The role of family planning in the world population crisis

Abstract

Public and private attitudes towards family planning problems remain confused. Not surprisingly, the implementation of those family planning programmes that do exist is uneven and torturous. There is general agreement that family planning has something to do with maternal and child health and with problems of population. The governmental provision for family planning is usually offered as a partial solution, but in practice there is no obvious correlation between a family planning programme and the birth rate. In Rumania, where contraception and most abortions are illegal, the birth rate is less than half that of lndia where the reverse is true. Socio-economic forces are the prime determinant of human fertility and family planning services have only a slight effect on the way in which a community achieves its fertility goals. When very freely available, they may accelerate a trend towards lower fertility. However, although opportunities for action are limited, modifications to family planning services present the only area where immediate action can be taken. Attention must be focused on improving the quality of service as seen through the perceptions of the potential consumer. Family planning is a novel subject in historical terms. The world has yet to see a really successful family planning programme, or possibly even a moderately successful one, and, therefore, there is no tested model on which to build. In many places important aspects of fertility control remain highly controversial, so that those programmes which are executed are often carried out within a series of artificial constraints which greatly undermine the possibility of progress. The control of human fertility is biologically and sociologically difficult and, therefore, unnecessary hurdles in the path of programmes are particularly unfortunate. At present, momentum in family planning programmes is maintained by a mixture of ignorance concerning the nature of the problem, combined with a blind, almost religious faith, among those who work in the field. Clearly, such a foundation for action is not the most secure. Historically, preaching and action relevant to family planning programmes can be traced back to the early years of the 19th century. Literally a handful of individuals were