World Development Report 1984

selves to birth control. Rates of contraceptive use an incentive, yet they cannot be stopped from
have risen to as high as 80 percent in some villages claiming it; and they may be those least in need of
that receive, or hope to receive, the benefits of this an incentive. Disincentives that work through tax
program. Qualifiers have been given credits for and benefits systems affect only a few people, yet
livestock, feed, and construction materials, and broader disincentives might unfairly burden the
have been offered lower prices for fertilizer, seed, poor, who gain most from children. Disincentives
garlic, dressmaking, hairdressing, and medical tied to school admissions may affect children who
treatment. Some communities have also been have no control over parental decisions. Verificaallowed
to use a "family planning bull" for servic- tion (was a child born and not reported?) can be
ing their cattle. The scheme also offers pig-rearing administratively difficult, and the money to
contracts: a woman acceptor gets a piglet to fatten reward compliance may be improperly used. Payover
a period of eight to nine months and is given ments for sterilization have little impact on fertility
a share of the profits. Should she become preg- if families have already had four or more children.
nant, the pig is not taken away, but she may lose The cost of incentives is also a consideration in
the opportunity to get another one in the future. judging their effectiveness. From a national
In the past decade, a few countries have started accounting point of view, incentives are transfer
offering small-family incentives to communities. payments and in themselves do not use up
The Indonesian program gives prizes and popular resources. Their economic impact will depend on
recognition for meeting fertility targets or for per- the savings and consumption patterns of those
forming better than other communities. In Thai- who are taxed and those who receive payments.
land the government rewards villages that achieve The principal question is likely to be a budgetary
certain targets with anything from a biogas plant to one for the government: is money available and
a cooperative store. Community incentives work might it be better spent in other ways? If convenwhere
there is a well-organized, community- tional incentive schemes absorb funds that might
based family planning system and where the vil- better go to investments, the cost to an economy in
lage or hamlet is an important social or political terms of long-run investment and growth may also
unit. matter. This is clearly a problem in China, where
Several other countries, including Bangladesh, incentives large enough to ensure one-child fami-
India, and Sri Lanka, have offered rewards to peo- lies would become a heavy burden on the econple
who volunteer to be sterilized, primarily to omy, unless those who received them in turn used
compensate them for the cost of travel and loss of the incentives for saving, say, for their own old
work time. These programs are easier to adminis- age.
ter than incentive systems tied directly to lower
family size. In most cases, volunteers have been Deferred incentives
carefully screened to avoid any possibility of coercion
or of changing their minds when it is too late. Deferred incentive schemes overcome some,
In Sri Lanka, for example, the couple must have at though not all, of the difficulties of conventional
least two children, the youngest at least a year old. incentives. They have not been tried on a national
These facts must be certified by the village head level, but two local experiments demonstrate their
and reviewed by a medical officer at the clinic feasibility. A township in China began a deferred
where the operation will be performed. The volun- bonus scheme in 1971, offering to pay the highteer
must sign a statement of consent; he or she school education of children of two-child families.
receives the equivalent of $20. At their peak in No specific family planning service was involved,
1980-81, sterilization payments cost an amount but parents had to show that they agreed with the
equal to 3 percent of total government spending on terms of the entitlement when their children were
health; that much could easily have been saved in ready to enter high school. Two-thirds of families
the costs associated with abortion and unwanted enrolled in the program; its effects on fertility
births. could not, however, be differentiated from a general
decline in fertility.
Unresolved issues A no-birth bonus scheme developed on three tea
estates in India also provided a deferred payment.
Payments and penalties raise a host of issues not Each woman worker had an extra day's pay credyet
resolved. Some people may be willing to defer ited to an account for every month she was not
pregnancy or to have fewer children even without pregnant. Her benefits were suspended for a year