Impact Of Family Planning Programs On Fertility

These four papers supplement the book Contraception and Reproduction: Health Consequences for Women and Children in the Developing World by bringing together data and analyses that would otherwise be difficult to obtain in a single source. The topics addressed are an analysis of the relationship between maternal mortality and changing reproductive patterns; the risks and benefits of contraception; the effects of changing reproductive patterns on infant health; and the psychosocial consequences to women of controlled fertility and contraceptive use.

Fertility rates and population growth influence economic development. The marked declines in fertility seen in some developing nations have been accompanied by slowing population growth, which in turn provided a window of opportunity for rapid economic growth. For many sub-Saharan African nations, this window has not yet opened because fertility rates have not declined as rapidly there as elsewhere. Fertility rates in many sub-Saharan African countries are high: the total rate for the region is estimated to be 5.1 births per woman, and rates that had begun to decline in many countries in the region have stalled. High rates of fertility in these countries are likely to contribute to continued rapid population growth: the United Nations projects that the region's population will increase by 1.2 billion by 2050, the highest growth among the regions for which there are projections. In June 2015, the Committee on Population organized a workshop to explore fertility trends and the factors that have influenced them. The workshop committee was asked to explore history and trends related to fertility, proximate determinants and other influences, the status and impact of family planning programs, and prospects for further reducing fertility rates. This study will help donors, researchers, and policy makers better understand the factors that may explain the slow pace of fertility decline in this region, and develop methods to improve family planning in sub-Saharan Africa.

This paper addresses the key elements and changes in population policies and programs, including the strength of program effort, from 1972 to 1982. Using a new scale with thirty items to measure family planning program effort, the presentation is based on an analysis of over 300 questionnaires received from ninety-three countries. Attention is given to measurement problems and change in program effort 1972-82 (including findings by country and regional differences). This study shows that a great deal of family planning program effort exists in a small number of countries; moderate effort occurs in a larger number of countries; and weak or very little effort is found in an even greater number of countries, including many in the Middle East, North Africa and sub-Saharan Africa. Concerning change over time, between 1972 and 1982, there was a modest increase in program effort in more than half of the nearly 100 countries studied and a substantial increase in program effort in more than a third.

The main contents are key findings and messages regarding the relationship between contraceptive use and fertility, for 195 countries or areas of the world. These highlights will draw mainly from World Population Prospects 2019, and model-based estimates and projections of family planning indicators 2019. Policy-related implications of and responses to trends in family planning and fertility will be integrated throughout the text. In particular, these issues are of relevance for contextualizing Sustainable Development Goals 3.7.1. and 3.7.2. and the achievement of the 2030 Agenda.