family planning
PRELIMINARY AND INCOMPLETE DRAFT
How effective are family-planning programs at improving the lives of women? Some perspectives from a vast literature
Shareen Joshi
February, 2011
Abstract
In the past 50 years, family-planning programs have been heavily promoted across the developing world. A vast academic literature now tests both the intellectual rationale for these programs, as well as their impact on a wide range of demographic and economic outcomes. In recent years, the availability of new methods and new datasets from the developing world has intensified the academic research on these issues even though the support for family-programs themselves has diminished. This paper examines the economic and demographic literature on family planning programs and summarizes evidence of their impact on fertility as well as additional outcomes such as child mortality, investments in children’s human capital, the economic status of households and the macro-impacts on communities.
The goal is to provide policy-makers with an understanding of the strengths, limitations and points of agreement that emerge from this vast literature.
PRELIMINARY AND INCOMPLETE DRAFT
1. Introduction
In the past 50 years, family planning (FP) programs have been heavily promoted across the developing world as a means to reduce fertility rates and promote economic development. The central assumption behind such programs is that the decline in birth rates during the early stages of demographic transition can promote economic growth, reduce environmental pressures, reduce dependency ratios and strengthen a societies’ ability to invest in health and education (Coale, Hoover, and Press 1958). At the micro-level, it has been assumed that a decline in fertility would relieve women of the burden of repeated child-bearing and free up opportunities for them to increase schooling and participate in the labor-force. A significant literature – shaped by economists and
How effective are family-planning programs at improving the lives of women? Some perspectives from a vast literature
Shareen Joshi
February, 2011
Abstract
In the past 50 years, family-planning programs have been heavily promoted across the developing world. A vast academic literature now tests both the intellectual rationale for these programs, as well as their impact on a wide range of demographic and economic outcomes. In recent years, the availability of new methods and new datasets from the developing world has intensified the academic research on these issues even though the support for family-programs themselves has diminished. This paper examines the economic and demographic literature on family planning programs and summarizes evidence of their impact on fertility as well as additional outcomes such as child mortality, investments in children’s human capital, the economic status of households and the macro-impacts on communities.
The goal is to provide policy-makers with an understanding of the strengths, limitations and points of agreement that emerge from this vast literature.
PRELIMINARY AND INCOMPLETE DRAFT
1. Introduction
In the past 50 years, family planning (FP) programs have been heavily promoted across the developing world as a means to reduce fertility rates and promote economic development. The central assumption behind such programs is that the decline in birth rates during the early stages of demographic transition can promote economic growth, reduce environmental pressures, reduce dependency ratios and strengthen a societies’ ability to invest in health and education (Coale, Hoover, and Press 1958). At the micro-level, it has been assumed that a decline in fertility would relieve women of the burden of repeated child-bearing and free up opportunities for them to increase schooling and participate in the labor-force. A significant literature – shaped by economists and
References: Amin, S. 1995. Socioeconomic change and the demand for children in rural Bangladesh. Population Council, Research Division. Angeles, G., Jason Dietrich, David Guilkey, Dominic Mancini, Thomas Mroz, Amy Tsui, and Feng Yu Zhang. 2001. A Meta-analysis of the Impact of Family Planning Programs on Fertility Preferences, Contraceptive Method Choice and Fertility Attane, I. 2002. China 's family planning policy: An overview of its past and future. Studies in Family Planning 33, no. 1: 103–113. Bauman, K. E. 1997. The effectiveness of family planning programs evaluated with true experimental designs. American journal of public health 87, no Becker, G. S, and H. G Lewis. 1973. On the Interaction between the Quantity and Quality of Children. The Journal of Political Economy 81, no Bertrand, J. T, M. E McBride, N. Mangani, N. C Baughman, and M. Kinuani. 1993. Community-based distribution of contraceptives in Zaire Binka, F. N, A. Nazzar, and J. F Phillips. 1995. The Navrongo community health and family planning project. Studies in Family Planning 26, no Birdsall, N., and D. T Jamison. 1983. Income and other factors influencing fertility in China. Population and Development Review 9, no Blanc, A. K, and A. O Tsui. 2005. The dilemma of past success: Insiders ' views on the future of the international family planning movement Bongaarts, J. 1987. Does family planning reduce infant mortality rates? Population and Development Review 13, no. 2: 323–334. ———. 1994. The impact of population policies: Comment. Population and Development Review 20, no. 3: 616–620. Bongaarts, J., T. Büttner, G. Heilig, and F. Pelletier. 2008. Has the HIV epidemic peaked? Population and Development Review 34, no Bongaarts, J., and S. Greenhalgh. 1985. An alternative to the one-child policy in China. Population and Development Review 11, no. Bongaarts, J., W. P Mauldin, and J. F Phillips. 1990. The demographic impact of family planning programs. Studies in Family Planning 21, no Boserup, E. 1981. Population and technological change: A study of long-term trends. University of Chicago Press. Caldwell, J. C, and P. Caldwell. 1987. The cultural context of high fertility in sub-Saharan Africa. Population and development review 13, no ———. 1988. Is the Asian family planning program model suited to Africa? Studies in Family Planning 19, no. 1: 19–28. Caldwell, J. C, Barkat-e Khuda, Bruce Caldwell, Indrani Pieris, and Pat Caldwell. 1999. The Bangladesh fertility decline: an interpretation Chowdhury, M. E, R. Botlero, M. Koblinsky, S. K Saha, G. Dieltiens, and C. Ronsmans. 2007. Determinants of reduction in maternal PRELIMINARY AND INCOMPLETE DRAFT mortality in Matlab, Bangladesh: a 30-year cohort study. Lancet 370, no. 9595: 1320–1328. Cleland, J. 1994. The determinants of reproductive change in Bangladesh: success in a challenging environment. Washington, DC: The World Bank. Cleland, J., S. Bernstein, A. Ezeh, A. Faundes, A. Glasier, and J. Innis. 2006. Family planning: the unfinished agenda. The Lancet 368, no Cleland, J., and W. P Mauldin. 1991. The promotion of family planning by financial payments: the case of Bangladesh. Studies in family planning: 1–18. Coale, A. J, E. M Hoover, and Princeton University Press. 1958. Population growth and economic development in low-income countries: a case study of India 's prospects Dayaratna, V., W. Winfrey, K. Hardee, J. Smith, E. Mumford, and W. McGreevey. 2000. Reproductive Health Interventions: Which Ones Work and What Do They Cost? Vol DeGraff, D. S, J. F Phillips, R. Simmons, and J. Chakraborty. 1986. Integrating health services into an MCH-FP program in Matlab, Bangladesh: an analytical update Ding, Q. J, and T. Hesketh. 2006. Family size, fertility preferences, and sex ratio in China in the era of the one child family policy: results from national family planning and reproductive health survey Duflo, E., R. Glennerster, and M. Kremer. 2007. Using randomization in development economics research: A toolkit. Handbook of Development Economics 4: 3895–3962. Duraisamy, P., and R. Malathy. 1991. Impact of public programs on fertility and gender specific investment in human capital of children in rural India: cross sectional and time series analyses Fathalla, M. F, S. W Sinding, A. Rosenfield, and M. M.F Fathalla. 2006. Sexual and reproductive health for all: a call for action. The Lancet 368, no Feyisetan, B. J, and M. Ainsworth. 1996. Contraceptive use and the quality, price, and availability of family planning in Nigeria. The World Bank Economic Review 10, no Freedman, R., L. C Coombs, M. C Chang, and T. H Sun. 1974. Trends in fertility, family size preferences, and practice of family planning: Taiwan, 1965-1973 Freedman, R., J. Y Takeshita, and others. 1969. Family planning in Taiwan: An experiment in social change. Freedman, R., J. Y Takeshita, and T. H Sun. 1964. Fertility and family planning in Taiwan: A case study of the demographic transition Gertler, P. J, and J. W Molyneaux. 1994. How economic development and family planning programs combined to reduce Indonesian fertility Glasier, A., A. M Gülmezoglu, G. P Schmid, C. G Moreno, and P. F.A Van Look. 2006. Sexual and reproductive health: a matter of life and death Halperin, D. T, J. Stover, and H. W Reynolds. 2009. Benefits and costs of expanding access to family planning programs to women living with HIV Harkavy, Oscar, and Krishna Roy. 1997. Emergence of the Indian National Family Planning Program. In Global Family Planning Revolution, W.C Heckman, J. J. 1991. Randomization and social policy evaluation. NBER Working Paper. Hermalin, A., and Z. Khadr. 1996. The impact of family planning programs on fertility: A selective assessment of the evidence. In conference,‘Assessing the Past for the Future: Family Planning Policy, Programs, and Resources,’June. Hobcraft, J. 1991. Child spacing and child mortality. In Demographic and Health Surveys World Conference, Washington, DC, Aug, 5–7. Janowitz, B., M. Suazo, D. B Fried, J. H Bratt, and P. E Bailey. 1992. Impact of social marketing on contraceptive prevalence and cost in Honduras Jensen, E. R. 1996. The fertility impact of alternative family planning distribution channels in Indonesia. Demography 33, no. 2: 153– 165. Joshi, S., and T. P. Schultz. 2007. Family planning as an investment in development: Evaluation of a programs consequences in Matlab, Bangladesh Kaufman, J., Z. Zhirong, Q. Zinjian, and Z. Yang. 1989. Family planning policy and practice in China: a study of four rural counties. Kelley, A. C. 1995. Revisionism revisited: an essay on the population perspective. In Population, Development and Welfare Symposium in Economics, Berlin: Springer-Verlag. ———. 2001. The population debate in historical perspective: Revisionism revisited. Population matters: demographic change, economic growth, and poverty in the developing world: 24–54. Kelley, A. C, and W. P McGreevey. 1994. Population and development in historical perspective. In Population and Development: Old Debates, New Conclusions, ed King, T. 1974. Population policies and economic development: a World Bank staff report. Johns Hopkins University Press.