Success or Failure? Family Planning Programs in the Third World

Success or Failure? Family Planning Programs in the Third World

Success or Failure? Family Planning Programs in the Third World

Success or Failure? Family Planning Programs in the Third World


"This is a good, solid explanatory work on family planning programs. The first three chapters are especially useful for general background information on the justification and problems of governmental family limitation programs. The case studies, including Taiwan, South Korea, Costa Rica, and Mauritius, explain the socioeconomic conditions that prompt such efforts. Using statistical data, Hernandez analyzes the effectiveness of the various programs. The concluding two chapters look at Third World socioeconomic situations and past programs in family planning, and offer readers a good background in population studies. Public and academic libraries, community college level and up." - Choice


Governments and private foundations have not always been attentive to evidence about what works. The exceptions are remarkable, and some admirable exceptions lie in research on fertility control programs. At least some of the exceptions are given in a fine catalog of fertility control project evaluations compiled by Cuca and Pierce (1977) for the World Bank. For example, randomized field experiments are very desirable on scientific grounds because when conducted properly they produce fair and unbiased estimates of the program's effect. Yet controlled, randomized experiments constitute a minority of evaluations that Cuca and Pierce list so conscientiously. Doubtless they are a minority because they demand considerable extra-scientific skill--managerial, bureaucratic, and political expertise--that is often unavailable.

As Hernandez observes, attention to quality of evidence has, however, increased in recent years. The origins of the stress lie partly with conscientious bureaucrats and scholars who are able to reiterate the need to take data seriously, to assure such data are collected, and to produce incentives for doing so. Those efforts are virtuous, especially in view of their infrequency, and they are exhibited from time to time in projects supported by UNESCO, the World Bank, the U.S. Agency for International Development, the Ford Foundation, and especially by the Population Council.

The importance of fertility control itself is clear from high average birth rates of women in countries such as Kenya, where the average woman has eight children, and from evidence that increases in health services may actually increase birth rates in Syria, Bangladesh, Bolivia, and elsewhere. The rate has a substantial impact on a country's efforts to enhance the well-being of its population, on some local and regional development programs, and on individuals themselves.

The importance of the problem of determining what works is also clear in principle. We need to understand whether and why our ef-

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