Family Planning in Asia and the Pacific - International Council on ...

FigureFigure945Relationship between total fertility rate <strong>and</strong> GDP per capita <strong>in</strong> eight <strong>Pacific</strong> countriesContraceptive prevalence rate403530252015R 2 = 0.2076101000 1500 2000 2500 3000 3500 4000 4500GDP per Capita PPPSource: Tables 2 <strong>and</strong> 3.high (<strong>in</strong> <strong>the</strong> context of <strong>the</strong>se countries) CPR contributesto low fertility. On <strong>the</strong> o<strong>the</strong>r, <strong>the</strong>re are two countries <strong>in</strong> <strong>the</strong>group with a CPR near <strong>the</strong> upper end of <strong>the</strong> range (about40%) that also have high TFRs between 4.0 <strong>and</strong> 5.0.The forego<strong>in</strong>g analysis, although rudimentary <strong>in</strong> terms ofprecise statistical measures of association, suggests thatdevelopment <strong>in</strong>dicators expla<strong>in</strong> some of <strong>the</strong> variationbetween <strong>the</strong> countries <strong>in</strong> terms of contraceptive use<strong>and</strong> fertility levels, but also leave much of <strong>the</strong> varianceunexpla<strong>in</strong>ed. From a broad cross-country perspective,higher GDP per capita <strong>and</strong> a lower proportion of <strong>the</strong>population <strong>in</strong> poverty are associated with lower fertility<strong>and</strong> higher contraceptive use, but <strong>the</strong> relationships aresufficiently weak that <strong>the</strong>re is no guarantee that an<strong>in</strong>crease <strong>in</strong> per capita <strong>in</strong>come or a reduction <strong>in</strong> povertywould necessarily produce higher contraceptive use orlower fertility. These weak associations at <strong>the</strong> macrolevel,essentially complement <strong>the</strong> f<strong>in</strong>d<strong>in</strong>gs of DHS at <strong>the</strong>microlevel where it was found that <strong>the</strong> associations betweencontraceptive use <strong>and</strong> <strong>in</strong>dividual socio-economic variables,such as completed education <strong>and</strong> household wealth, wereweak.Age patterns <strong>and</strong> gender issuesThe ma<strong>in</strong> issue with regard to family plann<strong>in</strong>g <strong>and</strong> age <strong>in</strong><strong>the</strong> <strong>Pacific</strong> is <strong>the</strong> low use of contraception among teenagers<strong>and</strong> result<strong>in</strong>g levels of teenage fertility. By <strong>the</strong> st<strong>and</strong>ards of<strong>the</strong> least developed countries as a group, <strong>the</strong> <strong>Pacific</strong> isl<strong>and</strong>sregion is not characterized by high teenage fertility rates,but some countries have quite high levels. In <strong>the</strong> region asa whole, <strong>the</strong> teenage fertility rate is somewhat higher than<strong>in</strong> South-East <strong>Asia</strong> but lower than <strong>in</strong> South-Central <strong>Asia</strong>.The teenage fertility rate currently ranges from 9 <strong>in</strong> Wallis<strong>and</strong> Futuna Isl<strong>and</strong>s to 127 <strong>in</strong> Marshall Isl<strong>and</strong>s (Table 3).A dist<strong>in</strong>ctive feature of teenage fertility <strong>in</strong> <strong>the</strong> <strong>Pacific</strong> is<strong>the</strong> lack of a clear relationship between teenage fertilityrates <strong>and</strong> TFR. As illustrated <strong>in</strong> Figure 11, <strong>the</strong> associationbetween TFR <strong>and</strong> <strong>the</strong> teenage fertility rate is extremelyloose when <strong>the</strong> two “outliers” are removed from <strong>the</strong> sample 18 .Although <strong>the</strong>re is a slight tendency for teenage fertility todecl<strong>in</strong>e with TFR, it is unlikely to be statistically significant.If <strong>the</strong> l<strong>in</strong>e between relatively “high” <strong>and</strong> relatively “low”teenage fertility rates is set arbitrarily at 45 per 1,000, itis clear from Figure 10 that “high” teenage fertility can befound <strong>in</strong> countries with a TFR rang<strong>in</strong>g from 4.7 to 1.6,<strong>and</strong> “low” teenage fertility can be found <strong>in</strong> countries witha TFR rang<strong>in</strong>g from 4.5 to 1.9. This suggests that teenagefertility is determ<strong>in</strong>ed by a different set of factors thanfertility <strong>in</strong> general. A plausible explanation is that socioculturalfactors play a larger role <strong>in</strong> teenage fertility thangeneral fertility. In particular, <strong>the</strong> barriers that restrictaccess to contraceptive <strong>in</strong>formation <strong>and</strong> services are muchgreater for teenagers than for older women. Teenagers arealso more likely to be unmarried, <strong>and</strong> sexual activity beforemarriage is still not broadly acceptable, even though it iswidely practised 19 .84