West Indian gender relations, family planning programs and fertility decline (original) (raw)

The impact of family planning programs on fertility in developing countries: A critical evaluation

Social Science Research, 1981

Controversy surrounds the question: do organized family planning programs produce fertility decline in developing countries that is independent of other causes? Two major conclusions emerge from this critical evaluation of 26 past studies on this question. First, the disparate results are associated with the differential validity of the studies. Second, the fertility declines or variations analyzed were generated mainly be indigenous causes, that is, they would have occurred and the means for bringing them about would have been available without family planning programs. Hence, the programs had little net effect on fertility.

Family planning: personal and political perspectives from Choiseul Province, Solomon Islands

Australian Journal of Public Health, 2010

Rapid population growth has put family planning on personal and political agendas in the Solomon Islands. With the release of a population policy in 1988, national leaders sanctioned the concept of family planning as a key strategy in reducing the rate of population growth. On a personal level, Solomon Islanders share their government's concern about population problems. There is a shortage of arable land, health services are stretched, and there are limited places in school for children. A study in Choiseul Province, a rural area in Solomon Islands, suggests that people want smaller families but have limited means to control their fertility. Meagre resources and infrastructure, compounded by geography, climate, culture and religion, constrain the development of family planning services. (AustJFublic Health 1995; 19: 61622) HE impetus for a family planning program in the Solomon Islands, as in many developing

Unmet Need for Family Planning in Developing Countries and Implications for Population Policy

Click to return to Contents ing further complexity, of couples. After reviewing the development of the concept and the debate surrounding it from the 1960s to the present, we address several questions that have been raised about the concept: (1) Is the concept valid, that is, are contradictions between fertility preferences and contraceptive behavior real? (2) Does unmet need have any bearing on the larger process of fertility transition? (3) What is the correspondence between unmet need, the demand for contraception, and the demand for family planning services? (4) Has the concept been too narrowly formulated? (5) Is unmet need amenable to programmatic action? (6) What is the role of unmet need in justifying population policies and informing the development of programs?

Reforming the Landscape of Family Planning in India

Context: Female sterilization, opted for by over one-third of married women, is the most popular contraceptive in India. It forms over 75% of all the contraceptive use in the nation and comprises 93% of all sterilizations nationally. Sterilization camps were some of the most popular avenues to offer this service to women, most often those from scheduled tribes, schedules castes, and other marginalized communities. Over 700 women died after undergoing sterilization at these camps, 356 of these deaths were confirmed to be a result of botched operations and postoperative complications. Methods: This policy review used a literature review and the forcefield analysis method to elicit the enabling and restricting factors that led to a family planning policy that largely propagates female sterilization in India. The factors were examined and categorized into the following domains: public health and health care system, political, social and cultural, legal, and others. Results: India’s ‘National Family Programme’ is governed by the National Population Policy, 2000 which emphasizes the role of family planning for the purposes of population control, but does not emphasize female sterilization in any way. However, several other factors, historically and contemporarily, have put female sterilization at the front and center of India’s family planning program. The enabling factors emerging from public health and the health care system in the country were the focus on reducing fertility rate rather than women’s health, inadequate community health workers to provide services that require continuous contact such as contraceptive pills, inadequate skilled health workforce in the public health care system, poor health infrastructure, and incentivizing sterilization for couples below the poverty line. Among the political factors there were the influence of donors and international funding or aid organizations that promoted sterilization, the negative political impact of pushing for male sterilization in the past, little power of women to negotiate with the political system, and focus on population control as the mechanism for economic growth. The enabling social and cultural factors included low status of women in society, the preference of both sexes to protect male virility, and gender dynamics within households. One particularly important legal factor was that there is no penal sanction for the violation of family planning or sterilization policies. Lastly, civil society engagement on reproductive health, health activism, and the judicial system were restricting factors as demonstrated in the Devika Biswas Vs. Union of India judgment of the Supreme Court of India that put an end to the sterilization camps in the nation. Conclusion: There is an urgent need to examine and devise a family planning policy in India that focuses on women’s health and wellbeing. This must include minimum standards for the health workforce and infrastructure. It is also imperative that the public health care system recruits and trains adequate community health workers to ensure outreach reproductive health services as well as the continuum of care following sterilization procedures. Additionally, it must include penal sanctions for violations of these rules. The family planning policy must also ensure a shift from an exploitative and coercive approach to one that promotes choice, agency, and equitable access to all contraceptive methods, not just female sterilization. Greater engagement of civil society organizations in the drafting of the policy is also recommended. At a larger policy level, it is necessary that the government of India make greater investments into women’s education, livelihoods, and empowerment to address the social and cultural factors emerging from the policy review.

Family planning as an investment in development: Evaluation of a program’s consequences in Matlab

The paper analyzes 141 villages in Matlab, Bangladesh from 1974 to 1996, in which half the villages received from 1977 to 1996 a door-to-door outreach family planning and maternalchild health program. Village and individual data confirm a decline in fertility of about 15 percent in the program villages compared with the control villages by 1982 , as others have noted, which persists until 1996. The consequences of the program on a series of long run family welfare outcomes are then estimated in addition to fertility : women's health, earnings and household assets, use of preventive health inputs, and finally the inter-generational effects on the health and schooling of the woman's children. Within two decades many of these indicators of the welfare of women and their children improve significantly in conjunction with the programinduced decline in fertility and child mortality. This suggests social returns to this reproductive health program in rural South Asia have many facets beyond fertility reduction, which do not appear to dissipate over two decades.

Gender Disparity and Family Planning/Welfare in India

Indian Journal of Spatial Science, Spring Issue, 12(1), 2021

This paper seeks to study and recognize the disparity in gender attention of permanent birth control methods, besides gender-wise access of sterilization in India. Gender inequality or disparity is firmly connected to the social well-being, and it determines the health risks, service accessibility and health outcome. Globally, India took the first initiative to adopt family welfare approach through the government-supported family planning programs to control family size and the very high fertility rate. It has been over seven decades of the family planning program, but women still bear the burden of sterilization and family planning in India although various modern methods of contraception are available in the market. Nevertheless, vasectomy or female sterilization is a well-known and highly accepted permanent birth control course in India, and it considers excessively intricate and expensive procedure than male sterilization. Female sterilization does not protect against sexually transmitted infections. Vasectomies are permanent sterilization procedure for men, and it is more affordable, more reliable, less invasive, and it doesn't boost the risk of ectopic pregnancy. The unusual observation is while the global proportion of female sterilization has decreased, it has grown in India. Lack of study on gender disparity in contraceptive use means very limited is known about this issue. This paper is an attempt to furnishing this knowledge gap on gender disparity and family planning in India. It attempts to find out the reasons behind the declining trends of vasectomy and increasing orders of female sterilization and also establish a comparison with selected developed, developing and neighbouring nations by using NFHS, World contraceptives and UN data.