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FAMILY PLANNING ON THE PEOPLE’S TERMS
It is important that health workers recognize and discuss the various ways that
birth control—as a tool of a well-informed people—can help meet the needs of the
poor and strengthen their social position. The facts are these:
• Many women desperately want to avoid another
pregnancy. The large number of unsafe and
illegal abortions in most countries is proof of this.
In Central America, for example, many women
in public maternity hospitals are there because
of complications from unsafe abortions. Many of
these women die. To prevent these deaths, safe
abortion must be legalized. But most important,
family planning services must be such that people trust and use them.
• For many women, the constant cycle of pregnancy, birth, and infant care drains
their energy and health. Child spacing can not only help protect the health of
mothers and children, it can free women to do other things: to work, study,
organize, and eventually gain greater equality with men.
• Although many poor families feel they want and need as many as 4, 5, or
6 children, most also agree that a very large number of children can create
hardships. They want a family that is neither too small nor too large, and
welcome family planning on their terms.
• Today, with modern medicine and health services, fewer children die, families
are larger, and populations grow rapidly. In some countries the population
doubles every 20 years. Although population growth is not the main cause
of poverty and hunger, in some areas it is a contributing factor. As numbers
of people increase, available land will become scarcer and more costly. Even
in some parts of Africa that seem ‘underpopulated’, the growing number of
people means too many trees are being cut for firewood. As a result, forests
and farmland are being turned into deserts.
The population problem is not usually discussed with the poor because planners
generally say that the poor think only of their immediate needs and are not
concerned with the future needs of society. But isn’t this because there is so little
opportunity for the poor to take part in the decisions that shape the social order?
History has shown, however, that when the poor begin to organize and gain control,
they often become deeply concerned with planning ahead for a healthier society.
Thus, if the poor are to cooperate with goals to limit population growth, they must
also have a strong role in policy and decision making for the future.
Group discussion about population control and family planning
The challenge to both instructors and health workers is this: How can we help
people to understand the issues surrounding birth control and to plan their
families effectively ON THEIR OWN TERMS?
It is essential that health workers try to understand the ideas and feelings of
those who are most affected. Perhaps they can lead discussions with women or
couples about their concerns and experiences related to family planning.
On the next page is a list of questions to help start a discussion. But they are only
suggestions. Think of your own questions to fit the situation in your area.