Birthspacing: A Common Cause

Abstract

The articles contained in this issue illustrate the importance of the role played by family planning in assuring good birth outcomes and subsequent health and survival for children born in the developing world. A growing understanding of the commonality of interests between the public health and population professions has been a significant development of the mid-1980s. As large-scale funding began to flow into family planning and population programs considerable anatagonism developed between the traditional public health community and the upstart family planning movement. Public health practitioners argued that family planning services could only be delivered effectively in the context of a maternal and child health infrastructure. Governments in the developing world were encouraged to establish separate family planning agencies a policy that gave rise to competition between their ministeries of health and directorates of family planning. Family planning workers were frequently better paid than were their counterparts in primary health care. As family planning programs were being adopted throughout the world some suggested that voluntary family planning was too weak an instrument to cope with the high rates of population growth. As a result governments began adopting programs that provided incentives and disincentives to promote birth control usage. The contribution of birthspacing to child survival is well-documented. Delaying the 1st birth and increasing the time between births can effectively slow down rates of population growth. The provision of contraceptives should not be viewed as the cause of the change in breastfeeding practices.