The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71975

Martha Campbell, PhD, CEIHD, University of California, Berkeley, 717 University Hall, Berkeley, CA 94720, 510-524 4320, campbell_mm@yahoo.com, Nuriye Hodoglugil, MD, Bay Area International Group, University of California, Berkeley, 1131 Tolman Hall, Berkeley, CA 94720, and Malcolm Potts, MB, BChir, PhD, Bixby Professor of Population and Family Planning, University of California, Berkeley, School of Public Health, Earl Warren Hall, Berkeley, CA 94720.

This paper suggests that the barriers to fertility regulation methods comprise a major factor in human fertility rates around the world. It will explain why, in the search for an explanation for low total fertility rates (TFR), the associations between TFR and the ease of obtaining fertility regulation methods may be more consistent than those between TFR and socioeconomic factors. The barriers to fertility regulation methods are observed in many forms and are discussed, including medical control, local regulatory constraints, prices, fear of health consequences, lack of correct information, and social obstacles. A taxonomy of barriers is discussed, drawn from demographic and health literature and data from 1980s to 2002. The review will include studies showing that, in a number of developing countries, decisions to limit family size has sometimes been formed on arrival of realistic availability of family planning. It will also demonstrate that this influence of the supply side on demand for contraception and for smaller families is consistent with our behavior as consumers as we make decisions about other products and services. Culture is viewed as a composite structure containing a variety of barriers to fertility regulation, on both sides – demand and supply. Ease of access to fertility regulation methods and correct information is also critical for reducing maternal mortality. Many of the barriers are amenable to change in the short term on a large scale under affordable budgets, and ways to reduce them are suggested.

Learning Objectives:

At the completion of the session, the participant of this session will be able to:
• Define different forms of barriers to fertility regulation
• Identify the examples of TFR reductions from different countries or regions which are inconsistent with the socioeconomic model of fertility decline.
• Discuss ways in which barriers to fertility regulation can be removed within affordable budgets.

Keywords: Access to Health Care, Family Planning

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.