[The role of family planning programs in the fertility transition in Latin America]. / Los programas de planificacion familiar y su funcion en la transicion de la fecundidad en America Latina.

"This article traces the origins of fertility changes, of attitudes towards contraception and of lower family size values in Latin America, on the basis of information collected during the 1960s and 1970s on abortion, fertility and contraceptive prevalence. It explores the origins and the role of family planning programmes and suggests that they acted as facilitators of the 'mass' transition rather than as the agents that unleashed this process." (SUMMARY IN ENG)

[Profamilia: immense unknown contribution]. / Profamilia: inmenso aporte desconocido.

PIP: In late 1965, when he presented himself to the International Planned Parenthood Federation headquarters in London weeks after founding the Profamilia Foundation, Dr. Fernando Tamayo was an unknown Colombian physician with a mission to modify Colombia's very rapid rate of population growth. Colombia in 1964 has a population of 17.5 million growing at an annual rate of 3.4%. By 1973, the population was 22.9 million and growing at 2.7%. Cultural, religious, and moral obstacles precluded an aggressive family planning campaign, which would have aroused violent resistance. Profamilia personnel worked discreetly but persistently, convinced that they would see few short term results but that their effect would be immense in the long run. Family planning is partly a process of educating families in the health, socioeconomic, and psychological benefits of smaller families. Profamilia has a centralized organization which administers 3 main programs, the clinical program with 40 traditional clinics in major cities and 8 well-accepted male clinics, the sterilization program in clinics and mobile units, and the community-based distribution program which distributes pills, condoms, and IUDs through 3000 community posts under the direction of 120 instructors. Between 1964-90, Colombia's total fertility rate declined from 9.2 to 4.4 in rural areas, from 5.2 to 2.2 in urban areas, and from 7.0 to 2.8 overall. The rate of population growth declined from 3.4 to 1.8%. It has been estimated that over half the decline is due to Profamilia services. The total investment by Profamilia during its history was US $100 million. The average cost of protecting a couple against unwanted pregnancy is US $5.26 per year. Colombia's population is projected to increase from 30 to 54 million between 1985 and 2025 even if the growth rate declines from 1.8% in 1990 to 1.3% in 2025. The most worrisome aspect of the projected growth is its concentration in urban areas, which are already beset by poverty, inadequate basic services, and a limited potential water supply already threatened by deforestation. It is clear that the work of family planning in Colombia is not done and that much remains to be accomplished.^ieng

Family planning and population policy in Brazil.

PIP: Attitudes toward population growth and family planning in Brazil were discussed from a historical perspective and reasons for the government's failure to institute an efective family planning program were examined. During the colonial period, Portugal encouraged population growth in order to exert firm control over Brazil's vast and sparsely populated regions. A large number of African slaves were introduced, and the country's expanding population became recially mixed. Following independence in 1822, Brazilian governments continued to stress the need to expand the population. European immigration was vigorously promoted in order to dilute the population's African ancestry. During the 1900s, population growth became increasingly identified with the nation's destiny. In the 1950s and 1960s, despite the continuing pronatalist attitudes of the government, Brazil's middle and upper classes began to practice family planning. By 1965, the fertility rate began to decline. Between 1970-78 the total fertility rate declined from 4.911-3.983; however, the rate among the poor remained high. In 1965, the medical profession established the Brazilian Society of Family Welfare (BEMFAM) to promote and provide family planning services, especially for the poor. The organization provides these services through the existing network of private and municipal health facilities and works in cooperation with many local and state governments. BEMFAM's goal is to promote individual and family well-being, and BEMFAM strongly believes that the national government should assume responsibility for providing these services to the Brazilian population. In 1974 the Brazilian government presented a statement at the World Population Conference in Bucharest that lead many to believe that government's attitude toward population growth had changed. The statement recognized the right of all couples to have the number of children they wanted and the responsibility of the government to ensure that the poor also had this right. Futhermore, in 1978, President Geisel expressed fear of the consequences of continued population growth, and the current president, Figueiredo, recently noted that progress in family planning was a prerequisite for the continued social and economic development of the country. Despite these public statements, the government faled to implement effective population policies. The government now provides limited family planning services through the exisiting network of private hospitals and clinics. These servies are provided in the context of the government's maternal and child health program. The program is understaffed and underfinanced. As a result, the family planning component is frequently ignored. The programs lack of support stems from the pronatalist views still held by many government officials. The program is also resisted by national level officials of the Catholic Church. Brazil's population was 119 million in 1980 and is expected to increase to 185 million by the year 2000. If raid population continues, Brazil will not attain its desired status as a major developed country in the near future.^ieng

[The population of Chile: past, present and future]. / La poblacion de Chile: pasado, presente y futuro.

PIP: This letter is a response to the article entitled "The Population of Chile: past, present, and future" by Banjamin Viel. The author states that a population policy for Chile was first established in 1967, when the need for caution and for more than a demographic solution to the problem of underdevelopment were stressed. The birth control policy of the National Health Service, which sought exclusively to combat the practice of induced abortion, was defended. The reformist intentions and limited health objectives for the Frei government led directly to the conversion of Chile into a colony for massive experiments in contraception by powerful international organizations. The International Planned Parenthood Federation, Ford and Rockefeller Foundations, Population Council, US Agency for International Development, UNFPA, Unicef, CELADE, WHO, and PAHO invested hundreds of thousands of dollars to make Chile, in the author's words, "the paradise of family planning in Latin American and an example of international collaboration between foreign agencies and local organizations in underdeveloped countries." The spread of birth control in Chile in the 1960s was entirely due to international aid and financing. The 1st reactions originated in academic medical circles, followed by the Catholic Church and the Chilean Episcopate. The Allende government in 1970 condemned foreign intervention in birth control and the sperad of the ideology that economic development is a problem of overpopulation. Despite gathering opposition, little was done in the early 1970s to stop the natality decline. Foreign assistance conditional on the acceptance of family planning continued to be accepted due to the critical econoimc situation. The Armed Forces have finally become alarmed about the effect of the natlaity decline on Chile's defenses. Health improvements said to be due to the massive use of contraception are, according to the author, actually the result of improved health programs sponsored by the Chilean government. Even if health benefits of birth control are acknowledged, the social, genetic, and health costs paid by the Chilean people were too high.^ieng