Family Planning and Implications for Uganda

 Since time immemorial, human beings have tried to plan the size of their families through birth spacing or prevention of conception or the birth of an unwanted child using traditional methods which were supplemented later on by modern techniques. For most of the time, the decision to act was voluntary.

The population in the developing countries grew very fast after 1945 thanks to the ending of the war, better nutrition, improved hygiene and modern medicines including vaccinations which drastically reduced death rates while the birth rates remained high. Visitors and researchers to Asia and elsewhere expressed alarm that unless population growth was brought under control, it would undermine economic development prospects, threaten peace and security and create conditions for the reemergence of famines, diseases and wars. For example, Prof. James Mead, an economist and Nobel Prize winner prophesied in the early 1960s that Mauritius’s development prospects were bleak largely because of its rapid population growth, which also carried the potential for ethnic tensions (Mitchell A. Seligson and John T. Passe-Smith, 2003. Development and Under-development).

In the early 1950s, the United Nations joined the hunt for solutions to the ‘exploding’ population growth in the developing world. In their report on Measures for Economic Development of Underdeveloped countries, the United Nations experts recommended, inter alia, the reduction of population growth.   

Initially, developing countries regarded family planning as an attempt to weaken and re-colonize the newly independent nations. For them greater social justice would end poverty however many mouths there were to feed.  Notwithstanding, the pressure for family planning mounted. And in 1966, in a spirit of compromise, the United Nations General Assembly reached a consensus to use ‘population assistance’ instead of ‘assistance to family planning’, thereby avoiding the controversial words ‘control and limitation’.

Henceforth, some developing countries with support from public and private donors began to introduce population programs to influence the reproductive behavior of couples, which until then was considered a private matter.  It was argued that small family sizes would release savings for investment in productive activities to boost economic growth and achieve higher living standards. The United Nations Fund for Population Activities (UNFPA) was established to assist governments. As an incentive, countries that pursued population activities received generous donations for population and other programs.

Various methods including persuasion, incentives and disincentives were employed to realize the established targets at family and country levels. In situations where the number of children was limited, for example one or two, couples preferred sons to daughters. The availability of ultrasound equipment even in remote areas facilitated the determination of the sex of the fetus. Accordingly more sons were born than daughters with serious sex imbalance and the associated economic and social challenges that are being experienced in China and India. Further, governments’ approaches to population programs were short term and the burden for example of single children taking care of their aging parents and grand parents has become a major challenge.

In view of these adverse developments, it is important that Uganda which is in the early stages of debating the future course of its population should draw lessons from these two Asian countries in order to avoid a repeat of what has happened there.  For a start, the setting of targets at the couple and national levels should be avoided largely because it is an infringement on the right of individuals to determine the size of their families. The easiest and least controversial approach is to educate girls and empower women so that through late marriage and gainful employment and old age security the desire to have many children is reduced. Family planning matters should, by and large, be left to local communities to avoid a situation where the national government may recommend a one-size-fits-all-program which is not suitable in present-day Uganda. It is also important that advisors, foreign or local, should listen to the views of the communities before they attempt to make recommendations on the way forward. Meanwhile family planning services should be established and staffed with qualified and experienced personnel to provide professional services to those who volunteer and address side effects as they arise. That way hopefully everybody will be satisfied.