Tens of millions of couples in developing countries have gained access to family planning, largely due to foreign assistance provided by the U.S. Agency for International Development (USAID).

Here are responses to commonly asked questions about USAID's international family planning programs.

Q: How does family planning save lives?

A: Throughout the developing world, millions of mothers and their children die each year due to complications from births that are too close together or too early or too late in a woman's life. Every day, more than 31,000 children under age 5 die -- many from low birthweight or other pregnancy-related complications. And each year, more than 585,000 women die -- at least one woman every minute of every day -- of causes related to pregnancy and childbirth; 99 percent of those deaths are in developing countries.

Family planning can prevent a quarter of infant deaths by spacing births at least two years apart. Family planning can also prevent at least one in four maternal deaths by allowing women to delay motherhood and avoid unintended pregnancies and unsafe abortions. And family planning programs can help prevent the spread of HIV/AIDS and other sexually transmitted diseases (STDs) by providing condoms and other barrier methods, counseling, and, in some settings, STD diagnosis and treatment.

Q: How is family planning connected to the environment and
U.S. national interests?

A: More than 95 percent of population growth is occurring in the developing world, where population pressures are contributing to deforestation, water and food shortages, global warming, wildlife extinction, and other environmental concerns. These global problems know no boundaries and affect people everywhere, including the United States.

Expanding populations also undermine developing country efforts to provide citizens with adequate health care, food, education, and jobs. These conditions slow economic and social development -- jeopardizing the potential for these countries to be reliable allies, good trading partners, and growing markets for U.S. exports. And chances increase that people will migrate to the United States in search of employment and a better life.

In the words of Secretary of State Madeleine Albright: "Clearly, family planning saves lives, enhances the well-being of women and their children, and prevents the tragic recourse to abortion. International family planning also serves important U.S. foreign policy interests: elevating the status of women, reducing the flow of refugees, protecting the global environment, and promoting sustainable development which leads to greater economic growth and trade opportunities for our businesses."

Q: How fast is world population growing?

A: Though the rate of population growth is slowing, the world's population, now at 5.9 billion, still adds another 80 million to the planet every year. That's the equivalent of adding another New York City every month, another Mexico every year, another India every decade.

In addition to improving the health of mothers and their children, family planning programs have made a major contribution to reducing population growth rates. If these programs are sustained, developing world population is projected to reach a level of about 8 billion in the year 2050. Without such programs, that population could grow to more than 11 billion in 2050.

Other factors also contribute to slowing population growth, including improving women's education and status, increasing child survival, and reducing poverty.

Q: What does USAID's family planning assistance do?

A: Assistance for voluntary family planning and reproductive health services is provided in more than 60 countries throughout the developing world, Eastern Europe, and the former states of the Soviet Union. USAID and its overseas missions work in partnership with governments; private businesses; nongovernmental organizations, such as CARE and Save the Children; universities; and other international donors, such as the United Nations Population Fund (UNFPA).

All the essential elements of a family planning program are supported by USAID, including training of health workers, supply of contraceptives, financial management, public education and marketing, and research and development of safe and effective contraceptives. USAID support is based on a broad reproductive health approach which emphasizes choice among a wide range of contraceptives, improved quality of care, and client-centered services. And USAID family planning programs are increasingly integrated with other community-based efforts to improve maternal and child health, enhance women's status, and prevent HIV transmission and other infectious diseases.

Q: Has USAID's family planning assistance been successful?

A: USAID's family planning program is recognized worldwide as one of the most successful components of U.S. foreign assistance. More than 50 million couples in the developing world use family planning as a direct result of USAID's efforts. In the 28 countries with the largest USAID-sponsored family planning programs, the average number of children per family has declined by one-third, from more than six in the 1960s to about four. These families are better able to feed, clothe, educate and provide health care for their children. Hundreds of thousands of women and children are alive today because of these programs.

Early USAID investments in family planning helped stabilize population growth in strategically important countries and resulted in the creation of strong U.S. trading partners such as Korea, Taiwan, and Thailand. In addition, USAID's contraceptive research efforts continue to yield significant benefits for Americans, including the introduction of low-dose oral contraceptives and the female condom.

Q: Isn't the U.S. imposing these programs on poor nations
and on poor women?

A: Men and women who participate in USAID-supported family planning programs do so on a voluntary basis, free of coercion, and with the information they need to make appropriate choices regarding their use of contraception.

Couples want smaller families. Recent surveys show that desired family size is smaller than actual size in almost every country in the developing world, regardless of religion and culture. At least 120 million couples in the developing world still want to space or limit childbearing but do not have access to contraception, and the number of reproductive-age couples is expected to increase by at least 20 million each year.

The vast majority of the world's nations recognize that family planning programs play an important role in human and economic development. About 130 national governments subsidize family planning services, including about 65 developing countries that specifically seek to slow population growth. USAID assists countries only at their request. No USAID family planning funds go to China.

Q: Are USAID funds used to perform or promote abortions overseas?

Since 1973, under the Helms amendment to the Foreign Assistance Act, USAID has been prohibited by law from using funds to support abortions as a method of family planning. Several procedures are used to ensure that the law is strictly followed. These include legally binding provisions within USAID contracts forbidding such activity, staff monitoring, and regular audits by nationally recognized accounting firms.

In fact, as research -- and common sense -- indicates, increased access to family planning helps prevent the need for abortions. In Russia, for instance, because of limited contraceptive availability, abortion has been used as the major method of birth control. However, the recent increased availability of modern family planning methods has already resulted in a greater than one-third drop in the abortion rate. In Hungary, the introduction of modern contraception coincided with a 60 percent reduction in abortions. Similar results can be seen in Chile, Colombia, Mexico, South Korea, Kazakhstan, and Ukraine.

The United Nations estimates that 40 percent of pregnancies worldwide are unintended, 60 percent of which end in abortion. As increasing numbers of people feel more strongly about having fewer children, family planning services will become even more critical. Already, approximately 75,000 women die each year from unsafe abortions -- often self-induced.

Q: What has happened to USAID funding for international family planning?

Though USAID funding for family planning followed a 30-year upward trend, the "purchasing power" of these funds actually diminished due to inflation and the increases in the number of women of childbearing age. Moreover, in 1996, The U.S. Congress reduced funds for international family planning by 35 per cent.

Q: Why do Americans support international family planning?

Poll after poll shows that the majority of Americans support international family planning assistance. The motivations are as diverse as the United States itself -- improving the health of women and children, enhancing women's status, helping to alleviate world poverty, reducing abortion, stabilizing population, protecting the global environment, promoting economic development overseas, and pursuing the economic self-interest of the United States. For each of these reasons, a continued and strong U.S. commitment to international population assistance
is essential.

Global Issues USIA Electronic Journal, Vol. 3, No. 2, September 1998