World Development Report 1984

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FIGURE 8.6 childbearing age have unmet need for contracep- Contraceptive use by method: Bangladesh, India, and tion to limit or space births. Pilot projects there Sri Lanka, 1975-83 have achieved rates of contraceptive use of 35 to 40 Percentage of married women aged 1549 percent with modern methods, three to four times 60 the prevalence of these methods nationwide. In Sri Lanka 44 percent of women of childbearing age who want no more children are nevertheless not 50 practicing contraception. To satisfy unmet need, family planning programs must resolve important issues of access and 40 quality. * Access. Better family planning outreach could 30 go a long way to increase contraceptive use throughout the region. Access is most restricted in Nepal and Pakistan. In Nepal there is unmet need 20 . for contraception among 22 to 27 percent of eligible women. About half of currently married women in * w | | | Nepal are unaware of a modern contraceptive 10 1 method, and an additional 15 percent who are aware do not know where a method can be - 1 t [ j ~~~~~~~obtained. In Pakistan, three-quarters of married _women of childbearing age knew of a modern 1975 1983-84 1975 1982-83 1975 1982 method in 1975, but only 5 percent were using Bangladesh India Sri Lanka one. A quarter to a half of these women had unmet need for contraception to limit births. Since then Method contraceptive use has stagnated. The government * Traditional (rhythm, abstinence, - TUD plans to meet the need for contraception by greatly withdrawal, other) - Injectable contraceptives and _1 IUD - Pill expanding and upgrading services. * Method mix. Family planning programs in vaginalmethods i: Condom _ Sterilization (male and female) South Asia have continued to emphasize sterilization to the neglect of reversible methods of contraception, particularly in India and Sri Lanka (see Figure 8.6). Sterilization accounts for more than three-quarters of modern contraceptive use in female education-all of which would have a pro- India and Nepal, two-thirds in Sri Lanka, and found effect on fertility. In Bangladesh family plan- about half in Bangladesh. Sterilization is clearly in ning and greater economic independence of demand among couples who want no more chilwomen are jointly promoted through credit coop- dren. But other forms of contraception are used eratives for women (see Box 8.8). A few countries less, largely because they are not widely available. are moving beyond schemes that compensate Given the high rate of child mortality in South those who adopt contraception to consider posi- Asia, reversible contraceptive methods may be tive incentives for small families. Bangladesh has more desirable for couples who have had two or contemplated offering bonds to sterilization clients three children but who do not wish to be sterilized with two to three children and to couples who immediately. To maximize contraceptive use, both postpone a first pregnancy or space children at reversible methods and sterilization need to be, long intervals (see Box 6.4). India is considering a made available. scheme to give "green cards" to couples sterilized The only widely available reversible method in after two children; these cards would entitle them India is the condom, which is provided through to preferential access to social services. 400,000 retail outlets in the social marketing pro- Desired family size in Bangladesh is now about gram as well as in family planning program outfour; actual size averages about 5.5. Sri Lankan lets. The pill, important in countries such as Indowomen are having on average one child more than nesia, is not offered through social marketing they want. According to a 1979 survey in Bangla- arrangements, and in 1981-82 was being distribdesh, as many as 41 percent of married women of uted through only 4,500 rural and 2,500 urban out- 174
Box 8.8 Family planning and women's credit cooperatives in Bangladesh Tb, Ba.-ng!lide'h Rur.id LW el- rpmenr turn tak, their memrbher; priNIM 3n111 .-.: n:.ni h.- -at t.-e t ri.ed cl tiked B,ard ha; bn rp- 'ri*rin :r'- di c"ip -j -Fi n;r-h t .hetrining ;e;iiri ...it ur mezdi,:al help rartr .-- ir rural i.rnkn ;ir-cr ism. 5 Ar . riiu. [- rhe program Vhad -tab- A cud b. th.. Bangihdth iPlan.n,ning tin.arwet 1b42 I and rilr:l-:.tianc:i- r4 h-ihrd I 1 *>'t-perati\ R lith 4 3-r.o C,.mm'i.n. it-.r. i> ccimprrd 1h a c imtpinem n. .i" populati-n prc-i- mcme r ,hare 3pitpal -l abu *u3 1*1kmL knm .ltd-g and practlce .o tarnil-. plan- e-:t- P., p- *-i dinc raiiili.g and 'ncc,.me- . 1nd a.ingr .I u I + Oit, TKh tiing anb'r, :- '..pc rant mecnLtr- ardi t3rrinrg pporiunitie the pr-.gram demand 1 .r lcan' tar .-ult;rip4 the ni-rianniblr4 t- ith ;intilar ;l.eiimC-ili | *-el to r-du.-e ,.:men * dt-pndrn-:: on .miurin a- ailabl- alith -uh the o-nih .l bckgrui'd; I in. the pr-le,r .area in bmih -:hmld-:itinc tor tirtr h..rat .ind jor.g Bank h3 '; rt.lt agreed ro r- i de n: -. grtup- -r m-p i-mn had pouiilt a3r,. tern -t u-r,L. t e ha. al di"-. capitali Trh rtpa. mrmnt r.tt ha; been iudtr: t:nimt, plinning Iu: .tpera- been u- d ti. trjnsmri ft,n'armt- .-n nrernrl, ir:,but high alt a:, - el J rrrcen I u menltrhIr-n - rtn,- ..L'-ut Trh dit- t.irnil% pl3nning Thti pru- Jd .3 'ial mit.n nr-r 11.111 pertent 1,m-m n h.-i tb-e nt, nlnvrh1,., and a larier pr-pi-rnti--n - jr*tiin that enLc-urae acc :pat3rnct and taktr' n--an-; tr pricetaing pajdd mutt .i re practit.i m .:rltraepr.tm.n \inc.-n: i-nr.tintrd u;-It .ct:-nirac: pten turmt ri: mu -tard -o:il dal 3:hili ti,hJand Mll mencrnbrt rca
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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
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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
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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 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
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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 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
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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
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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
Page 236 and 237: 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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World Development Report 1984

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