The implementation of family planning programs has been the principal population policy instrument in the developing world over the past few decades. This paper reviews that controversy over the role these programs have played in reducing fertility. Opposing views on a number of contentious issues (for example, the significance of unmet need and unwanted fertility) are summarized and a consensus position is presented. Surprisingly, recent estimates of the fertility reductions achievable through the implementation of strong family planning programs differ only modestly--from 1 to 1.4 births per woman. Since only a small proportion of countries have implemented strong programs, the (unweighted) average impact of programs in 1985-90 is estimated at only 0.33 births per woman. However, the (weighted) average, which gives the program impact for the developing world as a whole, is estimated at 0.96 births per woman in the late 1980s. This suggests that programs have been responsible for about 43% of the fertility decline in the developing world between 1960-65 and 1985-90.

This report summarizes presentations and discussions at the Workshop on the Social Processes Underlying Fertility Change in Developing Countries, organized by the Committee on Population of the National Research Council (NRC) in Washington, D.C., January 29-30, 1998. Fourteen papers were presented at the workshop; they represented both theoretical and empirical perspectives and shed new light on the role that diffusion processes may play in fertility transition. These papers served as the basis for the discussion that is summarized in this report.

This volume is part of an effort to review what is known about the determinants of fertility transition in developing countries and to identify lessons that might lead to policies aimed at lowering fertility. It addresses the roles of diffusion processes, ideational change, social networks, and mass communications in changing behavior and values, especially as related to childbearing. A new body of empirical research is currently emerging from studies of social networks in Asia (Thailand, Taiwan, Korea), Latin America (Costa Rica), and Sub-Saharan Africa (Kenya, Malawi, Ghana). Given the potential significance of social interactions to the design of effective family planning programs in high-fertility settings, efforts to synthesize this emerging body of literature are clearly important.

A history of the World Health Organization, covering major achievements in its seventy years while also highlighting the organization's internal tensions. This account by three leading historians of medicine examines how well the organization has pursued its aim of everyone, everywhere attaining the highest possible level of health.

From the perspective of human society, one of the most significant occurrences of the twentieth century has been the demographic transition —- the movement from tragic and wastefully high death and birth rates to low rates in many countries. Many other countries, however, are still at only the early or intermediate stages of this process. In these countries, means need to be found to accelerate the transition. This book brings new evidence to bear on aspects of the demographic trasition, with contributions from leading demographers, anthropologists, sociologists, and historians. The book ranges widely over the history and current experience of both developed and developing countries, with particular emphasis on Asia and Africa. The new field of anthropological demography is strongly represented, with contributions challenging much conventional wisdom.

Family planning programs have been highly successful over the past 30 years in providing women in developing countries with desired access to contraceptive services and helping to reduce fertility rates. Notwithstanding this success, there is still an urgent need for these programs. The world's population is increasing, with annual population growth still approximately 80 million people. Nearly all of this growth is occurring in developing nations, where fertility rates remain relatively high. This high fertility runs counter to the preferences expressed by millions of women, who actually want to have smaller families. Family planning programs are also desirable because they are associated with a range of other benefits, most notably improvements in women's and children's health. Host countries provide about 60 to 75 percent of funding for family planning. However, funding and technical assistance from donor nations, especially the United States, have been crucial to the past success of family planning programs and are equally important for strengthening and expanding program efforts to meet future challenges.