World Development Report 1984
World Development Report 1984
World Development Report 1984
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sanguine, however, as soon as one takes into some years much less. Despite the unpromising<br />
account specific requirements for fieldworkers: for conditions-per capita GNP between $100 and<br />
instance, they should be village-based rather than $300, adult literacy rates as low as 20 percent, and<br />
city-based, belong to the appropriate ethnic, lin- infant mortality rates as high as 150 per thouguistic,<br />
or caste group, and be favorably disposed sand-spending on family planning was effective<br />
to contraception. The Pakistani program has faced and economical.<br />
recruitment problems of this sort. In the late 1960s Furthermore, many of the factors that hamper<br />
only a seventh of the midwives assigned as effectiveness can be overcome as a program<br />
fieldworkers believed in the efficacy of modern develops. Culturally acceptable solutions to<br />
contraceptives. In the early 1970s they were administrative and personnel problems, and to<br />
replaced by a group including many unmarried limited public interest, take time to develop, as do<br />
women from urban areas who did not have the the quality improvements discussed above. But in<br />
confidence of the villagers. If finding appropriate every part of the world where an effort has been<br />
fieldworkers in each area is difficult, finding made, there has been progress.<br />
higher-level supervisors can be even more of a Foreign funding has been largely absent in the<br />
problem. early stages of some family planning programs, as<br />
Program expansion also depends on the demand it continues to be in China. In other programs it<br />
for contraceptive services. A principal task of pro- has played a catalytic role-for instance, through<br />
grams is to generate some of this demand itself, stimulating pioneering research of demographic<br />
but where initial interest is low or nonexistent this problems. Local finance, however, eventually<br />
task can take time. becomes critical; most of the older, more effective<br />
Taken together, these limits to rapid expansion programs in 1980 had 40 percent or less foreign<br />
might seem to suggest that programs could not funding. For one thing, local finance demonstrates<br />
make good use of more money. But such a view political commitment to family planning, the subwould<br />
be wrong. During the 1970s India, Pakistan, ject of the next chapter. Many of the obstacles to<br />
Bangladesh, and. Sri Lanka were spending as expansion of family planning can be overcome<br />
much as $2.50 per married woman on family plan- with sufficient commitment, and most of them<br />
ning programs and were still producing contracep- cannot be overcome without it.<br />
tive users at acceptable cost-under $20 each, in<br />
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