Effective Family Planning Programs by Rodolfo A. Bulatao

By Rodolfo A. Bulatao

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Since 1960, infant mortality rates in the developing world have fallen by half, from 150 to 73 per thousand. Again, certain East Asian economies have had the most dramatic experiences: infant mortality in Hong Kong and Singapore is now below that in the United States. Maternal mortality in developing countries has also fallen but is still high. Pregnancy and childbirth are risky in developing countries, and lower fertility, particularly when it can be achieved without resort to unsafe abortion, reduces the toll.

Many more developing countries fall in a middle range, with 30 to 60 percent prevalence. And a substantial number, mainly in Africa and the Middle East, have prevalence levels under 10 percent. Variation in contraceptive prevalence now explains at least two-thirds of the variation in fertility across developing countries. Of the various methods, sterilization has become the most popular, and it now accounts for about half of all contraceptive users. At the same time, more than 10 percent of users still rely on traditional methods.

Before the reproductive revolution, the traditional family is a network of mutual obligations extending outward to include relatives of several Figure 1. Number of Years Women Spend with a Child under Age Six, from Two Surveys, by Fertility Level Source: Freedman and Blanc (1991:16). Page 10 generations. As average family size shrinks, the family turns inward, gradually shedding multiple roles and becoming above all a private emotional haven for its members. Companionship becomes central to marriage (Shorter 1975; Caldwell 1977) and becomes more salient as a value expected from children.

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