World Development Report 1984

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Box 8.7 Changing policies and attitudes toward family planning in Brazil i?ina ;lan%p'-n.r' h idi* . I-ird ,rAJ MI I,nre i a lir11 .-flit' -mtE rinimurt pr. .gr3r. in prlrmc 1Hit'1 a. rrriplicii. 'iii J('4 r..r.irrI.:r In idrlb "' El3r:i.-il *. prtiEhilenr r-id -. rn Time n 3 und:-, , enir,c in K- iridir...r.ai rh-al ri'~ ;r,nifi ir. n) ,iir .- lirh i. w irTir. rapidJ r-pu- i.e er. -t rt.#rli ir,_w 'I r. b ir C..I..ni -I I I,m,- r.3 bj h- ih.i hrr. I ir.-- ,r - T rh :.3 It *au .r .4 ti'['id un i- pEr,. ni'i 'lol. tr.- hr iii. II.3r r-.ic 1t, I-' -. . .. irfrlJn iIrijr.Al n] p.ii3 i .r.r,r. *hc nd ,nil', *.-I it1r ,,r .h t l;]ri,iural r.;.r:- r: 1 ].lIa. -hi,.-, Ltiuld [,ad t.. *r-ii it. .h., h- l r. F- T.IcIiiir.. L, h-rTh fli~t iri 'r ...: .i'l . r, I iri rri r 'c,-.1rw,urt I-- IJ. Ld II -.I iii.T Ilia V thrill , r. [ -. T' Iti.iri I- ard _. tr r, nrei; ,rli, :?r.ri. ialii 1. r i. .3 . III-t -tirt ,i ( nra~. .1:.. - uI r i ~ 3rI1i.iri-i n i i r K-rI -m n .n..r, iFirn1 - 3pir, rh, * rr.-.r..---:i air.-. 1 ri-i. luring [-"4 i.,.rI.i r'..p.ala-~ n . r I Iriqirr i-I I .p ,.r Ip'i..r,'Iur 3----.- Itii T r .Iriitiiiii.,'... 1 r- K..i..ifl.t ale iiT- u ib-I.7 h v3er rrd .i. r' .pIitf i' h I r I pi-rinin Iii' 3rd -,r.i *.rF'nl '3- iLr' in ih.- ~.Ind T.Iii.-njI Lie....I..p. -'iahlI I '1r. -AIn r h, t'fii- and i.-"d- ii ir. pm.. ho .E I 'Jilt' -A i.riliZ i -n ir.) frI I,. In'id ilflrl r'i.- 'In iiir ,. ITi rii:r - H aI i h - rh, t pi . 'iii n iill- .e'rrn-cicJ th-. ,-i. -in I - In- hd S .1. '- r.r..-rr ruM hi-rl n! .i F.. IIT,fli i.'.i-n ,rI in r ih-i n-.li,r. w.d,l i. i.n ill,. Ii aridA lardt: r. yiI: r.. ,r i. h. ; r ' -.-. h,s~ 'ii [V.p.r. Irn. i.-.r . .ni.-r. iii-' 4 in - itr .i.rrit. .n . d r . I-ri- r rI.'~ l...*( rn. J,:d tI'.pnr-irii ' at -X Ii. ri t r1ir, a h-. ri J hi PhsrIti ii'i-L,~Ii. y. i r . h-li, ..i rii... c- r-ni r.. pr.. -r ar nid rii -tr In iC - -I 2 --i' r.iti.lI A zin C run-h r-i '1Mirli.r,l,i t ph..I. IT l r.ilC...-'.j1 . . rnr rn-,A.irc.jr*-.- n] i>.- iil-r,i . r.:h..i1. .npI:r..3 a-i...,I -. .r.i.z .. ii h-I r'ii 1r-. h r r ip T hrh ,i-K I i 1. h - niai ii -rp. I- n i r..r; Ira.- f air. (jTi.. [hrnin.n Ir !. hul Ir.:I -il.'' p.r -rT-~ r i'h-. ii. r-.iut [rr[ . I-iii a,. dni.- i I i .. h,h 1 ,41 lb. irrr i-i 5. p.. r nix ar -* I%A.13tdl pro. frj- .]- -3 i.i. -a 1 hrni p~'rrrun.nuI T, n ltrid rn hAn.. ri I .ntilrn-n... -i F nrinnr pr- -.i ,-i,r,- n.J i'. ih Frail Fir. ii. C iran..~~ I- *]itri'd I.-ih,, rl.-. r .id,r.-, I i:nr'ar ,III ii. - Fan- ij . 2rM. 1 ) I rCI 1 Inri ila t -inf 1,'i ;i..l pE.i' o-- i Ji F. .r. itrifr Ena:. r,r,I- r :'d . rlr.rrda Fr-I NJi.r.ii.rlr V. r ii.:i..r .-- ilti, Threrri 7I i .3 p''uar.r. CI iIN 11'p- - er -2.,lini.l rd hl ir..i.r [I.nr... 'it-ri I i-x.ri.iii' 4 i: 'i- r.i ir.. nluih. -'mirur n hanil-. Plannr.:- Fmnl i. ''l1. E d t I2.1 f r, a 'h.t, rl . rn-i-i i-i a tr. i, - IT hat B fl- i. r ~ B.- 'Ir.r i nl.3i.iifj i itrjl,. F' 'fir - N i i t Ii i.irli,nr Ith- F,- r I 1 n ,.I '.' Fr ... i. .- i p.i.rl. .h- ii i-r, r't.d. Ii hi, .r1 ,F-i T. :i ---cT - In . a ir.. IiUri.irl ir d hb. r-d ..I .- i',.ri. r n - - . 'r, i-,.l. .. -. J a ri-iar. i-] ti.ii.iir ' d ..r.n h.. ir ht I., 'q rit i. iri r,i r i.r i Ind Fin rn. f .- Ii, n .n:: . n- 1. .- hal I i - J. 1 , ,I -r. n i..r- .jl- --rn.3r...r. I - r Y.irndm 13.: -. ,d rn ri..ir- .i.-.l r--. r-r -.. i lhir: ,i. . 1 "..r (i'--'-~Fd in --I-s i, i-i '.0h pnirli ri r'-[--r "In' Ill ni-id--ri LI .I rT .1 -i ri 'ai , d oFri Ir ri. ph. riflrng -u 'mIt- i rhn .th.i ..' Ir'' i . - L,nri. .Jr I I l,. i I .. 1 .pr.tj- r" Idtii..ir- 1 'l. J. . ThI: i r c In.] Fri..-. . TF-.- r .-.. nj-.Ii. nc TI ci - In --:ar n i- -. rin A d 1,I t Pia.ii. - i.ipr,1 ,rin.iii h1 pr-. II-.-. r: rc.ini- .:..-ii.i- rai.in -l iripi. Ciiiiil-4 .. nr-i 113 In. *~-iJ iii. h---I -ri P. riu l n-tF. F'I2 aT Cil I'K" I AiiiLI i i1'rIr .. --ri r, -I ''u p i-lih Id I.-rn.- l.-i r n.t. Pt-l i h,C rh.i. ivrjhi 1 . rh,'ir.i. .iii. Mr m i rl., I ib. ji.' n rV..%r.-.T T i--in. rid i r rj ,ii r. r n.r. i,.-,n- I-iiI ni.. Jp'ilrii lii -ph 'i.: .,,,.riliii n ., nti-,lr. u r. a.t..] I in , ia -ri in, Jr-I- uS i.- nirJhl tu. 'I I. -TO .pii:Ll pitri-- l:rI .I. hr 1 .-un h'u.uiii :.nd .J.I-rlda. -l,n ir n. -nii.:. 'r r , ar- t r I.r. r. ir. ri'it r, .i- --.- I. -Il -ririri. ,in.rjIrh..] r ,n' i.-j f'.' fl inL J,' '---a,t mn-,i. .. -ri h, tK,-; iu 1ri r.- i-r . t II.,iuij r.r-i . iil-,n,.iI -ir.Fi - . ir pii 1 on.i.,n. Jl rIp I t: it Ii' , n r -P1 -r I - -, h --I I r---pr..: r'I F' . r F-- ridi -ii - > -- ii'i .I r . ,.iiirriu ri. uI p.pirlr 'r u.n ii .iiti. r. IT - Fu. Ir.nd-I. in .p r. ir di.J riiiC, ifi i -Iui -' lIiri pIiriiL4 n patr- rin. 3- -i , riw- it P- nrhn 1 ir_pr~' iin m Rr.'r I- tin- mumi-I -r i m p '.r T.ii. p'iai n r.un1 rii.-.ii.- - iri 1 .h flr3r ,, [,i .-..hT ra,r - Id.- n :ind-~J1,.ih nrr,.r , hI- .. . .3 .i.irc , d 1 r i ' Ih,ir m'.-iH Jl., - -['-r.] [ r It, i' I r lpr .,C .ni,inl.:i -- I i1-lrt1 ,ii runtJ - T r (nl pI ri.- i ifl-l. ni. priih I .iinli-. r- i-. 'i iL, IV. lr..r rh. 1 lim ir-ui m r%Iid u ., ud : T d-.puir a IAl.-urr LI ri.), r I - ---. T o rt. - ri', T i rh..j .-I - fi p.-.rh u-_i', .lu u ii, I .~ . 'r, T 'I., l re i. h i I' nEtod lb ... h ... i r '.'I.i r -mr',m .n U, -r3 ' - I. 'I,iiiln1in Sra Ii h. r .. tr vd- -\- i rd.:tI . -i .- [ri I i.4n-ii .1Br- lini mu iar..i ri.-f (Fir af-1---rn n.i-a lrmiF.r- cI ,dn TI ,r -x,-- n 1172- , n r m ML- t~nl p j ni, r..r, . 3 , - . , O tP ;I h
American countries could all benefit from stronger FIGURE8.5 policies. Rapid population growth in El Salvador Fertility in relation to income: selected developing has been identified by many as a partial cause of its countries in South Asia, 1972 and 1982 civil war. In Bolivia and Haiti, the poorest coun- Total fertility rate tries in the region, initiatives to slow population 8 growth are among the most urgent policy needs to 1972 combat poverty. U 1982 * 1982 7 Bangladesh South Asia: expanding and improving programs Pakistan The 930 million people of Bangladesh, India, Nepal, Pakistan, and Sri Lanka comprise one-fifth 6 Nepa of world population and one-quarter of the popu- Norm for 92 developing countries, 1972 lation of developing countries. Although incomes in South Asia are among the lowest in the world, 5 the region's fertility has already fallen substan- India tially (see Figure 8.5). In Sri Lanka, for example, riLanka the total fertility rate fell from 5.5 in 1960 to 3.5 in 4 S L 1974; in India it dropped from 6.5 in the 1950s to / 4.8 in 1982. The rate of contraceptive use (both Norm for 98 developing countries, 1982 modern and traditional methods) is 55 percent in 3 Sri Lanka, the highest in the region. About 28 per- 0 $1000 $2000 $3000 cent of couples in India use modern contracep- Income per capita (1980 dollars) tives. No other country at India's level of socioeconomic development-measured by low literacy and per capita income and high infant mortalityhas a lower level of fertility. Bangladesh and Paki- Progress in South Asia has not been uniform, stan have had more modest declines. In Bangla- however, and rapid population growth is a source desh 19 percent of couples use either modern or of continuing concern. In India and Sri Lanka mortraditional methods (see Figure 8.6). tality has declined as fast as, or faster than, fertil- What accounts for this impressive record? Con- ity. As a result, population growth has increased in tinued progress in raising female literacy and low- India-its population is now increasing by 16 milering infant mortality, as well as a concerted effort lion a year, more than in any other country, includto expand access to family planning, have both ing China. India's birth rate has remained at 33 to been important. Within India there is wide varia- 34 per thousand since 1976; contraceptive use, tion in fertility and in contraceptive use, a variation steady at 23 to 24 percent since 1976, has only which closely corresponds to patterns of social recently begun to rise again. Total fertility has development. For example, in the state of Kerala, stopped falling in Sri Lanka, and has been fluctuatwhich has the lowest total fertility (2.7 in 1978), 75 ing between 3.4 and 3.7 since 1974. In Bangladesh percent of rural women are literate, infant mortal- contraceptive use increased from 8 percent in 1975 ity is 47 per thousand live births, and 32 percent of to 19 percent in 1981, but appears to have made couples are protected by modern contraception. In slow progress since then (though the share of contrast, in the state of Uttar Pradesh total fertility modern methods has apparently risen). In Pakiwas 5.6 in 1978, infant mortality is almost four stan only about 5 percent of couples practice contimes higher (171 per thousand), and female liter- traception, and in Nepal only 7 percent. Both of acy and contraceptive use are, respectively, one- these countries lag behind others in providing seventh and one-third the levels found in Kerala. health and family planning services, although both The experience in Sri Lanka is similar. Despite a show signs of a renewed political commitment to per capita income of only $320 in 1982, infant mor- curb population growth. tality had been reduced to 41 per thousand and The experience in Sri Lanka and in some Indian virtually all primary-school-age girls were enrolled states suggests that much more could be done to in school. Of a contraceptive use rate of 55 percent, bring about fertility decline. In every country there almost two-thirds comprised modern methods; is considerable scope for reducing infant mortality, total fertility had declined to 3.4. raising the legal marriage age, and increasing 173
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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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from rural to urban areas mainly re
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other developing countries suggests
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emigration by providing information
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Box 5.7 Coping with rapid fertility
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6 Slowing population growth Experie
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feTtility; nor is it easy to judge
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the education of mothers increases
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etter education and health services
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TABLE 6.1 Total fertility rates and
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effectiveness of existing laws, ins
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in the 1950s and 1960s, fertility w
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FIGURE 6.6 Fertility dedine within
Page 136 and 137: Box 6.3 Mleasuring the value of chi
Page 138 and 139: few births; to encourage spacing, T
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
Page 156 and 157: clients may develop can be promptly
Page 158 and 159: Box 7.6 The impact of service quali
Page 160 and 161: medical examination was not always
Page 162 and 163: measuring social acceptability, or
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 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
Page 212 and 213: Table 5. Status of women Number enr
Page 214 and 215: Table 6. Family planning policy _ _
Page 216 and 217: Bibliographical note This Report ha
Page 218 and 219: Background papers Note: Source refe
Page 220 and 221: -1984. "The Malthusian Case: Preind
Page 222 and 223: I I
Page 224 and 225: Table 10. Structure of merchandise
Page 226 and 227: Key In each table, economies are li
Page 228 and 229: same order is used in all tables. T
Page 230 and 231: Population I~~~~ - * S: ~ -- ' X -
Page 232 and 233: Table 1. Basic indicators GNP per c
Page 234 and 235: 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 10. Structure of merchandise
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Table 11. Structure of merchandise
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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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