Today, I want to concentrate on the role that family planning programmes may or may not have made in the extraordinary
reduction of the birthrate in a number of developing countries where birth rates are previously high,
six, seven, eight children per family now reduced down to three to one point eight, even lower.
The almost equally astonishing effect in other countries where family planning programmes development and has had almost no effect,
and where birth rates are still at the traditional level of six, seven or even eight.
As in some parts of north western Africa. This problem introduces all sorts of issues.
It introduces a big question about the fundamental rationality of fertility and high fertility, both in traditional and in less traditional settings.
What is family planning policy and their failures and successes? Tell us about that.
What does it tell us about.
The whole possibility of influencing these very fundamental human motivations and instincts in terms of reproduction and family,
the motivation for family planning, the government evidence is clear enough concerns about the rate of population growth
unleashed by the demographic transition up to three or even four percent per year.
Population growth at is extreme in in Kenya, in Yemen in the 1970s prompted all sorts of fears amongst governments,
amongst economists, amongst ordinary observers about the adequacy of human resources,
of water, of food, of space, of land, to to cope with populations doubling every 25 years or so,
which, of course, is what is implied with that kind of rate of of population growth.
That kind of consideration was paramount in the astonishing turnaround of population attitudes in China, for example, a very direct,
very straightforward Malthusian concern for food supply, water resources, population density, self-sufficiency and all the rest.
In all the cases,
the concern was more to do with the mismatch between the current and projected rates of the population of working age on the one hand,
and the capacity of the economy as it then was or could be envisaged to be in generating jobs for
those people with the prospect of growing unemployment amongst the young distress and poverty,
possible unrest when when young populations remain unemployed and unmarried for long periods of time.
That was highly instrumental in the case of turning around population attitudes in Mexico in the middle of the 1970s,
for example, a very direct example of that kind.
Curiously enough, while governments were falling into line, as it were,
one after the other in terms of accepting the need for family planning policies,
the need to reduce population growth rates, the need to reduce overall fertility back in the in the 70s and even in the 1960s,
in the 70s and even into the 1980s, there was considerable equivocation amongst economists as to whether rapid population
growth actually was so harmful from the point of view of economic growth.
If you read literature at that time, you will see a number of articles which suggest that population growth,
perhaps not at the highest level, at least at an average sort of level, was not all that damaging to economic growth.
Those views are, I think now in the past, at least for the time being, as far as the economic consensus is concerned,
the more recent economic literature in the 90s and in the last 10 years seems to be
rather more clear that rapid population growth is was harmful to economic growth,
that it was beneficial, indeed necessary to bring rates of population growth down.
How far down is a different matter? So it's interesting that government should have adopted or apparently seen the need for
family planning and seen the need for reduction in fertility reduction of birth rates,
reduction of growth rates for the point of view of their very practical, immediate concerns,
while academic economists were much less clear about the benefits of reductions.
As I mentioned at the beginning, this is something not just of political and policy and practical interest,
but also, I think a considerable scientific interest, because if it is the case that governments can bring birth rates down by by various means,
some some persuasive, some perhaps in some cases more coercive,
then what does that say, for example, for the very widely accepted view or very widely promoted view in the 1970s,
notably by Jacques Cauldwell and other distinguished economists and demographers,
that under traditional circumstances of high fertility was entirely rational.
It is the case that the birth rates and come down even when the level of development
is not very great and doesn't appear to justify rapid reductions in the birth rate,
then what does that say for all literature, all the theory about the economic rationality of high fertility in conditions of traditional society,
where where the population is still mostly agricultural and as a kind of a peasant subsistence economy,
as opposed to living in cities where smaller birth rates are obviously much more
sensible because of the very different kind of economy in which most people live.
That goes hand in hand with with a controversy which still is very current and not really resolved,
that is to say, how far is a reduction in the birth rate in the developing world,
primarily due to two due to the advent of higher levels of education, high levels of participation in the modern economy,
a more secular attitude towards life, all the usual kinds of perfectly understandable and well tested factors affecting
birthrates in developed as well as developing societies on the one hand,
and how far how family planning programmes just accentuated that and accelerated that effect.
Or have they had a more or less independent effect in bringing down birth rates even when development was not very
powerful and would not normally be expected to have brought birth rates down to the extent that they have fallen?
As we'll see, it's quite technically difficult to to separate technically in a numerical fashion,
in a way which is evidence based to show that that one fact or the other is more important.
I'll go on to that in a moment. And there's an interesting other aspect to this to do with ideology.
Generally speaking, I think it's fair to say that those in favour of.
The the independent effect of family planning policies on the one hand and the of the
importance of development on the other tend to follow a kind of ideological divide,
a sort of right left divide in terms of broader political sympathies.
And it's interesting that in international forums on family planning policies,
the international conferences of Bucharest in nineteen seventy four in Cairo in 1994 and many others,
there's a clear split between the approval by different governments for family planning programmes on the one hand and an emphasis on development.
The other going very much with a sort of non Marxist Marxist split with in 1974 in particular,
the then communist countries who really strongly opposed the notion that family planning programmes
should be promoted independently in any way of development which they felt was the best contraceptive.
That was a great slogan is only for development is the best contraceptive, not a contraception, as it were.
And this this reflects a rather messy kind of ideological divide.
The obvious one in his remarks and Maltose remarks, as you know, is highly critical of Maltose Marx took the view that,
as we all know, that the problems of poverty, which is what this is really all about, poverty alleviation,
were primarily due to the to the improper distribution of ownership of the means of of production exchange and a distribution,
and that what was required was a political solution to to equalise those entitlements,
equalise those rights, and that would make population problems disappear of their own accord.
There was no need for population policy. Furthermore, that was not even any general law of population of the kind of MALTOSE was very keen to promote.
These controversies dating from the middle of the 19th century, rattle on to the present day and I still very much alive and well,
and you may recall whiffs of it in the recent Human Sciences Symposium, which you may have gone to two or three weeks ago.
So that's still very much alive. But it's complicated in an interesting way.
There's a kind of unholy alliance between the views of Marxists and those who
take a Marxist analysis of these problems on the one hand and the free market.
Right. And the religious right coming together, as it were, from opposite sides of the spectrum,
having gone around the circle to meet each other on the other side. Some free market economists are very keen on the idea that the population growth,
at least in the developed world, is necessary and desirable for for economic growth.
The religious right as well, which may or may not be allied in individuals with the right wing economic views.
Tends to be very strongly opposed to family planning and particularly abortion,
and you can see this very clear in American presidential campaigns at the present time.
And this has an effect on the Third World. One of the most important international donors for family planning programmes worldwide is USAID.
When there is a president in power of the United States who does not approve of abortion,
whose policy is not to support those family planning programmes which include access to abortion, then U.S. aid has cut its funding very considerably.
Under the Bush years, funding was severely cut for precisely that reason.
Under Obama, it's going up again. What will happen after the next election,
I think rather does depend upon upon whether Mr. Obama or Mr. Romney or whoever it is is going to win the election comes to power.
If Obama continues family planning, aid will continue. If it's Romney comes to power,
it seems reasonable to suppose that family planning will be cut with quite a considerable effect upon the family planning budgets of poorer countries,
particularly in Africa. What are these programmes consists of lots of things, a great spectrum of of approaches,
some essentially nudging, others moving in extreme cases towards towards coercion mostly,
of course, simply providing at state expense or a state subsidy for family planning subsidies based on clinics, hospitals.
And more effectively, village based,
a local service delivery going around to meet the people rather than expecting the people to come to the clinic in Bangladesh and elsewhere.
That's a very much more important way of doing things rather than just making things available.
If you will come along to a particular building at a particular time and ask for particular services, that can be particularly difficult,
of course, in traditional societies where being seen by the local community to be attending a clinic or visiting some place which is new,
possibly rather dubious because of its Western associations and all that may be a very difficult
thing to do and a big impediment towards acceptance or taking up anyway of family planning,
social marketing. So call is also important. Social marketing is is essentially subsidising private provision of family planning services,
not not just handing them out in some state clinic or hospital, but subsidising private providers of family planning so that pharmacies, shops,
ordinary suppliers where you buy food and clothing and all the rest can also supply family planning products.
But of course, at a subsidised rate, hence the term social marketing to make sure that people can afford propaganda and publicity is very important,
not just the direct media, but also indirect media at one stage.
Of course, this put a huge premium on literacy as being an important facilitator or its absence an obstacle to family planning knowledge.
Nowadays, less important,
one of the interesting developments nowadays in the in the take up of family planning policy or family planning methods, rather,
in developing countries is a way in which illiterate women are increasingly taking up family found,
though, of course, by definition they can't read about it. This is well documented in India and many other places.
And one of the reasons for this is the universal access nowadays to transistor radios and the fairly universal access to televisions,
not in every poor person's house, of course, but in most of the Third World.
Every village has got televisions, even if every house hasn't got televisions, people are aware of what's going on.
And they're looking at and listening to not just government propaganda, but also programmes, a very different kind of,
many of which have nothing to do with the government, which nonetheless promotes small family norms.
This is best documented amongst the telenovelas of Brazil,
essentially people the world over love soaps and the soaps in the Third World don't like the soaps in England.
Do it themselves primarily to the deeds and misdeeds of the working class in east London.
Like EastEnders, they're much more concerned with promoting.
We're not promoting, but displaying and describing and documenting the exciting antics of glamorous people leading high income lives.
These people, very much to be emulated, live in comfortable surroundings, in nice houses,
have no money worries, and above all, tend not to have more than two children.
And this message, which is not a government funded policy at all,
that merely a consequence of aspiration is broadcast to many, many, many millions of homes.
And this has been shown, especially in Brazil, is a rather careful studies to be influential in spreading small family norms even
before literacy newspapers have reached the more remote parts of the country.
One of the better innovations of recent years is the integration of family planning services with
a much broader policies promoting infant and maternal health and health and education in general,
so-called reproductive health programmes. These have sometimes distracted attention from family planning provision,
but they tend to put it into a more gentle and more broadly acceptable light.
Educating men always important, of course, payments and other material inducements feature from time to time they featured in the
famous or infamous Indian family planning craze of the 1970s for vasectomy camps,
where, if you'll recall, men were offered a transistor radio if they had their tubes tied.
Similar sorts of things happen elsewhere. They are not necessarily ineffective, but they can't be afforded to any important degree.
Of course, other things like changing the law is important in raising the legal age of marriage is one very widely followed pattern.
It may, of course, be ineffective under the Raj. The British regime in India tried to raise the legal age of marriage but did raise
the legal age of marriage back in the 19th century with rather little effect.
After independence, the Indian government has continued with this policy and of course, if you really can raise the legal age of marriage,
if you can enforce that, if you can persuade people to marry later, they'll have a birth later.
And on the whole, they'll have fewer births. And also the health will improve and the financial situation will be better.
We'll have a kind of favourable circle effect upon subsequent reproductive behaviour and other kind of legal change,
which is important is removing previous impediments of family planning.
The French colonies, for example, in Africa and elsewhere, naturally inherited French legislation concerning family planning from the 1920s.
This was highly restrictive of the 1920s, motivated by affairs for the very low level of fertility then prevalent in France.
The dissemination sailele propagandising provision of family planning was made illegal abortion already illegal,
the subject of much more severe penalties than previously was the case.
These were not listed in France itself until 1960 four in the case of family planning in 1976.
I think in the case of abortion, of course, by that time both those things were done in law or no law.
Nonetheless, the law wasn't changed that in some of the African countries of North West Africa.
They were not changed until much later. I think in some of them they haven't been changed yet.
So that kind of legislation has to be removed before a progress can can really accelerate nagging and coercion, coercion in particular.
We're all familiar with from from from the family planning policy in China, to a lesser extent, also in Vietnam.
So lots of different approaches in making up what a family planning programme is.
Here's an example of propaganda from the Indian Family Planning Programme of about 20 years ago.
This is a picture of a double poster stuck up on billboards like a cigarette advert somewhere.
And you can see the contrast on the left hand side.
You have a big family with living in poverty and misery without shoes and proper clothing and all rested on the right.
We have a two child family things all together very much that in every possible respect you
will see the child sexual the bottom with her homework there and also also her things.
You'll also note that the Adoption and Family Planning Programme turns drought into rainfall,
puts leaves on trees, men's holes in roofs and and other desirable things as well.
So it's not exactly a poster. Still, you get the message and this kind of picture has gone off on on hundreds of thousands of billboards
in dozens of countries up and down the developing world with very much the same kind of message.
This, I think, is something which I've already mentioned this this argument between between essentially a rather more left wing approach,
you might say, or some would say more economically informed approach to development is the best contraceptive or as it were,
contraception and contraception, not really necessarily antithetical at all, but nonetheless a difference in emphasis.
Whatever has happened, it's important to realise there's been a huge increase in family planning take up,
which, of course, has gone hand in hand with the tremendous reduction in overall levels of fertility.
Back in the 1970s and 1960s, about 10 percent of the developing world married couples using modern methods of family planning.
Now it's over 60 percent and keeps on increasing. A tremendous turnaround with consequent necessary obvious effects upon the birth rate.
Factors that can affect rapid fertility decline include family planning policies, which I put here at the bottom,
but it's very important to realise that there are lots of other things going on
which which fuelled this debate between development and family planning policies,
which facilitated and important to realise also that it's not just what happens to the economy, what happens to GDP per head,
what happens the proportion of people in different ages attending secondary schools and tertiary education,
what proportion are in the secondary and tertiary sector of the employment as opposed to the primary sector of employment?
It also matters very much, it seems, what the predisposing pre-existing factors are in terms of in terms of the culture of the country,
in terms of the equality between the sexes,
in terms of the kind of religion which is predominant in the country, the extent to which the country is regionally divided or unified,
the extent to which the country is divided by into, say, 14 different tribal groupings like in Kenya,
generally regarded as being an impediment to adoption of family planning or is reasonably uniform,
like Botswana, where there's essentially only one major ethnic group not counting the miserable and marginalised bushmen.
In terms of in terms of religious background, it's often claimed that those countries with a strong Buddhist heritage like Sri Lanka,
like Thailand, are like the southern part of India, for example, tend to be much more receptive to family planning.
They tend to have no specific objections to it on religious grounds or or on broader cultural intellectual grounds,
and tend to welcome it as being part of what is often claimed to be the favourable Buddhist attitude towards enlightenment,
unquote, which doesn't just mean enlightenment in relation to the scriptures,
but also appears to embrace a rather wider, open minded outlook to try new ideas from outside.
And indeed, it's the case that birth rates in the countries I mentioned in Sri Lanka, in Thailand,
in the southern states of India, especially Kerala, have gone down much faster than elsewhere.
There are other reasons for that, obviously, but it certainly isn't economic development.
There are no more developed than anywhere else in terms of Kerala, less so.
Islam is often thought to be an impediment. And there are there are reasons for doing that, for thinking this,
not because there's any objections specific to Islam against particular methods of family planning, unlike the Roman Catholic Church.
Impossible to say exactly what the Islamic view about about family planning is,
because it's diverse and absurd for me to pretend to be an Islamic scholar, which I'm certainly not.
Nonetheless, it seems to be widely understood that in Islam there is no central authority,
no single central authority laying down the law on family planning or birth control or other matters.
But there is a consensus of the faithful, motivated and informed,
particularly by two or three particular respected centres of Islamic scholarship in Cairo, in Jerusalem and elsewhere.
The the consensus there appears to be that there is no specific objection to family planning in Islam,
and a number of passages in the Koran can be interpreted rather clearly.
It seems as enjoining families, particularly in joining husbands,
not to burden the wives of too many children, not to burden the family with too many children,
but to pay attention to protecting the wife's health and also to protecting the
economic standing of the of the family are not impoverished by too large a family size.
So the notion that Islam is is inherently at is perhaps not justified.
Where there does seem to be a religious effect is not so much in any specific injunction's of a pro or anti contraception kind,
but rather in the rather numerous prescriptions concerning the position of women insofar as those help to keep women secluded at home,
not in the workforce, in the private realm or not in the public realm, not educated rather than educated.
That will have an indirect effect upon upon family planning and also may have an effect upon upon economic development as a whole.
And of course, if you are living in a traditional society where levels of education,
particularly of women, are relatively low, certainly a modern education,
then you will tend to regard innovations like family planning as being something of Western and threatening to Islam,
even when they are not inherently anti-Islamic at all.
Some of these differences are very apparent in the contrast between north and south India,
where the variation in birthrates at the present time between the states of south India,
not particularly rich compared with those in the north of your or three,
comparing Kerala with the TFR of one point six, one point seven with Bihar or decide whether TFR is over for.
Autocratic government tends to have an effect, generally speaking, autocratic governments are in favour of more population.
It's the old mercantilist approach. Perfectly understandable. The other factors I don't need to dwell on, they're pretty self-evident.
One curiosity here. I like to draw attention to actually occur to me the other day.
That is to say that that of all the countries in the developing developed well,
the only one which features in the top 10 of the projected future population increase in the world,
which are the ones on the right from the right, well, is the US.
Once upon a time, there was quite some interest in the US in the notion of zero population growth,
in the notion that there might be limits to the appropriate level of population growth, which the US might might think to experience in the future.
And there was a congressional committee on that in the 1970s and quite a movement towards moderating U.S. population growth.
All that, for the time being, seems to be seriously in eclipse. The US population exceeded 300 million a couple of years ago.
It's going to be at 440 million by mid century, probably half a billion by the end of the century.
And as you see, it's still in the world's top 10. So in that respect is another example, I suppose, of American exceptionalism.
Is all this going against the grain?
After all, what happened, what is happening to all that vast and very persuasive literature from the 1960s and 1970s,
particularly from Jack Caldwell and also from Mede,
came numbers of others apparently showing that there was a lot of rationality in the high fertility of.
In traditional societies, and this was magnified rather than reduced, at least for the time being,
by the advent of the modern sector in those countries and also magnified by the reduction in the death rate.
After all, in the past, as I'm sure you will appreciate, the actual effective surviving family size of children who made it to be young adults the
same age as their parents were when their parents gave birth and could not have been.
On the whole, much more than two know how many were born four or five, six, seven, eight.
Only about two or so would survive to to to say age 35 or something of that kind.
Well, that's not the case. Then, of course, the world population would have exploded hundreds of years ago.
And it hasn't. People did not in the past benefit from large private armies of adult children to act as their workforce,
their private army, their Social Security or.
But and that is often forgotten, but the analysts in the 1970s felt that even even though there was now a large number of surviving children,
this is not so much putting pressure upon family resources on available land available to each family,
but rather it was a benefit for all the reasons which I put here, particularly wealth flows.
The view being that wealth in traditional societies have flowed, flowed on the whole from children to parents, rather than from parents to children,
which is the dismal experience of all adults in countries like the UK at the present time and has been for quite a long time.
Likewise, the importance of old support in countries without without a welfare state,
without much civil society and where kinship links are much more important than they are in
the rest of the world and much more important than they ever have been in the Western world,
at least in terms of recorded history. All these things are entirely plausible.
They don't, at the end of the day, seem to have, as it were, carried the day,
even though the values underpinning high fertility are in many cases very strong and deeply embedded in culture,
as those of you who've studied anthropology were very well aware.
Here are some examples.
There are many, many examples, and all I can do is pull out a couple to to to emphasise or provide evidence for for these favourable points of view.
This is the division of rural labour, and I call it Xiahe. I should call it the Democratic Republic of the Congo.
It keeps changing its name. Originally Belgian Congo, then Zaire, then Democratic Republic of the Congo.
Next week, who knows?
But anyway, a very large country in Central Africa, you can see that the division of labour, essentially, that women do the work.
Adult women score 100 days of ploughing.
Even men in this extreme example only score 15, looking after banana trees and other horrible tasks to land girls to do a bit.
Boys do rather little. Even old women do quite, quite a lot of light work in the fields compared with old men.
This is an extreme example that I presented to us as part of the evidence which reinforced the entirely
understandable arguments for the rationality of the continuation of high fertility in this case,
particularly of girls. Quite the reverse of what happens in many Asian countries, of course, and would not happen so much in a Muslim country.
And of family support. Here are some examples of patterns of family support in Thailand as recently as 1996 at a time,
incidentally, when the Thai birthrate was already in freefall.
Even so, parents with children, a very high proportion daily contact,
a very high proportion of parents receiving support of various kinds food, clothes, money from children, a majority doing that.
Even so, the birth rate went down. What the result of all this has been a complete turnaround in my lifetime, indeed in my career,
in the pattern of acceptance of family planning policy in different countries.
When I started standing up here lecturing miserable students about family planning policies about 30 years ago,
it was it was then possible to point to rather small number of countries which are
unequivocally adopted family planning programmes and where those programmes appeared to be,
if not effective, then least associated with some reduction in the birthrate.
Now it's totally different. It's a complete turnaround.
Now, instead of producing, as I did then, rather short list of countries which did adopt family planning programmes,
mostly other developed ones, small islands, countries strongly influenced by the West, Thailand, Singapore, Costa Rica and Taiwan and so on.
Now it's the unbelievers, as it were, those who not accept your family planning policies, which are still which are now making this very short list.
This is as of 2009. And these are countries which still have a policy either not to intervene in their birth rate,
having got a very high birth rate, or want to maintain it, or even in some cases were needless ones to increase it.
As you can see here, that they're not all that new in Africa that's been in Brunei's, not in Africa.
That's I should put that somewhere else. It's in Asia, but I good Sierra Leone gobble.
Gobble is the only one that governs, the only one which actually wants to its birth rate up.
The rest have high birthrates. We don't want to reduce Libya up 2009.
God knows what the policy is going to emerge in Libya after removal of Mr. Gadhafi.
Mr. Gadhafi, predictably, was was a person out in favour of more people, which frankly, in a country the size of Libya is not unreasonable,
even though most of it is sand, the Middle East, Israel's poor nations, for reasons which we've well understood and don't be elaborating Kuwait.
Likewise, Oman until 2005 now changed his mind is now.
It now has a family planning policy. Saudi Arabia at least wants to maintain its birthrate, which was relentless, isn't it?
Not notice any longer. And whatever its policy, the birth rate in Saudi Arabia is going down as it is in Kuwait,
as it is in Oman, a few in Latin America, a few in Asia and the Pacific in Afghanistan.
Heaven knows what the policy is going to be if a real government ever emerges.
Mongolia is the only really ponytail's country that Mongolia, as you know,
gigantically large country with a tiny population is not obviously irrational.
To want to have rather more people in their president presently have,
even at a cost of some damage to the Eastern Shore, although in fact, in Mongolia the birthrate is really quite low.
It's about two and a half. So it's not going to make very much difference to to economic progress.
This is an example of the change of mind here, a very good graph as viewed from here.
The the black areas in 1976 and 2005 are the ones where the birth rate was thought to be too low and needs to be increased.
As you can see that they've diminished to almost nothing.
The the pale areas with the little dots were the ones the then high birth rate was reckoned with satisfactory.
With no intervention. They have now diminished to a small number down that central corridor.
As you can see, most now regard their birth rates as being too high.
And of course, Africa is as well the international laggard in terms of family planning programmes.
These are some people who people, countries which have changed their minds rather radically over the years.
I won't dwell on this or talk about them a bit more in a moment. A few examples might be instructive, at risk of overloading you with detail,
the Indian Family Planning Programme was the first in the developing world of independent country.
It had been thought about a lot in the time of the Raj, but but in the time of British Dominion of India,
it was thought to be really politically impossible to try to introduce a policy
of of family planning to bring population growth rates more under control,
even though it seemed very obvious that it was desirable.
Even though many Indians themselves felt that it was desirable, nothing was done, couldn't really be done.
But as soon as it was independent, Review of Independence and Family Planning Programme began in 1952, typically,
as in family planning programmes at that time, rather ineffectual, very much top down, very bureaucratic, inconsistent, changing.
As one minister was replaced by a different minister. The very first minister was a Christian who believed in Gandhian approaches to family planning,
and therefore it was not a very vigorous proponent of artificial methods of birth control.
Things started to heat up, but essentially the Indian policy has been characterised by a succession of crazies.
In the 1960s, it was all IUDs, which initially had some success.
And then then that that that weakened a bit. By the 1970s, it was sterilisation, particularly vasectomies,
male sterilisation with the development of discectomy camps where where mass was actually carried out,
where the famous bribe or inducement of the transistor radio was on offer, which we've all heard about.
A big boost to family planning of a eventually counterproductive kind happened during the national emergency in nineteen seventy five.
Mrs Gandhi, the Congress party of Prime Minister of India at the time declared a national emergency.
Nothing to do with family planning. It was a consequence of a major rail strike, which, as you felt,
was threatening to bring India to its knees, suspended the constitution declared the emergency.
Her son, Sanjay, a great enthusiast, a family planning policy,
seise the opportunity of these new powers which have been given to government irrespective of parliament,
to introduce a much more vigorous family planning policy involving much more incentives for sterilisation,
trying to persuade regional governments to persuade all their employees and lots
and lots of public employees in India to adopt family planning programmes whereby,
for example, promotion will be made dependent upon adopting family planning policies.
Promotion will be denied to those who had more than, say, three children.
Quotas were assigned to public employees to recruit other people to to to adopt family planning.
Imagine being persuaded to a number of your children by the chef of selling railway tickets.
A very, very interesting.
So there are lots of nudging, lots of encouragement, lots of cajoling, lots of bullying and eventually some coercion, particularly Muslims.
A minority in India, of course,
being being corralled into family planning camps and given forced sterilisations in some cases creates a major scandal.
So essentially one party for that party for lots of other reasons why Mrs Gandhi had to call an election.
She lost it. The the nationalist Janta Party, one family planning policy was not abolished.
It was put on the back burner for some time and is now essentially come back into fashion.
It's now a very active, more active perhaps than ever before.
The national population policy of 2000 has got this target of two point one TFR by by two years ago, alas, not achieved.
It is down to two point five. But there is enormous regional variation.
As I mentioned that last week, we haven't yet got 50 percent use of family planning by families in India.
It's just under that. One of the downsides of that is it's very, very much still a sterilisation.
85 percent of couples who are protected by family planning policy of any kind are sterilised,
mostly women as women sterilised if commercialisation is new is a new craze.
Except in the South, marriage is still quite early. Almost no one is remains unmarried.
And this is unlike those countries where family planning has really made a big progress here.
Just a reminder of the enormous variation of. Family planning, acceptance and TFR in different parts of India and these parts of India being more.
Almost every every way except economic development, more favourable to family planning,
much more cultural gender, gender equality here, a much higher level of education,
much later marriage, much lower levels of mortality up here, high mortality, high fertility, much more poverty, much bigger population as well.
China I mustn't dwell on because it's it's so, so much to say and also I think it's very well known to some people in this room.
What's interesting in China is the same kind of thing that's interesting in Iran, that is to say,
a complete volte face in policy, apparently directly contradictory to what ideology would expect.
China, of course, is only 49. Is that a communist government?
A communist governments are, as we're supposed not to believe in Malthusian analysis of the causes of poverty,
not to feel that any need for family planning policies,
but rather to regard the population something which can simply managed like everything else in the economy and which will solve itself.
Because the central problem of poverty is not population, as Marx said,
but that is the ownership of property and and distribution and all the rest of it.
Nonetheless, despite what ought to be a almost religious adherence to Marxist principles in
terms of avoiding family planning policy and adopting a Malthusian rhetoric,
nonetheless, that's exactly what China has done. The pronouncements on the need for family planning,
the need to reduce population size and population growth since the 1970s in official Chinese
publications would even make the most hardened Malthusian society pink with embarrassment.
They are so enthusiastically Malthusian, not citing the need for mothers particularly,
but but expressing a Malthusian sentiments in a way which are a naive year student being slightly rebuked for even by pro population control teachers.
And and so. So it's continued. Important to remember amongst all of this detail that the major reduction in the
birthrate in China took place not during the one child policy starting in 1980,
but in the earlier policy, which I think was the slogan as later longer, fewer later marriage and childbearing, longer birth intervals,
fewer children that was promoted without coercion,
although with lots and lots of nudging and propaganda at a time when the prestige of the regime was very,
very high and were contrary to the cynicism which we normally express towards politicians,
trust in the government of Mao and his successors were very high.
And if if the government wanted something doing, then that was the right thing to do.
The birthrate went down to about two point five from over five, almost six, I think, over a relatively short period of time.
And one child policy has kept it there. And of course, the great problem, the one child policy is, is how to continue it or not to continue it.
Given the birth rate is now below replacement rate and population, momentum of a negative kind is building up with the possibility,
as I say at the bottom, to cite a well-worn slogan that China may become old before it becomes rich.
Policy changes not urgent, thanks to the of the combined effects of development of progress and and family planning policy in that huge country.
We know all about that. I think Vietnam has sort of followed followed suit, and that's well known policy.
But nonetheless, one with with some coercion, particularly if people go on to have three children.
It's one child policy. It's kind of two child policy. Frankly, I'm not sure what is present status is better.
Until a few years ago, this is what it was. And the Vietnamese TFR, for one reason or another, is certainly now quite modest.
Bangladesh is often cited as a particularly strong case for the possibility of family planning programmes to promote low fertility,
even in countries with rather modest levels of development, which Bangladesh certainly has, its infant mortality is still relatively high.
Expectation of life is not very great, although much higher than it used to be illiteracy.
This is these are data is not quite up to date, but they're still not immensely better than these is quite high, especially amongst women.
It's mostly agricultural, mostly Muslim, mostly rural, one of the least urbanised countries in Asia.
And right down at the bottom of the Human Development Index.
Thirty six out of 150 back in 1991, when the family planning programme appeared to be having its success and by no means rich.
Nonetheless, the TFR, which was about seven in 1979, is now down to just over three.
The extent to which the family planning policy is responsible for this is controversial,
but it is possible to evaluate it because of the somewhat experimental nature,
at least at the beginning of the family planning programme and its effectiveness or partial effectiveness,
at least in this apparently unpromising cultural and religious belief that was attributed
to the way in which rather than having a top down programme driven driven by it,
by the government, incentives given by government, exhortations given by clinics,
it was a programme was adopted of trying to deliver family planning services to women in in rural areas by other women,
particularly women who were themselves married with children, of course, Muslim and a reasonably high status.
All of these things are important, not possible in a country of pious Muslim women like Bangladesh to have men going
around promoting family planning or even women who are not themselves married,
don't have children, don't understand. It is important to talk to women in a frank way women can do to women.
And it wasn't a society of men absolutely cannot do whether related or otherwise.
Others have failed, Nigeria's policy started a long time ago, in 1988, it appears to have had no effect.
The Nigerian birthrate is still about six, is gone down a little bit, possibly one child,
but that may be more probably due to development rather than anything else.
It's partly a consequence of weak and unstable government poverty.
It's often claimed of the divided nature of Nigeria, which is a huge country divided into many different tribal groups,
particularly and importantly divided between the north of the country,
almost entirely Muslim House and Fulani and other smaller groupings compared with the South, Yoruba and Ibo and others,
mostly Christian, but by no means all with very different views about about the way the country ought to be run.
Very apparent at the present time.
With the unrest in Nigeria and made worse, by the way, in which the the episodically democratic government in Nigeria is run on provincial basis,
the population of provinces north and south and all their subdivisions determines representation in the parliament.
So the more people you've got, the more power you got and the more resources you can divert to your area rather than anyone else's.
And that is messed up in Nigeria censuses and Nigeria's family planning policy, arguably ever since the 1960s.
Brazil is an interesting case, Brazil, a very important country, the biggest in Latin America, as you know, one where the birth rates are very low.
Her replacement. Sorry, this ferry started off in the TFR about six.
Even by the 1970s. This was deemed too, too much by very many families.
The level of illegal abortion in the absence of a family planning provision was very high in Brazil, with very dire consequences for health,
as it was in most other parts of Latin America,
where abortion in many countries still remains illegal altogether or only accessible to the most extreme circumstances.
Until 1985, the government was not interested enough in population, became more so after then.
But because of the opposition, the Roman Catholic hierarchy could not introduce a fully fledged family planning policy,
but instead facilitated is permitted it in a kind of compromise with with the church.
What happened instead is very interesting,
motivated partly by a strong hostility to the very high level of illegal abortion and all the illness and death that followed.
From that, the medical profession started a programme to market a family planning and promote family planning in hospitals and elsewhere.
This Bentham's organisation is a branch of the international Planned Parenthood Federation set up in in in India in 1954 to promote family planning.
Also, the pharmaceutical companies aware that there was an unmet need for family planning, started marketing it to meet private demand and.
The doctors again started to circumvent the law against sterilisation,
tubal ligation by but by providing tubal ligation to women who are in hospital having caesarean sections and as a consequence of all this,
had much, much increased reduction in the birth rate.
The TFR in Brazil is now about one point eight, having been six about 30 years ago.
And this is in the absence of an official family planning policy,
which you might say that that the doctors and the pharmaceutical companies public demand have, as it were, replaced it with with something else.
There are there are downsides to this far too many Caesarian operations.
And there are there are big, rich and poor urban rural differences because of the market based approach to to access to contraception,
because of the public free or subsidised family planning is really not on offer.
I'm sorry, you've got to go. Iran is another example, slightly analogous set of China, Iran,
where the advent of the ayatollahs in 1979 saw the removed total removal of the Shah's programme of
secularist modernisation and its replacement by a theocratic regime strongly opposed to family planning.
Not all Islamic grounds, particularly because it was Western, I think is the underlying objection.
Also, all the women were bundled out of universities, back into the chador,
and women's education came to a full stop after the horrific Iran-Iraq war that the policy became even more prenatal.
As the birth rate went up to about eight, population growth nudged four percent.
The terrible consequences of the war, plus the consequences of this growth which was unleashed, caused a complete turnaround.
In the past. It was it was argued that in order to be strong and confront Great Satan, namely the United States, Iran had to be very numerous.
The ayatollahs then decided that in order to confront Great Satan and promote Iran's interests and the interests of the people,
of course it was necessary for the family planning programme to be to be redeveloped and promoted with great vigour.
And by 1989, just 10 years after the Islamic revolution, the Islamic clergy was actively promoting family financing,
planning in the context of the census around that time,
and also a very important programme of rural rural focus, education and health linked with family planning provision.
Very much the village level, highly effective, going with the grain, of course, Iranian society.
Iran is a very ancient, civilised population. It's had a it's been there for about three thousand years.
It's quite unlike tribal societies elsewhere in the world. So women have felt that it was ripe anyway for family planning acceptance.
This was happening a big time in the cities. In any case, anyway, GFR is now a national level one point.
And even in rural areas, it's down to about rephase. On average, there's some variation.
This is a quite extraordinary achievement and shows the importance of the value, if you like, of the way in which in Islam,
the interests of the nation and the interests of religion are the same because the state is religion and religion is the state.
There's no separation. This is often regarded as being a problem in the West.
In the case of Iran, it's clearly been turned to great advantage at his birth rate going up during
the early period of after the Shah and then going down in a major reduction.
Kenya, progress on hold, I think I talked about the fertility stall in Kenya, a somewhat important to work out why this should be the case.
Some insist that it's a reassertion of the fact that high levels of fertility are, in fact, rational.
And under the circumstances, most people still offer live live in the countryside.
For my part, I think this is deeply unlikely and that postponement of an recuperation may be
important that certainly the reduction of funds devoted to family planning,
partly because of the distraction of AIDS, has been very important and.
Other problems in particular to Africa and especially to Kenya, led this to be the case with the consequence.
There is a measurable increase in unwanted pregnancy in Kenya.
So that, I think, suggests it's not actually a rational response to what was before.
I've exceeded my time rather badly. I'm not going to talk about calculating programme effort except to say that a lot
of attention has been devoted to trying to work out how effective programmes are.
Huge amounts of money being spent on family planning programmes,
a lot of efforts being made by the United Nations and elsewhere to devise statistical ways of testing how far the policy is responsible.
On the one hand, how far development is responsible.
On the other, with very mixed results, sometimes as high as 40 or even 80 percent of fertility decline attributed to policy factors.
More recently, not much more than 20 percent in a recent analysis in Iran and in Bangladesh, for example.
And finally, these things now appear to be, in some cases, moving towards a natural end and towards reversal.
These countries have already reversed their family planning programmes previously very anti-nuclear.
Now, of course, with low birth rates and high ageing Principlist, these countries are about to tap into population decline.
I think we will see a turnaround in family planning policy in all of these over the next 10 or 20 years as family planning policies,
possibly, except in Africa, will finally have done their job insofar as they have done it and can be laid to rest there.
I must stop with apologies for overrunning.