Approach to Family Planning: A Tale of Two Countries

Jan 14th, 2015 | By | Category: Family Planning

By Suzanne York.

[photo credit:]

What is the role of government when it comes to having babies?  Should the goal be to empower women or promote economic growth?

The government of Ethiopia announced earlier this week that it will try to lower its total fertility rate to 2.6 by the year 2020 from the current rate of 4.1 (total fertility rate refers to the average number of children that would be born per woman if all women lived to the end of their childbearing years and bore children according to a given fertility rate at each age).

Berhane Assefa, a family planning service coordinator at the Ministry of Health, said that “The country has been engaged in a strong family planning campaign since 2000 to achieve the same goal [bringing the fertility rate down].”  He noted that in the year 2000, only 6 percent of childbearing age mothers benefited from the service, but now this figure had now risen to 42 percent.

Ethiopia is doing it by investing in health extension workers who receive training in offering birth control services who then go out to the rural villages where most Ethiopians live.

The program invested in a network of 38,000 frontline health extension workers (HEWs) based at 17,000 health posts to bring education and contraceptive products and services to rural areas that previously lacked trained health personnel and high-quality facilities.

In 2013, Ethiopia was selected to be the host for the International Conference on Family Planning (held by the Johns Hopkins Bloomberg School of Public Health and the Gates Institute) because of its commitment to family planning and the success of the health extension workers program.

Health extension worker in Ethiopia [photo credit:]

Birth Control = Treason?

Contrast the Ethiopian success story and government support to that of Turkey, which recently announced a new government reform package for married couples to have more children to counter a slowdown in population growth.  It includes several financial incentives, including special commemorative gold coins for first time mothers. After the birth of a child, couples will receive a one-off payment up to 600 Turkish liras, which is roughly US$260.  Those with more than one child will be given extra funding.

President Recep Tayyip Erdogan has said that “one (child) means loneliness, two means rivalry, three means balance and four means abundance.”  Reportedly, he has claimed that women were not equal to men and described birth control as “treason.”

Turkey’s fertility rate is 2.1 and the government is concerned about population aging and its economic future.

Turkey is not alone.  Back in 2009 the Iranian government launched a 14 point plan to reverse its declining birth rate and last year outlawed vasectomies and sterilization.

The corporate world has also gotten on board. Let’s not forget last year’s “Do it for Denmark” campaign by a Danish travel company that launched a competition encouraging couples to schedule their vacations during the woman’s ovulation cycle in the hopes that they will conceive during their travels and populate Denmark with more young people.

It’s About Women’s Lives

Women should bear children when they want to do so.  Governments should support them to have healthy lives, pregnancies and children.  Economic incentives to have kids should not play a part.  Yes, many countries are undergoing population aging, but it is not necessarily a bad thing.  This demographic experiment is only just beginning.

Meanwhile, there are 225 million women in developing regions that want to avoid pregnancy but are not using an effective method of contraception.  Kudos to the Ethiopian government for making family planning a priority.  Now, if only they could get other governments to understand why it should be a priority – for the sake of women and families, not economics.

Suzanne York is a senior writer with the Institute for Population Studies.

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