World Development Report 1984
World Development Report 1984
World Development Report 1984
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dren than they want, or would want had they as rhythm and withdrawal, which are less effective<br />
more information about, and better access to, eas- in preventing conception, or on abortion, which, if<br />
ier fertility control. For example, couples may lack primitively performed, puts the mother's life at<br />
(or disbelieve) information about falling child mor- risk.<br />
tality-or about their chance to reduce the risks to In this situation, the role of the government is<br />
their existing children by keeping numbers critical. As a start, it can encourage parents in their<br />
down-and thus have more children than needed desire to have fewer children simply by providing<br />
to reach desired family size. They may not know more information-about changing mortality and<br />
that by stopping breastfeeding they risk more the health benefits of controlling fertility. It can<br />
closely spaced births. They may not be fully aware encourage wider provision of modern contracepof<br />
the health risks, to mothers and children, of tives. This can be achieved by private suppliers,<br />
Box 4.1 The isolation paradox<br />
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many and closely spaced births. The very idea of especially in towns and, for some methods (such<br />
planning pregnancies may be unknown, especially as condoms), in rural areas as well. But private<br />
if social norms dictate early marriage for young suppliers are unlikely to provide the full range of<br />
women and if couples do not discuss sexual family planning services, especially in remote<br />
matters. areas. Many modern means of contraception can<br />
Even if they know about family planning, cou- be made available only with medical backup, and<br />
ples may not know how to practice it. They may be there is little profit in disseminating information<br />
reluctant to ask questions, especially if their par- and contraceptives where distribution systems are<br />
ents pressure them to have many children. Or they poor, health care is limited, and demand is<br />
may lack ready access to modern contraceptives unknown and possibly limited. In many countries<br />
and be forced to rely on traditional methods such government may need to subsidize or even orga-<br />
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