children so that some will survive.	Reduce the infant mortality rate
Where women lack self-esteem, employment, schooling, and/or the full legal and social rights of citizenship, they depend on children for status and security.	Provide jobs or small business opportunities for women. Education of females. Give women a voice in government. Reproductive health clinics help promote self-esteem by demonstrating that a woman's life is worth preserving.

- provided in part by the National Resource Defense Council
National Resource Defense Council

9 out of 10 American voters believe family planning services are important.
• 74% of American voters favor public sector funding for family planning services.
• 66% of American voters believe it is important to ensure that abortion remains accessible.

There are a Wide Range of Suggestions for Attaining Population Sustainability.   Those that believe that there aren't enough people in the world will tell you that everyone should have all the children that they can. They will say that there is a 'birth dearth', overlooking the fact that there are more people on the earth than ever before, and overlooking that in the Bible (Genesis) God told not just humans, but the animals to 'Be fruitful and multiply. (we seem to be wiping out plant and animal species by our overabundance) Those that believe that the environment is being degraded, and see the connection between bad human habits (i.e. sprawl and overconsumption) and the degraded environment, but do not see the connection between increasing numbers of people and the loss and degradation of plant and animal habitat - these people will tell you that any effort to reduce population is an attempt to 'control people', or an attempt to 'target' certain groups of people. Why Population Matters Some, not really seeing the magnitude of population impact, will say that the U.S. has no business in the reproduction policies of other countries and neither should we be making any reproduction policies in this country, either, so let every family (or church) make it's own reproduction decisions. WOA!! believes, along with about 170 countries, the United Nations, and a large number of people in the U.S., - that human sustainability and the environment are being severely impacted by overpopulation, and that 'population control' is NOT the answer. The answer lies in the principles of the Cairo Conference in 1994 (United Nations International Conference on Population and Development (ICPD) September 1994, Cairo, Egypt), which include: a. Empowering women and girls in the economic, political, and social arenas, b.Removing gender disparities in education c.Integrating family planning with related efforts to improve maternal and child health, and d. removal of 'target' family sizes. More on this below. Many believe that the earth is fast reaching it's 'carrying capacity'. They don't think that reduction in population growth is happening fast enough. The less severe methods recommended are incentives and disincentives, which include: eliminating tax breaks or welfare caps for more than two children, and trying to socially ostracize people for having more than two children. Others want more severe methods because of the severity of the impacts caused by foreseen human overpopulation. The Chinese, in their one-Child policy, used large disincentives, ostracizing, and even imprisonment to enforce their policies. Of course there will always be the few radical elements that will suggest more severe methods, some as bad as the methods Hitler used in Germany. WOA!! asks that you do not let these bad examples deter you from wanting to do something worthwhile about human overpopulation. We cannot afford to let more and more of the world, humans and animals, suffer a degraded existence or early loss of life altogether due to too many people.   WOA!! website

How Many Chinese Are Enough?.   Because China has worked hard over the last 30 years, we have 400 million fewer people. In the eyes of supporters, that justifies the infringements on people's freedoms. The end justifies the means, doesn't it? Not having more than two billion people in 20 years time is a desirable outcome for China. There is a limit to how many people China can support. But did the regime have to impose such a draconian birth-control policy? The Chinese government's "soft" birth-control policy, encouraging later marriage, fewer births and longer birth intervals - brought the fertility rate down from 5.7 in 1970 to 2.9 by 1979. And it happened before the one-child policy was introduced. Critics point to the Indian experience, where an early experiment with enforced birth-control measures created a backlash and yet, India's birth rate has also fallen to only 2.8 this year. The transition from high birth rate, high death rate societies to longer-lived communities works its magic eventually. But it does take its time. Compulsion does make a difference. By 1980 China's fertility rate was already down without compulsion to the rate that prevails in India today. With compulsion, it has fallen to little more than half the current Indian fertility rate. So China's population will level off at about 1.4 billion by 2020, while India's will go on growing to at least 1.7 billion. If China had taken India's approach, its population would probably reach two billion before it stopped growing. That could easily be the margin between success and disaster. China's economic miracle skates along the edge of environmental calamity. Breathing the air in Beijing is the equivalent of smoking 20 cigarettes every day. Dozens of cities are experiencing severe water shortages. It's bad enough but what would it have been like without the one-child policy? In large parts of the world, it is not acceptable to suggest that the number of people can be a problem. Population control is absent, for example, from discussions about how to minimise climate change. It's partly out of concern for the religious sensibilities, and partly because of the human rights issues. In addition there are demographic implications. The shrinking number of people in the working-age population who have to provide for an aged population. Another is a wave of selective abortions and female infanticide. In China girls are in such short supply that by 2010 there will be 37 million young Chinese men with no prospect of a wife. Almost two-thirds of Chinese families have only one child. And the Government is determined to retain the policy and intends to bring the population down whatever the collateral social damage. China is well beyond its long-term "carrying capacity" even with its present population. There are things worse than a one-child policy such as social disintegration and civil war.   October 25, 2007   New Zealand Herald

India;: Let Men Do Their Bit.   For 30 years, vasectomy has been taboo, and the burden of family planning has been on women. But modern vasectomy techniques are a success in the West. India needs to try them. India's most populous State, Uttar Pradesh, will account for 22% of India's population by 2026. Fertility rates here destined to take decades to reach replacement levels. Andhra Pradesh, Karnataka, Kerala and Tamil Nadu are forecast to jointly account for only 13% of the population increase during the same period. Currently, 42% of India's population produces three or more children. Of 188 million couples requiring contraceptive coverage, only 53% cent are using contraceptives. The percentage of women having more than three children is 57% in Uttar Pradesh, 54% in Bihar and 49% in Madhya Pradesh. Almost half the girls there are under 18 at marriage. There is urgent need to push up the age of marriage, delay the birth of the first child and widen the scope for spacing and limiting families. Vasectomy is a feasible way. Unfortunately, any efforts to limit population are attacked by critics as an invasion of "human rights". Given the culture of the northern States, such goals are dumped as "unacceptable" and "impossible" and invariably shunned by many politicians. The Millennium Development Goals do not envision family planning as the route to improving maternal and child health. This acts as a deterrent to organisations getting involved overtly. Concentration on maternal and child health services has excluded men. Counselling on vasectomy is just not their business. In India, men have ceased to be the object of family planning ever since eight million male sterilisations were conducted coercively and haphazardly during the draconian Emergency period. Even now horror stories of three decades gone by give shudders to politicians, especially in the Hindi belt. With no other terminal option available, millions of women have perforce to undergo tubal ligations having already borne the brunt of unwanted pregnancies and induced abortions. The recent resurrection of the vasectomy programme comes as a welcome surprise. Madhya Pradesh has doubled vasectomies in the span of just one year from 7,000 to over 15,000. Haryana has shown higher and higher performance each passing year. Punjab has quadrupled the number of vasectomies in a matter of one year. Rajasthan has upped the vasectomy performance from just 1,700 during 2003-04 by almost five-times. On October 6, in Vadodara, nearly 900 vasectomies were performed and hundreds of men had come willingly for this outpatient procedure. At every health facility, ANMs and village women togged up in their best attire escorted the "acceptors" for vasectomy. Surgeries progressed speedily and while the patients waiting their turn, paranthas, enthusiastic counselling and a bag full of condoms were kept in readiness to complete the day's work. Whether the carrot was the Rs 200 motivation money or the Rs 1,000 compensation for acceptors, an enormous response was evident. But India's annual vasectomy total remains less than a 10th of the pre-Emergency levels, despite hundreds of surgeons having acquired the Chinese non-scalpel skill. In India, vasectomies are treated as the poor man's option. In some Latin American countries vasectomy has been presented as an alternative to female sterilisation. What is needed is for decision-makers to stop worrying about resurrecting the ghost of 1975 and understand that our population growth is having a detrimental effect on maternal and infant mortality.   October 23, 2007   The Pioneer

Fertility Rate Dips in Pakistan, Contraceptive Awareness Rises.   The fertility rate among women in Pakistan has dipped from 5.6% in 1990-91 to 4.1% in 2004-06, attributed to rising use of contraceptives. The trend is more in Punjab than other provinces. Women bear the brunt of controlling childbirth. Half of married women use contraceptives and few know about the use of condoms by males. Female sterilisation is on the rise and 84% children are breastfed in the first year of birth. The study was done by the research arm of the Population Welfare ministry, funded by USAID, to collect reliable estimates on pregnant women and family planning usage. The last such survey was done in 1990-91.   October 02, 2007   Indian Muslims website

Family Planning Helps Kon Tum Village Thrive.   Kontum Ko Pang Village has 217 households with more than 1,000 people, most ethnic minorities. In the past, more than half of the families had between five and six children, and many suffered poverty. But recently, most young couples have one or two children. The village has about 60 young couples, and only three of them have more than two children. The others have used modern contraceptive methods, obeying the regulations of the village. This is due to the effort of the village's people who want to build a better life, for themselves and for their children. Every Monday the head of the village takes a few minutes to tell stories about family planning, effective contraceptives and the harms of having too many children. Collaborators visit each family to encourage newly married husbands and wives to use proper contraceptives. Y Lim is one of the women in the village praised for her family planning practise. She got married at 21, but didn't have her first child for another three years. She waited until they had a stable income. Now she has two children who are well-behaved and excel at their studies. They have been able to afford adequate accommodations and two family motorbikes. Y Lim is attending classes to improve her business skills. Y Lim's family is one of many in the village practising modern birth-control methods, ensuring that the children have a brighter future.   September 26, 2007   Vietnam News Agency

Family Planning Success Stories in Sub-Saharan Africa.   Malawi, Zambia, and Ghana, with limited resources, have seen growth in contraceptive use and fertility decline, despite poverty and illiteracy in a predominately rural population. In Malawi, agencies worked through the Ministry of Health. Dedicated individuals maintain motivation and sustain programs. Research can lead to large-scale programs if there is involvement of stakeholders and if it is followed by action to implement recommendations. Improving the logistics for contraceptives is key to strengthening family planning. Mobilization of partnerships with the private and civil sector society can be an effective complement to the system. Bringing services to the doorstep via outreach is an effective way to get services to hard-to-reach, populations, but needs to be widespread. This is important for people living in rural areas. Community-based distributors (CBD) also raise awareness of family planning and refer women for services. The introduction of a range of methods into family planning has raised contraceptive use. Behavior Change is a necessary part of holistic programming; neglecting it will diminish program impact. Exposure to radio and TV was associated with increased contraceptive use in Zambia. Training must build clinical and counseling skills and also address biases. Clinical Officers as well as physicians can and do provide female sterilization. Registered Nurses and Nurse-Midwives can provide Depo-Provera(r) and intrauterine devices. Involving men proved to be an important factor in program success.   August 20, 2007   The Info Project

Jamaica;: Women Having Less Children, Owning More Businesses.   Once you educate and liberate your women, everything else takes off, and in several decades we have seen a dramatic increase in women opting to have careers, getting educated, and becoming liberated. Women are having one or two children, and later, due largely to Jamaica's family planning programme. The total fertility rate has fallen, reaching 2.5 children per woman in 2002. In 1997, the fertility rate stood at 2.8 children per woman. This number continued to decline to 2.21 in 2001, 2.05 in 2002, 1.99 in 2003 and 1.93 in 2004. 20% of female-run businesses have been in existence for over 20 years, 57% are sole proprietorships or partnerships, 76% operate from well-defined business plans and 34% are college or university-educated. The Bureau of Women's Affairs monitors government policy on women. The Association of Women's Organisations of Jamaica (AWOJA) co-ordinates women's organisations islandwide. Women's Crisis Centres help those in dire straits. The Women's Political Caucus facilitates participation in politics. The Women's Construction Collective trains women in construction. Woman Inc runs a crisis centre and shelter.   August 14, 2007   Jamaica Observer

Pakistan;: Population Welfare Programmes Achieve Success.   In Pakistan the fertility rate is down to 4.0 and growth rate to 1.8% per year. The population had reached 156.26 million, 81.1 million male and 75.2 million female. The total fertility rate declined from 6.0 in 1984 to 4.0 in 2005. Maternal mortality declined from 500 in 1991 to 350-400 per 100,000 life births in 2005. The female population 15-49 years was 39.2 million which was 52.1% of total female population. Life expectancy of females had risen to 66 from 61 years in 1991, for male expectancy was 64 years. The population ministry was pursuing awareness campaign and rise in female' mean age at marriage from 21.7 years in 1991 to 23.4 years was a testament to its success. The contraceptive prevalence rate had risen from 11.8 in 1991 to 36.0. The credit also goes to media that had adopted an active role in creating awareness about over-population, especially at the grassroots level. The government was encouraging public-private partnerships to help achieve their targets.   June 26, 2007   Associate Press of Pakistan

Senegal;: What the Rest of Africa Could Learn About AIDS.   The HIV infection rate in Senegal is 0.9%, lower than in African countries such as Namibia (19.6%), South Africa (18.8%) and Botswana (24.1%). What is Senegal doing right? The Senegalese government has taken an active role in the sex education of its citizens. In 1986, the government launched a massive prevention program, pouring resources into AIDS education. The Senegalese brand of Islam dictates there is little opportunity for teenagers to be alone together. The lack of alcohol plays a role in disease prevention. Senegal's sex worker registration system, in place since 1969, provides prostitutes with weekly health care and free condoms, 100% of sex workers surveyed said they use condoms with every customer. But there are other reasons for the country's low AIDS rate, including the early and intensive efforts by the country's powerful imams to educate their congregations about AIDS. While imams limit their sermons to discussions of abstinence and fidelity, doctors are often on hand to handle practical instruction and clinical questions. Teaching people to use condoms is a contradiction of Islamic law. The imam teaches fidelity in marriage and abstinence before marriage. Outside the mosque, he said, he can discuss HIV and AIDS more directly and, like many Senegalese imams, he refers congregants to a local clinic or doctor. Imams enjoy enormous political and cultural power in Senegal. Senegal's anti-AIDS strategy provides a blueprint for other countries struggling to contain the spread of the disease. Another of Senegal's successful HIV/AIDS prevention techniques is frank, open and comprehensive sex education beginning at age 12, and AIDS awareness training starting as early as 1st grade. It provides peer counselors to students and sponsors family life education clubs in schools. Senegalese girls have delayed sex three years longer than their mothers' generation, and condom use has risen threefold from 10 years ago, to nearly 70%. Comprehensive sex education, including information about condoms and how to use them, is one of the most important weapons in the fight against AIDS. In Senegal and in Uganda, where the HIV rate has fallen to about 6%, the governments were quick to implement "Abstinence, Be Faithful and Use Condoms", approach. Senegal's policy of legalized prostitution means the country is ineligible for PEPFAR funding, so it relies on donations from the UNFPA and the Global Fund. That means Senegal's teachers and community leaders are free to discuss condom use as part of a larger prevention message.   April 23, 2007   Chicago Tribune

Population Growth Rate Drops to 1.8%.   Pakistan's population growth rate has dropped from 2.1% to 1.8% per year. Officials stated that they plan to bring the rate down to 1.3% by 2020. The Ministry credited the media for adopting an active awareness program about the implications of over-population.   January 29, 2007   Daily Times

Beijing Women Don't Have a Child Until They Are 29.   The average childbearing age of Beijing women rose to 28.83 in 2005 from 27.24 in 2000. In 2005 for one hundred Beijing women, there were only 68 children. Before 1974, the fertility rate was around 2.6 children per woman but decreased when the family-planning policy was implemented in 1973. By the mid and late 1990s, the fertility rate of Chinese women had dropped to about 1.8. Employment pressures, delayed wedlock and longer life expectancy have all influenced women's childbearing age. In the 1990s, a Chinese woman would marry at 22 but now the age has climbed to 24.   January 12, 2007   Xinhua General News Service

Managed Birth Rate to Rein in Nation's Population Explosion.   Viet Nam's population will stabilise at about 115-120 million people by the middle of the 21st century. Family planning is an important part of reproductive healthcare. The lowering of the birth-rate will help improve living standards. Viet Nam has unveiled a programme that implements reproductive healthcare and family planning under the Cairo model. The country's population will face more difficulties, including how to improve living conditions. From the Human Development Index (HDI), Viet Nam ranks 107th out of 184 countries. From individual HDI criteria, the country's average income of US$650 per person per year places Viet Nam on the list of impoverished nations. Vietnam will come off the list if the country reaches an annual per capita income of $1,000. At the current development level and with a stable replacement birth-rate, Vietnam will reach this goal in the next 10 years. The country's GDP has been increasing at 8% annually, while population has gone up by 1.3-1.4%. When parents have children, expenses for feeding, housing and education are high. It takes time for children to become contributing members of society. Therefore, if we work on population, we will reduce the social burden.   January 10, 2007   Vietnam News Service

Infant Mortality on Par with Developed Nations in Las Tunas, Cuba.   The Cuban province of Las Tunas has an infant mortality rate of 4.76 deaths per thousand live births in 2006, on a par with developed nations and 1.76 lower than last year. Among the factors that contributed is the expansion of the Infant-Maternal Program to the remotest communities. The services provided at the maternity homes, where future mothers with health problems are hospitalized, were also a key. Las Tunas is among the provinces with less qualified medical personnel and a weaker healthcare infrastructure, yet has equalled those that have traditionally had better results. Five years ago, Las Tunas reported 12.9 deaths per thousand live births. Cuba has achieved the best results to reduce infant mortality. Over the past few years the country's rate has ranged between five and seven, very similar to the statistics of many developed nations.   January 09, 2007   Periodico26.com

Cuba Leads in Sustainable Development.   Cuba is the only country in the world with sustainable development, and registered a 12.5% increase in its GDP during the last 12 months. In 2007, Cuba will assign 22.6% of its GDP for public health and education. Spending for health, education, culture, sports, security and social assistance represent 69% of the 2007 budget. The progress of countries toward sustainable development can be assessed using the UN Human Development Index (HDI) as an indicator of well-being, and the ecological footprint as a measure of demand on the biosphere. As world population grows, less biocapacity is available per person. In 2003, Asia-Pacific and Africa regions were using less than world average per person, while the European Union countries and North America had crossed the threshold for high human development. Only Cuba qualified for sustainable development. The Havana government has organized a socialist society with a high level of literacy, education, long life expectancy, low infant mortality and low energy consumption. It is the world's leader in organic agriculture, and is making contributions to medical research, not to mention that Cuban doctors are serving the people in poor developing countries. Cuba has developed a considerable research capability. Castro declared: Humanity is going through difficult times, plus a non-stop consumption process typical of the globalized imperialist system.   January 07, 2007   Canadian Dimension

Brazil's Population to Grow Older by 2030.   A longer life expectancy and lower birth rates indicate the Brazilian population will grow older in the next 24 years. The country's demographic pattern started to change in 1991, when longevity became more common and birth rates fell. Brazil needs to get ready for the elderly population to come.   December 15, 2006   Xinhua

Cuba;: Addressing Aging Population.   Cuba has the highest life expectancy and lowest birth rates and a dwindling population. In 13 years the retired people will outnumber the labour force. The Cuban media has run a candid coverage of a phenomenon that promises to wreak havoc on a strained social service. The effort to sustain the socialist society is being constantly challenged by emigration, aging adults and childless women. Since 1978, Cuba's fertility rate can no longer sustain current population levels. During the 1960s and 1970s, Cuba's annual birth rate was about 250,000. In 2005, there were slightly more than 120,000. Seniors 60 and older make up about 16% of Cuba's population. By 2025, 26% of Cubans will be elderly and Cuba will join the 11 countries with the world's oldest populations. Among the causes are housing shortages, high cost of living, lack of day-care centres and goods like children's clothing and the migration of adults of child-bearing age. Advances for women in the workforce and availability of birth control also contributed. Cuba's population rate started to slip in the 1950s. If communism collapses Cuba is likely to witness a massive outward migration of youth. Cuba has about 300,000 people over the age of 80, but the government has focused its attention on infant mortality and educating children. The Cuban health system is not geared toward the catastrophic illnesses of older people. Elderly people earn less than $10 a month from pensions, so many are street vendors who say they were forced to return to the workforce because they could not survive on their incomes.
Karen Gaia says: Cuba is unique in that it has one of the best health care systems, best education system, lowest infant mortality rate, and lowest birth rate among the developing world. But Cuba is a poor country due to the trade embargo and the economic and brain drain resulting from the emmigration of the wealthier people of Cuba. If it were not so poor, perhaps it would not lose so many of its people. Perhaps it was a mistake for Cuba to send health care workers overseas to help other poor countries.   December 08, 2006   Miami Herald

India;: Just 0.8% Men Sterilised.   Only 19.3% children in Delhi under three were breastfed within one hour of birth while 34% children were only breastfed till five months of age. In family planning, 23% women had gone in for sterilisation while only 0.8% men were sterilised. Nearly 23.3% couples used condoms. Over 16% women have experienced spousal violence, nearly 70% women participated in household decisions. Men and women in Delhi are obese. The immunisation rate of children is low. Anaemia is a big problem. But Delhi's fertility rate stands at 2.13, which is perfect. Married women in Delhi seem to have accepted the two child norm. Over 92% live with two children and didn't want a third. Over 70.7% of mothers who had two daughters didn't want a third pregnancy in the hope of a male child.   November 30, 2006   Times of India

Institutional Delivery Brings Down Mortality Rate.   By encouraging women to go to hospitals for deliveries, India has reduced maternal mortality from 398 per 100,000 births in 1997-98 to 301 in 2002-03. A total of 4,484 maternal deaths from 1.3 million births to 14.4 million females aged between 15 and 49 years were investigated during 1997-2003. Based on about 26 million births in 2004, nearly 78,000 maternal deaths are estimated in India in that year. The leading causes of death have been haemorrhage 38%, sepsis 11% and abortion 8%. Seven states, including Karnataka, are performing poorly. Uttar Pradesh leads in avoidable deaths during childbirth. Uttar Pradesh 517, Assam 490, Rajasthan 445, Madhya Pradesh 379, Bihar 371 and Orissa 368 with MMR ranging between 517 and 358 still remain a cause of concern. As in childbirths, India has managed to reduce rate of infant mortality from 80 per 100,000 in 1990-91 to 58 per 100,000 2004. Expectant mothers opting for institutional delivery will be given Rs.2,000 at the time of child birth. In the villages, the incentive is being provided through young women known as ASHAS. Incentives given to men and women opting for sterilisation is also being enhanced to Rs