LECTURE NINE LEVEL II MBChB

PROF. E.K. MUCHUNGA

School of Public Health
University of Nairobi

Population Policies
GOAL
To learn about population policies relating to
fertility, mortality and migration with specific
reference to developing countries of Asia,
Africa and Latin America.
To define population policy and outline how
government policies influence demographic
behaviour.
To focus on Chinas one child per family pop
policy and determine the consequences of
such a policy.

Definition of Population Policies

According to Kenneth Godwin, policy is
something that a government chooses to do or
not to do. The policy or policies may be
pronatalist, antinatalist or neutral.
These
policies may be either stated (documented) or
not stated in public document.
Hope T. Eldridge defines population policies as
legislative
measures,
administrative
programmes, and other governmental action
intended to alter or modify existing population
trends in the interest of national survival and
welfare.
However, there is clearly lack of consensus with

Areas of Disagreement on Pop

Policy

Three areas are discussed:

(i) Should there be an explicit statement or
document by the government that a population
policy exists?
() Using United States as an example, no official
population policy exists.
Yet the Federal
government finances and supports programmes
designed to eliminate unwanted childbearing
and avail contraceptives to target populations
(especially the disadvantaged or the poor).
These programmes have a demonstrable
demographic effect of lowering fertility despite
the absence of an official pop policy.

(ii) Should there be a planned course of

action or (programme)?
() Absence of specific measures to
influence the population is interpreted as
a form of population policy i.e. where
total fertility rate is below 2 children per
woman and no measures to raise the
birth rate, then it is argued that refusal to
intervene in this context is a population
policy in favour of low fertility. Others
dont agree with this standpoint.

(iii)Should the goals be demographic or

could they be social and economic?
Additionally, should the demographic
effects be intended and direct, or they
could be indirect and unintentional?
() China, attempted to increase the status
of women for ideological reasons, but
these measures had a demographic
effect. Does China have a pop policy in
this context?
() In Latin America, governments had
attempted to lower the prevalence of
induced abortion by providing women
with contraceptives. Do these

 These three fundamentals areas are

discussed to show that there are no
correct answers in matters relating to
population policy. It is very difficult to
determine whether a country has a pop
policy or not.

Attempts to Influence Fertility

Levels

Pronatalist and Antinatalist Measures

Pronatalist policies were prevalent before
the twentieth century, and were geared
towards high fertility and population
growth.
They assumed the following
characteristics.
Pronatalist propaganda
Measures related to the family i.e family
allowance programmes, tax systems and
rewards to mothers with large families.
Restrictions on the distribution and use of
contraceptives and abortion.

 In developing countries, there was a

perception that a larger population was
necessary for economic growth, or for
settling sparsely populated areas.
Marxist and leftist Latin America leaders
also believed that problems in their
countries were social and economic rather
than demographic. To their view,
population growth is a prerequisite the
revolution necessary to achieve social,
economic and political change. They
opposed the idea of limiting population
growth terming it a reactionary plot by the
West in order to exploit the resources of

 Developed countries such as Japan,

Germany and Italy adopted population
policies to encourage high fertility
between World War I and World War II.
Intensive pronatalist propaganda, cash
payments to families with children the
restriction of access to contraceptives, the
regulation of emigration all reflected the
attempts by these governments to raise
fertility.

 France and Romania adopted a pronatalist

population policy while having an
antinatalist policy as well. Marriage loans,
premiums on the birth of a first child, and
other forms of aid for parents were
provided in France.
Romanian government was even more
forthright.
Stopped official importation of oral
contraceptives and IUDs.
Taxes on unmarried and married couples
with no children aged 25 years and above
were raised by 10 and 20 percent.

 Taxes on families with three or more

children were reduced by 30 percent.
Mothers of large families were promised
early retirement from their jobs.
Divorces were made extremely difficult to
obtain, and the required fees were raised
to prohibitive levels.
Mother Heroine awards established to
reward mothers of large families. They
were given wide publicity by the media.
The result for Romania were apparent.

 The birth rate tripled from 12.8 per 1000 in

1966 to 39.9 in 1967 (9 months).
Thereafter, it declined fairly steadily,
reaching 20 per
1000 in 1980.
Reliance on one method of contraceptives
to prevent births can result in high fertility
if there is restriction to that method in the
short run.
In conclusion, it does not appear as if
pronatalist
measures
in
developed
countries have been effective. In France,
Belgium, Bulgaria and Germany, crude

Romanian Graph: 1966-1970

 The Romanian example shows that

traditional Romanian preference for a
small family was not affected by the shift
in legislation.
In the absence of a
fundamental change in motivation for
limiting family size and engage in family
planning, legal restrictions on abortion,
coupled with generous pronatalist welfare
provisions, are likely to result in more
than a short term increase in the birth
rate.

Antinatalist Policies
These aim at reducing fertility. The two
basic
approaches
are
governmentsponsored family planning approaches and
non-family planning approaches.
National Family Planning Programmes.
Aim is to reduce fertility by providing
contraceptive supplies, services, and
information to couples who want to space
or stop their family size.
The rationale of F/P Programme is that if
you inform people about the methods and
give them good service, then a significant

Antinalist Policies (Cont)

It is voluntary in nature, with the emphasis
on the right of parents to decide the
number and spacing their births.
Avoidance of unwanted births is stressed.
However, changes in attitudes, values and
desired family size are not underscored.
In Kenya, the Government published a
policy paper entitled African Socialism
and Its Application to Planning in Kenya,
Sessional Paper No. 10, in which the main
theme was how to utilize resources of the
country (1965).

Antinalist Policies (Cont)

The basic tenets were:
Recognition of high population growth rate
and the consequences in terms of a large
dependent population, the reduction of
money available for development, and
increased pressure on the social services.
Unemployment problem was cited as a
major
concern,
and
saving
for
development would be reduced by high
population growth rate.
Steps to be towards family planning
education were recommended by the
paper.

A Case study of China

Has a population estimated at 1.341 billion
by 2010. Ten years earlier, Chinas
population was 1.295 billion as per census
results.
Chinas one child per family population
policy has averted 400 million births since
its inception in 1980.
In 1997, 85% of married women practiced
some form of Contraception with majority
preferring IUDs after the birth of the first
child. Abortion is also prevalent.

Incentives for 1 child family

include:

Bonuses for their family, lower taxes.

Free health care
Priorities in housing, school and
employment.
Those with no children at all are rewarded
when they retire.
This rigid population policy is enforced by
the government using these social and
economic benefits, peer pressure, while
each commune determines the number of
children to be born.
All women are required to attend lecturers

 Women who become pregnant for the third

time are urged to get an abortion. It is
considered unpatriotic to be pregnant for a
third time.
More recently, Family Planning Programme
has undergone reforms which is more
flexible following the 1994 World
Population Conference in Cairo, Egypt.
Emphasis on client needs, informed choice
of contraceptives are becoming prevalent.

Non-family Planning Approaches

Attempt to influence fertility by motivating
people to desire and have fewer
children.
There is recognition from this approach
that family size could be a response to the
way a person perceives the socio cultural
world.
Emphasizes in the importance of altering
the desired family size through changes in
the institutional alignment and socio
cultural environment of the population.

 The most reliable non-family method of

reducing
family
size
is
societal
modernization. As modernization occurs
better health conditions that follow ensure
that a woman will conceive and retain the
foetus to term. Lower mortality raises the
proportion of survivors to the age of
reproduction, and reduces the probability
of widowhood.
Many countries have recommended for
family planning and modernization to be
accomplished together.

Another Non-Family Method

Include:

Increased female labour force

participation.
Research has established that women who
participate in the formal sector have fewer
children than women who do not
participate in the labour force. This is
consistent to Millennium Development
Goal number 3 that emphasizes promotion
of gender equality and empowerment of
women.

Attempts to Influence Mortality

Governments in industrialization countries
subsidize health care and often provide
free care to the public. The overall effect
of such measure is to increase life
expectancy.
Other measures include development of
new drugs and new techniques focused on
organ transplants, heart and kidney etc.
Government policies aimed at reducing
the incidence of specific communicable,
non-communicable
diseases
and
reproductive health ailments are part of
this strategy.

 Government regulations that focus on

safety measures on driving (speed limits,
safety belts) save thousand of lives.
Other measures include immunization
nutrition related information for mothers
during ANC and Postnatal care services,
smoking, drinking, drug abuse, and
occupational
health
regulations
for
workers.

Measures to increase mortality

Measures that endanger health, though
unintentionally,
include,
international
welfare; During World War II alone, 50
million people were killed.
Other
undeclared ethnic and internal conflicts of
various types contribute to an increase in
mortality.
Genocide, as practiced in Nazi Germany
resulted in the death of over six million
Jews. Rwandas example is also a case in
point.

Measures to increase mortality

(Cont)
Government policies to allow tobacco
growing (cigarette factories are major
industries) plus establishment of breweries
to produce beers, spirits, wines are
examples of policies that indirectly
contribute to a rise in mortality.
Governments
benefit
from
taxation,
employment and development.

Policies on Migration
Some nations encourage immigration in
order to increase the rate of population
growth. This was the case in United States
during the nineteenth century. Canada
and
Australia
have
also
allowed
immigrants.
Israel is a country that explicitly seeks
more immigrants.
Countries that are characterized by high
population pressure view emigration as a
safety valve to relieve pop. pressure.
Some Caribbean countries are examples.

Policies on Migration (Cont)

Barriers to immigration are numerous.
Immigration policies are subject to change
in response to national, demographic
economic, and political factors.
Levels
of
education,
acquired
in
employment, financial stability are some
of the considerations used in screening
potential migrants.
Indeed the term brain-drain is used to
connote that the most educated, well
trained persons stand the best chance of
emigrating to other countries to work. In
return, these emigrants remit money back

Conclusion
Demographic Dividend
India has benefitted immensely from a
demographic dividend due to global
competitive advantage brought about by
the people.
What is required for a demographic
dividend to commence is for a sudden
preferably natural fall in the fertility rate of
a country. The large number of young
people who mature and start working will
have fewer children, and fewer
dependents.
The economy will have an opportunity a

 This opportunity could result in rapid

economic growth that might lead to
economic takeoff.
Consequently, a more affluent society
always finds its total fertility rate of about
2-3 children per woman. In India, the
people were transformed into human
capital.
New arrivals are systematically given
education, marketable skills to make them
productive and consumptive. Lower
mortality, leads eventually to a lower
fertility, and as such, savings for

 The pool of skilled labour create a

source Indigenous Investment
capital. (Infrastructure, education,
and demand for goods & services.

THANK YOU