Birth-based approach to family planning: an empirical justification.

Amid persistently high population growth rates in developing countries, people have questioned whether the recent change from a fertility-reduction oriented family planning program strategy to a reproductive health-oriented and meeting-unmet-needs based program of contraceptive services will slow the pace of fertility decline, exacerbating population problems and developmental issues in developing countries. The authors consider the question and suggest reorienting program strategy such that both the microlevel needs of couples and the macrolevel objective of fertility reduction are simultaneously and efficiently met. A birth-based approach to family planning program is proposed in which efforts will be made to identify all pregnant women and recently delivered mothers and provide services to them. This approach would comprise a key component of a reproductive health program. The authors empirically test the hypotheses that the unmet needs of contraception for birth spacing and limiting are relatively higher among recently delivered mothers than among all women of comparable age and parity, and that recently delivered mothers are self-selected for their higher fertility.