Take population growth and family planning. When I started work in Kenya in the l960s, rural women wanted to have seven or eight children. Four or five might die of disease and one or two move to cities in hope of sending back some cash, leaving one or two to keep the gardens and take care of elders. With massive perinatal medical foreign aid (both secular and religious), many Kenyan women wound up, in one generation, with seven children instead of two or three. Everyone was unprepared.posted by Firas at 4:19 PM on May 25, 2007 [2 favorites]
Families could not divide their small holdings among so many children. Many young boys (then girls) left for the city, found little work, and, frustrated, joined opposition political groups. They died in insurrections (and then of AIDS) rather than as infants.
To lower family size required an understanding of the complete human life cycle from birth control to teenage employment to old-age insurance. Parents needed assurance that if they had fewer children, most would live long enough to take care of them as elders. Or, they needed to believe that the government would provide pensions for them in their old age. This complex organizational transformation rests on a combined program of medical aid, birth control, old age pensions, urban/rural taxation programs, city jobs, education, cooperation from donors, and land tenure security. Few governments, let alone NGOs, have been able to organize a painless transition to family planning.
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posted by gubo at 12:41 PM on May 25, 2007