Policies Seeking a Reduction of High Fertility: A Case for the Demand Side

IT IS A COMMON CLAIM in contemporary documents discussing national strategies concerning population change that policies aimed at reducing high fertility comprise two components. One addresses supply-the means that enable individuals or individual couples to control their fertility (family planning programs). The other component addresses promoting economic and social development to ensure that demand for the services provided by family planning programs brings fertility, and thus population growth, down to a socially desired average level. This standard dichotomy is in many ways unsatisfactory. For example, how family planning programs are organized and how services are delivered have a significant influence on the capacity of these programs to attract clients. Thus, supply influences demand. Conversely, the ability of even the most determined suppliers of contraceptives to sustain an effective family planning program is a function of the level of demand: it is difficult, nay impossible, to maintain hamburger outlets in a resolutely vegetarian neighborhood. Thus supply-program effort-is not an independent variable: it reflects, inter alia, demand. These reservations notwithstanding, even cursory examination of the relevant evidence reveals that, in actual practice as distinct from rhetoric, these two pillars of fertility policy at present receive vastly unequal levels of attention and emphasis. Preoccupation with family planning programs absorbs the lion's share of budgetary and physical resources allotted to population, and also claims much of the analytic and research capacity at the disposal of decisionmakers in this area of public concern. In the light of relevant facts and considerations, this imbalance between the presumed two pillars of fertility policy is highly anomalous. The aim of