10

# PROGRAM EFFORT

||Stronger|Weakar|
|---|---|---|
|More|||
|favorable|A|B|
|SOCIAL|||
|SETTING|||
|Less|C|D|
|favorable|||

26. Tyve A countries are those in which both factors are favorable and in which broad and substantial support for family planning programs is warranted. The government is committed and relatively capable of delivering services, and the social setting suggests a strong predisposition on the part of couples to limit family size and to space births. Surveys generally show average desired family sizes of fewer than four children. In such countries, governments should be encouraged to adopt policies which provide incentives to the private sector to meet the rising demand for contraception. Policies such as elimination of duties and tariffs on contraceptives and permitting commercial firms to market resupply methods (pills, condoms) are but two examples of how governments can meet expanding demand by providing incentives to the private sector rather than by expanding public service delivery systems. Examples of countries in this category are China, Thailand, S. Korea, Sri Lanka, parts of south India (e.g., Kerala), Indonesia, Tunisia, and Mexico. Much of East Asia falls into this category, as do a few Latin American countries.

27. Type B countries are those in which the development indicators (and often survey data) suggest a strong interest on the part of couples to limit fertility, wiEh desired family sizes being comparable with Type A countries, but where government lacks the will (and perhaps, but usually not, the ability) to effectively deliver services. Since such countries generally have relatively high living standards, resulting in part from effective public sector performance in some social service areas (e.g., education and health services), it is normally lack of will rather than lack of capability that explains the relative absence of public sector activity in the population field. Often the reason for lack of government commitment is concern about alienating politically powerful groups, such as religious organizations or ethnic minorities. In such cases, the private sector is the obvious channel for responding to the desire of couples to control their fertility. Much of Latin America and some Middle Eastern countries fall in this category.

28. Type C countries are the reverse of Type B: a strong commitment on the part of the government to control population growth (often without commensurate administrative capability because these are generally quite poor countries) in a socio-economic environment that may not be conducive to rapid fertility decline because of high rates of illiteracy, infant mortality, and lack of opportunities for women outside their traditional childbearing and child-rearing roles. Surveys usually show desired family sizes of more than four, and often six or eight, children. Yet, even in such countries, there will be substantial numbers that will be interested in controlling fertility. These are typically urban dwellers and others in the modern sector of the economy, and women who have already borne many children and who want to terminate childbearing. Some years ago, before data from sources such as the World Fertility Survey and the Demographic and Health Surveys were available, demographers generally underestimated the number of such couples. Today, we know that these numbers often are substantial and tha.i if program effort is strong, investments in family planning programs usually will yield significant results. However, it is also true that, even with extremely strong political commitment, fertility is likely to fall more slowly than in Types A and B countries. This is why some Type C countries have been willing to contemplate, and in some cases implement, special efforts