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Studies In Family Planning. 2010 Dec; 41(4):241-50.Unintended pregnancy can carry serious consequences for women and their families. We estimate the incidence of pregnancy by intention status and outcome at worldwide, regional, and subregional levels for 2008, and we assess recent trends since 1995. Numbers of births are based on United Nations estimates. Induced abortions are estimated by projecting from recent trends. A model-based approach is used to estimate miscarriages. The planning status of births is estimated using nationally representative and small-scale surveys of 80 countries. Of the 208 million pregnancies that occurred in 2008, we estimate that 41 percent were unintended. The unintended pregnancy rate fell by 29 percent in developed regions and by 20 percent in developing regions. The highest unintended pregnancy rates were found for Eastern and Middle Africa and the lowest for Southern and Western Europe and Eastern Asia. North America is the only region in which overall and unintended pregnancy rates have not declined. We conclude with a brief discussion of global and regional program and policy implications.
Nature. 2011 Jun 30; 474(7353):579.Add to my documents.
Washington, D.C., Negative Population Growth [NPG], 2003 Jun. 8 p. (NPG Forum)The United Nations Population Division has put the highlights of its new population estimates and projections onto the Web. Present world population is 6.3 billion. It is projected to rise to 8.9 billion by 2050, a number almost identical to the 1998 projection but 400-million-below-the-2000-version and slightly below the U.S. Census Bureau projection of 9.079 billion. The projection reflects (1) the expectation that fertility is heading below 2.1 in all but the poorest less developed countries (LDCs) and (2) the growing seriousness of AIDS. The new report represents an ongoing effort to bring the projections into line with recent experience. That process is still incomplete. Uncertainties internal and external to the calculations raise several questions: Will European fertility rise as anticipated? Will mortality continue to decline, particularly in the least developed countries, or will it rise and thus eventually bring population growth to a stop through the grim process of rising death rates rather than the benign process of reduced fertility? Do the projections still understate U.S. fertility and population growth? The report makes no effort to analyze the external forces that will affect mortality and migration. (excerpt)
[The European Fertility and Family Planning Survey in Hungary] Europai Temekenysegi es Csaladvizsgalat Magyarorszagon.
DEMOGRAFIA. 1995; 38(4):309-39.During December 1992 and November 1993 data were collected in Hungary in accordance with a questionnaire developed by the Population Unit of the European Economic Committee of the UN consisting of 10 chapters. A total of 3554 women aged 18-41 and 1919 men aged 20-44 completed the questionnaires which were processed by using the Integrated System of Survey Analysis package. 14% of the women and 10% of the men had been raised without one or both parents up to age 15. In the cohorts under age 25, twice as many children experienced the divorce of their parents than in the cohorts over age 40. 57% of the women left the family home by age 24 versus 27% of the men. Only 21% of women aged 20-24 were married by the age of 20, while 41% of women had been married by that age. 17% of women aged 20-24 lived in consensual union as opposed to 4% of women aged 40. Notwithstanding these findings, marriages that were not preceded by cohabitation were more stable. One-third of women aged over 25 gave birth to the first child by age 20 and two-thirds by age 24; only one-fourth of women aged 20-24 had their first child by age 20 and two-fifths by age 24. The average number of children is 1.9. Women's use of oral contraceptives is most popular up to age 40, while over that age the use of IUDs is increasing. The number of women under 25 using condoms makes up only one-fifth of the number of women relying on OCs. 25% of women over age 40 versus 7-8% of adolescents had undergone at least one abortion. The average number of children wanted by women was 2.1; only 1-2% of young people wanted no children during their lifetime; and 80% of both men and women disagreed that the institution of marriage was an outdated concept.
Addendum: Manual IX. The methodology of measuring the impact of family planning programmes on fertility.
New York, New York, United Nations, 1986. viii, 38 p. (Population Studies No. 66; ST/ESA/SER.A/66/Add.1)These guidelines pertain to the application of evaluation procedures: the standardization approach; component projection approach I; and path analysis. The application of the standardization approach utilizes the initial year and the last year of the period under study as the basis for decomposition. The input data utilized with the case study of Sri Lanka illustrate various points relevant to the proper definition of input data for the CONVERSE method of the component projection approach. The basic principles of path analyses include the purpose of the path diagram and the basic theorem for decomposing the correlation coefficients into direct and indirect effects. A new methodology for estimating the fertility impact of contraception obtained through a family planning program is called the "prevalence method" because the principal data required for its application are estimates of the prevalence of contraceptive use at a given point in time. It is the objective of the prevalence method to estimate the number of births averted as well as the reduction in the crude birth rate that results from the use of contraception. The basic concepts and variables used in the prevalence procedure are: a) observed fertility, the age-specific fertility rate expressed in births per 1000 women in a given age group; b) natural fertility that would prevail in the absence of contraception; c) potential fertility that would prevail in a population if all program users stopped contracepting. Multi-level analysis, by combining elements from both levels of social reality, permits greater concordance between the theoretical views and the models employed for studying behavior. Multi-level analysis, also called contextual analysis, has a long tradition within certain subfields of called social science, such as voting behavior, school performance, and social deviance.
The evolution of policy on fertility in Tanzania: drawing on, and influence of international experience.
In: Population policy in Sub-Saharan Africa: drawing on international experience. Papers presented at the seminar organized by the IUSSP Committee on Policy and Population, in Kinshasa, Zaire, 27 February - 2 March 1989 / Echanges d'experiences internationales en matiere de politique de population en Afrique au Sud du Sahara. Communications presentees au seminaire organise par la Commission des Politiques Demographiques de l'UIESP, a Kinshasa, Zaire, 27 fevrier - 2 mars 1989. Liege, Belgium, International Union for the Scientific Study of Population [IUSSP], 1989. 333-60.The idea of adoption of population policies globally was associated with the unprecedented high population growth rates of over 2.5%/annum in most underdeveloped countries after World War II. The goal of Tanzania's population policy is to facilitate economic recovery. The policy, rooted in the Coale-Hoover model, is not viable because of the unrealistic assumptions of the model: 1) internal and international economic structures are not conducive to savings and their translation into investments; 2) old-age structures resulting from fertility decline do not bode well for a labor-intensive economy like that of Tanzania if economic expansion has to take place; and 3) no clear and consistent relationship between population and economic growth has been empirically observed. The evolution of population policy in Tanzania went through 2 significant phases: 1) opposition to family planning which was a spontaneous response to problems of socioeconomic development including maternal and child health and rural-urban migration; 2) the change toward working for an explicit population policy with central focus on reduction of population growth rate and fertility limitation. Since the mid-1980s efforts were exerted to reduce the population growth rate from the 1967-78 estimate of an annual 3.2-2.5% by reducing the total fertility rate from about 7.0 to 4.0. From the start of the new phase, a UN Population Fund project, executed by the International Labor Organization, was established in the Ministry of Finance, Economic Affairs and Planning to organize a Population Planning Unit. The main activities of the project have been population awareness seminars and coordination of the activities of the National Population Committee that drew up proposals on population problems.
[Unpublished] 1984 May 8. 31 p. (CE 92/12)This report shows how demographic information can be analyzed and used to identify and characterize the groups assigned priority in the Regional Plan of Action and that it is necessary for the improvement of the planning and allocation of health resources so that national health plans can be adapted to encompass the entire population. In discussing the connections between health and population characteristics in the countries of the region, the report covers mortality, fertility and health, and fertility and population increase; spatial distribution and migration; and the structure of the population. Focus then moves on to health, development, and population policies and family planning. The final section of the report considers the response of the health sector to population trends and characteristics and to development-related factors. The operations of the health sector must be revised in keeping with the observed demographic situation and the projections thereof so that the goal of health for all by the year 2000 may be realized. In several countries of the region mortality remains high. In 1/3 of them, infant mortality during the period 1980-85 exceeds 60/1000 live births. If measures are not taken to reduce mortality 55% of the population of Latin America in the year 2000 will still be living in countries with life expectancies at birth of under 70 years. According to the projections, in the year 2000 the birthrate will stand at around 29/1000, with wide differences between the countries of the region, within each of them, and between socioeconomic strata. High fertility will remain a factor hostile to the health of women and children and a determinant of rapid population growth. Some governments view the present or predicted growth rates as excessive; others want to increase them; and some take no explicit position on the matter. The countries would be well advised to assign values to their birthrate, natural increase, and periods for doubling their populations in relation to their development plans and to the prospects for improving the standard of living and health of their populations. An important factor in urban growth is internal migration. These migrants, like some of those who move to other countries, may have health problems requiring special care. Regardless of a country's demographic situation, the health sector has certain responsibilities, including: the need to promote the framing and adoption of population and development policies, in whose implementation the importance of health measures is not open to question; and the need to favor the intersector coordination and articulation required to ensure that population aspects are considered in national development planning.
WORLD HEALTH. 1987 Nov; 10-2.Breastfeeding is at times referred to as "nature's contraceptive." Intensive breastfeeding naturally stops the discharge of eggs from the ovaries, which commonly is experienced as a delay in the return of menses after the birth of a baby. An obvious limitation is that for breastfeeding to produce a contraceptive effect, a successful pregnancy and suckling are essential, and it is not possible to predict when the contraceptive protection might cease. Consequently, in terms of fertility regulation, breastfeeding is regarded as a birth spacing rather than as a contraceptive method per se. The sooner a woman starts to menstruate after a birth, the shorter the birth interval is likely to be, assuming the woman is sexually active, there are no miscarriages, and no contraceptives are used. In women who do not breastfeed, the menses usually returns within 2-3 months after delivery. For those who breastfeed intensively for 1 or 2 years, the menses generally return within 6-10 months or 15-18 months, respectively. The ideal way of prolonging the birth interval seems to be by combining prolonged breastfeeding with the commencement of contraceptive use at the appropriate time, provided this time were known. Without breastfeeding and contraceptive use, the birth interval averages 16 months, but with prolonged and intensive breastfeeding it potentially could be extended by another 18 months, giving an average interval of 34 months. This suggests that the fertility of women who do not breastfeed could be halved by breastfeeding alone. The tendency for fertility to increase during the early stages of modernization is observed in countries where the trend away from a traditional of prolonged breastfeeding is not accompanied by increased use of modern contraceptive methods. It is known widely that breastfeeding helps to postpone the next pregnancy, practices and beliefs vary by region and ethnic group. For a long time, the World Health Organization Special Program of Research, Development and Research Training in Human Reproduction has been involved in the study of natural methods of fertility regulation, and it is important that WHO continues to study breastfeeding in different ethnic and social group if it intends to give sound advice on this issue to family planning programs.
[Unpublished] 1986. Paper presented at the Population Association of America Annual Meeting, San Francisco, April 3-5, 1986.  p.This paper summarizes reactions to a 1984 report on population and development prepared by the World Bank. A major finding of the Committee on Population of the National Research Council is that research on the consequences of rapid population growth has been inadequate. The report could have done more to emphasize the change in the demand for farm labor as a stimulus to the demographic transition. The World Development Report 1984 (WDR84) shows that some, perhaps many, countries with total rural populations of a billion inhabitants or more remain untransformed, not transforming, or transforming only slowly. These countries need to introduce policies that can increase output and worker productivity. Conclusions about renewable resources and how they relate to rapid population growth are similar in WDR84 and WDR86; both reports recognize that market failures associated with ill-defined property rights lead to uneconomic exploitation of forests and fisheries. European countries led the economic-demographic transition; among the industrial countries birth rates declined by 67% between 1960 and 1982, and the share of labor force in agriculture declined by 31%. In the period since 1950, governments in developing countries have pursued explicit fertility-reduction goals and have urged their citizens to reduce family size. Fertility is lower when policy is stronger and the share of workers on farms is lower. The findings of the 1986 Committee on Population of the National Research Council report complement and qualify some of the scientific analyses on which WDR84 is based; they do not reverse any of its main conclusions or undermine the analysis of the consequences of rapid population growth. Overall, 2 years after its publication, WDR84 still seems a sound statement about the negative effects of rapid population growth on prospects for economic development among developing countries.
Studies in Family Planning. 1986 May-Jun; 17(3):153-60.Data from a prospective child health study conducted in Gaza by the WHO was used to examine the relationship between infant feeding and subsequent fertility. The study group consisted of 769 women living in 2 refugee camps in Gaza who gave birth in a 2-month period in 1978, and their index children, followed up for 23 months with monthly visits. Women who became pregnant within the 23 months were followed up until the end of their pregnancy. Women who practiced contraception after the birth of the index child were excluded. Life table analyses demonstrate a strong relationship between breastfeeding and 2 components of birth intervals, the postpartum anovulatory period and the waiting time from the end of the anovulatory period to conception. Duration of breastfeeding in this population averaged 12 months. Once menses have resumed, main factors related to waiting time to conception are age, husbands education, and measures of breastfeeding intensity and duration. Women who are breastfeeding when menstruation resumes and continue to do so are less likely to conceive than other women.
Population Today. 1986 Feb; 14(2):3, 8.The UN recently released its lastest population projection for 1985-2025. Although demographers remain uncertain about the future shape and rate of population growth, the UN figures are generally regarded as representing the state of the art in projection making. The UN makes medium, high, and low variant projections. According to the medium variant, the world population, in millions, will be 4,837 in 1985, 6,122 in 2000, 7,414 in 2015, and 8,206 in 2025. High and low variant projections, in millions, for 2025 are 9,088 and 7,358. The medium variant projection indicates that between 1985-2025 the population, in millions, will increase from 3,663-6,809 in the developing countries but only from 1,1754-1,396 in the developed countries. In other words, the proportion of the world's population residing in the developed countries will decrease from 24%-17% between 1985-2025. The world's growth rate will continue to decline as it has since it peaked at 2.1% in 1965-70. According to the medium variant, the projected growth rate for the world will be 1.63% between 1985-90, 1.58% between 1990-95, 1.38% between 2000-05, 1.18% between 2010-15, and 0.96 between 2020-25. The growth rate will decrease from 1.94%-1.10% for the developing countries and from 0.60%-0.29% for the developed countries between 1985-2025. The medium variant projections assume that the total fertility rate will decrease from 3.3 in 1985-90 to 2.8 in 2000-05 and to 2.4 in 2020-25. Respective figures are 3.7, 3.0, and 2.4 for the developing countries only and 2.0, 2.0, and 2.1 for the developed countries only. By 2025 the age structure of the developing countries is expected to be similar to the current age structure of the developed countries. In 2025, the 10 countries with the largest populations and their expected populations, in millions, will be China (1,475), India (1,229), USSR (368), Nigeria (338), US (312), Indonesia (273), Brazil (246), Bangladesh (219), Pakistan (210), and Mexico (154). The populations of some countries which are relatively small at the present time will be quite large in 2025. For example, the population, in millions, will be 111 for Ethiopia and 105 for Vietnam. The projections are summarized in 4 tables.
In: Third Asian and Pacific Population Conference (Colombo, September 1982). Selected papers. Bangkok, Thailand, Economic and Social Commission for Asia and the Pacific, 1984. 9-40. (Asian Population Studies Series No. 58)This report summarizes the recent demographic situation and considers prospective trends and their development implications among the 39 members and associate members of the Economic and Social Commission for Asia and the Pacific (ESCAP). It presents data on the following: size, growth, and distribution of the population; age and sex structure; fertility and marriage; mortality; international migration; growth and poverty; food and nutrition; households and housing; primary health care; education; the working-age population; family planning; the elderly; and population distribution. Despite improvements in the frequency and quality of demographic data collected in recent years, big gaps continue to exist in knowledge of the demographic situation in the ESCAP region. Available evidence suggests that the population growth rate of the ESCAP region declined between 1970 and 1980, as compared with the preceding decade, but that its rate of decline was slow. Within this overall picture, there is wide variation, with the most developed countries having annual growth rates around 1% and some of the least developed countries having a figure near 3%. The main factors associated with the high growth rates are the past high levels of fertility resulting in young age structures and continuing high fertility in some countries, notably in middle south Asia. The population of countries in the ESCAP region is expected to grow from 2.5 billion in 1980, to 2.9 billion in 1990, and to 3.4 billion persons by the year 2000. This massive growth in numbers, which will be most pronounced in Middle South Asia, will occur despite projected continuing moderation in annual population growth rates. Fertility is expected to continue its downward trend, assuming a more widespread and equitable distribution of health, education, and family planning services. Mortality is expected to decline further from its current levels, where life expectancy is often at or around 50 years. In several countries, more than 10 in every 100 babies born die before their 1st birthday. The extension of primary health care services is seen as the key to reducing this figure. Rapid population growth and poverty tend to reinforce each other. Low income, lack of education, and high infant and child mortality contribute to high fertility, which in turn is associated with high rates of natural increase. High rates of natural increase feed back to depress socioeconomic development. High population growth rates and their correlates of young age structures and heavy concentrations of persons in the nonproductive ages tend to depress production and burden government expenditure with high costs for social overhead needs. Rapid population growth emerges as an important factor in the persistence of chronic undernutrition and malnutrition. It increases the magnitude of the task of improving the educational system and exacerbates the problem of substandard housing that is widely prevalent throughout Asia.
In: Methodological foundations for research on the determinants of health development, by World Health Organization [WHO]. [Geneva, Switzerland], WHO, Office of Research Promotion and Development, 1985. 1-7. (RPD/SOC/85)Health development planning is part of overall development planning and is influenced by the total development process. Those dealing with health planning may present the health sector's development as the most important aspect of development whereas there may be more urgent problems in other sectors. All socioeconomic plans aim at improving the quality of life. There is some correlation between spending on health programs and the health indices. The health indices are poor in countries which accord low priority to health. A table gives measure of health status by level of GNP/capita in selected countries. No direct correlation appears between income and mortality. This paper examines the functions of health development planning; health development plans; intersectoral collaboration; health information; strategy; financial aspects; implementation, evaluation and reprogramming; and manpower needs. A health development plan usually includes an analysis of the current situation; a review of the immediate past plan and previous plans; the objectives, strategy, targets and physical infrastructure of the plan; program philosophy with manpower requirements; financial implications; and the role of the private sector and nongovernment organizations and related constraints. The main health-related determinants include: education, increased school attendance, agriculture and water, food distribution and income, human resources programs and integrated rural development. The strategy of health sector development today is geared towards development of integrated health systems. Intercountry coordination may be improved with aid from the WHO. Health expenditures in countries including Bangladesh, India and Norway is presented.
[Unpublished] 1984. Presented at the Second African Population Conference, Arusha, Tanzania, January 9-13, 1984. 21 p.This discussion of Ethiopia focuses on: sources of demographic data; population size and age-sex distribution; urbanization; fertility; marital status of the population; mortality and health; rate of natural increase; economic activity and labor force activity rates; food production; education; population policies and programs; and population in development planning. As of 1983, Ethiopia's population was estimated at 33.7 million. Agriculture is the mainstay of the economy. Ethiopia has not yet conducted a population census, however, the 1st population and housing census is planned for 1984. The population is young with children under 15 years of age constituting 45.4% of the total population; 3.5% of the population are aged 65 years and older. The degree of urbanization is very low while the urban growth rate is very high. Most of the country is rural with only 15% of the population living in localities of 2000 or more inhabitants. In 1980-81 the crude birthrate was 46.9/1000. The total fertility rate was 6.9. Of those aged 15 years and older, 69.2% of males and 71.3% of females are married. According to the 1980-81 Demographic Survey the estimates of the levels of mortality were a crude death rate of 18.4/1000 and an infant mortality rate of 144/1000. At this time 45% of the population have access to health services. It is anticipated that 80% of the population will be covered by health care services in 10 years time. Ethiopia is increasing at a very rapid rate of natural increase; the 1980 estimation was 2.9% per annum. Despite the rich endowments in agricultural potential, Ethiopia is not self-sufficient in food production and reamins a net importer of grain. Enrollment at various levels of education is expanding rapidly. There is no official population policy. Financial assistance received from the UN Fund for Population Activities and the UN International Children's Emergency Fund for population programs is shown.
[Unpublished] . Presented at the Second African Population Conference, Arusha, Tanzania, January 9-13, 1984. 3 p.Liberia's population characteristics and dynamics are briefly decribed, the current status of population data collection is noted, and the government's population policies and programs are summarized. National censuses were conducted in 1962 and 1974 with assistance from the UN Fund for Population Activities (UNFPA), and a 3rd census is planned for February 1984. National population growth surveys were conducted in 1969 and 1972, and demographic growth surveys were undertaken in 1978 and 1979. An administrative structure for registering births and deaths was recently created, however, most births occurring outside of hospitals and clinics will not be covered. In 1973, a demographic unit was established at the University of Liberia to develop the manpower needed to upgrade population data collection procedures. According to data collected in the 1974 censuses and subsequent surveys, the birthrate is 48.6, the death rate is 17.3, and the gross reproductive rate is 3.2. the total fertility rate is 6.7, and the infant mortality rate is 110.4. Life expectancy at birth is 49.1 for males and 52.5 for females. there are 97.3 males/100 females. The proprotion of the male population under 15 years of age is 47.9%, and the respective proportion for females is 46.9%. The total population is 1.8 million. Although Liberia does not have a population policy, the government recently established a National Population Committee to formulate a national policy and to coordinate population acitivities. 3.5% of Liberia's women of childbearing age currently use family planning services provided either by the International Planned Parenthood Federation or by the government with the assistance of UNFPA and the US Agency for International Development.
In: United Nations. Economic and Social Commission for Asia and the Pacific, World Fertility Survey, and International Institute for Population Studies. Regional Workshop on Techniques of Analysis of World Fertility Survey data: report and selected papers. New York, UN, 1979. 15-36. (Asian Population Studies Series No. 44)The World Fertility Survey provides data from national maternity history inquiries. Detecting trends and differentials is only as accurate as the data collected. Where evidence suggests error, the analysis may be restricted to obtaining only a measure of fertility level. The basic data is the date and order of birth of each live born child for a sample of women in the reproductive period, according to the current age of the women and their duration of marriage. The cohort marker is usually separated into 7 5-year classes determined by age at interview; sample of women is representative of the female population of childbearing age. Total births for each cohort are allocated to different periods preceding the survey date. Reading down the columns gives the births to different cohorts over different ranges in the same time interval preceding the survey. To detect omissions, check the overall sex ratio and the sex ratios by periods; examine the trends of infant mortality by cohorts and periods; an excess of male mortality over female indicates poor reporting of dead female children and/or of sex (a common omission). From data on age of mother and number of surviving children at the survey and estimates of mortality level, the numbers of births at preceding periods may be calculated.
New York, N.Y./Edinburgh, Scotland, Churchill Livingstone, 1983. xi, 100 p.This manual describes the methods commonly used to measure and interpret trends in the fertility of populations when adequate data are available from birth registration systems, censuses, and sample surveys. Information is presented on period measures of fertility, cohort measures of fertility, the correlates of fertility, and fertility surveys. The volume was motivated by the belief that population policies and programs must be based on appropriate and accurate measures of fertility, valid interpretations of fertility trends and differentials, and informed conjecture about their future direction. It is intended as a teaching aid for statisticians in public health programs, health planners, health administrators, other health professionals, and government officials involved in the analysis of national fertility data. The manual is also intended to serve as a resource for training activities and refresher courses in health statistics sponsored by the World Health Organization.
[Unpublished] 1983. Presented at the 1983 Annual Meeting of the Population Association of America, Pittsburgh, April 14-16. 35 p.In 1950 fertility levels in the developing countries were high. The crude birthrates (CBRs) were about 47 in Africa, 42 in the Americas, and 41 in Asia and the Pacific. In Asia and the Pacific, several countries are thought to have had fertility rates between 35-40/1000. In Latin America, Argentina, Cuba, and Uruguay the birthrates were less than 30/1000 and between 30-35/1000 in Chile and Jamaica. No country in Africa was reported to have had a rate below 40 with the sole exception of Gabon which is reported to have had a crude birthrate between 30-35/1000, not only in 1950 but this remained unchanged up to 1980. By 1965 there had been a little change in several countries but virtually no change at all in Africa. During the next 15 years the situation changed markedly in Asia and the Pacific with the crude birthrate decreasing by almost 1/4, from a little more than 39 to 30. There was a similar but slightly smaller decrease in Latin America, a decrease from 40-32, or about 20%. In Africa there was virtually no change. Many scholars and laypersons concerned about the rapid rate of population growth have expressed the view that population policies have been slow to develop. By 1980, 39 countries with a population of 2.6 billion or 78% of the population of all developing countries had adopted official policies to reduce the population growth rate. Many of these policies are without substance but a fairly large number of the countries have developed substantial population programs, as well as policies to reduce rates of population growth. There were an additional 33 countries with a total population of 554 million that had no demographic policy to reduce rates of population growth but nonetheless gave officcial support to family planning activities. Prior to 1960 only India had a population policy to reduce rates of population growth but during the 1960-64 period 4 additional countries in Asia and the Pacific adopted such policies, namely China, Korea, Pakistan, and Fiji. It was not until 1965 and after that African and Latin American countries adopted such policies. The annual number of family planning acceptors in large scale programs increased from a few tens of thousands around 1960 to about 2 1/2 million in 1965 and to approximately 25 million in 1980, excluding China, for which quantitative data are less readily available. In some countries contraceptive prevalence rates remain low after many years of a national family planning program, e.g., Ghana, Kenya, Morocco, and Bangladesh. Various macroeconomic studies, using countries as units, have found that both socioeconomic and population programs have important effects on fertility decline. UN projections (medium variant) to 2000-2005 assume a continuation of fertility decline in less developed countries (LDCs), including the start of decline in black Africa and Arab countries. Even if the UN projections are consistent with the realities of the years ahead, there is enormous population growth ahead.
Washington, D.C., World Bank, Population, Health and Nutrition Dept., 1982 Oct. 46 p. (PHN Technical Notes RES 3)This paper uses data from the World Bank and UNFPA sponsored survey on the determinants of fertility decline in Sri Lanka. The multivariate analysis shows that whereas the traditionally strong influences on fertility, and hence contraceptive use, such as education, age, and labor force participation still exist among the older women, changes in the nature of delivery of family planning services are making these socioeconomic factors less salient among younger women, as well as among subgroups of older women. (author's)