Access to Family Planning Is Increasing, Report Says

Botswana and Iran cited as success stories in providing services

THE dimensions of global overpopulation are illustrated best by simple statistics. Every 24 hours, for example, the earth takes on a quarter of a million new passengers. The numbers alarm demographers and environmentalists.

But a report issued today, entitled "World Access to Birth Control," brings some cheer to a gloomy subject: Even as the human family swells, access to family planning services and information is improving "dramatically."

The biggest gains have been in the developing world, where 95 percent of future population growth is projected to occur, says the report, issued by the Population Crisis Committee (PCC), a Washington-based private research group. The result is that for the first time millions of couples now have the ability to choose how many children they want and when to have them.

"There are two important implications of the study," says PCC president J. Joseph Speidel. "The first is that when family planning services are made available, they are used. People want them. The second is that improvements in family planning programs will eventually be reflected in lower birthrates, with all the health and economic benefits that implies."

Using data collected in 1990, the report says 50 percent of couples use some method of contraception, up more than 15 percentage points since PCC's last such report in 1987. Excluding China, contraceptive use in developing countries during this period has risen by about one-third.

The report says the global contraception-prevalence rate must rise to 75 percent before world population growth can be stabilized. If this rate is reached by the end of the century, population could stabilize at 9 billion by the middle of the 21st century, the report says. The current world population is 5.4 billion.

The report ranks 124 countries on the basis of three criteria: the range of available birth control methods, including abortion; the scope of distribution of contraceptives; and the competence of family planning providers.

One highlighted success story is Botswana, where the government's fiscal and political support has dramatically improved the availability of family planning services and information. Another is Iran, where high birthrates and poor economic conditions have prompted an ambitious campaign to curb population growth.

"Botswana, which has 1.4 million people, is a wonderful example of what can happen when you can get services and contraceptives where they're needed," says PCC spokeswoman Sally Ethelston. "But the scale of resources is far less than would be needed in a Nigeria, with 90 million...."

Despite gains, half of developing nations still fall into the "poor" or "very poor" categories. The lowest-ranked countries are in Africa and the Middle East, where family planning programs are young and face cultural and religious resistance.

On a separate listing for developed countries, the PCC report ranked the United States 14th, far behind such nations as Denmark and the Netherlands but well ahead of Japan, where access to oral contraceptives is banned.

The US ranking is based on the insufficiency of family planning programs for adolescents, the limited availability of some forms of contraception, and the failure of some health insurers to pay for family planning services.

Two weeks ago, Congress approved a foreign aid bill that significantly increases support for family planning. The money will go to various private family planning groups and to national family planning associations in dozens of developing countries.

As in recent years, the legislation excludes funding for the International Planned Parenthood Federation and the United Nations Population Fund due to opposition from the Bush administration. White House officials object to IPPF providing information on abortion as a family planning method and say the UN fund employs coercive abortions.

The legislation increases population funding by more than 30 percent, from $325 million to $430 million, and will make contraceptives and services more widely available.

"It will give millions of families a chance to choose when to have a child," says Nancy Wallace of the Sierra Club, one of a number of private groups that have lobbied for increased US family planning aid.

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