Family Planning Program Effort and Birthrate Decline in Developing Countries

Preliminary results from a study of family planning program effort in 93 developing countries indicate that family planning programs can contribute substantially to increased contraceptive usage and declines in fertility. Questionnaires were used to rate countries on 30 items grouped into 4 components: policy and stage-setting activities service and service-related activities recordkeeping and evaluation and availability and accessibility of services. The countries with the highest program effort scores out of a possible 120 for 1982 were China (101) Republic of Korea (96.9) Singapore (95.3) Taiwan (92.6) Indonesia (87.1) Colombia (85.3) Mauritius (84.6) Hong Kong (82.6) and Sri Lanka (81.6). 4 countries--Kampuchea Laos Libya and Mongolia--had scores of 0. Unweighted mean program effort scores by region were 55 for South and East Asia 46 for Latin America 24 for the Middle East and North Africa and 18 for Sub-Saharan Africa. Of the 9 countries that improved their program effort scores by 25% or more in 1972-82 7 are in South and East Asia or Latin America. 18 countries (including Brazil China Colombia Indonesia Thailand and Turkey) had declines in their crude birth rates of at least 25% in the 1965-80 period and an additional 16% had declines of 10% or more. However no significant fertility declines occurred in Sub-Saharan Africa or in most of the Arab and Muslim countries. Contraceptive prevalence in the 74 countries for which data were available ranged from 0-80% with an average of 26% of married women of reproductive age. The birth rate declines and contraceptive prevalence increases in an orderly manner as program effort and socioeconomic setting improve. The article concludes with case studies of countries representing each of 3 program effort categories: Colombia (strong) Malaysia (moderate) and Kenya (weak). It is suggested that the collection and analysis of program information can help program administrators government and private sector policy makers and donor agencies to improve program perforance. Final study results will be available in a forthcoming World Bank monograph. (summaries in ENG SPA FRE)