Family Planning Program Effort Has Increased During the 1980s, with East Asia Ranked Highest

Abstract

A capsule of family planning (FP) program activity in East Asia South Asia sub-Saharan Africa Middle East/north Africa and Latin America in 1982 and 1989 is presented based on a cross sectional study conducted by Mauldin and Ross. Activity increased >50% over 7 years. East Asia ranked the highest at 64% followed by South Asia at 52% Latin America at 54% sub-Saharan Africa at 36% and Middle East at 33%. Africa increased from 15% but was still low in program effort. Program effort was scored (0-4) on policy and stage setting activities service and service-related activities record keeping and availability of contraceptives. Scores were converted to a 100-point scale. Response rate was 433 respondents (FP government officials donor agency staff knowledgeable citizens and foreigners) out of 100 countries in 1982 and 359 out of 98 countries in 1989. Countries included those developing ones with a population of >1 million. Specific country analysis showed China with the highest program effort score of 84 or 101 out of 120. Gabon Kuwait Libya and Saudi Arabia had scores of 0. Scores were high for Tunisia (68) and Egypt (65) even though the region was very low. The average score among countries was 29 in 1982 and 44 in 1989. Effort was further grouped into strong (67+) moderate (46-66) weak (21-45) or very weak (0-20). Countries with strong scores in 1989 increased from 23 to 42 those with weak scores decreased from 65 to 46. Strong scoring countries constitute 64% of developing country populations (14 countries including China India and Mexico). Moderate scores of 29 countries (including Ghana Lebanon and the Philippines) contribute 15% of the developing worlds population. 38 weak scoring countries (most sub-Saharan countries) contain 17% of the population. 17 countries had weak or no programs and contain 4% of the population including Iraq Kuwait Laos and Malawi. Gains were made in all 4 categories but sub-Saharan Africa had the lowest score on availability. Social setting was also ranked and compared to FP effort. Only Bangladesh had a low social setting score and strong FP effort. FP effort and the effect on fertility and social setting are also discussed. For example total fertility rates (TFRs) declined by 6% in countries with weak programs 24% with moderate programs and 34% with strong programs. TFR declined the most in countries with the highest social setting. It is concluded from statistical analysis that modern contraceptive method are a necessary condition for fertility decline.