World Development Report 1984

in the 1950s and 1960s, fertility was changing little 1977 rather than levels at one point in time during
during the late 1960s. the period.
But family planning programs spread rapidly in One objection to this type of study is that the
the late 1960s and early 1970s, and more systematic family planning index may itself be the result of a
information on them is now available. demand for contraception that already existed as a
* A country-level family planning index was byproduct of development. In this case, family
developed in the mid-1970s. It was based on coun- planning services provided by the government
tries' performance in 1972 on fifteen criteria, such may simply displace traditional methods of contraas
the availability of many contraceptive methods, ception or modern methods already available
either through government programs or commer- through the private sector. Indeed, analysis does
cially; inclusion of fertility reduction in official pol- show that in the early 1970s family planning proicy;
adequacy of the family planning administra- grams were more likely to be instituted and were
tive structure; and use of mass media and more successful where demand for contraception
fieldworkers. The index has been updated for this already existed: Korea, Hong Kong, and Singa-
Report to 1982; countries are classified into groups pore. The existence and strength of early programs
by this index as of 1972 and 1982 in Table 6 of the is closely related to the proportion of educated
Population Data Supplement. women (itself a measure of demand for services),
* Household and community surveys con- and to the degree to which fertility had declined in
ducted within countries during the 1970s provided the late 1960s. But these factors do not completely
information on the distance and travel time to explain differences in the family planning index; to
services for household members. Those carried out some extent, indices were stronger or weaker
as part of the World Fertility Survey (WFS) project because of other factors-political leadership, for
in over forty countries, and of the Contraceptive example. And the change in country effort between
Prevalence Survey (CPS) project in about fifteen 1972 and 1982 is not at all related to earlier declines
countries, have several advantages: most are rep- in fertility or to levels of development; it has been
resentative, nationwide samples and, because sim- more clearly the result of government initiatives.
ilar questions were asked everywhere, are largely Furthermore, although family planning programs
comparable among countries. are in part a response to preexisting demand,
These two sources, supplemented by the results recent studies show that such programs do have
of small experimental field studies, have provided an independent effect on fertility. Cross-country
the basis for careful analyses of the effects of family analysis shows that, for the average country, preplanning
programs. They leave little doubt that the vious fertility decline accounted for 33 percent of
programs work. the total fall in fertility between 1965 and 1975;
socioeconomic change accounted for 27 percent;
CROSS-COUNTRY STUDIES. Using the family plan- the family planning index accounted for more than
ning index, along with indicators such as literacy, either: 40 percent.
life expectancy, and GNP per capita in about 1970,
research in the late 1970s found that birth rates STUDIES WITHIN COUNTRIES. The cross-country
declined most (29 to 40 percent) between 1965 and studies are complemented by several examples of
1975 in countries such as Costa Rica, Korea, and apparent family planning success in individual
Singapore, where socioeconomic development countries. In China and Indonesia, per capita
was relatively advanced and family planning pro- income is low and the population still overwhelmgrams
were strong. There was a modest decline in ingly rural, but governments have made a conbirth
rates (10 to 16 percent) where development certed effort to bring family planning services to
was relatively strong but the family planning index the villages. In China the birth rate at the end of
was weak, as in Brazil and Turkey. There was also 1982 was estimated to be nineteen per 1,000 peoa
modest decline where development levels were ple, down from forty in the 1960s. The current figlow
but the family planning index was moderately ure, based on birth registrations rather than on a
strong, as in India and Indonesia. (Indonesia's census, may slightly understate the actual birth
family planning program, now one of the world's rate; but it would still be well below current rates
strongest, had been operating for only two years in South Asia, Africa, and most of Latin America.
by 1972, the reference year for the family planning Up to 70 percent of Chinese couples of childbearindex.)
The same results emerged from using mea- ing age are estimated to be using modern contrasurements
of socioeconomic change from 1970 to ceptives. The government believes that its family
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