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REPRODUCTIVE HEALTH MATTERS. 1993 May; (1):67-77.Malaysia's population policy established in 1984 aimed to slow the decline in the fertility rate to .1 point every 5 years from the current decline of .3 or .4 points every 5 years. The aim was to achieve a stable population of 70 million by the year 2100, instead of the projection of 39 million by the year 2150. The perceived social and economic implications of this policy were considered, but the impact on women was not. Earlier policies have focused on the health of women and the need for family planning (FP), but the new objective was to spur economic growth through a larger number of "quality" human resources. This article examines the public response to the policy, the impact on FP programs, the impact on women and women's fertility, the role of donor agencies, women-centered policies and programs, and an action agenda for women's organizations. From academic circles, the response was to question the viability of increasing population when already there was insufficient infrastructure and services. In 1990, 34% of rural areas still did not have safe water and 10% had no electricity. The current Deputy Minister Fong had previously expressed the concern that work force needs did not demand large numbers, but rather, highly skilled persons were needed. Few of these concerns were expressed in the media. Chinese and Indians thought the policy was an attempt to increase the Malay numbers. The Malays saw it as a call to strengthen their race and religion. The FP Board set new targets for acceptors. Abortions were not as easily obtained. Reports surfaced of FP clinics refusing to give pills or IUDs to women with few children. Actual fertility declined from 3.9 to 1980 to 3.3 in 1990 and varied by region and ethnic group. Malay fertility increased from 4.5 in 1989 to 4.8 in 1985, and then began to decline in the late 1980s. A survey found 59% of women favored the policy of which 75% were Malays. There was some decline in donor support. The maternal mortality rate was unaffected. Women apparently want fertility limitation. Women's groups were more active in reflecting their concerns around 1984 than at present, but women activists are still a new phenomena. There is need for women's groups to link up with other national and international women's health networks.
Ottawa, Canada, International Development Research Centre, 1973. 30 p. (IDRC-009e)This paper evaluates the progress of a Latin American population through stages in family planning adoption. The focus is on changes in knowledge of contraception, attitudes, and practices which occurred over 5 years (1964-69) of widespread public discussion concerning family planning and of program activity in Bogota, Colombia. Data from 2 surveys, 1 in 1964 and the other in 1969, permit the 1st temporal analysis of family planning adoption for a major metropolitan city in Latin America. Additional data on rural and small urban areas of Colombia from the 2nd survey permit a limited assessment of diffusion of family planning from the city to the nation as a whole. The 1st survey in Bogota revealed moderate to high levels of knowledge of contraceptive methods and generally favorable attitudes to birth limitation. However, at this time many women had never spoken to their husbands about the number of children they wanted, nor tried a contraceptive method at any time. The 2nd survey showed substantial changes in this picture. The proportion of currently mated women who had spoken to their husbands about family size preference changed from 43 to 62% for an increase of 71%. Fertility fell appreciably over this period, especially among younger women. Family planning program services had a significant direct contribution to the adoption process, since 36% of mated women had been to a clinic by 1969. The most modern methods of birth control -- the anovulatory pill and the intrauterine device -- which were scarcely known in 1964 were widely known in 1969, and contributed most to the observed increase in current contraceptive practice. However, among the previously known methods, the simplest method of all, withdrawal (coitus interruptus), showed the greatest increase in current practice and remained the most commonly used method. These findings suggest that favorable attitudes and knowledge tend to become rather widespread before levels of husband-wife discussion of family size preferences and levels of contraceptive trial increase appreciably. The results also indicate that contraceptive knowledge and favorable family planning attitudes are spreading rapidly outward from the cities into the rural areas, but that contraceptive practice is still predominantly restricted to urban populations. (author's)