The Impact of Family Planning on Women's Lives: Toward A Conceptual Framework and Research

This paper proposes a conceptual framework for examining the impact of family planning on six areas of women's lives: personal autonomy and self-esteem; physical and psychological health; educational attainment; employment and economic resources; family relationships; and public standing. It also identifies priorities for future research.

Editor's note: The full text of this paper is not posted on FHI's Home Page. For a copy of the No. WP94-02 paper, please write: Publications Assistant, FHI, PO Box 13950, Research Triangle Park, NC 27709 USA

Summary

When the modern family planning movement began in the United States and Europe in the early 20th century, its primary purpose was to liberate women from the social and health consequences of unwanted pregnancies. When organized family planning programs reached the Third World, beginning with India in the early 1950s, these programs were viewed as the means to alleviate the pressure of rapid population growth on economic development. In the last decades, the purpose of family planning has broadened to encompass both these objectives and the objective of improving women's health and welfare.

Although women are seen as obvious beneficiaries of family planning, too little attention has been given to assessing the impact of family planning on their lives. Previous research has examined how women's roles and status influence their use of contraception and their fertility. In this paper, the authors reverse the equation and examine the opposite causal direction -- how family planning affects women's lives. A central hypothesis is that family planning can be a catalyst for change and that family planning programs have the potential to enhance the quality of women's lives.

The conceptual framework presented in this paper is based on research and extensive discussions with key social scientists concerned with women and family planning. The purpose of the framework is to suggest how family planning might influence women's lives. Two pathways of influences are examined:

• the impact of family planning on the lives of contraceptive users;
• the impact of family planning on employees of family planning programs.

Family planning programs are hypothesized to affect women's lives in at least six areas:

• personal autonomy/self-esteem -- the right to make and stand by one's own decisions; value or regard an individual places on herself;
• health -- both physical and psychological well-being;
• educational attainment -- the ability to obtain an education and the level of educational attainment;
• employment and economic resources -- the nature of employment; acquisition and allocation of resources;
• family relationships -- degree of equality with spouse and role within kinship structure;
• public standing -- ability to participate in public activities and esteem accorded individual women by community.

In addition to contraceptive users themselves, other people are affected by family planning use, including children, other women, men and society in general.

Family planning programs vary in their characteristics and elements. Consequently, programs may differ in the ways they influence contraceptive use, employment opportunities, and other aspects of women's lives. These variations must be taken into account in any explanatory model of the effect of family planning on women's lives.

Chief among the elements that need to be considered are:

• accessibility of services;
• the range of other sexual and reproductive services offered and the degree to which family planning is integrated with other health and development programs
• quality of services, including the range of methods available, technical competence of the staff, client-provider interactions, etc.;
• nature and extent of information, education, and communication (IEC) activities;
• management and organization (including personnel policies) of family planning programs;
• policies affecting political and financial support for family planning programs.

Women's use of contraceptives to limit family size or to delay the birth of the first child may not have an equally positive effect on all their lives. A woman's individual characteristics -- age, economic situation, marital status, religion and educational level, as well as the number, sex and age of her children -- affect her decision to use contraception. These characteristics also affect method choice or the decision to seek work in a family planning program. If a woman decides to stop childbearing after having six children, one more child may not make much difference in terms of her future educational and employment opportunities. By contrast, if a woman delays her first baby until after she finishes her schooling, this may affect not only her educational level but also her future employment, since education tends to have a strong effect on an individual's income level, regardless of development level.

Apart from individual characteristics, sociocultural factors may either encourage or prevent women from fully exercising their choice to use contraception or to work in family planning programs. These factors include: prevailing expectations and norms regarding women's roles; family systems that promote or discourage high fertility and son preference; opportunities for women's social and economic independence through education, employment, inheritance, and property laws; and restrictions (e.g., religious or legal) on access to family planning information and services.

Among the important questions for future research on contraceptives users are:

• As a result of effective contraception, do women experience or perceive greater control over fertility?
• What are the differences for women if the decision regarding contraceptive use is made by the woman or by others, such as her partner, in-laws or a doctor?
• What are the health risks of contraception and how do women perceive these risks?
• How does the use or non-use of contraception affect the probability women will continue their educations?
• How does contraceptive use affect a woman's ability to enter the labor force, to stay in the labor force and to advance?
• Are contraceptive users more likely than non-users to share in household decision-making?
• Do contraceptive users and non-users differ in the degree of participation in community activities?

Among the important questions for future research on women employed in family planning programs are:

• How many new family planning jobs for women have been created?
• How many jobs have been expanded to include family planning services?
• Have new leadership positions for women been created and filled?
• Have women been trained for management roles?

In their studies of women as family planning employees, researchers should consider the impact of family planning on unskilled, lower-level field workers; skilled female medical and paramedical staff; and women in mid- to top-management positions.

Family planning is already a major force for social change in developed and developing nations. The paper hypothesizes that family planning affects change primarily through involvement of women -- women as users of contraceptive methods and services and women as employees in family planning programs. Through future studies on both contraceptive users and employees of family planning programs, researchers will gain a better understanding of the impact of family planning programs on women's lives. This understanding can, in turn, lead to improvements in policies and programs that will ultimately benefit women.

-- Sawon Hong, PhD
-- Judith Seltzer, PhD

Editor's note: The full text of this paper is not posted on FHI's Home Page. For a copy of the No. WP94-02 paper, please write: Publications Assistant, FHI, PO Box 13950, Research Triangle Park, NC 27709 USA