DHAKA, BANGLADESH — BATASHI, a woman in her 30s wearing gold jewelry and a bright blue sari, stands in front of her tidy cement and packed-mud home in a village called Nabogram. She and millions of women like her in the developing world are helping to answer a question that is central to the effort to slow global population growth: Is it enough to hand a poor woman a contraceptive?
Batashi's village, about two hours outside Dhaka, Bangladesh, is perched on earthen ridges that divide rice paddies and keep people above the flood plain during the rainy season. Most people work tiny plots of land they don't own. But Batashi's economic situation is better than average because of small loans and other assistance she has received from a private development agency called BRAC, the Bangladesh Rural Advancement Committee.
She now owns three cows, tethered in a nearby shed, that produce 10 kilograms (22 pounds) of milk every day. She also owns three bicycle rickshaws, one pulled by her husband and the other two rented to men who earn their living by pulling them.
Do the cows and the rickshaws have any bearing on Batashi's decision to use family-planning services? "Yes, family planning is easier for me," she says. Economic opportunity "gives me freedom and ... gives me power." Batashi has two sons and a daughter. "This is enough," she says, "because I want these three to be educated persons. I don't want my children to be rickshaw pullers."
Batashi's case illustrates why many population analysts now believe that "parallel efforts" and "holistic approaches" to overpopulation - that is, combining the delivery of family-planning services with programs that improve women's standing in society - are critical to slowing birthrates.
"What's clear," says Sharon Camp, senior vice president of the Population Crisis Committee in Washington, "is that if you can do good family planning and secure improvements in the status of women - legal, economic, social, and political - those things interact so powerfully that you can get declines in birthrates at breathtaking speeds. That's probably the solution to the world's population problem."
Even so, family-planning bureaucracies in many developing countries have been slow to expand beyond the traditional approach to family planning - providing contraceptives and advice on using them.
"From a program standpoint, the woman is a target to achieve demographic ends," says Saroj Pachauri, a program officer at the Ford Foundation in New Delhi. "It's not her concerns that are paramount."
Population experts have long understood the importance of "female empowerment" - a catchall term that covers women-centered health care, improvements in social and legal status, access to education and jobs, and a fairer distribution of responsibility for children between mothers and fathers.
But during the past 10 years, a growing body of evidence has verified the correlation between empowerment and reducing family size.
One of the best examples in the world is nearby in the southern Indian state of Kerala, where the fertility rate - on average, 2.3 children per woman - is one of the lowest in the developing world. One reason is a female literacy rate of 66 percent, several times the average in India's northern states, according to a United Nations report.
The other reason is the status of women. According to tradition, women inherit land in Kerala, and families pay a "bride price" to the parents of the bride, symbols, the UN Population Fund says, that women are considered an asset and not a liability. Education changes outlook
There is plenty of evidence to show that eight or more years of education for women, because it encourages later marriages and broadens a woman's outlook, results in fewer births. "With education and economic opportunities, women begin to define themselves as citizens, not just family members," says Judith Bruce, a senior associate at the Population Council, a private research group in New York. "Interacting in a wider set of relationships means having access to more objective information [on the costs a nd benefits of having more children]. It means more equality in the marital relationship."
Research also links increased family planning with economic opportunity. One study looked at a group of 1,600 women members of the Grameen Bank, a Bangladeshi institution that provides small loans to promote small businesses. Fifty-nine percent of the bank members were using some sort of family planning, compared with 43 percent of women in a control group.
Economic insecurity, on the other hand, can have a reverse effect, driving up birthrates since children, especially sons, are considered essential to old-age security.
According to recent research, 60 percent of women in India over age 60 are widows. But some of India's many castes prohibit widows from returning to the village of their birth or joining the lineage of their married daughters.
"Unless she has adult or married sons, she is left virtually on her own," says Marty Chen of the Harvard Institute for International Development, in Cambridge, Mass., and author of the research.
In a village near Batashi's, a woman named Behula says she had three girls before she bore a boy.
"When my three daughters marry, my house will be completely empty," she says. "If I have a boy, he will be present in front of my eyes [and] in the end he will see me in my old age."
"To me it seems so obvious that we really don't have to explain it because women are [the] ones who make the choice," says Amina Islam, a program officer at the UN Population Fund in Dhaka. "If you improve their status, they will be in a [better] position to make decisions about their fertility."
Sitting in the government family-planning office for Manikganj District, where Batashi's village is located and where BRAC has been active, two low-level male bureaucrats corroborate the point.
"It is very easy to talk about family planning with a working woman," says one, Motalib Hussain, the district family-planning supervisor. "It is very easy for us because she has already developed herself. [But] it is very difficult to talk about family planning with housewives."
At the higher levels of Bangladesh's family-planning bureaucracy, however, there is less regard for the impact that education and economic opportunity can have on fertility. "We are proud of our success," says A. K. M. Rafiquzzaman, director-general of Bangladesh's Family-Planning Directorate, sitting in an office air-conditioned against Dhaka's 100-degree heat.
"Bangladesh has disproved the theory," he asserts, that economic development and literacy are prerequisites to a contraceptive-prevalence rate of 40 percent. `Can't wait for development'
"The main problem," writes Alia Ahmed in her 1991 book, "Women and Fertility in Bangladesh," "is that one cannot wait for socioeconomic development to solve the problem of overpopulation when development itself is being stifled by the high rate of population growth."
But most experts insist that there are limits to relying exclusively on a "supply side" approach to family planning, providing contraceptive services to interested couples.
To produce deep cuts where they count most - in fertility rates - the "demand side" of the equation must be addressed as well by providing the education and economic opportunities that create a desire for smaller families and thus a wider demand for family-planning services.
"It's one thing to reduce fertility rates from five or six children per woman to three or four using traditional family-planning services," says Ronald Ridker, a senior economist at the World Bank in Washington. "But unless there is substantial social and economic progress, including improvements in the status of women, it will be impossible to get from three or four [per mother] to a replacement level of 2.1.
"We can't wait for social and economic progress to occur to accomplish these things," adds Dr. Ridker.
"We have to intervene selectively in the development process to ensure that the conditions that change attitudes toward family size are fostered."