IN a house-turned-clinic in the Tunisian capital's Bardo quarter, Mohamed Boukhris greets the dozens of female visitors and reviews the day's appointments, which range from simple information sessions to a handful of sterilizations and abortions. In a low white-washed office building a neighborhood away, student midwives from across Africa, many of them women in the bright-print dresses and head wraps of their native lands, listen attentively as an instructor lectures on the merits of various methods of birth control.
``Tunisia's success in its family-planning program has made it a center for training for African and Arab countries,'' says Dr. Boukhris, president and director-general of Tunisia's National Family and Population Office.
``Our success is the result of our philosophy, which is that we are more about helping women attain their rights than we are about birth control, more about helping families than about population policy,'' he adds. ``We believe that healthy women and children are an investment in the country's development.''
Tunisia, a small country sandwiched between Algeria and Libya on Africa's north coast, is emerging as a model for the developing world, and especially for its African and Arab neighbors, in the area of population policy. As the United Nations warns of the dire consequences of the developing world's continuing high population growth, Tunisia is beginning to reap the benefits of an ambitious 30-year-old population program.
From an average of 7.15 children per woman in the mid-1960s, Tunisia's average birthrate has fallen to just over 3 per woman today - about half the average for all of Africa.
Although most African and many Asian countries continue to see economic growth outstripped by population growth, Tunisia (except for the post-Gulf-war stagnation, which officials hope to shake off this year) has managed to buck that trend.
Tunisia has brought down its annual population growth rate to less than 1.9 percent. Thus the accelerated economic growth of recent years has not been eaten up by new mouths to feed. Even better results are projected for the rest of the decade.
Plans to lower growth rate
``It's ambitious, but by the end of our next five-year plan [in 1996], we expect to lower annual population growth to 1.7 percent, as opposed to an annual economic growth rate of 4 to 4.5 percent,'' says Mustapha Kamel Nabli, Tunisia's minister for economic planning and regional development. ``With economic growth outpacing the population like that, we'll be able to improve living conditions significantly.''
Tunisia wants to lower its annual population growth rate to 1.6 percent by the year 2000. But already its rate of 1.9 percent is significantly lower than those of its North African neighbors - and the African average, which tops 3 percent.
That high figure will have to fall sharply if the world is to gain only 1 billion more people - from 5.4 billion to 6.4 billion - by the year 2000, the UN's Fund for Population Activities estimates. Even with that mildly optimistic projection, many developing countries will continue to experience population growth that rules out improvements in living standards, the UN agency says.
Part of the attraction of Tunisia's success is that it has come without the Draconian constraints or social engineering attempted by some countries. Nor has it been mired in controversies over birth control or abortion.
``An essential element in our success is a longtime progressive policy on women,'' says Ahmed Smaoui, Tunisia's minister of social affairs. Tunisia's code of individual rights has guaranteed equal status for women since 1958, and girls are also guaranteed equal access to education. And although family planning has confronted virulent opposition from the religious hierarchy in some other Muslim countries such as Egypt, that has not been the case in Tunisia.
``Our office faced some opposition when it was created in 1973,'' says Boukhris, ``but it has always been marginal.'' That was also the year access to free abortions was approved, ``well before similar legislation in France,'' Boukhris notes.
The country's abortion law escapes the kind of fury the issue receives among religious conservatives in the United States, for example, because, according to Boukhris, Islam holds that the human soul enters the forming body at three months. ``That makes [abortion] religiously tolerable for the first trimester,'' he says.
Still, the place of abortion in Tunisia's family planning program is marginal, with primary emphasis placed on contraception. About half of Tunisian women are covered by the country's free contraceptive services.
That average hides a wide range from two-thirds of women in cities to about one-third in rural areas, however. To try to close the rural lag, Tunisia's 48 family planning clinics have been reinforced by several mobile units.
Though officials here remain optimistic about their continued progress - as well as about prospects for transferring some of Tunisia's success to its neighbors through programs like the midwife training classes - they say much depends on continuing international assistance.
Program is subsidized
Tunisia pays less than one-third of its own family planning bill. The midwife training program, for example, is partly funded by Johns Hopkins University. But already assistance from the US government, one of the program's original supporters, has been cut back. Yet the UN estimates that international aid to family planning will have to double if population goals for 2000 are to be met.
Although Tunisia does not tell its families how many children they should have, it has outlawed marriages for men under 20 and women under 18 - a factor Mr. Smaoui says has proved significant in lowering the number of children per woman.
But more important in lowering birth rates than any laws on legal marriage are the mounting economic difficulties facing young married couples - especially in North African countries like Tunisia, where Western-style expectations about living conditions are growing.
On a recent evening in a small shop of Tunis's central souk, or marketplace, eight young men ate couscous and chatted together. They ranged in age from 31 to 24. None was yet married.
``Women expect much more when you marry today, it takes longer to provide what they require,'' says Mohsen, himself 28. ``I'm saving for an apartment because women today don't want to live with their mother-in-law.''