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Methodological problems in evaluation of family planning impact of programmes that are integrated with other development sectors.
In: Studies to enhance the evaluation of family planning programmes by United Nations Department of International Economic and Social Affairs. Population Division [DIESA] New York, New York, United Nations, 1985. 108-110. (Population Studies No. 87 ST/ESA/SER.A/87)Governments of developing countries began to undertake family planning in the 1960s thanks to a sudden availability of funds for programs exaggerating an already existing cleavage between program and general demography professionals. Discussion at the World Population Conference (WPC) in Bucharest recognized social and economic factors as an important element in the use of family planning and attempted to encourage better cooperation between program evaluators and demographers. Separation of family planning effects from development effects has been difficult. The WPC's World Population Plan of Action (WPPA) reiterated that population and population policies were interrelated with and should not be considered substitutes for socioeconomic development policies. Increasingly, governments have been integrating family planning with education and health programs as recommended by the WPPA. Family planning being a relatively new venture, it is necessary to develop a theoretical framework to justify assumptions that family planning and development are productively integrable and synergistic, determining demographic effects and their causal mechanisms, whether social or program related. A careful record of program inputs must be kept. Important issues in education, which generally speaking has an inverse effect on fertility, are: in which sex and age group of the population is education most effective for fertility control allowing for lag time; and what are the intervening effects--age at marriage, better knowledge, or change of attitudes? Some of the simplest integrated programs combine family planning with educational programs in schools, health programs, and agricultural programs. Thus teachers are trained to educate pupils in population problems; health workers educate family health consumers a logical diversity of function that is however limited by the scope of the health program. The benefits of small family size may be incorporated into rural development ideology. Critical evaluation will necessitate demonstration of integration's beneficial effects.
In: Current problems in obstetrics and gynecology, Vol. 5, No. 6, edited by John M. Leventhal. Chicago, Illinois, Year Book Medical Publishers, 1982. 4-41.This article addresses the medical aspects of population growth, with specific focus on a demographic overview, population policies, family planning programs, and population issues in the US. The dimensions of the population problem and their implications for social and economic development are reviewed. The world's response to these issues is discussed, followed by an assessment of what has been accomplished, particularly as it relates to the record of national family planning programs in developing countries. The impact of population growth on such issues as education, available farm land, deforestation, and urban growth are discussed. Urban populations are growing at an unprecedented rate, posing urgent problems for action. From a public health perspective, data are reviewed which demonstrate that having children at short intervals (2 years) or at unfavorable maternal ages (18 or 35) and/or parity (4) has a negative impact on maternal, infant and childhood morbidity and mortality, particularly in developing countries. Increasing the age of marriage, delaying the 1st birth, changing and improving the status of women, increasing educational levels and improving living conditions in general also are important in reducing population growth. Probably the most important, but most controversial intervention, has been the development of national family planning programs aimed at increasing the public's access to modern contraceptive and sterilization methods. India was the 1st country to declare a formal population policy (in the 1950s) with the goal of reducing population growth. Currently, close to 35 countries have formal policies. The planned parenthood movement, with central support from the London office of the International Planned Parenthood Federation (IPPF), has played a most important role in making family planning services available. 2 population issues in the US today are reviewed briefly in the final section: teenage pregnancy and the changing age structure.