WASHINGTON — AFTER increasing contraception use to the highest level in sub-Saharan Africa, Zimbabwe's family-planning program gained a reputation as a solid success story.
But as Zimbabwe grapples with economic restructuring and southern Africa's worst drought in a century, the $2 million it needs each year to continue providing family-planning services is getting harder to scrape up.
"You are looking at a situation where [foreign] donors are going to have to be important players here for some time to come," says Alex Zinanga, director of the country's National Family Planning Council.
Zimbabwe is not alone. All across the developing world, where 95 percent of population growth will take place, budgets are being stretched to the limit to accommodate a fast-growing demand for family-planning services. Without a significant transfusion of outside aid, millions of couples will have unwanted children, retarding efforts to slow runaway growth.
"In many African countries, family planning is available only in urban areas," says Martin Vassin, vice president of Macro International in Silver Spring, Md. "That's one reason why in many African countries only 2 to 3 percent of women are using contraceptives, as opposed to 75 percent in developed nations. There's a huge need out there."
Contraceptive use is also limited because many types, including intrauterine devices and female sterilization - the world's most widely used method - are priced out of reach of millions of women. According to United Nations estimates, responding to the rapidly increasing demand will require doubling the $4.5 billion now spent each year worldwide on family-planning services by the end of the decade. Experts say the cost is small compared with the benefits.
For governments, the average annual $20-per-user cost of family-planning services translates into lower bills for roads, housing, schools, and health care. One study found that for every peso spent for family planning in urban areas by Mexico's social-security system between 1972 and 1984, nine pesos were saved on reduced maternal and child-care costs.
For families, the benefits of family planning are also substantial. Studies in rural Thailand, for example, found that families with fewer children were able to accumulate more money for savings and consumer goods, weakening the argument that large families are needed for economic security. Children from smaller Thai families also advanced further in school, while the parents proved more upwardly mobile professionally.
Studies show a link between lower population-growth rates and economic development. Nations with higher growth rates have lagged behind in all areas of social and economic progress, notes a recent UN Population Fund report.
"People are slow to think through the implications of population growth until it translates into something they can understand, like traffic congestion or unemployment," says Duff Gillespie, director of the population program at the United States Agency for International Development. "Even if birthrates decline, it will still be necessary to generate millions more jobs, more schoolrooms, more acres of agriculture. This isn't rocket science, but it's something people are finally beginning to think about."
Outside funding for family planning has slowed since the Reagan administration cut assistance to agencies like the UN Population Fund for abortion-related reasons. But Sweden, Germany, and Britain have pledged to help bridge the funding gap. Other European donors and Japan are likely to follow suit.
"There's ample evidence of high unmet demand for family-planning services, even in the poorest countries," says Steven Sinding, who directs the population program at the Rockefeller Foundation in New York. "Although family planning is not the whole solution, expanding family-planning services is likely to have a significant effect on birthrates."