Family planning programs have success in developing countries, but need to be expanded

While many researchers generally credit the desire for smaller families for the decline in fertility rates in developing, low-income countries, new research suggests that prevention of unwanted births may actually be a larger factor.

The advent of safe and more effective birth control means that people have better control of when and if they have children, said John Casterline, director of the Initiative in Population Research at Ohio State University.

"While it is true that people now want smaller families, my research suggests a more important factor in the decline in birth rates over the past half-century is that people are now more successful than in the past in having the number of children they want," said Casterline, who is also a professor of sociology.

This fact has important implications on the effort by policymakers to limit global population growth in the coming decades, he said.

Casterline gave an invited talk on the contribution of family planning programs to stabilizing world population on Feb. 20 at the annual meeting of the American Association for the Advancement of Science in Washington, D.C.

His talk was part of the symposium "Estimating Earth's Human Carrying Capacity."

Recent projections suggest the human population will peak at more than 9 billion people by 2050.

"The large increases in population that are predicted will only exacerbate other problems, such as resource depletion," Casterline said.

"We want to minimize the growth that occurs, and there is no viable way to do that except through more effective family planning."

Casterline said that the good news is that his research shows how the success of contraception has played a large role in the fertility decline in low-income countries, even more than the more widespread desire for smaller families.

In his analysis of fertility decline in 50 low-income countries from 1975 to 2008, Casterline estimates that about 44 percent of that decline is the result of prevention of unwanted births. About 13 percent was due to people wanting smaller families. The remainder was other factors, such as women marrying later and thus having fewer children.

"We are a lot more successful in family planning than we have ever been. It is one part of the whole medical and health revolution."

But the problem has been expanding that success, particularly in sub-Saharan Africa and South Asia, where the needs for family planning are greatest and where future population growth is expected to be the largest.

Studies have shown that about one in four women (who are currently married or in a union) in Africa have an unmet need for family planning. That means that they report in surveys that they don't want any children in the near future, but are not using contraception.