The Government of Korea's 5th 5-Year Economic and Social Development Plan (1982-86) seeks to reduce the population growth rate from its 1982 level of 1.58% to 1.49% by 1986; it is assumed that the population replacement level of fertility (total fertility rate, 2.1) will be attained in 1988. The task of achieving these demographic targets is expected to be made more difficult by factors such as the impact of the 1950s baby boom and widespread son preference. New population control policy measures announced in 1981 call for improvements in the current family planning program management system; a new social and institutional support system to inculcate the small family size norm; strengthened information, education, and communication activities for family planning; and establishment of coordination among the government organizations involved in population-related activities. Numerous social support measures have already been put into effect, including income tax exemptions for up to 2 children, inclusion of population education in the school curriculum, priority in alloting public housing to sterilization acceptors with 2 or fewer children, and provision of IUD services through the medical insurance system. The number of contraceptive acceptors in the government program increased 78.3% from 1981-83, from 614,000 to 1,094,600. Sterilization and menstrual regulation services have shown particularly sharp increases. Program achievement for 1983 was equivalent to 19% of eligible women ages 15-44 years. The total fertility rate stood at 2.7 in 1982. Major efforts now must be directed toward eradicating the strong parental son preference and ensuring better family planning program efficiency and effectiveness.
An integrated family planning center, i.e., guidance center, was established in 1983 in the Qingbaijiang District of Chengdu to provide family planning publicity and education, contraceptive guidance, effective contraceptive distribution, and family planning training for village workers. The center serves a predominantly rural population of 355,788. The center's staff of 6 medical workers utilizes a variety of educational materials to popularize family planning, healthy births, and to inform the residents about the government's family planning policies, e.g. "Travels of Monkey King to Huanjin Production Brigade," is shown throughout the countryside. Some medical workers remain at the center and furnish medical and contraceptive services on an outpatient basis. Other medical workers travel throughout the countryside delivering family planning and medical services. During the 1st 6 months of operation the traveling medical workers visited 11 towns and 47 villages. They furnished the IUDs to 994 women who currently had 1 child and performed 492 vasectomies on fathers with 2 or more children. Traveling medical workers also trained village workers to distribute contraceptives on a regular basis to all users in their village, to follow-up IUD acceptors, and to provide prenatal care. Combining all these components into 1 program provided an effective, intensive, and inexpensive approach to family planning. Due to the efforts of the center, 91.52% of the 55,869 married fertile couples in the area have accepted birth control. Presently, the center consists of an outpatient office, an information office, and a patient room. There are plans to further strengthen the center by using it as a facility for training technical personnel at the grassroots level in collection and analysis of population information. Eventually the center will be equipped to provide more technically advanced contraceptive services.
The 1st part of this paper presents findings on differences in socioeconomic characteristics between the Chiang Mai (Thailand) city population and populations in other study areas based on analysis of data of a demographic sample survey in Chaing Mai. A 2nd section includes a description of findings on attitudes towards "small" and "large" family sizes. A subsequent section describes the detailed patterns of rapid fertility decline from 1954-78 for each study area. The last part of the paper examines nuptiality and family planning factors in accounting for the decline of fertility. Each women interviewed asked 2 questions concerning her attitude towards large and small family sizes. The findings suggest that women in both urban and rural areas of Chiang Mai province prefer a small family size. The ideal family size preferred by 80.5% was 3 or less. 49.7% accepted an ideal family size of only 2 children. Fertility levels of the Chiang Mai city population as compared with rural populations from 1954-78 show a marked fertility decline in every age group starting after 1954-78 for women in Chiang Mai city and after 1959-63 for women in the other study areas. By 1974-78 fertility levels reached levels "lower than replacement" in all study areas. There was a marked fall in fertility in every age group of the currently reproductive age in all of the study areas. Fertility in every age group continues to fall, even though it has already reached very low levels. As a result, the actual fertility in women at high reproductive ages is now very low. The pattern of fertility decline in all study areas in almost universal. Lastly, the start of the fertility decline took place earlier in Chiang Mai city, in the cohort age 40-44 when they were 25-29, but the start of fertility decline also occurred in the remaining 3 study areas in the same cohort (age 40-44), at age 30-34, instead of 25-29 as in the city, suggesting that fertility decline in the Chiang Mai rural areas followed Chiang Mai city by approximately 5 years. The age structure of the Chaing Mai population in 1960 represents the typical high fertility population; whereas the changes observed in the age structure of 1970, in age group 5-90 and 0-4, suggests that some decline of fertility had already occurred during the first half of the decade and became more rapid in the second. In addition, the changes in age struture of the city population in 1980, in age groups 0-4, 5-9, 10-14, and 15-19, demonstrates the continuing rapid fertility decline into the 1970s. Women in the Chiang Mai area accepted many contraceptive methods. The most popular methods were oral contraceptives and injectables. Findings from this demographic sample confirm the impact of family planning programs on the decline of fertility, from a high level to below the replacement level in fewer than 20 years.
The population of the Mongolian People's Republic is rapidly increasing due to the high birthrate, encouraged by the pronatalist policies of the government, a marked decline in the death rate following the revolution, and a further decline in the death rate due to improvements in health services. In 1918 the population was 542,000, in 1940, 738,000, in 1960, 936,900, and in 1980, 1,639,700. In the last 60 years the population tripled. At the present time there are a little over 1.8 million people living in Mongolia's 1,555,000 square kilometers of land. In 1980 the birthrate was 378/1000 population, the death rate was 104/1000 population, and 274,000 people were added to the population in 1980. These changes have altered the age and sex distribution of the population. An estimated 47% of the population in 1982 was less than 17 years of age. The increase in young people has rejuvenated the working sector. There has been a marked change in the socioeconomic structure of the country as evidenced in the proportional changes in social group membership. Between 1956-79 the percent of the population composed of workers, employees, and their families increased from 25.9% to 61.7%, the percent composed of members of agarian and artisan cooperatives and their families increased from 11.1% to 38.1%. During the same period the percent of the population composed of livestock breeders and non-cooperated artisans and their families decreased from 62.8% to 0.2%. Rapid industrialization has also lead to a marked increase in the urban population. Tables provide information on 1) birth, death and population growth rates for 1955-80; 2) percent of urban and rural population for 1950-1980; 3) population by social groups 1956-1979; and 4) total population figures for 1918-79.
Great progress has been made in the advancement of social equality, the eradication of disease, and the reducation of poverty, yet much remains to be done to improve people's welfare. Of particular urgency is the need to extend to all people the basic human right of reproductive freedom and choice, embodied in the 1968 Proclamation of the International Conference of Human Rights at Teheran and the World Population Plan of Action adopted at the Bucharest Conference in 1974. For most people of the world, and particularly the economically disadvantaged, that right does not exist. In all countries, those with more means usually have smaller families, in large part because they have knowledge about and access to services to regulate their fertility, while those who are underprivileged do not. It tends to be forgotten that with reproductive freedom and choice come health benefits for both mothers and children. The effects of frequent pregnancies and short birth intervals contribute to maternal health problems and add to the high rates of infant mortality in many developing countries and among deprived groups in some economically privileged countries. It also tends to be forgotten that with reproductive freedom and choice come opportunities for women to participate in the affairs of family and society that are otherwise closed off to them. Couples gain greater control over their lives and their hopes and aspirations for their children with reproductive freedom. They have the right to determine the number and spacing of their children, consistent with the needs and capabilities of the family and the community. For those couples who do seek the human right of reproductive freedom, the choices for limiting fertility are but three -- abstinence, including the decision to delay marriage; contraception, including the breastfeeding of a new baby; or abortion. In developing countries, where 90% of the world's pregnancies occur, each year there are almost 20 million unintended pregnancies resulting from contraceptive failure. In light of these realities, the work of biomedical scientists, who seek more effective, safe, socioculturally acceptable family planning methods, can be viewed as the search for new technology that would reduce the frequency of abortion, alleviate suffering, and enrich the lives of women and families throughout the world. Despite accomplishments, much more needs to be done but funds are lacking. With adequate funding in the future, further scientific discoveries will bring totally new contraceptive methods.
