World Development Report 1984

FAMILY PLANNING. In many countries-such as of countries, even among those with the strongest
Brazil, Nigeria, Sudan, and Tanzania-subsidized programs, have more broad-ranging incentives
family planning is provided as a basic health mea- and disincentives.
sure for mothers and children although the government
has not formally adopted a policy to BIRTH QUOTAS. China is the only country to have
reduce population growth. But once the objective implemented a system of assigning to communiof
reduced population growth has been estab- ties (sometimes employees of a particular factory)
lished, support for family planning services inten- a quota of births to be permitted each year (item
sifies. As noted in Chapter 7, family planning poli- M). Individual couples within communities are
cies tend to evolve in similar ways. Government then given permission to have a child, with priorprograms
are often preceded bv private family itv given to couples who have followed the recomplanning
organizations which eventually receive mendations for marrying only after a certain age,
government financial support (item E). As political and who are older. The system of quotas, and the
commitment increases, government assumes a accompanying pressure to have an abortion when
bigger role, providing public services (item F), a woman becomes pregnant without permission,
family planning outreach (item G), educational are an additional policy "step" over and above the
and informational activities (item H), and subsi- extensive system of incentives and disincentives.
dized commercial distribution of contraceptives
(item I). Policy anld ethics
Policy steps E to I help couples have the number
of children they want. Virtually all countries in the Birth control is not just a technical and demotable
could reduce their fertility by increasing the graphic issue; it has a moral and a cultural dimenavailability
and quality of family planning services. sion. Becoming a parent is both a deeply personal
Countries with moderate and weak programs have event and-in virtually all societies-central to
yet to generate any outreach services; many with community life as well. Procreation is held by
stronger programs, including outreach, fail to many to be a right which is personal and fundacover
the entire population. Subsidized commer- mental, superior to any "good" which might be
cial distribution of contraceptives is not widely bought and sold, and subject to challenge only by
used, even among countries with relatively strong some other right. The tradeoff between the rights
programs. Based on estimates of "unmet need" and welfare of the current generation and those of
described in Chapter 7, there are about 65 million future generations, insofar as a tradeoff exists, will
couples in developing countries who want to limit differ in different settings. But regardless of setor
space births but do not have effective access to ting, a public policy to reduce fertility must be senfamily
planning services. sitive to individual rights today as well as to longrun
social goals, and must recognize the
INCENTIVES AND DISINCENTIVES. By ensuring that distinction between encouraging lower fertility (by
people have only as many children as they want, changing the "signals" which influence people)
governments can slow population growth. How- and coercion. Governments need to recognize that
ever, this might not be enough to bring privately once they are actively involved in reducing fertiland
socially desired fertility into balance. If a pri- ity, the methods they use require careful and convate-social
gap still exists, it cannot be reduced tinuous scrutiny.
simply by providing more family planning. Eco- Virtually all the programs to lower fertility recnomic
and social policies are indispensable to ommended in this Report would also improve
reduce this gap in the long run. They may take individual welfare; they pose no obvious tradeoff
some time to have an impact on fertility, however. between present and future welfare. Programs to
Items I to L are policies that close the gap more raise education and reduce mortality raise welfare.
quickly: eliminating all implicit subsidies for large Family planning programs expand the options
families (item J), offering financial or other incen- available to people, allowing couples to realize
tives for small families (item K), and imposing dis- their own fertility objectives and improving the
incentives for large families (item L). A large num- health of mothers and children. In many countries
ber of countries have disincentives built into their current fertility exceeds desired family size; within
tax system and their benefits system for public most countries, there is "unmet need" for family
emplovees, but these are generally mild and affect planning. Incentives and disincentives, carefully
only a small part of the population. Only a handful designed, can also meet the criteria of improving
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