Shifting fortunes for family planning: The role of norms

Levels of attention for family planning in low-income countries have fluctuated considerably over the past half century, and stagnated over the last decade. In response, proponents have launched a number of global initiatives in recent years to rekindle commitment. This paper examines past and present efforts by global and national actors to convince governments of low-income countries why and how they should support family planning. It draws on interviews with 35 actors from the global south and north involved in family planning and reproductive health promotion, as well as archives of past and present efforts to promote family planning.

We find that two normative streams dominate this history. An ecological stream has focused primarily on the macro effects of family planning, particularly the benefits for national development from lower fertility. A rights stream has focused primarily on the micro effects, particularly the impact on the ability of women to live healthy and meaningful lives. These streams have co-existed uneasily. Influential individuals in each stream are now attempting to bridge differences. These bridging efforts may be a result of deliberate learning from history, and could lead to a synthesis of the two streams and a durable alliance. Alternatively, these efforts may just be the latest attempt to take advantage of new political opportunities – especially the MDGs. Family planning's future in low-income countries depends on many factors other than the fate of this possible alliance; however, the alliance's health may well shape the issue's prospects.