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# 11. RESOURCES AND THE DEMAND FOR FAMILY<sup>PLANNING</sup>

19. Profound changes in governments' commitment<sup>to fertility reduction have brought a significan'</sup> turnaround in the relationship between the amount of<sup>donor resources available to support population policies</sup> and family planning programs and the demand for those<sup>resources from governments. Between the mid-1960s</sup> and the late 1970s, donor commitment to fertility<sup>reduction programs exceeded considerably that of</sup> governments in the less developed world. Up to the<sup>mid-1970s, only a few governments, mostly in Asia,</sup> had mounted significant programs to reduce population<sup>growth rates. Because many governments were</sup> reluctant to develop population policies and/or<sup>to mount family planning pr, .ams, donor funds often</sup> supported health programs that were deemed important<sup>to the eventual delivery of family planning services</sup> (e.g., interventions to lower infant mortality<sup>and programs to expand rural clinical facilities) and private</sup> programs that represented innovative approaches<sup>to the delivery of family planning services.</sup> 20. After the Bucharest Conference, many more countries<sup>began to adopt policies to reduce population</sup> growth or, in some cases, simply to provide family planning<sup>services so that "couples may determine the</sup> number and spacing of the children they desire," to quote<sup>from the Bucharest final resolution. By 1985, 70</sup> governments, representing 95 percent of the developing<sup>world's population, had adopted policies that either</sup> explicitly called for fertility reduction or offered<sup>family planning services as part of the broader system of</sup> social services. Simultaneously, the pace of development<sup>in many poor countries meant that incomes were</sup> rising, literacy rates were improving, infant mortaiity<sup>was declining, and the role and status of women were</sup> improving, so that the demand for children was<sup>rapidly declining and the demand for family planning services</sup> was increasing. While it is difficult to chart these<sup>changes precisely, it is generally acknowledged by experts</sup> in the field :hat the demand for resources to support population<sup>and family planning programs began to exceed</sup> the grant funds available from the major donors in the<sup>field (USAID and UNFPA, principally) by the early</sup> 1980s. Grant funds also began to plateau at this<sup>time, a situation that prevailed through the decade. By the</sup> end of the 1980s, it was estimated by UNFPA (van<sup>Arendonk, 1990) that around $550 million per year</sup> (including $125 million in IBRD loans and IDA<sup>credits) was being contributed by donors to the $4.5 billion</sup> being spent on these programs from all sources, including<sup>developing country governments and individual</sup> users of the services.

21. The demand for resources in the future is expected<sup>to continue to grow markedly for several reasons.</sup> First, countries are continuing to adopt, or to strengthen,<sup>existing population and/or family planning policies,</sup> particularly in Sub-Saharan Africa. Second, the demand<sup>by individual couples to control their fertility is</sup> growing rapidly, accurding to the Demographic and<sup>Health Surveys (DHS), as social and economic changes</sup> occur and a- familiarity with the concepts of limiting and spacing<sup>births spreads. As programs directed at</sup> improving these social and economic conditions, and<sup>at poverty reduction generally, proceed and succeed,</sup> the demand for family planning services will continue<sup>to escalate. Even today, according to DHS estimates,</sup> there are 300 million women in the developing world<sup>who say they want no more children or wish to space</sup> the next birth, who are not currently practicing family<sup>planning. In an analysis that was prepared for the</sup> donors late last year, Bongaarts, Mauldin and Phillips<sup>(1990) estimate that 21 percent of current fertility in</sup> developing countries is unwanted; this supports<sup>the argument of unsatisfied demand and the case for</sup> significant increases in funding for programs<sup>that will satisfy it.</sup> 22. There have been several efforts to estimate future<sup>costs of family planning programs (see references).</sup> In one widely accep, ,d analysis, the UNFPA estimates<sup>annual costs at $9 billion per year by the year 2000.</sup> In many countrins, private payments have replaced<sup>government and/or donor subsidies as contraceptive</sup> prevalence has increased (e.g., Thailand, Mexico,<sup>Indonesia, Brazil). While this trend will undoubtedly</sup>