Fertility and Family Planning in Rural Northern Thailand

Abstract

From the mid-1960s to the mid-1970s, when fertility was declining in Thailand as a whole, especially rapid declines occurred in Northern Thailand, but they did not occur uniformly in all the region's provinces. The Northern Thailand Fertility Study, initiated in 1975 to study the reported fertility changes, gathered data in two provinces: Chiang Mai, where fertility decline has been quite rapid, and Chiang Rai, which experienced relatively little decline until 1974. This preliminary report discusses fertility levels and trends in the two provinces, fertility experience and expectations of respondents, attitudes toward and knowledge of family planning, and contraceptive practice. The results suggest that most of the difference in fertility decline is related to the different level of family planning program activity in the two provinces.Substantial declines in Thai fertility levels coincide with a marked increase in family planning activity, both public--the National Family Planning Program, announced in 1970--and private--e.g., McCormick Hospital Program, started in Chiang Mai in 1963. Regional and changwat (provincial) differentials in rate of fertility decline have been observed. In Chiang Mai changwat, for example, where efforts began in 1963, there has been a more rapid decline than in Chiang Rai, where family planning was introduced only in 1970. The Study of Social and Psychological Barriers to the Adoption of Family Planning in Rural Northern Thailand (The Northern Thailand Fertility Study, NTFS) was an attempt to identify the reasons for this differential and the relationship of family planning activities to fertility decline. A random sample was drawn from each of 190 rural villages chosen randomly from Chiang Mai and Chiang Rai. All ever-married women aged 15-44 and husbands of currently married women were interviewed from September 1976 to February 1977. Response rates were 88.5% of 1921 women and 80.5% of 1615 men. Interviewers were mostly students from Chiang Mai University, intensively trained and closely supervised. Substantial declines in age-specific fertility rates occurred in both changwats between 1968-1972 and 1973-1976, with the Chaing Rai fertility level lagging about 5 years behind that of Chiang Mai. In both changwats, expectations of and desire for large families have virtually disappeared although Chaing Rai women expected larger families than Chiang Mai women. Infant mortality rates were lower in Chiang Mai due to improved MCH services. While the reported rates of induced abortion were low for both provinces, indications are that the actual rates are about 3 times higher for Chiang Mai -- in line with the lower fertility performance and desires reported there. Attitudes toward family planning were favorable in both changwats but knowledge of contraceptive use was greater in Chiang Mai. Statistics of contraceptive use correlated to levels of knowledge and to activities of family planning programs. The article concludes that nearly all of the fertility declines observed are the result of organized family planning activities.