Fertility transition in Sri Lanka: programme and non-programme factors.

PIP: During the past 4 decades, Sri Lanka has experienced significant changes in the level and pattern of fertility. The total fertility rate and crude birth rate showed a steady decline, and age specific fertility rates have shown continuous declines in fertility in all age groups. This is attributed to a host of program and non-program factors, which have been in operation in Sri Lanka and facilitated the development of the social environment in which reduced fertility is an important demographic trend. This paper examines these factors under several distinctive areas. With regard to program factors, the areas of policy environment and strategies, institutional development, managerial processes, and contraceptive services are examined. In the context of non-program factors, the areas examined include participation of nongovernmental organizations, socioeconomic development, rise in age at marriage, induced abortion, breast-feeding, and decline in fertility. Overall, it is noted that in the Sri Lankan experience social development policies and programs have been accompanied by the commitment and dedication of health personnel and population planners who brought about the desired changes in fertility.^ieng

The population slide.

PIP: The level of total fertility in Bangladesh has fallen from 7 in 1975 to 3 today, the sharpest fertility transition in South Asia. Fertility decline in Bangladesh and Nepal follows such transition occurring first in Sri Lanka, then in India. While in Western countries, levels of fertility began to fall once an advanced stage of development had been reached, these new declines in South Asia are not directly correlated with indicators of development such as increased literacy or the alleviation of poverty. Bangladesh has experienced major fertility decline despite being one of the world's 20 poorest countries. Fertility decline in Bangladesh may be attributed to a combination of an effective government family planning program, a general desire among Bangladesh's population to bear fewer children, reductions in mortality, the availability of microcredit, changes in women's status, and the provision of health and family planning information over the radio 6 hours per day.^ieng

[Demographic transition or revolution? The weaknesses and implications of the theory of the demographic transition. Part 2: the consequences]. / Transition ou revolution demographique? Les insuffisances et les implications de la theorie de la transition demographique: II--Les consequences.

PIP: In 1929, Warren S. Thompson published a three-part classification of world populations according to their fertility levels and growth rates that explained the progressive passage from one group to another in terms of economic and social factors. American demographers, preoccupied by the Great Depression, paid insufficient attention to this early formulation of demographic transition theory. During 1928-31, Robert Kuckzinsky systematically analyzed the historical evolution of mortality and fertility in Europe and introduced the term "transition" in reference to eastern Europe. In 1944-45, Frank Notestein and Kingsley Davis presented the theory of demographic transition in the form that came to be nearly universally accepted. All societies, it was believed, would pass through the three stages, from a preindustrial to a postindustrial demographic equilibrium. Mortality was presented as a dependent variable under economic control, while fertility was a dependent variable under social control. Demographic transition theory would provide the conceptual framework for UN demographic projections and the justification for family planning programs for the massive agricultural populations of Asia. As the theory developed, the relationship between development and demographic transition was inverted; it was argued that rapid growth constituted an insurmountable obstacle to industrialization or any kind of modernization. Fertility had to be reduced in poor countries by any means possible to permit their economic advancement. Family planning programs in developing countries were supported, and major resources were devoted to KAP studies and the World Fertility Survey. The struggle to control fertility became the most urgent objective. It was not until the 1974 UN World Population Conference in Bucharest that the American delegation abandoned the extremist position of the preceding decade and acknowledged that population policies are not substitutes for development policies.^ieng

The demographic transition in the Korean peninsula, 1910-1990: South and North Korea compared.

PIP: North and South Korea have both experienced demographic transition and fertility and mortality declines. The fertility declines came later in North Korea. In 1990, the population was 43.4 million in South Korea and 21.4 million in North Korea and the age and sex compositions were similar. This evolution of population structure occurred despite differences in political systems and fertility determinants. Differences were in the fertility rate and the rate of natural increase. The total fertility rate was 2.5 children in North Korea and 1.6 in South Korea. The rate of natural increase was 18.5 per 1000 in North Korea and 9.8 in South Korea. Until 1910, the Korean peninsula was in the traditional stage characterized by high fertility and mortality. The early transitional stage came during 1910-45 under the Japanese annexation. Health and medical facilities improved and the crude birth rate rose and then declined. With the exception of the war years, population expanded as a function of births, deaths, and international migration. Poor economic conditions in rural areas acted as a push factor for south-directed migration, migration to Japan, and urban migration. Next came the chaotic stage, during 1945-60. South Korean population expanded during this period of political unrest. Repatriation and refugee migration constituted a large proportion of the population increase. Although the war brought high mortality, new medicine and disease treatment reduced the mortality rate after the war. By 1955-60, the crude death rate was 16.1 per 1000 in South Korea. The crude birth rate remained high at 42 per 1000 between 1950-55. The postwar period was characterized by the baby boom and higher fertility than the pre-war period of 1925-45. Total fertility was 6.3 by 1955-60. The late transitional stage occurred during 1960-85 with reduced fertility and continued mortality decline. By 1980-85, total fertility was 2.3 in the closed population. The restabilization stage occurred during 1985-90, and fertility declined to 1.6. In North Korea, strong population control policies precipitated fertility decline. In South Korea, the determinants were contraception, rising marriage age, and increased use of abortion concomitant with improved socioeconomic conditions.^ieng

Socio-cultural dimensions of population policies in the Third World: the Egyptian case.

PIP: The author reports his findings from the use of an anthropological perspective to explore the obstacles to fertility transition in Egypt. The study is guided by an integrated model formulated to modify demographic transition theory as well as to portray a precise picture of fertility transition in Egypt. Reviewing the mainstreams of the theory and the various developments presented by social scientists, the author found gaps in need of bridging as well as shortages to be avoided. An integrated model which examines the issue of fertility reduction from a sociocultural perspective was subsequently formulated, with empirical verification of the model achieved through field work in two communities in Menoufia and Kalubiya governorates. Analysis indicates that fertility increased in the two communities due to the uncertainty of development, contraceptive method side effects, and cultural rigidity.^ieng

Characteristics and causes of the fertility transition in China.

PIP: Three methods were used to describe the fertility transition in China between 1953 and 1987: 1) analysis of the comprehensive fertility index, married women's fertility index, and the married women's ratio index used by Coale; 2) measurement of the degree of deviation of marital fertility rate from the natural fertility rate; and 3) analysis of the direct causes of marital fertility based on UN demographic techniques. In the Coale analysis, a fixed point was determined after which there was fertility decline. Based on this method, the Chinese fertility transition began between 1971 and 1973, when the country was at a medium level of socioeconomic development at best. The pace of decline was slow between 1953 and 1965, rose rapidly between 1965 and 1970, and peaked in 1975. The European fertility transition model was characterized as fertility decline preceded by marital pattern changes. In China, the most important marital changes in age at first marriage and age specific marital fertility occurred between 1970 and 1980, a period of simultaneous rapid fertility decline. In a UN-style demographic analysis, gross fertility declined from 180.2 in 1953 to 77.5 in 1987 due to birth control, women's marital ratio, and age distribution. The economic and social conditions were conducive to fertility decline, and contraceptive use increased during the 1970s. Fertility transition can occur gradually through social and economic development and couple decision-making or through carefully controlled government intervention. The impact of Confucianism in Chinese culture was to give preference to the social norm of behavior over conduct within the family. China did not follow the Western model of fertility transition because of the speed and brevity of the transition, which was the quickest and shortest in the world, and the short interval between the decline of age specific fertility among fertile and infertile women. The strongest impact on fertility decline in China was the family planning policy, which regulated delayed marriage age and parity progression.^ieng

How socioeconomic status affects birth and death rates in rural Kerala, India: results of a health study.

Data relating to birth and death were collected from throughout the state of Kerala, India, in a health survey conducted by the Kerala Sastra Sahitya Parishad, a voluntary organization. In this study, the authors analyze birth and death rates as calculated from the sample of 9,940 households (57,665 persons), with respect to other variables such as region, religion, and socioeconomic status. In order to study the effect of socioeconomic factors on birth and death rates, a socioeconomic status rating (SES rating) was developed, taking into account such factors as income, education, housing conditions, and land ownership. Socioeconomic status was found to have a definite influence on birth and death rates, with higher socioeconomic status resulting in lower birth and death rates. This effect was independent of such confounding variables as age structure of the population, religion, and region. The higher risk of mortality among the poorer households can partly be explained by the material deprivation: the higher birth rates could be the result of poorer educational attainments.

PIP: Data on births and deaths which occurred between July 1986 and June 1987 were obtained from a survey in all 1001 villages (9940 households and 57,665 persons) in Kerala state, India, by nongovernmental health activists. This study aims to examine the different patterns of mortality and fertility by income, education, religion, and region in order to understand the determinants of the health transition from high to low mortality and fertility. 80% of the study population resided in villages. Weights were assigned to the various characteristics on the basis of their value for understanding health status: income (0.35), education (0.25), housing type (0.25), and land (0.15). Four social classes (socioeconomic status [SES] groups) were used: 14% in the poorest class, 49% in the next poorest class, 29% in the middle class, and 8% in the highest class. The poor were not uniform in level of the four characteristics. Standardization of birth and death rates was performed for each SES group and community. Hindus made up 57% of the sample, of whom 9.8% were scheduled castes and 2.1% were scheduled tribes. 21.5% of the subjects were Christians, and 21% were Muslims. 28% of the scheduled castes were in the poorest SES group and 1% were in the highest SES group. The regional official crude birth rate was 22.3/1000 in rural areas. Crude death rates were 6.7/1000. The study rates were 23.6/1000 for births and 5.9/1000 for deaths. The highest birth and death rates unadjusted for age were in the lowest SES group. The rates were below the national figures. After age standardization, the SES differences in birth and death rates persisted and varied greatly between religious groups. SES differences in death rates were greatest in the under five-year age group.

Population change and economic development in Indonesia.

PIP: Standard demographic transition theory holds that transition takes place concurrently with socioeconomic development. Oshima has generalized that the pace of demographic transition in Indonesia has been slow and in keeping with standard theory. This article, however, challenges Oshima's contentions and points out that Indonesia has been able to attain a level of demographic transition with a lower level of economic development than that experienced by present-day developed countries during their transitions from high fertility and mortality to low fertility and mortality. Sections consider the theory of demographic transition, population and economic change in Indonesia, and the likely impact of demographic changes on the future of Indonesia's economy. The more rapid demographic transition experienced in Indonesia may be used to stimulate even faster economic progress in the country.^ieng

Anticipated child loss to migration and sustained high fertility in an east Caribbean population.

Development today is commonly accompanied by rapid urbanization and, where possible, high rates of migration to industrialized countries. At the same time, the expected demographic transition has often not materialized despite decreases in death rates. Child-to-woman ratios in St. Vincent and the Grenadines are related to the educational attainment of women in a census district, the percentage of men engaged in agriculture, whether the district has direct access to the outside world through a port or airport, and, when the other variables are controlled, the stability of a district's population. Those districts with the greatest stability of population had the lowest child-to-woman ratios, suggesting that the anticipated loss of children to migration may be an important factor in maintaining high reproductive rates.

PIP: As mortality declines over time in most developing countries, commensurate declines in fertility would also be expected. Declines would together foster overall demographic transition and economic development. Demographic transition has not, however, always been spurred and driven by declining mortality. Such is the case for St. Vincent and the Grenadines. There, high fertility persists in a context of rapid urbanization and marked emigration to industrialized countries. Using 1980-81 census data and interviews, research was conducted to elicit which of a host of independent variables help determine the child/woman ratio in census districts of the country. At the district level, ratios were found to be related to the educational attainment of women, the percentage of men engaged in agriculture, and whether or not there was direct access to the outside world via a port or airport. Controlling all other variables, the stability of the district's population also proved to be a significant factor. Ratios were lowest among more educated women, where agricultural dependency was lowest, in port districts, and where population were most stable. Loss of children to rural-urban and international migration has replaced mortality as the leading cause of child loss in St. Vincent and the Grenadines. It may therefore be suggested that continued high fertility is strongly influenced by the anticipated loss of children to emigration. More broadly, one may expect demographic transition to remain stalled where nucleated development prevails. This study points to the need to consider in concern both fertility and mortality for a more complete understanding of demographic transition in developing countries.

Innovation-diffusion or adjustment: the case of Taiwanese fertility transition.

PIP: This study uses KAP data sets to analyze the determinants of Taiwan's fertility decline between 1964 and 1980 and to evaluate whether innovation-diffusion or adjustment or both can be applied to explain the transition. Furthermore, this study examines the roles of innovation-diffusion and adjustment in the stages of the transition of Taiwan's fertility from high to low levels. The 5 cross-sectional KAP surveys, collected by the Taiwan Provincial Institute of Family Planning and used in this study, focus on the fertility behavior of married women living in Taiwan in 1965, 1969, 1970, 1973, and 1980. Analyses of both cross-sectional and pooled-time series data sets provide evidence to support the theory that demand-side diffusion of birth control behavior from urban centers to more rural areas plays an important role in Taiwan's fertility transition. Contradictory findings on the supply-side of diffusion suggest that family planning programs have no consistently direct effects on fertility behavior. The adjustment variables of wife's education, husband's occupation, and the index of consumer goods generally have important influences on changes in family size, suggesting that the adjustment model has significant impact on fertility transition in Taiwan. Duration of marriage, not surprisingly, is the most powerful explanatory variable. Overall, the innovation-diffusion model is more useful in explaining Taiwanese fertility transition in the 1960s, and the adjustment model plays a more important role throughout the late years.^ieng

Fertility transitions of four Chinese populations under different birth planning programs.

PIP: This article analyzes the processes involved in the fertility transition in 4 Chinese populations: mainland China, Taiwan, Hong Kong, and Singapore. In 20 years, the Chinese in Singapore have brought their total fertility rate below replacement level, and Hong Kong is rapidly moving toward this state. Taiwan remains far from the replacement level, but has made substantial progress in the area of birth control. Within 10 years, mainland China has brought fertility from its traditional high level to below replacement. Taiwan, Hong Kong , and Singapore have adopted the Western model of family planning, in which family size decisions and contraceptive choices are largely left to the individual and family planning orgaizations serve as agents to provide contraceptive services. Mainland China, on the other hand, has relied on a planned birth model involving education, persuasion, mass political pressure, and incentives and disincentives. Family size decisions are essentially in the hands of the government. The planned birth model has limited reproduction in mainland China to a 10-year period, whereas the family planning model in the other 3 Chinese populations has concentrated childbaring in the 20-34-year age group. The practice of contraception in the planned birth program is under the initiation, management, and supervision of the government. Mainland China's effective contraceptive users rate (70%) is about 10% higher than that of Singapore, 20% higher than Hong Kong's and at least 50% higher than Taiwan's. The experience in mainland China attests that birth control can be spread even under the most adverse economic conditions if it is viewed as a political issue. The family planning model lacks the power to manipulate the course of the fertility change; mass mobilization and social engineering are required.^ieng