4 A major objective of this paper was to deter-mine the relative roles<sup>of the demand</sup> to limit fertility and the access to means of doing so in expanding contraceptive<sup>use. The</sup> WFS showed that 49 percent of women wanted no more chil, tren and that the actual fertility was 1.5 childrLn higher than the desired level (Lightbu,irne 1987).<sup>It is</sup> interesting to note that the czrrent TFR is very close to the desired TFR in 1978. It is also important to note that not all groups have been equally successful in implementing their fertility preferences. While those with more than primary schooling<sup>now have fewer</sup> children than they said they wanted a decade ago, the uneducated<sup>still have in excess of</sup> one child more than they said they wanted. In addition, the desired family size<sup>has</sup> decreased by about half a child for all educational groups. This indicates that there<sup>is</sup> still potential unmet demand for family planning among the less educated.<sup>The family</sup> planning program plays a major role in helping women achieve their fertility preferences. It is also a hypothesis of this paper that family planning access also plays a role<sup>in</sup> shaping those preferences. In the next section, we will briefly outline<sup>the characteristics</sup> of the program and then turn to the analysis of the data.

# B. **The Family Planning Program**

The policy to support fertility decline evolved in several stages. In the first<sup>stage</sup> (1956-64) emphasis was placed on making changes in social legislation to encourage reductions in the demand for children and in liberalizing legal access to the means<sup>of</sup> reducing fertility (see Table 1). The second stage began with an experimental program to deliver family planning in maternal and child health centers.<sup>3</sup> By 1973, this<sup>program</sup> had only expanded to 38 centers and a more aggressive approach was deemed necessary. Therefore, in that year, the office of Family Planning and Population (ONFP)<sup>was</sup> founded<sup>4</sup> and charged with the responsibility for research, orientation, coordination and delivery of population and family planning activities. In 1980, despite the progress made by ONFP, more needed to be done. Thus, an effort was made to provide family planning in an integrated approach through the Basic Health Care (BHC) services<sup>of the</sup> Ministry of Health (MOH).

Currently, two-thirds of Tunisia's family planning services are offered through ONFP. Each governorate has one training and one regional family planning<sup>ceinter</sup> operated by ONFP. In addition, with the use of 67 mobile teams, ONFP<sup>offers services</sup> through 800 of 1462 BHC facilities whose own staff can not or do not provide<sup>such</sup> services. There are also 10 mobile ONFP units which can provide services where<sup>there</sup> are no facilities available. The MOH staff itself only provides services directly in 16 percent of its clinics. The private sector is also relatively limited in its service provision.

3 This program was set up in 1963 in collaboration **with** the Ford<sup>Foundation.</sup> 4 This has gone through several changes ;n its place within the government,<sup>but was initially and is now</sup> a quasi-independent institution operating undcr the Ministry of Health.