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In: Family planning programmes and fertility, edited by J.F. Phillips, J.A. Ross. Oxford, England, Clarendon Press, 1992. 3-9.There is increasing evidence that family planning (FP) programs shape demographic trends as substantiated by pronounced variations in fertility trends between countries and regions after a uniformly high level in the 1960s. The issues addressed include the debate on the role of FP programs as fertility determinants, methods for evaluating fertility outcomes, techniques for fertility assessment as codified in the 1970s by a committee of the UN Population Division, and the application of methods in research, training, and policy formulation. The recognition for theories to guide research on the demographic role of programs was summarized by a subcommittee on population of the US National Academy of Sciences stressing that theory was obliged to generate testable processes about the contraceptive service supply system. Community level factors affect FP services by putting constraints on parental demand for birth. Reductions in costs of family regulation can affect the demand for children. The Easterlin Synthesis Framework is used for examining the demand-supply paradigm. Programs as fertility determinants are examined in relation to social, familial, and programmatic influences on reproductive behavior. The demand for contraception is examined based on data collected by the Demographic and Health Surveys Project: demand reached 76% in 8 of 11 countries studied suggesting that fertility could be substantially lowered by meeting this unmet need. Adjustment and promotion affect the demand for contraception. The impact of effective, low-cost contraceptives on contraceptive behavior is analyzed along with how program intensity, convenience, and proximity increase contraceptive prevalence. Social and institutional factors also govern reproductive behavior as the limitations and successes of the 1-child policy of China illustrates.