World Development Report 1984

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measuring social acceptability, or easy formula for the amount spent by its formal layers of governensuring it. ment-central, provincial, prefectural, and county-on providing contraceptive supplies free Financing family planning to users; reimbursing service fees for sterilization, abortion, and IUD insertion; and providing train- Public family planning programs, like programs in ing and information on family planning. These education and health, are heavily subsidized, and costs amount to $213 million annually, about $0.21 services are often offered free of charge. Although per capita. In addition, the rural collective system the private sector makes a significant contribution finances the family planning staff at the commune to providing services in some countries, public or brigade level (at an estimated cost of $0.34 per finance will continue to be critical, especially in capita) and pays incentives, in the form of food low-income countries and in backward regions, supplements and reimbursement of travel costs, to where contraceptive demand is limited and health holders of one-child certificates ($0.25 per capita) services are weak. and to individuals undergoing sterilization ($0.15 per capita). Finally, additional time is spent by Ptiblic spending barefoot doctors on family planning work (though not much: in Shandong Province they allocate an China and India-the two most populous coun- average of 1.5 percent of their time to family plantries in the developing world, with approximately ning, valued at approximately $3 million). Health half its population-spent roughly $1.00 and $0.30 workers and midwives probably spend more time per capita, respectively, on population programs in on family planning. Adding all these contributions 1980. In most of three dozen developing countries together produces a figure for family planning for which rough estimates are available, spending expenditure in China of nearly $1 per capita. fell within this range (see Table 7.4). If other devel- Although governments finance a large share of oping countries with programs were spending their population programs, the amounts spent are equivalent amounts, the total spent on population still trivial-both in absolute terms and in relation activities in all developing countries in 1980 must to other government outlays (see Box 7.7). In have been about $2 billion. China the state budget for the family planning pro- Practically all spending on population in China, gram absorbs only 0.4 percent of total current and close to 80 percent of the total in India, is spending, compared with 5.2 percent for health financed from domestic resources. For all other and 13.1 percent for education. In India and developing countries combined, government and Mauritius spending on family planning in 1981 foreign donors each contribute about 50 percent. accounted for only 0.5 percent of total government The government share tends to rise the longer a expenditure. The figures are even lower in Korea program has been in existence. Three out of four (0.2 percent) and in Malaysia (less than 0.1 countries with programs less than five years old percent). were contributing less than 10 percent of the costs Foreign donors spent an estimated $491 million of their programs, in contrast to an average of 54 for population programs in developing countries percent among twenty-seven countries with pro- in 1981; about two-thirds of this amount was for grams at least ten years old. Nepal is one of the family planning and related programs. In realrare exceptions: the share of domestic government terms, population assistance grew at almost 6 perfinancing fell from 80 percent of its spending on cent a year during the 1970s but fell 3 percent inpopulation in 1975 to 40 percent in 1980. 1980 and 6 percent in 1981. The prospects for Even among well-established programs there is increased assistance are not good: UNFPA, a major wide variation in government spending. Domestic channel for population assistance, expects its, budgetary outlays in 1980 are estimated to have spending to rise by barely 1 percent over the next been $0.42 per capita in Sri Lanka, about $0.71 per four years. Population assistance from donors is capita in Korea, and $1.45 per capita in Costa Rica. discussed further in the next chapter. But these estimates probably understate the true government contribution. The cost of health work- Private spending ers, whose functions often include family planning, is not always imputed to the population pro- Important constraints limit the growth of private gram-nor are contributions by local government. suppliers of family planning, especially in rural The estimate for China of $1 per capita includes areas. The most severe constraint is the need for 148
TABLE 7.4 Public expenditure on population programs, selected countries, 1980 Expenditure Total Per capita per current public public contraceptive expenditure expenditure user Region and country (millions of dollars) (dollars) (dollars) Sub-Saharan Africa Ghana 2.8 0.24 16 Kenya 11.8 0.71 68 Liberia 2.3 1.22 a Mauritius 1.7 1.81 24 Sierra Leone 1.5 0.44 a Swaziland 1.8 2.89 a Tanzania 3.3 0.18 a Zaire 1.8 0.06 a Zimbabwe (1978) 1.9 0.27 13 Middle East and North Africa Egypt, Arab Rep. 34.1 0.81 22 Iran, Islamic Rep. (1976) 50.6 1.30 38 Jordan 2.5 0.78 21 Morocco 13.3 0.66 a Tunisia 8.3 1.31 32 South Asia Bangladesh 45.1 0.51 26 India 226.9 0.34 10 Nepal 10.6 0.72 69 Pakistan 24.5 0.30 33 Sri Lanka 6.2 0.42 7 East Asia China 979.6 1.00 10 Hong Kong 2.0 0.40 3 Indonesia 86.2 0.59 11 Korea, Rep. of 27.1 0.71 9 Malaysia 16.4 1.18 19 Philippines 37.6 0.78 11 Singapore 1.8 0.74 7 Thailand 28.1 0.60 7 Latin America and Caribbean Bolivia (1977) 0.1 0.03 a Brazil 10.6 0.09 a Colombia 8.1 0.31 4 Costa Rica 3.3 1.45 15 Dominican Rep. 3.8 0.70 11 Ecuador 6.3 0.75 15 El Salvador 8.1 1.77 35 Guatemala 9.3 1.28 47 Haiti 3.9 0.77 27 Honduras 3.0 0.81 20 Jamacia 4.8 2.19 27 Mexico 61.3 0.88 15 Panama 4.4 2.42 26 Paraguay 2.1 0.69 13 Peru 5.3 0.32 5 Note: Expenditure includes funding from domestic and foreign sources on population activities, including (but not limited to) family planning services. a. Contraceptive prevalence rate unavailable or close to zero. Source: Bulatao, <strong>1984</strong>a. 149
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Public Disclosure Authorized Public
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Oxford University Press NEW YORK OX
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labor markets. And they have a vest
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8 The policy agenda 155 Population
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Boxes 1.1 The arithmetic of populat
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Glossary Demographic terms informat
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I I
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countries regain their momentum of
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4 Box 1.1 The arithmetic of populat
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example. Between 1955 and 1980 inco
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ment-all the more so if human skill
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etween 1 and 2 percent-moderate com
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FIGURE 2.1 directions-with a lag in
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14 Distribution of product among se
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TABLE 2.2 Rates of growth in the re
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export restraints and orderly marke
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Box 2.2 Comparisons between the 193
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TABLE 2.6 indebtedness is denominat
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TABLE 2.7 Change in export prices a
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Burundi, Guinea, Mali, Malawi, and
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TABLE 2.9 Exports from developing c
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of rapid and painful adjustment for
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In many countries internal adjustme
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3 Prospects for sustained growth Wi
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TABLE 3.2 Growth of GDP per capita,
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TABLE 3.4 Current account balance a
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over time. The main focus of indust
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TABLE 3.6 Growth of trade in develo
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Box 3.3 Delinking from the world ec
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nal surplus. The resulting rise in
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Because the public sector in low-in
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developing-country creditworthiness
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themselves and, by caring for young
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fertility in a changing world is a
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nize contraceptive services. As wil
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Economic transformation: Europe, Ja
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scious control of family size, prob
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Box 4.3 The European fertility tran
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FIGURE 4.2 Birth and death rates an
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Box 4.4 Alternative measures of fer
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largest city in 1950, will not even
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FIGURE 4.4 Fertility in relation to
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government goal is a nationwide rat
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North America's population in 2000
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IBox 4.6 Three views of population
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TABLE 4.6 Population size and densi
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Box 5.1 Consequences of population
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implied by a simple division of tot
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and on farms. But the evidence on e
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get in GDP. Alternatively, all or p
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youths, who are presumably able to
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saving because they come from the c
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acre increased from 15.4 million to
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food they need. Although the amount
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is so scarce, they can do so only o
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Page 114 and 115: other developing countries suggests
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Page 118 and 119: Box 5.7 Coping with rapid fertility
Page 120 and 121: 6 Slowing population growth Experie
Page 122 and 123: feTtility; nor is it easy to judge
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Page 126 and 127: etter education and health services
Page 128 and 129: TABLE 6.1 Total fertility rates and
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Page 132 and 133: in the 1950s and 1960s, fertility w
Page 134 and 135: FIGURE 6.6 Fertility dedine within
Page 136 and 137: Box 6.3 Mleasuring the value of chi
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Page 140 and 141: Box 6.4 A deferred incentive scheme
Page 142 and 143: Box"7.1 Family planning for health
Page 144 and 145: FIGURE 71 88 in Romania (1979). Res
Page 146 and 147: 132 Box 7.2 Birth planning technolo
Page 148 and 149: TABLE 7.2 Percentage of married wom
Page 150 and 151: TABLE 7.3 Discontinuation of contra
Page 152 and 153: may be delaying a first pregnancy,
Page 154 and 155: family planning and maternal and ch
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Page 158 and 159: Box 7.6 The impact of service quali
Page 160 and 161: medical examination was not always
Page 164 and 165: Box 7.7 Military versus social expe
Page 166 and 167: costs per user. Public cost per use
Page 168 and 169: sanguine, however, as soon as one t
Page 170 and 171: TABLE 8.1 Population policy indicat
Page 172 and 173: Box 8.2 China's census: counting a
Page 174 and 175: FAMILY PLANNING. In many countries-
Page 176 and 177: improving the availability of famil
Page 178 and 179: Box 8.4 Africa: how much land, how
Page 180 and 181: Box 8.5 Infertility: a challenge to
Page 182 and 183: FIGURE 8.2 upper Egypt want no more
Page 184 and 185: growth. Fertility has declined in t
Page 186 and 187: Box 8.7 Changing policies and attit
Page 188 and 189: FIGURE 8.6 childbearing age have un
Page 190 and 191: able several types of condoms, pill
Page 192 and 193: housing schemes to parents with onl
Page 194 and 195: and training, data collection and a
Page 196 and 197: 9 Ten years of experience Much that
Page 198 and 199: ecause few effective methods are of
Page 200 and 201: Population data supplement The six
Page 202 and 203: Table 4. Factors influencing fertil
Page 204 and 205: 190 Births and total fertility =Ice
Page 206 and 207: Table 1. Population projections Rat
Page 208 and 209: Table 2. Population composition Low
Page 210 and 211: Table 3. Contraceptive use and unme
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Table 5. Status of women Number enr
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Table 6. Family planning policy _ _
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Bibliographical note This Report ha
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Background papers Note: Source refe
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-1984. "The Malthusian Case: Preind
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I I
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Table 10. Structure of merchandise
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Key In each table, economies are li
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same order is used in all tables. T
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Population I~~~~ - * S: ~ -- ' X -
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Table 1. Basic indicators GNP per c
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Table 2. Growthi of production Aver
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Table 3. Structure of production GD
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Table 4. Growth of consumption-and
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Tadble 5. Structure of demand Distr
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Table 6. Agriculture and food Value
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Table 7. Industr Distribution of ma
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Table 8. Commercial energy Energy c
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Table 9. Growthi of merchandise tra
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Table 12. Origin and destination of
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Table 13. Origin and destination of
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Table 14. Balance of payments and r
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Table 15. Flow of public and public
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Table 16. External public debt and
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Table 17. Terms of public borrowing
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Table 18. Official development assi
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Table 19. Population growth and pro
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Table 20. Demographic and fertility
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Table 21. Labor force Percentage of
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Table 22. Urbanization Urban popula
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Table 23. Indicators related to lif
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Table 24. Health-related indicators
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Table 25. Education Number Number e
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Table 26. Central goverrnment expen
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Table 27. Central government curren
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Table 28. In-come distribution Perc
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Technical notes This edition of the
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difficulties in assigning subsisten
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series in national currencies are a
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Public loans are external obligatio
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estimates, the total fertility rate
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expenditure and current revenue sho
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Bibliography of data sources Nation
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