The family planning program in Taiwan: did it make any difference?

Being one of the first developing societies to experience a major decline in fertility within the past 20 years Taiwan is often regarded as exemplary in the successful execution of family planning (FP) efforts. Taiwans FP program began in 1963 in Taichung one of the regional capitals. This study is aimed at verifying the true "effectiveness" of the FP program in Taiwan: the definition of effectiveness has been based on the estimation of the number of people reached by the program and on further assumptions as to the number of births averted as a result of such a contact. This study asserts that criteria for "effectiveness" in the past have actually measured the extent to which funds spent resulted in FP efforts. Criteria were not designed to measure whether any additional fertility decline beyond that linked to socioeconomic modernization actually resulted from a FP program effort. Promoters of the Taichung experiment regarded it as successful because FP information and propaganda efforts reached directly and indirectly around the key city and spread the acceptance of controlled fertility. This assertion is challenged by the study which shows that the city of Taichung where the FP efforts were initially concentrated displayed a lower rate of fertility decline than other cities and regional provinces in Taiwan. The essential focus of the investigation compares a target population with a control population differing little from it except in exposure to FP programs and propaganda. The statistical analyses indicate that FP efforts did not have any significant impact on Taichung City or its surroundings by causing a faster fertility decline than that experienced elsewhere in Taiwan during the same period. The claim that FP programs in themselves have accelerated a decline in fertility is therefore unsupported by the investigation which concludes that fertility decline followed its own course in the communities studied. The study concludes that FP programs by themselves cannot be expected to significantly alter fertility behavior. They should be an integral part of development planning however within programs which promote effective disincentives to large family size desires.