Front Cover
 Title Page
 Table of Contents
 Executive summaries
 General analytical framework

Title: Rural development programs and their impacts on fertility
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00087134/00001
 Material Information
Title: Rural development programs and their impacts on fertility state-of-the-art : summary report
Series Title: Rural development programs and their impacts on fertility
Physical Description: ii, 91 p. : ill. ; 28 cm.
Language: English
Creator: Research Triangle Institute
South East Consortium for International Development
United States -- Agency for International Development. -- Office of Rural Development
Publisher: s.n.
Place of Publication: s.l
Publication Date: 1978?
Subject: Rural development   ( lcsh )
Fertility, Human   ( lcsh )
Developing Countries   ( mesh )
Family Planning Services   ( mesh )
Public Policy   ( mesh )
Rural Population   ( mesh )
Genre: non-fiction   ( marcgt )
Statement of Responsibility: conducted by Research Triangle Institute and South East Consortium for International Development.
General Note: Cover title.
General Note: "Produced for Agency for International Development/Office of Rural Development and Development Administration as part of the Rural Development and Fertility Project."
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Bibliographic ID: UF00087134
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 06634297

Table of Contents
    Front Cover
        Front Cover 1
        Front Cover 2
    Title Page
        Title Page
    Table of Contents
        Table of Contents
        Page i
        Page ii
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
    Executive summaries
        Page 9
        Page 10
        Page 11
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    General analytical framework
        Page 70
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Full Text

SSummary Report

0 Rural Development Programs
and Their Impacts on Fertility:

Conducted by
Research Triangle Institute
South East Consortium fo.r Interatnatnal Development

Produced for
Agency for International Development/Office of Rural Development and
Development Administration as part of
The Rural Development and Fertility Project


Abraham S. David, RTI Project Leader Edward Vickery, SECID Project Leader
Laurie Zivetz, RTI Project Coordinator William T. Levine, SECID Project Coordinator

Ronald V. Curtis, Office of Rural Development, USAID, Project Moniter

State-of-the-Art Papers

Rural Development, Women's Roles and Fertility in Developing Countries: Review
of the Literature
Gloria Javillonar, Laurie Zivetz, Susan Thompson, and Janet Griffith

Rural Development, Education and Fertility: A State-of-the-Art
Benjamin Cheng, William D. Lawson, and William T. Levine

Rural Development, Migration and Fertility: What Do We Know?
Sally Evans Findley, James Gundlach, Douglas P. Kent, and Richard Rhoda

Rural Development Activities, Fertility, and the Cost and Value of Children
Boone A. Turchi and Ellen S. Bryant

Rural Development, Land and Human Fertility: A State-of-the-Arts Paper
C. Shannon Stokes, Wayne A. Schutjer, Terry L. McCoy, and Charles H. Wood

The Relationship of Fertility to Income and Wealth in Rural Development
Thomas J. Meeks and Bun Song Lee

Relationships of Rural Development Strategies to Health and Nutrition Status:
Consequences for Fertility
Raymond B. Isely, Laurie Zivetz, Roland Norman, and Hetty Banatte

Table of Contents


Forward i

Introduction 1

Background 4

Executive Summaries: Rural Development, Women's Roles, and 9
Fertility in Developing Countries

Rural Development, Education and 15

Rural Development, Migration and
Fertility: What Do We Know? 16

Rural Development Activities, 31
Fertility, and the Cost and Value
of Children

Rural Development, Land and Human 38

The Relationship of Fertility to Income 48
and Wealth in Rural Development

Relationships of Rural Development 55
Strategies to Health and Nutritional
Status: Consequences for Fertility

General Analytical Framework


This report is part of a series of State-of-the-Art Papers called for

under AID Project 931-1170, Rural Development and Fertility. The Project

was designed to assist AID officials, overseas and in Washington, to comply

with the mandate included in the 1975 Foreign Assistance Act, Section 104d.

That section stipulates that "(1) Assistance ..... shall be administered so

as to give particular attention to the interrelationships between (a) pop-

ulation growth, and (b) development and overall improvement in living standards

in developing countries, and to the impact of all programs, projects, and

activities on population growth. All appropriate activities proposed for fi-

nancing under this chapter shall be designed to build motivation for smaller

families through modification of economic and social conditions supportive of

the desire for large families, in programs such as education in and out of

school, nutrition, disease control, maternal and child health services, improve-

ments in the status and employment of women, agricultural production, rural

development and assistance to the urban poor." The amendment to the FAA

continues to authorize the President "...to study the complex factors affect-

ing population growth in developing countries and to identify factors which

might motivate people to plan family size or space their children."

These papers examine the extensive literature which encompasses rural

development and fertility relationships. Seven State-of-the-Art Papers (SOAPs)

were produced: addressing the primary determinants of fertility. From this

research base the second phase of the project will "...study the complex factors

affecting population growth..." in operational settings, particularly through

the medium of project implementation. Case studies will be designed to examine

development in rural areas and to isolate the fertility implications of changes

in the socio-economic environment. Translating the results of this investigation

to decision makers in developing nations and within donor organizations is also


a primary goal of the Project. In addition to publications, a series of

seminars, workshops, and intensive technical assistance in participating

countries are planned as part of an outreach component of the Project.

Ronald V. Curtis
Project Manager
Office of Rural and Administrative
Development Support Bureau
Agency for International Development
Department of State
Washington, DC

The views and interpretations in this publication are those of the

authors) and should not be attributed to the Agency for International

Development or to any individual acting in their behalf.

The seven papers were reviewed by an independent panel of experts


Dr. William P. McGreevy, Battelle Memorial Institute

Dr. Cecile E. De Sweemer, Johns Hopkins University

Dr. Rae Lesser Blumberg, University of California

Dr. Nadia Youssef, International Center for Research on Women

Dr. Roxann Van Dusen, AID/PPC/PDPR

The SOAPS reflect the comments of the review panel: however, re-

sponsibility for content rests with the authors.


"I know from my own painful searching, with its many blind alleys,
how hard it is to take a reliable step, be it ever so small, toward
the understanding of that which is truly significant." Albert Einstein

The challenges of the Rural Development and Fertility Project (AID/ta-CA-1)

are indeed significant. The quest for distilling some of the key elements that

underpin observed or hypothesized interrelationships that govern change in indivi-

dual behaviors operating within the context of a very complex socio-economic-

political and religious environment is a tremendous objective. This quest was

initiated in this project by the search of what has been written on the subject

at hand. This report summarizes the results of the effort to ascertain the

State-of-the-Art with respect to the impact of rurai development interventions

on household fertility decisionmaking.

It is important to emphasize that the focus of this effort was not on rural

population policy but on the demographic impact of rural development programs

targeted primarily toward other objectives. Similarly, it is important to remember

that the goal of fertility reduction in rural areas is, for the most part, an

intermediate goal that is instrumental in achieving the primary goals of rural

development policy: increased income per person, improved agricultural productivity,

reduced mortality and morbidity, etc. Consequently, the majority of rural develop-

ment projects are targeted toward objectives that would appear to be only tenuously

related to fertility reduction.

However, any nation's rural development budget may contain severe misallocations

of resources if rural development programs contain unintended fertility effects

that are not included in the criteria used to select them. Since the number and

scope of rural development projects are always constrained by the availability of

public resources, competing projects must be compared and ranked according to some

criterion or set of criteria. The objective of this comparison of projects is to

select that subset that makes the greatest contribution to development given

the resources at hand.

If a capital investment project has unintended fertility consequences

that are not included in the cost benefit calculations, the actual rate of return

on a project might be considerably higher or lower than otherwise suspected. It

is, therefore, highly desirable that the unintended consequences of rural develop-

ment policy at least be considered and at best be fully understood and accounted

for. The mandate to include population impact statements in AID rural development

proposals is a recognition and codification of the desirability of understanding

the demographic consequences of rural development policy.

The set of rural development programs actually undertaken as component parts

of an overall rural development policy often affect the target population in

diverse ways. Many of the programs tend to have the most direct impact upon the

economic environment, affecting agricultural production technologies, financial

markets, marketing and transportation systems, and the labor force. However,

these programs may have secondary demographic affects that are ultimately important

determinants of rural fertility patterns. In general three sets of linkages are

important in understanding the connection between rural development policy and

reproductive behavior: (1) the connection between specific rural development

programs and the social, economic, political, and technical environment within

which rural populations reside, (2) the relationship between this environment

and the factors that are the immediate determinants of reproductive behavior, and

(3) the connections between the salient decision factors and reproductive behavior.

To understand how rural development policy affects reproductive behavior, it is

necessary to understand all three linkages; however, as this review paper demon-

strates, the scholarly literature on fertility in developing countries is almost

totally silent with respect to the first linkage, fairly scanty with respect to

the second linkage, and better but still inadequately descriptive of the third

linkage. In large part new insights will come only as new data sets are

developed. The problem of assessing the population impact of rural devel-

opment activities is not a short-run problem, and without explicit attempts

to conduct and analyze quasi-experimental studies of actual rural develop-

ment projects, our ability to assess their fertility impacts will be hampered.

New research should be designed that can help development administrators

and policy makers assess the demographic impact of their programs. The

small cost of such studies relative to the cost of rural development

projects themselves, should be ample incentive for their early initiation.


Effective July 10, 1978, the Research Triangle Institute (RTI) and the

South-East Consortium for International Development (SECID) began the process

of assembling a group of professionals from within their respective member

institutions to prepare seven State-of-the-Art Papers (SOAPs) that would examine

the relationship of fertility and each of the following topics in the context

of different types of rural development activities:

women's roles
the cost and value of children
income and wealth
land tenure systems
educational status
health and nutrition status
rural-urban migration

Each SOAP included the following:

An annotated bibliography of literature on the subject including
monographs, articles, dissertation theses, and secondary sources
such as abstracts of projects undertaken by U.S., LDC and other
donor agencies;
An "inventory of hypotheses" distilled from the literature;
An analysis of the hypotheses in the context of the overall set
of rural development/fertility interactions;
An executive summary.

This volume includes the executive summaries from the seven SOAPs as well as a

general analytical framework which synthesizes the major findings of the seven

papers into a coherent model.

In all, 23 professionals representing disciplinary expertise in sociology,

demography, political science, economics, medicine, and public health collaborated

on the seven SOAPs. Over 1500 references were reviewed. The geographic and topical

breakdown of these citations are tabulated in Tables 1 and 2. Much of the data were

obtained from U.S. sources and included among others:

TABLE 1. Number of Citations by World Region and By Topica)


Latin America and Caribbean 68 220 288
Subsaharan, Africa 35 150 185
East and Southeast Asia 68 79 147
South Asia 40 87 127
Europe, United States, Canada
and Australia 60 26 86
North Africa/Middle East 28 49 77
General and Other 206 473 679

TOTAL 505 1084 1589

aThis table was compiled by Dr. William P. McGreevey, Ms. Constance Carrino
and Anne C. Kubisch of the Batelle Population and Development Policy Program,
Washington, DC. Dr. McGreevey was one of a five-member panel of peer reviewers
who evaluated the State-of-the-Art Papers.

b)s in which the word fertility or a synonym appears.
Includes citations in which the word fertility or a synonym appears.

TABLE 2. Number of Citations by Country and by Population Sizea)


China 835,800 2
India 620,440 64
Indonesia 130,887 16
Japan 112,768 3
Brazil 110,124 16
Bangladesh 80,400 22
Nigeria 77,056 30
Pakistan 71,306 16
Mexico 62,025 42
Philippines 43,293 27
Thailand 42,960 23
Turkey 40,930 13
Egypt 38,228 8
South Korea 35,860 15
Iran 33,592 8
Ethiopia 28,680 6
South Africa 26,130 4
Argentina 25,719 4
Zaire 25,389 4
Colombia 24,301 19
Morocco 17,197 8
Algeria 16,463 3
Taiwan 16,330 24
Sudan 16,127 6
Peru 16,068 20
Tanzania 15,136 10
Afghanistan 14,000 4
Kenya 13,850 5
Sri Lanka 13,819 10
Nepal 12,857 4
Malaysia 12,653 4
Venezuela 12,361 10
Uganda 11,937 2
Chile 10,375 13
Ghana 10,310 15
Cuba 9,464 1
Syria 7,655 2
Cameroon 7,606 5
Ecuador 7,306 3
Ivory Coast 7,025 2
Guatemala 6,251 8
Bolivia 5,794 9
Tunisia 5,732 5
senegal 5,135 5
Zambia 5,063 1
Dominican Republic 4,835 4
Haiti 4,668 5
Hong Kong 4,444 5
El Salvador 4,129 4
Israel 3,460 5
Lebanon 3,266 4
Sierra Leone 3,053 8
Honduras 2,959 3
Papua New Guinea 2,829 2
Uruguay 2,800 1
Jordan 2,792 4
Paraguay 2,625 5
Nicaragua 2,338 4
Singapore 2,278 1
Jamaica 2,072 4
Costa Rica 2,018 5
Panama 1,718 2
Liberia 1,600 1
Botswana 679 2
Fiji 580 1
Gambia 531 1
Barbados 247 1
Western Samoa 153 1
Montserratc 12 1

Note: Table does not include North Atlantic countries

a)See notation d) Table 1
Source: World Bank. 1978 World Bank Atlas, Population, Per Capita Product,
and Growth Rates. Population statistics from mid-1976.
SSource: Sidney E. Chernick. The Commonwealth Caribbean (Baltimore: The
Johns Hopkins University Press, 1978), p.3.


published summaries of data and state-of-the-art papers, e.g., FAO's
Progress in Land Reform publications, the Land Tenure Center Reports,
and the SOAP produced by RTI (the SU 507 Report Series) and the
Smithsonian Institute's ICP occasional papers;
.annotated bibliographies of major "information banks" such as, the
University of North Carolina's Pop Scan Bibliographies of its Carolina
Population Center's Technical Information Service,
*major institutional publications such as the UN's general and specialized
agencies' publications, the Population Council publications, the HEW's
International Health Unit's Syncrisis reports; and USAID's publications;
*published journal articles, monographs and books; and
.some unpublished reports and theses produced by various universities
within the U.S.

All SOAPs search the literature on the basis of certain posited hypotheses

culled from theoretical constructs which have been either developed by other

scholars or synthesized by the SOAP writers. Underlying the major theoretical

constructs were the following key assumptions:

*fertility of the rural population is influenced by (and dependent on)
the social, economic, political, cultural and religious context within
which these populations reside;
S* differing social, cultural, political, economic and religious
systems place differing "values" on offspring;
.publicly funded rural development activities "transform" the economic
and social environment, thus affecting the "context" within which
fertility changes occur;
* the effects of rural development program/policy inter-
ventions on fertility is indirect
* fertility decisions and preferences are socially and
culturally defined rather than biologically
the "desire for offspring vary among cultures, sub-populations within
a region and even a country, and is basically subject to "rational"
decision making (based on economic and cultural constraints);
the relative economic and social weights assigned to various levels
of "desired family size" can be studied;
*the relative weights can be influenced by deliberate
programmatic interventions which in effect alter the
social-economic-political-cultural context; therefore,


although "time lags" are built into the decision making intervention
chains, such lags are usually not dealt with adequately;
.observed correlative relationships between intervening variables and
fertility on the one hand, and rural development program interventions,
on the other hand, are first approximations of possible causal relation-
*the strength of the causal chain of change relationships cannot be fully
determined at this juncture because many links, and their subsequent
strengths, must be treated as conjectures at best.

In the final analysis, all theoretical constructs attempt to model an

individual couple's motivation to have small, moderate or large families. Such

motivation rests with the individual perception of his present status, the socio-

psychic and economic impact of moving from one parity position to the next, and

the desired changes in status at time t + 1. Access to family planning services

becomes important to individual's freedom/capacity to attain their desired family

size objectives.

A final word of caution is needed here: fertility impact and population

change is not necessarily synonymous to fertility or population size reductions.

All SOAPs tended to assume a decline as an a priori objective of this whole

exercise. It must be emphasized here, though, that both positive and/or negative

rural development programs' impacts on fertility/population size changes are

relevant to AID's section 104d of 1977 amended U.S. Foreign Assistance Bill.



Gloria V. Javillonar, University of South Alabama
Laurie Zivetz, Research Triangle Institute
Susan G. Thomason, Tuskegee Institute
Janet Griffith, Research Triangle Institute


The report reviews the state of knowledge on the impacts of rural develop-

ment on fertility in the developing regions of Africa, Asia, Latin America, and

the Middle East and North Africa, especially as specifically types of externally

introduced rural development activities produce changes in women's familial,

economic, and other roles. Two central questions are addressed:

1. How are the roles of rural women likely to change as a
result of rural development?

2. What are the consequences of such changes on fertility-
related behavior?

The immediate objective of the review of the literature is to generate an

inventory of hypotheses relating rural development, women's roles, and fertility

which, at a later time, would be tested using data from selected completed or

on-going rural development projects in several LDCs.


The effects of rural development on women's status and roles are problematic

and are influenced by several key intervening variables, including the following:

1. Economic variables, particularly regional, country and subcultural

variations in the extent, nature, and visibility of traditional female

economic activities and in conditions of agricultural labor supply

and demand. To illustrate: (1) regional differences in female economic

participation range from the low, largely invisible subsistence activities

of women in the Middle East and North Africa to the substantial,

highly visible, and largely unrestricted income-genera ting activities

of African and Southeast Asian women on or off the farm; (2) among

Asian women, the participation continuum range from the very low in

Bangladesh to the very high rates in Thailand, and (3) Ln ind.a,

agricultural employment is high in the south but negligible in the


2. Demographic variables, particularly variations in age at marriage,

type of marriage and family structure, and marital disruption.

3. Cultural variables, such as values and attitudes related to motherhood,

women's seclusion and mobility, son preference and male dominance.

4. Social psychological variables, such as sex role attitudes, work

commitment, fate control, perceived costs and benefiLs at children.

5. Political and conjugal power, particularly variations in women's rights

related to mate selection, marital decisionmaking, and postmarital


6. Stratification variables, particularly those related to land ownership.

Sex roles segregation and definitions of appropriateness of agricultural

work for women differ by social class, with women fruin iaidles, poor

families more likely to equally share in most agriculturaiL work and


7. Family planning variables, such as marked regional and cour:iry variations

in organized family planning efforts and goals;. T. i ist ie

explicit government policies promoting and suppoi'rL ug fa;.il, planning

programs which are decidedly anti-natalist in orientation a-r unique to

the Asia region. At the other extreme is Africa where half of the

countries have pro-natalist policies. It may be noted, however, that

generally, family planning programs have not effective! redicced


fertility in the rural areas of the less-developed countries.


A general proposition that has considerable support in the literature

is that agricultural development has negative effects on women's roles under

certain conditions, specifically (1) where women's participation in the sub-

sistence economy is traditionally high, as in most of Southeast Asia and sub-

Saharan Africa, and/or (2) where there is an excess of landless hired female

agricultural labor, such as in parts of Indonesia and India. The literature

suggests that the adverse impact of rural development is due, at least in part,

to the indiscriminate application of the Western model of gender-based division

of labor in rural development projects, even in areas where women are active

participants and decisionmakers in food production, processing, and marketing.

The model has excluded women in the planning and design of development programs,

has ignored their economic roles and needs in skills training and technology

transfer, and has directed women to family planning, training in childcare,

nutrition and homemaking. Extension services are generally aimed at men, even

in subsistence activities which traditionally fall under the women's domain,

e.g., seed storage, care of poultry and animals, tending a vegetable garden,

etc. Thus, women are simultaneously being deprived of their significant

traditional economic roles and being precluded from participation in non-

traditional economic activities, as the economy shifts from subsistence farming

to cashcropping and modernization. Largely due to the displacement of female

rural workers by men and machine, downward trends in economic participation have

been noted in Egypt, India, Pakistan, Peru, and Guatemala. Moreover, declines

in rates of labor force participation by females in the prime of their child-

bearing years are projected in all the major regions of Asia and parts of the

Middle East and Africa.

The impacts of rural development strategies on women's roles are related

to ownership of or access to land. The benefits of farm modernization, for


example, accrue to the female members of land-owning families, particularly

in areas where hired agricultural labor is in short supply. Farm mechanization

reduces the tediousness and the amount of time spent by women in paid or unpaid

agricultural work.

Cultural values and practice of female seclusion, which are very marked

in the Middle East and in most of South Asia, make women particularly vulnerable

to exclusion from participation as agents or beneficiaries of rural development

projects. Cultural prohibition of contact with non-kin male precludes women's

access to marketing channels for the products of their subsistence activities,

to credit, and to non-agricultural employment opportunities. Rural development

projects geared toward providing women with income-generating skills and activities

would have problematic impact on women's extra-familial roles unless these cultural

factors are taken into account. An approach suggested in the literature is to

establish small-scale, women-only, collectively organized light industry which

also provides residential quarters for young single women.


Several hypotheses relating women's fertility to various types of economic

participation, namely, in subsistence agriculture and home-based industry, cash

cropping, off-farm industry, and trading and commerce, are examined.

Participation in Subsistence Agriculture/Home-Based Industry and Fertility

The available evidence generally suggests that female participation in

subsistence agriculture or home-based employment is either positively related

to or has no significant impact on marital fertility. The reasons frequently

cited in the literature for the apparent compatibility between this type of work

and marital fertility include the following:

1. A woman may keep her children with her while being engaged in
extra-familial income-generating activity. She does not have
to choose, therefore, between the economic and the motherhood


2. The value of children as productive helpers is high, while
the cost of childbearing is low. Thus, women are motivated
to have as many children as possible and are not likely to
practice birth control.

There are indications, however, that the direction of the cause-and-effect

relationship between subsistence-farming/cottage-industry work and childbearing

is in the opposite direction than that generally assumed in the literature. That

is, it is the need to help support a large family that forces rural women to seek

employment in agriculture/home-based industry rather than either of the latter

encouraging high fertility.

Participation in Cash Cropping and Fertility

Most of the women's participation in cash cropping is either as helpmates

to their husband/fathers or as hired casual agricultural workers. There is no

evidence indicating that the fertility of women in cash cropping is different

from that of women in subsistence agriculture or home-based industry. The

increasing displacement of women due to agricultural modernization in the absence

of alternative employment opportunities may be expected to have negative consequence

for their status and roles in the family and in society. This, in turn, may be

expected to have pronatalist consequence since their reproductive role may become

the only significant role open to them.

Participation in Off-Farm Industry

In general, the data suggest a positive or lack of relationship between off-

farm employment and marital fertility in the rural areas, due to the following


1. Availability of cheap domestic help.

2. Extended-family residential patterns which ensure the
presence of surrogate mothers.

3. More flexible hours of employment which provide considerable
compatibility between child care and work patterns.

Moreover, employment alone, even in the urban areas, does not by itself

lower fertility. The central factor in the employment/fertility equation is the


degree to which the separation of domestic and work-related activities are

made attractive by real economic gain. The negative relationship is that

between fertility and well-paid work outside of traditional economic roles.

Participation in Trading/Commerce and Fertility

The empirical evidence suggests a compatibility between fertility and

participation in trading and commerce. Macro data show that in parts of sub-

Saharan Africa and Southeast Asia, where women play an important and highly

visible role in trade and commerce, fertility rates are not significantly lower

than in other developing regions. Micro data in Latin America show no incompati-

bility between market activities and childbearing. The hypothesis remains largely

untested in the Middle East and South Asia since women's participation in trade

and commerce in these areas is negligible.



Birdsall, Nancy

Boserup, Ester

Germain, Adrienne

McGreevey, Willia

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Overseas Liaison

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Martin's Press. London: George Allen and Unwin.

Some Aspects of the Roles of Women in Population and
Development. Paper prepared for the International Forum
on the Role of Women in Population and Development.
Warrenton, Virginia: Airlie House.

im P. and Nancy Birdsall
The Policy Relevance of Recent Research on Fertility.
Interdisciplinary Communications Program. Washington, D.C.:
Smithsonian Institution.

"Women in rural development." Rural Development Network
Bulletin 6, part 1. Washington, D.C.: American Council
on Education.

"Women in rural development and index, nos. 1-6, part II,
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Ridker, Ronald G. (ed.)
1976 Population and Development: The Search for Selective
Interventions. Baltimore: Johns Hopkins University Press.

Rihani, May

"Development as if women mattered: an annotated biblio-
graphy with a third world focus." Occasional Paper 10.

United Nations Department of Economic and Social Affairs
1975 Status of Women and Family Planning: Report of the Special
Rapporteur Appointed by the Economic and Social Council
Under Resolution 1326 (XLIV). New York.




Benjamin Cheng, Southern University
William D. Lawson, North Carolina A&T State University
William T. Levine, SECID

The primary aim of the Rural Development, Education and Fertility paper

is to provide a comprehensive review of the present state of knowledge con-

cerning selected rural development interventions and their impact on education

and hence fertility in the developing regions of Africa, Asia, Latin America

and the Middle East. The rural development interventions considered were

participation of the rural poor, extension of social services, rural marketing

systems, area development, rural finance systems and off-farm employment.

The paper includes a conceptual explanation of the rural development

interventions, both a general and region-specific hypothesis inventory on the

relationships between the rural development interventions, education and

fertility, and an annotated bibliography.

The authors utilized a theoretical model of human fertility developed by

Richard Easterlin to integrate the hypotheses identified into a logical frame-

work for analysis and review.

The Easterlin model basically focuses upon three sets of variables which

affect fertility: demand for children, supply of children, and motivation for

fertility regulation. Demand for children refers to the number of surviving

children that parents would have if it involved no cost for fertility regulation.

Demand for children is seen as depending on (1) income, (2) prices, and (3)

tastes and preferences. Supply of children has to do with the number of surviving

children that parents would have if they did not deliberately limit fertility. The

supply of children depends on human fecundity, which is influenced by cultural and

health factors as well as the survival prospects of children. According to Easterlin,


it is the relationship between demand for and supply of children which determines

the motivation and cost for fertility regulation.

The paper reports on a considerable body of literature linking formal

education and fertility, while noting the absence of existing literature on the

relationship between non-formal education and fertility. Furthermore, almost

no studies were identified which specifically focused upon the consequences of

the rural development interventions for education and hence fertility.

A number of tentative and speculative hypotheses concerning the linkage

between rural development activities, education and fertility were advanced by

the authors, but only the education-fertility hypotheses are presented with

supporting theoretical and empirical evidence.

The analysis of the education-fertility linkage suggested the following:

(a) With respect to supply factors:

(1) Education will vary inversely with probability of a woman's
ever marrying.

(2) The greater the level of education, the greater the delay
of marriage of women. This will shorten the fertile period
of a woman's life.

(3) The greater the level of education, the better the health of
couples. This will result in increased fertility.

(4) The greater the level of education, the more likely will it
be that cultural predispositions toward longer lactation
periods and postpartum abstinence will be altered and short-

(5) The greater the level of education of parents, the lower the
level of infant or child mortality.

(b) With respect to the demand for children:

(1) The-greater the level of education the smaller the ideal
family size and the smaller the desired family size.

(2) The greater the level of education the lower the desire
for a large number of sons.


(3) The greater the level of education the lower the perceived
benefits of children and the higher the perceived costs
of children.

(4) The higher the level of education the greater the perceived
ability to afford children.

(c) With respect to fertility regulation factors:

(1) The greater the level of education the greater the knowledge
of birth control.

(2) The greater the level of education the more positive the
attitude of couples toward birth control.

(3) The higher the level of education the more likely the use
of contraceptive devices.

(4) The higher the level of education the more likely will there
be husband-wife communication concerning family planning

The hypotheses were generally supported by empirical studies in each of

the developing regions, however, for some of the hypotheses much more significance

was accorded them in urban areas than rural areas.

Although no substantive conclusions were drawn from the empirical literature

with regard to the impact of the rural development interventions on fertility via

education, there appears to be a theoretical basis for the view that over the long

run rural development interventions promote higher levels of education among rural

populations which, in turn, depresses fertility rates. This, of course, depends

upon the transformation of group norms, familial institutions and personal attitudes.

Finally, the paper recommends the following for future research considerations:

(a) an examination of specific rural development projects and their
fertility-related consequences. The rural development conceptual
categories currently employed by USAID are too vague and unwieldly
to be of any value in measuring the population impact of USAID
rural development interventions.


(b) an examination of the effects of non-formal education on fertility
behavior. This is warranted if intelligent and informed conclusions
are to be made regarding the impact of rural development projects
on fertility.

(c) an examination of the fertility-related consequences of rural develop-
ment interventions by means of retrospective and prospective case
studies which employ extended time frames. Both types of studies
are required in order to assess the nature and extent of measurable
changes in the rural development education fertility relationships.



Becker, G.S.
1960 "An Economic Analysis of Fertility," Pp. 209-240 in
National Bureau of Economic Research, Demographic and
Economic Change in Developing Countries. Princeton,
New Jersey: Princeton University Press.

Cochrane, Susan H.
1978 "Fertility and Education: What Do We Really Know?"
Population and Human Resources Division, Development
and Economic Department, World Bank.

David, Kinsley and Judith Blake
1956 "Social Structure and Fertility: An Analytical Framework."
Economic Development and Cultural Change 4:211-235.

Easterlin, Richard A.
1974 "The Effect of Modernization on Family Reproductive Behavior."
pp. 263-288 in the United Nations (ed.), The Population
Debate: Dimensions and Perspectives, Papers of the World
Population Conference, Bucharest.

Gregory, Paul R., and J.M. Campbell, Jr.
1976 "Fertility Interactions and Modernization Turning Points."
Journal of Political Economy 84:835-847.

Gregory, Paul R., J.M. Campbell and Benjamin S. Cheng
1972 "A Cost-Inclusive Simultaneous Equation Model of Birth Rates."
Econometrica 40:681-687.

Heer, D.M., and E.S. Turner
1965 "Area Differences in Latin American Fertility." Population
Studies 18:279-292.

Holsinger, Donald

B. and John D. Kasarda
"Education and Human Fertility:
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Sociological Perspectives."
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Janowitz, Barbara

Stycos, J. Mayone

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Human Fertility in Latin America. New York: Cornell University




Sally Evans Findley, Minnesota State Planning Agency
James Gundlach, Auburn University
Douglas P. Kent, SECID
Richard Rhoda, Private Consultant

In the last few years, a number of reviews of migration and development

have been published. While smaller in number and scope, there have also

been a few reviews of the extent to which we understand the relations between
migration and fertility. Then, why is it necessary to produce yet another

document reviewing the "state-of-the-art" for development, migration, and

fertility? First, the focus for this document is the interaction of rural

development efforts, migration out of rural areas, and fertility, especially

rural fertility. To our knowledge, there are no comprehensive reviews that

explicitly incorporate all these variables. Second, the existing reviews do

not adequately reflect the very diverse nature of the migration process, in

which migrants, migrant destinations, and migrant origins each vary considerably.

Certainly, one lesson development practioners have learned is the importance
of designing programs for specific target groups and specific situations. There-

fore, we have attempted to provide a level of discussion which is more specific

with respect to the nature of the rural outmigration or development context,

specific variables inducing migration, the types of persons responding to the

migration variables, and the nature and limitations of subsequent rural fertility


1See Brigg, 1973; Findley, 1977; Simmons et al., 1977; Todaro, 1976.
See Zarate and Zarate, 1975; Findley, 1977: Chapter 5; Bouvier and Rosenberg, 1975.
3See Chambers, 1974; Owens and Weiss, 1975.
See Chambers, 1974; Owens and Weiss, 1975.


Migration and Fertility: A Summary of the Findings

Migration and fertility are both demographic phenomena that are assumed

to involve decisionmaking by individuals or households. In the review of

migration theories and findings, we show that migration can be viewed as a

conscious attempt by individuals or households to increase their income by

moving to an area when they perceive employment opportunities to be superior

to those available in their present community. Of course, the degree to which

migrants actually weigh alternatives and "optimize" their choice of destination

varies. There is ample evidence that migration decisions are somewhat con-

strained by limited information, resources and time to invest in moving per se

and by family-related concerns.

Fertility decisions are also assumed to reflect a conscious consideration

of the economic gains or losses associated with childbearing. Yet these decisions-

and their degree of conscious analysis--are also constrained by limited information,

ability of the household to take risks with respect to childbearing, and by

expectations of the family or partner. Easterlin has developed a generalized

model for these factors. According to his model, a woman or household varies

childbearing in order to optimize its utility. The childbearing decisions are

affected by the household's income, price of children, and costs of regulation.

Theoretically, these variables determine desired family size. Bongaarts

agrues that actual fertility behavior is almost completely determined by the

four proximate variables of contraception, lactation, induced abortion, and age

and duration of marriage. It is through these proximate variables that the

income and cost of regulation variables affect fertility behavior.

4See Easterlin, 1969.

See Bongaarts, 1978.


To correctly identify the effects of migration on fertility, we must

examine the net effects via these proximate variables and, indirectly, the

Easterlin model variables. Based on our review of the evidence regarding

the effect of migration on these variables, we conclude that migration affects

fertility levels among migrants and perhaps among nonmigrants in the rural

origin. The fertility effects are, however, very complex and not automatic.

Migrant women will desire or have smaller families after moving if they:

1. Are young at time of migration;
2. Delay marriage or first union;
3. Experience lower infant and child mortality in conjunction with
continued lactation and abstinence or use of birth control methods;
4. Have or obtain literacy skills;
5. Have aspirations for self or children;
6. Interact with reference groups supportive of small families;
7. Are committed to work outside of the home and a non-housewife career;
8. Are less reliant on children for help and plan more investment in
children's education and support;
9. Exhibit cultural openness to modernization and change; and
10. Are aware of and can obtain contraceptives.

The findings do not permit generalization regarding an additive or interactive

nature of influence.

Of all the factors that are likely to result in migrant fertility declines,

education for the migrant woman is probably the most critical. Through education

and residence in the city a migrant woman is more likely to develop a desire to

limit births and to evolve into a situation where such limitation is feasible,

supported, and economically advantageous. But the relation between migrant

education and fertility reduction is complex; many circumstances, such as cultural

norms, can alter the expected size or direction of influence.

For which woman is migration less likely to produce a lowering in fertility

goals or attainment? Basically, the women who may not reduce fertility are women

whose situations are opposite to those stated in the ten propositions above.


1. If a migrant is old (over age 30), she has probably had children,
and moving to a city is not likely to reduce her family size.

2. If a migrant woman marries shortly after arrival, she is less
likely to have fewer children. This results both from an in-
creased exposure to risk of pregnancy and a lower probability
of setting in motion the education-aspiration link.

3. If a migrant woman continues to experience high infant mortality,
she will continue to have closely-spaced births and replace deaths.

4. & 5. If a migrant woman has little education, she is less likely to
develop aspirations or a commitment to work outside the home. She
is also more likely to be locked into traditional child-dependency

6. If a migrant is relatively isolated from groups who might stimulate
and support a desire for small families, she is aldo not likely to
have a small family. Thus, women who live in neighborhoods with
little observable family size variation or who work primarily with
those like themselves are not likely to experience a fertility decline.

7. If a migrant is unable to obtain employment outside the home or has
a "traditional" attitude towards women's roles, she is not likely to
deviate from the expected pattern of childbearing.

8. Perhaps most important, unless the economic realities for women differ
substantially, the migrant in the city may be just as dependent on a
large number of children as her rural sister. Families with low incomes
generally cannot afford to send children to school; instead, children
are needed to help out at home and with the families' income-producing
activities. In addition, families living at the margins of subsistence
are expected to prefer the certainty of children with their known costs
and benefits to the risks of smaller families.

9. Even if a woman wishes to limit or space births, she may not do so if
she has no close friends who use contraceptive methods. If a woman is
not interacting with persons unlike herself in terms of family planning
experiences, she is not likely to have friends who will recommend using
birth control methods.


The migration findings suggest three additional, related conditions under

which migrant women would not be expected to alter their fertility goals or


First, many migrants do not go to cities, and the differences between the

origin and destination communities may be more limited, particularly with

respect to the variables outlined above. Because we model the migration-fertility

relation as a change in fertility behavior in response to contextual or personal

changes from the old patterns, there is little stimulus for fertility change.

Second, much migration is not once-in-a-lifetime. Migrants may move back

and forth between the home village and one or more destinations, depending on

changes in opportunities in the various places. In this instance, a migrant

may be in and out ot the rural context many times. ecabise of the changing

destinations or durations of migration, the migrant may not develop strong

commitments to urban living. For him or her, the home rural community may con-

tinue to be the central reference point for decisions. Thus, fertility expecta-

tions would continue to be shaped by rural norms. Again, duration and the

repetitive dimensions of migration are much needed variables in subsequent

migration-fertility studies.

Third, migration often is the vehicle by which rural households spread

their resources between different areas. If families pursue the "dual household,

extension strategy," they maintain a rural base, the stem household from which

others branch out. For these households, migration is the means by which the

household, adapts its large household size to the changing economic constraints

of rural and urban areas. Any nascent economic pressures to limit births are

diffused by geographical relocation of "excess" members. In addition, the

strategy works best if there are several children: some to continue subsistence

farm work, some to assist with household chores and child care, and some to

seek out wage labor in other rural or urban areas. Thus, the migration strategy


of household extension may perpetuate or even intesify pronatalist forces

operating through perceptions of child utility. This is a top priority item

for migration-fertility research.

Migration and Rural Fertility

Most migration-fertility literature has focused on the effect of migration

for migrant fertility. Very little research addresses the related issue: Does

out-migration influence the fertility behavior of women left behind in the rural

origin? The following are potential mechanisms through which migration may lead

to a rural fertility decline.

1. Change in the sex ratio resulting in a higher probability of women
remaining single. Alternatively, where women are the migrants,
limitations on male marriage. The research shows no consistent
relations between changing sex ratios and fertility of women
remaining behind.

2. Reduced exposure to the risk of pregnancy due to lengthy separations.
Again, the findings suggest no certain relation between separations
and ultimate family size.

3. Returnees who introduce new "small family" ideas and examples,
especially over a long period of time. Limited evidence supports
this proposition for more selective migrant returnees.

4. Remittances which operate via the "price effect." If remittances
are used to defray child-related expenses, such as schooling,
migration does not stimulate activity declines.

The following are potential mechanisms for which there is no evidence:

5. Increased information about urban lifestyles, consumption goods,
and opportunities, operating to change "preferences" for children
vs. other goods.

6. "Demonstration effect" of successful educated migrants which would
operate via a change in perceptions about the number of children
and the level of education necessary for "success." Essentially,
the demonstration effect operates through the "price" effect.

7. Continued maintenance of large family norms via the migration house-
hold extension strategy.

Fertility Outcomes of Rural Development Programs; Indirect Effects via Migration

The final section of the paper briefly reviews the potential rural fertility

outcomes of selected rural development programs that affect migration. Programs

considered include:

1. Increased participation of the rural poor in development activities;

2. Expansion of off-farm employment opportunities;

3. Development of rural financial markets;

4. Extension of social services to the rural poor;

5. Development of rural marketing systems; and

6. Area development.

Given the assumed program outcomes, most of the programs will have an impact

on rural migration, but very few of the programs will slow or stop rural-urban

migration. Rather, a major effect of the programs which improve the income and

opportunities for the rural poor will be less rural-rural migration, and then

only if the long-term economic outlook for rural areas has changed significantly.

Most of the programs accelerate rural-urban migration of the moderately selective,

if not immediately, in the long term. Depending on their scope, the off-farm

employment programs probably offer the most potential for a change to the rural-

urban migration patterns of the moderately selective migrants. In particular,

such programs can facilitate more short-distance rural-urban moves or rural staying

with urban commutation. Without substantial changes in the prospects for agricultural

income growth via improved rural-urban terms of trade, it is unlikely that solely

rural-based strategies will generate a long-term rural staying response among the

moderately selective.

Migrants respond to conditions of economic opportunity and if the long-term

urban opportunity expectations for either a formal sector or family-based informal

sector strategy continue to be superior to rural opportunities, migrants will con-

tinue to be superior to rural opportunities, migrants will continue to move to

cities. If among cities, these economic opportunities are fairly homogeneous,


destination choice may increasingly depend on non-economic kin, proximity, or

quality of life factors, but the choice will still be in favor of cities. Those

differences depend not on rural development but on urban development patterns.

Just as the immediate migration consequences of the rural development

priorities are limited to shifts in the magnitude or destinations for less

selective rural-rural migrants, migration's indirect effect on rural fertility

is fairly limited. But in the long term, the indirect effects may be substantial,

depending on the fertility consequences of migration remittances, returnees,

visits, positive feedback, demonstration effects and so on. These effects will

depend on the migrants' experiences in cities. In particular, if migrants adopt

small family norms, then they may introduce these concepts to rural areas when

they return or through their visits. As noted above, there are many factors

which can inhibit migrants' adoption of small family norms. Thus, even if the

indirect, long-term rural fertility effects exist, we cannot expect them to be

associated with all migrants.



Annable, James

Beals, Ralph E.

Boswell, Thomas

Byerlee, Derek,

Greenwood, Mich

Hay, Michael

Levy, Mildred B

Levy, Mildred B

Munro, John M.

Rempel, Henry

Sahota, Gian S.

E., Jr.
"Internal migration and urban unemployment in low-income
countries: a problem in simultaneous equations."
Oxford Economic Papers 24(3).

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"Rationality and migration in Ghana." The Review of
Economics and Statistics 49(4):480-486.

"Municipio characteristics as factors affecting internal
migration in Puerto Rico: 1935-40." unpublished paper,
Department of Geography, University of Florida.

Joseph L. Tommy and Habib Fatoo
"Rural-urban migration in Sierra Leone determinates
and policy implications," African Rural Economy Paper
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Shaw, R. Paul

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Boone A. Turchi, University of North Carolina
Ellen Bryant, Mississippi State University


As experience with rural development programs and family planning

programs has accumulated it has become increasingly apparent that the

fertility of rural populations is not independent of the social, economic,

and political context within which these populations reside. To the

extent that publicly funded rural development activities transform the

economic and social environment, they also may alter the context within

which fertility changes occur. It becomes desirable, therefore, to under-

stand how these activities either promote or retard the reduction of rural


This paper is an attempt to use existing social science research on

fertility in low income countries to assess the connections between economic

development programs, the cost and value of children, and fertility. It

develops a model of reproductive behavior that will serve as a framework

for the analysis of the ways in which rural development programs can, inten-

tionally or unintentionally, affect fertility levels and trends by altering

the cost and/or value of children to their families. In addition, it pin-

points those areas where our current understanding of the linkages between

development programs, the cost/value of children, and fertility is weakest.

The theoretical framework adopted for this paper draws heavily upon

the recently developed microeconomic theories of fertility. Over the past

two decades there has been a growing consensus among social scientists that

reproduction can be viewed as an allocative process. Families are faced with

limited stocks of time and money that must be allocated to child rearing, the


family's social and economic advancement, the demands of the extended family,

and to the government in the form of taxes. To the extent allowed by law and

the socioeconomic environment, this theory characterizes couples as attempting

to choose the mix of family size and other activities that maximizes their own

or their children's perceived welfare. This theory of fertility differs from

the standard theory of the consumer in that it explicitly recognizes the impact

that the socioeconomic environment has on allocative decisions. Moreover, it

is flexible enough to include allocative behavior in settings that would appear

to preclude purposeful, rational, or consistent activity. It specifically

recognizes that the normative economic and social pressure to have children may

be so strong, the cost of rearing them so low, and the impediments to effective

fertility regulation so severe that fertility may appear to be essentially un-

planned and irrational. This so-called irrational fertility behavior can, there-

fore, be considered to be a special case of the general decision-theoretic model

of reproductive behavior in which parents balance the benefits and the costs of

child rearing in determining their own family size.

This paper focuses on the nature and determinants of the benefits ("value"),

both economic and psychosocial, and the costs, both temporal and financial, that

are associated with children and child rearing in the rural areas of developing

countries. It recognizes that allocative reproductive behavior takes place in a

socioeconomic context that may be radically altered during the course of rural

development, and it demonstrates the manner in which rural development programs

can alter rural fertility by changing the social and economic context within which

individual reproductive decisions are made.

The Value of Children

Section II of this paper discusses the many psychosocial and economic

benefits that children bring to their families in rural areas. A large and

growing literature on the value of children in peasant societies is discussed


and comparisons are made between major geographic regions: Asia, Africa,

Latin America, and the Middle East. Among findings that emerge is the almost

universal tendency of the economic value of children to decline as economic

development proceeds.

In urban areas throughout the Third World, the economic contribution of

children has ceased to be a major motivating factor for large families. Only

in rural areas (and in particular, in the poorest rural areas) does the economic

contribution of children remain a significant motivating factor for large families.

However, whether or not children are perceived as net economic benefits or costs

in rural areas remains a subject of considerable debate. Many studies through-

out Asia have indicated that children in low income rural areas are perceived to

be of significant economic value. Findings from West Africa also indicate that

children are perceived to be of considerable economic value in agricultural areas.

However, other findings suggest that children remain in sizable net financial drain

on their parents, and the debate continues over whether or not children represent

financial assets in rural communities.

In a sense, this debate is academic for policy purposes. What is important

is to understand how the economic value of children is altered by rural develop-

ment policy. To the extent that these alterations are understood and their effect

on fertility can be plotted, the connection between rural development programs

and reproductive behavior will be understood. At this point in time, the literature

has little to say about the effect of development policy on the economic value of

children, and this remains an obvious subject of future research.

The other dimension of the value of children is their psychosocial value.

Section II of the paper describes in detail studies exploring the different psycho-

social needs that children fulfill in various societies. In particular, the

connections between the social and political structure of a region and the value

of children are assessed. Again, major differences appear by geographic region.


These are discussed in detail in the paper. A major general finding of the

review is that the psychosocial value of children is a relative value, relative

in the sense that benefits from parenthood are weighed in relation to the benefits

available from alternative activities in rural areas. For example, in some rural

settings there may be virtually no alternatives available for a woman besides the

role of wife and mother; however, in other settings the alternatives to mother-

hood may be sufficiently attractive to make the relative value of children smaller.

Development policy can be carried out in such a way so as to maximize the alterna-

tives to parenthood that present themselves in the course of the economic trans-

formation of rural areas.

The Financial Cost of Children

Demographic research has, over the past two decades, consistently reported

that parents perceive the high financial cost of rearing a child to be the major

factor motivating them to have smaller families. This result has been reported

in settings as diverse as the urban United States and rural Philippines. Moreover,

many parents who report that the cost of children is a major limiting factor on

their desire for additional children specify that it is the cost of educating their

children that is perceived to be the most burdensome component of that cost. Un-

fortunately there are hardly any studies available that can inform policy makers

as to the actual component-by-component cost of children, either in urban or rural

areas. Although the view that children cost more in urban areas is current and

plausible, there is as yet virtually no documentary evidence that this is true.

The financial cost of a child is determined by the normative standards that

parents bring to child rearing, and by the availability and price of the market

commodities employed. However the literature is deficient also in its treatment

of the determination of child rearing standards, and since it is these standards

that determine the possibilities for the substitution of commodities in child

rearing as relative prices change, it is not possible on the basis of current


knowledge to describe how rural development programs can alter the price of

a child. Therefore, although there is strong theoretical evidence that the

cost of a child is an important determinant of fertility, the link between

rural development and the financial cost of a child remains largely unexplored.

The paper presents what evidence there is available from the Third World, and

suggests ways in which research might be utilized to strengthen our understanding

of the relationship.

Time Cost and Fertility

The situation is slightly better with respect to time costs of children.

We know in a very general way that various measures of the time cost of a child

are strongly related to fertility. In numerous settings in the Third World,

high time costs are associated with lower fertility, particularly when the high

costs are associated with the mother. Another finding that is both plausible

and widely reported is that the time cost of a child is less important in areas

where nonchild rearing activities can routinely be carried out jointly with

child care. This suggests that the social and economic organization of rural

society is much more conducive to the joint roles of producer and mother.

However, a number of issues remain unresolved. In particular, the measure-

ment of the opportunity cost of parental time continues to present problems. The

variables used to measure opportunity cost are deficient on a number of theoretical

and empirical grounds and as a result it is not possible to trace with any pre-

cision how rural development activities might actually affect the value of a

woman's time in varying pursuits. Very little empirical evidence exists detailing

the linkages between development policy and the cost of children; however, a

number of suggestions for the interpretation of available evidence are advanced.


The paper concludes with a number of suggestions for policy interventions

that can be inferred from the literature on fertility and the cost and value of


children. Given the state of the literature in this field, many of these

suggestions can be only tentative in nature. Perhaps more importantly, the

paper suggests research that can be undertaken relatively cheaply that would

markedly increase our understanding of the rural development policy, cost and

value of children, and fertility nexus.



Arnold, Fred, Rodolfo A. Bulatao, Chalio Buripakdi, Betty Jamie Chung,
James T. Fawcett, Toshio Iritani, Sung Jin Lee, and Tsong-Schien Wu
1975 The Value of Children: A Cross-National Study. Vol.1,
Introduction and Comparative Analysis. Honolulu: East-
West Population Institute.

Cain, Mead T.
1977 "The economic activities of children in a village in
Bangladesh." Population and Development Review 3:201-27.

Cochrane, Susan Hill
1975 "Children as by-products, investment goods and consumer
goods: a review of some micro-economic models of fertility."
Population Studies 29:373-90.

Easterlin, Richard Ainley
1975 "An economic framework for fertility analysis." Studies
in Family Planning 6:54-63.

Espenshade, Thomas J.
1972 "The price of children and socio-economic theories of
fertility: a survey of alternative methods of estimating
the parental cost of raising children." Population
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Galal el Din, Mohamed El Awad
1977 "The economic value of children in rural Sudan." Pp. 617-32
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Hoffman, Lois W. and Martin L. Hoffman
1973 "The value of children to parents." in James W. Fawcett
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Turchi, Boone Alexander
1975a The Demand for Children: the Economics of Fertility in the
United States. Cambridge, MA: Ballanger.

Rosenzwerg, Mark and Robert Evenson
1977 "Fertility, schooling and the economic contribution of
children in rural India." Econometrica 45:1065-79.




C. Shannon Stokes, Pennsylvania State University
Wayne A. Schutjer, Pennsylvania State University
Terry L. McCoy, University of Florida
Charles H. Wood, University of Florida

Rural development policies in less developed countries are often designed

to change the availability, access, and quality of land for rural populations.

The impacts of such policies on demographic behavior, particularly fertility

behavior, have been largely ignored. This paper initially reviews the existing

theoretical and empirical literature on the relationship between land and

fertility; then it examines selected rural development policies designed to

directly influence the availability and institutional access to land. Finally,

mechanisms which indirectly affect land tenure arrangements are reviewed.

The central importance of land to agrarian societies has not been recognized

in most demographic development policies or programs. The relative availability

of land and labor greatly influences agricultural production patterns and

techniques and, at the same time, largely determines the distribution of income,

wealth, and power resulting from the use of land. The distribution of land is

thus a major determinant of the class structure in rural areas.

We have found it useful to think of land availability as having three

major dimensions. First is simply the physical availability of land, which is

perhaps the usual concept. Second is the quality or use-capacity of the land

which includes variation in the productive capacity of the land. Third is legal

and informal institutional forces which govern the use of property and the distri-

bution of the produce of the land. In short, in viewing the availability of land

it is important to consider not only the physical availability but also the

quality of the land and the conditions governing access to land.

The dimension of land that has received the greatest attention is its physical


availability. The relationship between land availability and human fertility

has been examined at the aggregate level where the major concern has been to

explain the fertility impact of settlement patterns and programs designed to

increase the number of farm sites available. The relationship between farm

size and human fertility has also been examined where family size is postulated

to be a function of the area cultivated by the individual family.

The literature on the physical availability of land is basically Malthusian

in concept. That is, the availability of land at the aggregate level is associated

with higher levels of areal fertility, and at the individual level, farm size is

positively associated with family size. At one level, it might be argued that

within an agrarian system social and economic forces exert pressure toward a

uniform land-man ratio. It can also be argued from the household perspective

that larger farm sizes increase the economic value of children and negate the

need for off-farm employment by women in the household. Further, the implications

of the cost-benefit analysis regarding family size are reinforced by a positive

income effect on the demand for children and a smaller quality or price effect

across various farm sizes.

The literature reviewed supports the thesis that the physical availability

of agricultural land at the aggregate and individual family level is positively

related to human fertility. The aggregate relationship was found for areas as

diverse as the historical U.S. and Canada, Latin America, India, Thailand, the

Philippines, Iran, Poland and many countries of Western Europe during the eigh-

teenth and nineteenth century. The positive relationship between farm size and

fertility likewise appears to hold over the diverse conditions of the developing

world. It is only under conditions of dynamic technological change, coupled

with increasing farm size, that the relationship appears to break down.

Theoretically, increases in land quality appear to be similar to increases

in the quantity of land available under conditions of constant technology.


That is, land of a higher quality would seem to increase the absorptive capa-

city for labor and capital inputs and produce greater levels of income. Simi-

larly, if the value of agricultural land is closely tied to the flow of income

the land can generate, it would seem that doubling the quality of a given piece

of land would be comparable to increasing the land size by a factor of two.

However, the conceptual relationship between the quantity of land and the quality

of land available breaks down with changes in technology. Thus, technology is

not neutral in its impact on the demand for the various factors of production.

Technology may increase the relative demand for land, capital and/or labor. As

a result, improvements in land quality brought about by changes in technology

may influence factor proportions differentially. Evidence on the relationship

between quality of land and fertility is virtually non-existent. The one study

we found which attempted to directly measure land quality or land-use capacity

in terms of productivity reported quality to have a positive effect in one

instance and no effect in another. The available evidence affords no basis for

generalization about land quality and fertility.

Theoretical and empirical work on the relation of institutional access to

land and fertility is more diverse and less systematic than that on land avail-

ability, yet more suggestive than that on land quality. Access to land is

practically and theoretically essential to an understanding of the connections

between the economic and social organization of rural societies and their fer-

tility patterns. One of the problems plaguing research in this area is con-

fusion between the institutional mechanisms which alter the availability of land

to individual families, and the aggregate level results of the operation of

those mechanisms, i.e,. the distribution of landholdings.

Inheritance systems, land tenure patterns, and the distribution of land in

rural areas each appear to have important potential impacts on the relationship

between land and human fertility. Inheritance systems have an effect on nupti-


ality and fertility which are extremely complex and tied to other aspects of

social organization, such as the land tenure system and economic opportunity

in the nonfarm sector. Thus while characteristics of inheritance systems may

well influence marital and reproductive behavior, it was not possible to de-

lineate uniform effects of such systems. Instead, a more appropriate strategy

would be to examine such systems within a given society, at a minimum, within

a given level of technology and/or stage of development.

Historical work in Western Europe, as well as contemporary studies in the

Philippines and Mexico, found land tenure to exert both positive and negative

effects on fertility. It seems likely that the basis for the diversity of

findings is that land ownership per se is associated with lower fertility, but

that the relationship can be overcome by pronatalist inheritance systems.or

conditions governing land ownership which encourage large families. Thus, in

the Philippines, land ownership appears to be negatively related to fertility

through its influence on factors such as age of marriage and female education.

However, in Mexico, the ejido system of land ownership apparently encourages

early marriage and childbearing. The paucity of work on this topic limits

generalization. Nonetheless, the existing work is sufficiently suggestive,

and the area is so central to development policy, that further research is

clearly indicated.

Agrarian reform, settlement and colonization schemes are major types of

programs designed to directly influence the availability and access to land

of rural populations. Several tentative conclusions about their effects on the

man-land relationship in developing countries may be advanced. In evaluation the

results of agrarian reform for the specific dimensions of the relationship of

interest here, it is necessary to keep in mind a fundamental contradiction. On

the one hand, there is a consensus that neither agricultural development nor the


amelioration of rural poverty is possible in most countries without significant

changes in the land tenure system. Yet, on the other hand, such change is

clearly very difficult to accomplish, and there are relatively few real world

examples of successful agrarian reform programs. Those that do exist offer

support for the proposition that reformed land systems are more equitable and

more productive, but the literature is not very helpful as a guide for achieving


Agrarian reform and settlement and colonization schemes rarely make land

more widely available. The nature of access to and limited amount of land

raise questions about the relevance of the hypothesized relationships between

land availability and fertility derived from historical studies of frontier

situations. The man-land ratio in reformed areas is invariably high, although

many reforms attempt to mediate this by establishing collective ownership. In

theory, the quality of land distributed under a reform should be high; in prac-

tice, it appears that the best land remains unexpropriated. These generaliza-

tions suggest that the real significance of reform lies, first, in how it governs

access to land, and, second, in the fact that it is generally unable to affect

a large percentage of the rural population who increasingly join the ranks of

the landless.

Several analyses of such programs conclude that in social and economic

terms the record is discouraging, as serious implementation problems plagued

all types of projects ranging from smallholder schemes to large state farms.

The record in Latin America exemplifies the above. In Indonesia, the govern-

ment-sponsored "transmigration" programs designed to settle the "outer islands"

have had a negligible effect on rural poverty in Java. A conspicuous exception

in Asia seems to be the Sri Lanka program where nearly 500,000 rural families

were settled in lands short distances from the original residences. Although

unit costs were high, a large proportion of the rural poor have benefitted.


The opening up of new territories, whether through directed or spontaneous

colonization programs, is a development strategy distinct from agrarian reform.

Settlement schemes have often been adopted to siphon off excess population in

areas of high demographic density, and to divert pressure for land redistribu-

tion. Colonization in this sense is a politically expedient "solution" to

over-crowding that avoids confrontation with entrenched rural elites who con-

trol large tracts of land.

The literature on settlement and colonization programs suggests several

conclusions. The first, and perhaps most obvious, is that colonization is not

a viable option for many countries. In many areas where density is very high,

as in most of South Asia, Java, and Egypt, the arable land frontier has been

used up. A second generalization is that colonization efforts rarely attain

the goals they set out to accomplish. While any development program formulated

and carried out within a political context invariably contains references to

targets that are essentially rhetorical, colonization schemes frequently suffer

from a more fundamental misconception. Faced with the contradiction between

the pressure for agrarian reform on the one hand, and the resistance of landed

elites on the other, the assumption emerges that new territories can be opened

up for small farmers thereby creating an agrarian structure that is different

from the already settled regions. This reasoning assumes that the process of

colonization can be carried out in a way that is unaffected by the socioeco-

nomic and political environment. This premise is untenable as colonists, par-

ticularly those engaged in spontaneous efforts, are subject to the same forces

that are at work in the society of which they are a part. In many areas both

small farmers and wealthy investors are attracted to newly opened lands that

end up in the hands of large corporations who employ migrants as laborers rather

than settlers, with few benefits accruing to the rural poor as a result. Finally,

the expense involved is among the most limiting factors.


The literature on agrarian reform suggests that attempts to alter the

distribution and access to land in most developing countries through direct

policy intervention have had relatively minimal impact. At the same time,

it is evident that the agricultural sector in many areas is undergoing sig-

nificant change as a result of a variety of indirect factors.

In principle, it is clear that forms of land tenure, as well as their

geographical distribution and prevalence among different types of producers,

are the final outcome of an exceedingly complex set of interactions. The

original patterns of land distribution and land tenure, as well as the factors

that contribute to changing these patterns, are conditioned by the socioeconomic

and political context, historical events, factor prices, inflation, government

policies, the international market, and include such variables as topography,

soil quality, and the availability of water. The particular constellation of

factors that have contributed to change in the agricultural sector, and the

consequences of the trends that are taking place, vary in Latin America, Asia,

and Africa. Even within national boundaries there are regional differences

that demand attention. Under these circumstances broad, encompassing generali-

zations simply cannot do justice to the variety and complexity of the real world.

Among the most important factors that appear to affect the quality, quantity,

and the access to land is technological change. Biological innovations such as

the introduction of high yield varieties (HYV) and increasing use of mechanized

production processes have a significant impact on the structure of the agricultural

sector. The literature strongly suggests that the majority of benefits of mechan-

ization and the adoption of HYV's accrue to large landholders. The introduction

of high yield strains, and the efficiency provided by machinery results in greater

productivity and profits, and substantially increases the value of land. As the

net worth of land rises, and if renting is a common form of land tenure arrangement,


the landholder will probably be able to prevent the appropriation of the wind-

fall profits by the tenant. One analysis of Pakistan, India, and the Philippines

concluded that increased mechanization (tractorization) led to increased con-

centration of land ownership, a return to owner cultivation resulting in direct

tenant eviction, and land renting by large farmers causing indirect eviction.

In summary, the present knowledge base regarding the connections between

rural development policies, land and fertility provide only limited policy

guidance for efforts designed to lower fertility. Nonetheless, the literature

strongly suggests several points at which dimensions of land and development

policy intersect with family size decisions, and which represent possibilities

for policy intervention. Although the exact nature of these connections cannot

be specified, an awareness of the potential impact od land-related changes on

fertility behavior may at least reduce the chances of implementing policies

that are pronatalist in effect.



Barraclough, Solon and Juan Carlos Collarte (eds.)
1973 Agrarian Structure in Latin America. A Resume of the CIDA Land Tenure
Studies of: Argentina, Brazil, Chile, Colombia, Ecuador Guatemala, and
Peru. Lexington, Massachusetts: D.C. Heath and Company.

Beaver, Steven E.
1975 Demographic Transition Theory Reinterpreted. Lexington, Mass.: D.C.
Heath and Co.

Birdsall, N.
1977 "Analytical approaches to the relationship of population growth and
development." Population and Development Review 3: 63-102.

Esman, Milton
1978 Landlessness and Near-Landlessness in Developing Countries. Ithaca,
New York: Rural Development Committee, Center for International
Studies, Cornell University.

1979 Review and Analysis of Agrarian Reform and Rural Development in the
Developing Countries since the Mid-Sixties. Reference Document for
World Conference on Agrarian Reform and Rural Development, Rome, 12-20
July 1979. WCARRD/INF. 3.

1975a Report on the FAO/UNFPA Seminar on Agricultural Planning and
Population. Malta, 18 November 7 December, 1974. Rome: FAO.

Griffin, Keith
1974a Political Economy of Agrarian Change: An Essay on the Green
Revolution. Cambridge, Mass.: Harvard University Press.

1974b The Political Economy of Agrarian Change. Boston: Harvard University

Hiday, Virginia A.
1978 "Agricultural organization and fertility: A comparison of two
Philippine frontier communities." Social Biology 25: 69-75.

Jaffe, A.J. and K. Azumi
1960 "The Birth Rate and Cottage Industries in Underdeveloped Countries."
Economic Development and Cultural Change 9: 52-63.

Leet, Don R.
1977 "Interrelations of population density, urbanization, literacy and
fertility." Explorations in Economic History 14: 388-401.

Maclnnis, R.M.
1977 "Childbearing and land availability: Some evidence from individual
household data." Pp. 201-227 in Ronald Demos Lee (ed.), Population
Patterns in the Past. New York: Academic Press.


Rich, William
1972 "Smaller families through social and economic progress." Pp. 193-287
in Overseas Development Council (ed.), New Directions in Development.
New York: Praeger.

Rosenzweig, Mark R.
1977 "The demand for children in farm households." Journal of Political
Economy 85: 123-146.

Rosenzweig, Mark and Robert Evenson
1977 "Fertility, schooling, and the economic contribution of children in
rural India: An econometric analysis." Econometrica 45: 1065-1079.

Schutjer, Wayne A., C. Shannon Stokes and Gretchen Cornwell
1978 "Relationship among land, tenancy, and fertility among Philippine
barrios." Paper presented at the annual meeting of the Population
Association of America, Atlanta, GA, April.

Theisenhusen, William C.
1966 "Agrarian reform and economic development in Chile: Some cases of
colonization." Land Economics 42 (3): 282-292.




Thomas J. Meeks, Virginia State University
Bun Song Lee, Research Triangle Institute

Paradoxes abound in the relation of fertility to income and wealth. The

sign of the relation (positive or negative) appears to depend largely on whether

one is considering the long or the short run, the direct or indirect effect, the

pure income effect or the substitution effect from economic development. Given

the important effects of population growth on development, one should like to

know whether and how the level and distribution of income are necessary, sufficient,

or merely coincidental factors in changing fertility.

The empirical findings reportedly are broadly consistent with a threshold

relation of fertility to income in which fertility first increases, then decreases

as the level of income and development rises (Easterlin, 1978). Even at the

higher levels of development, however, the inverse relation is small relative

to the total variation in fertility. Factors other than income are able to explain
directly much of this variation in fertility. Income growth by itself then does

not seem to be necessary for significant fertility decline at higher levels of

income nor sufficient at lower income levels. The observed relation of income

and fertility also supports the proposition that an increase in income would

lower the demand for children to the extent that parents have an incentive to

substitute quality for quantity of children with their higher incomes. The

1Tsui and Bogue (1978), Chenery and Syrquin (1975), Encarnacion (1975), Simon

2Mauldin and Berelson (1978), Tsui and Bogue (1978), Anker (1978).


high-quality route would make further substitutions more likely by increasing
the cost of children.

Most studies have found a positive relation of fertility to agricultural

landholdings, suggesting that children and land are in some sense complements.

Parents with land may be able to afford more children or children may be more

useful to parents for working or acquiring land.4 The few studies available

(in Asia) indicate that by itself equality of land distribution is associated

with higher fertility (Kleinman, 1973; Rosenzweig and Evenson, 1977). By

contrast it has been argued that equality of income distribution is conducive

to lower fertility (Repetto, 1978; 1976b; Kocher, 1973; Rich, 1973). This may

be true at the higher income levels or for all countries combined, but for less

developed countries the evidence that equality of income by itself lowers

fertility is quite weak. Nonetheless, a good case can be that a more equal

distribution (and higher level) of social services, which could accompany the

change in income distribution, would lower fertility or hasten a fertility

decline, even at the lower income levels.

The persistence of high fertility in low-income countries does not require

the assumption of irrationality or shortsightedness of parents for its explanation.

On the contrary, parents may be quite rational in preferring large families,

given their social and economic milieu, including uncertainty and a low return

on alternative investments.5

Becker and Lewis (1974), Becker and Tomes (1976), T. P. Schultz (1974b:
40-44). For a detailed survey, see Turchi and Bryant (1979).

Summarized more extensively in Stokes et al. (1979).

Schnaiberg and Reed, Caldwell (1977), Ware (1978), Nag et al. (1977), Bulatao
and Arnold (1972), Arthur and McNicoll (1978b), Mamdani (1972), Cassen (1976),
Simon (1974).


One way of describing the conditions that give rise to high fertility is a

pervasive failure of markets in both the private and public sector to provide a

menu of alternatives that would make low fertility attractive (Neher, 1971;

Blandy, 1974). Such failures do not seem to be inevitable.

In the extension of social services, reforms would include not merely

larger expenditures on family planning, health, and education but an optimal

mix of such services. There is good evidence for favorable synergisms of public

health and nutrition measures with the combination producing better health than

the sum of the parts. There is also evidence that family planning is more

readily accepted where health standards are higher. An integrated program of

health nutrition and family planning then might provide more effective service

at lower cost than the separate components. How much fertility might be reduced
as a result would seem to have a high priority on the research agenda. It seems

plausible that such a family health program synergisms would be strongest where
life expectancy and health conditions were lowest. If so, integrated programs

might yield the highest benefits where population problems have been particularly

intractable and have had the most deleterious consequences for development.

Improved health might also result in measurable productivity gains (Ram and

Schultz, 1979). Increased life expectancy and productivity would both give

parents further incentive to substitute quality for quantity in their fertility

decisions as income rose.

Johnston and Meyer (1977) and Cassen (1976)

For evidence, see Taylor et al. (1975), Johns Hopkins University (1978),
and T. P. Schultz (1976b).

8For example, infant mortality has a much smaller estimated effect in Latin
America than Asia or Africa in the Tsui-Bogue equations (1978), corresponding
to the difference in life expectancy.


Another quality-quantity tradeoff might be effected through educational

expenditures if parents with low fertility could be provided with increased

access to educational facilities for their children to match the lower costs
that they imposed on the educational system. Increased emphasis on nonformal

education might also provide more immediate benefits to adults. A conjecture

worth further study is the such nonformal education opportunities would lead

them to substitute investment in themselves for the marginal child.

Rural development strategies offer a number of ways that growth and equity

might be promoted. There is a considerable body of literature supporting the

efficiency of less concentrated landholdings Johnston (1977). As Stokes et al.

(1979) note, however, development is more likely to follow if the smaller farmers

have adequate access to extension services, rural infrastructure, credit, and

appropriate technology, all of which policy can significantly influence. Con-

versely, it has been argued that the distribution of landholdings may influence

the direction of public policy (Raj, 1972; de Janvry, 1973; Griffin, 1974a, 1976).

The direct effects of rural development strategies on fertility are not well

established. The limited evidence available suggests that by itself a more equal

distribution of land would raise fertility. A plausible case can be made that

agricultural modernization would lower fertility, more certainly in the long-run,

by raising the return on alternative assets. By this view, nontraditional farm

inputs and children would be substitutes, unlike land and children. The hypothesis

is virtually untested for low-income countries. Nonetheless, it is consistent

with the view that appropriate technologies (Carr, 1976) and pricing policies

(Mellor, 1976) could accelerate agricultural and industrial development. The

policymaker is presumably already concerned with rural modernization. Estimation

of the strength of the modernization-fertility relation might be of interest

9Salaff and Wong (1978); Wang and Chen (1973).


because of positive feedbacks from lower fertility to development, for example,

through increased saving.

Financial institutions provide another vehicle for raising the return on

non-child assets for "bond" holders. They can increase credit access and net

return on investment for borrowers at loan rates lower than on unorganized

markets. Lack of credit access seems to have been a major obstacle to adoption

of new agricultural technologies and mechanization by smaller farmers (Lipton,

1978). The security of higher-yielding financial assets and the higher return

on modern farm technologies provide plausible alternatives to investment in

larger families. Lifting ceilings on interest rates and loan rates could help

to accomplish both of these objectives. Casual empiricism supports these

demographic implications, but they have not yet been subjected to a more direct

test. Such reforms, however, could have substantial advantages for other

reasons (McKinnon, 1973).

Participation of the rural poor beyond the areas already mentioned is

likely to be effective to the extent that social mechanisms can be devised that

are perceived to be in their direct interest. Even negative social controls

may be accepted if they are seen as working toward the general interests of those

in the community (Salaff and Wang, 1978; McNicoll, 1975). Effective social

organization may be consistent with a wide range of institutional settings to

reach the same end, but effective "intermediate level" organization seems

especially important for internalizing the social benefits of community and

regional action and the social costs of individual actions, for example, the

costs of high fertility on social services (Arthur and McNicoll, 1978b). Success

is more likely where organizations are able to concentrate on the ends of community

action (mass literacy, etc.) rather than simple aggregates (number of schools, etc.).

In connection with fertility, this would give a sharper focus to the real social

tradeoff between quantity and quality.


As has been indicated, there remain a number of promising but inadequately

tested areas for further research on fertility determinants. Many of the pro-

spective policy reforms, however, could improve development prospects and allo-

cative efficiency quite apart from their effect on fertility. Their demographic

impacts would merely strengthen motivation for policy adoption. In this connection

a high research priority would be to establish more secure empirical grounds for

the effects on economic development from fertility decline and the factors associ-

ated with fertility decline. Recent worldwide experience of fertility change may

provide the necessary data for this purpose. Such knowledge could provide moti-

vation for a closer integration of development policy and population policy, to

their mutual advantage.

An important aspect of modernization is the shift in specialization of pro-

duction (broadly interpreted) from the household to the general economy. Becker

(1960) has noted that there are no good substitutes for children but there may
be many poor ones. As part of the great institution of reciprocal caring that

is the family, this is undoubtedly true of children. But as a source of material

advantage, there may be adequate substitutes for the large family. A key to the

demographic transition consistent with enhancing development prospects of present

and future generations may be to find such substitutes. Given the low absolute

return on children estimated in a number of studies (Cassen, 1976), the develop-

ment of substitutes might not be as distant a possibility as it first appears, if

properly pursued.

10To use the phrase of Griliches (1974).



Arthur, W. Brian and Geoffrey McNicoll
1975 "Large-scale simulation models in population and develop-
ment: what use to planners?" Population and Development
Review 1(2):251-265.

Becker, Gary

Cassen, R.H.

Easterlin, Ri

Johnston, B.I

Mauldin, W. F

S. and N. Tomes
"Child endowments and the quantity and quality of children."
Journal of Political Economy 84(4):S143-162.

"Population and development: a survey." World Develop-
ment 4(10, 11):785-835.


"An economic framework for fertility analysis."
in Family Planning 6(3):54-63.


and A.J. Meyer
"Nutrition, health, and population in strategies for
rural development." Economic Development and Cultural
Change 26:1-23.

:ker and Bernard Berelson
"Conditions of fertility decline in developing countries,
1965-75." Studies in Family Planning 9(5):90-147.

Ram, Rati and Theodore W. Schultz
1979 "Life span, health, savings, and productivity."
Economic Development and Cultural Change 27(3):399-421.

Salaff, Janet and Aline K. Wong
1978 "Are disincentives coercive? The view from Singapore."
International Family Planning Perspectives and Digest

Simon, J.L.
1974 The Effects of Income on Fertility. University of North
Carolina at Chapel Hill: Carolina Population Center.

Schultz, Theodore W. (ed.)
1974b "Fertility and economic values." In Theodore W. Schultz
(ed.), Economics of the Family: Marriage, Children, and
Human Capital. Chicago and London: The University of
Chicago Press.

Tsui and Donald J. Bogue
1978 "Declining world fertility: trends, causes, implications."
Population Bulletin 33(4).





Raymond B. Isely, Research Triangle Institute
Laurie Zivetz, Research Triangle Institute
Roland Norman, Tennessee State University
Betty Banatte, Florida A & M University

If a direct relationship of the health status of mothers and young children

to fertility can be assumed, (Park et al., 1979) the question for development

planners and managers is then the impact of development strategies on health

status, specifically the interrelated health, nutritional status, and survival

of women of child-bearing age and their under-five children. In this paper a

series of relationships linking fertility through health status to measurable

outcomes of development strategies are explored, using a review of more than

120 references from all parts of the developing world. These relationships are

summarized in Figure 1 and in the paragraphs which follow:

Health and Nutritional Status and Fertility

Maternal health status and child survival (0-4 years) are posited as the

two major health factors influencing fertility, the former positively, the

latter negatively. Their influence on fertility is no doubt mediated through

the intermediate variables of Davis and Blake (1955): namely, the exposure

to intercourse, influenced by child survival in societies with post-partum and

lactational taboos; the exposure to conception, influenced by maternal health

status, particularly the incidence of sterilizing diseases, and by child survival

in societies where prolonged breastfeeding is practiced; and the outcome of

gestation, influenced chiefly by maternal health status with particular reference

to nutrition and the incidence and prevalence of abortion and stillbirth-causing




Figure 1. Relationships of development strategies to health determinants and health outcomes
with consequent effects on fertility.

Women with improved nutrition are probably more fecund (Frisch, 1978)

although severe degrees of malnutrition may be required to reduce fecundity

(NRC, 1970), but are undoubtedly more fertile because of earlier menarche

and delayed menopause (Frisch, 1978). In addition they have improved pregnancy

outcomes because of heavier fetuses with a greater chance of survival (Naeye,

1973). At least a part of the effect of improved maternal nutrition is there-

fore exerted through improved child survival, but the overall effect seems to

be an increase in fertility or at least an improved attainment of fertility

goals (Hull, 1977).

The impact of improved child survival on fertility appears to occur largely

through the effects of prolonged breastfeeding on ovulation, and of taboos on

intercourse on pregnancy interval (Singarimbun and Hdll, 1977). These biologic

effects appear indisputable, but the role of psychological effects is much less

clear. Do parents who experience improved child survival lower their fertility

expectations? There is some evidence that this effect may hold true for some

populations (Liu, 1972), but the effect appears to be delayed. Park et al.

(1979) conclude that the total effect of infant death on national fertility

may be minimal, less than three percent of total births, but that important micro

level fertility effects must take place. The interplay of infant mortality with

social and economic factors impinging on family size must also be taken into

account. In any case, there is no country with a high infant mortality and low

fertility rate (Birdsall, 1977).

Fertility itself also has reverse effects on health status of mothers and

the survival of young children. In particular, parity rate and interpregnancy

interval (Population Reports, 1975) appear to affect maternal health through

increasing the complications of pregnancies, and aggravating underlying diseases

(Wishik, 1974; Omran, 1974; Baskett, 1975). Maternal age also exerts a role in

influencing the pregnancy complication rate (Eastman, 1940; Nortman, 1974).


Infant and child mortality rates rise after the fourth pregnancy, and child

survival is shortened when the interpregnancy interval is less than two years

(Population Reports, 1975). Widespread disregard of cultural taboos on inter-

course during lactation is probably the chief contributor to this condition

(Thompson and Rahman, 1967; Zempleni-Rabain, 1967, Hull, 1977).

Immediate Determinants of Health and Nutrition Status

Three major determinants emerge from the literature of the Developing World:

nutrition, the prevalence and incidence of infections, and the availability,

accessibility, and utilization of appropriate health services in decreasing order

of importance.

Nutrition affects maternal health status in ways important for fertility

by affecting fetal size and therefore survival, and pelvic size and therefore

the ability to deliver vaginally (Thompson and Billewicz, 1963; Naeye, 1973).

Two manifestations of maternal nutrition are significant: maternal height,

a reflection of antecedent (premenarchal) nutrition, and weight gain in the

third trimester of pregnancy, more a reflection of current diet.

Twenty-five percent of all childhood deaths (ages 1-4) in developing countries

are due to some form of malnutrition, while over 50 percent may have malnutrition

as a contributory cause (Morley, 1973). These statistics illustrate well the

important role of nutrition in determining child survival. Nutrition, however,

seems to act synergistically with infections in producing higher mortality rates

(Scrimshaw et al., 1968), the latter affecting caloric loss because of vomiting,

diarrhea, cough, or fever (McGregor, 1976).

Infections of seeming general importance to maternal health include malaria,

schistosmiasis, venereal diseases and tuberculosis. In terms of implications for

fertility, malaria acts to interfere with fetal growth and survival through invasion

of the placenta as well (Cannon, 1958). Schistosomiasis poses a particular risk

to women in some societies because of their multiple water-related activities:


water drawing, clothes washing, bathing children, and wetland rice cultivation.

The health consequences may include anemia, weight loss, and anorexia, all

having indirect implications for fertility, and in some women ovarian and endo-

metrial lesions leading to impaired fertility. Venereal infections have well-

known fertility implications: syphilis through its tendency to produce abortion

and stillbirth (WHO, 1975), gonorrhea because of its propensity to inducing

infertility through blocked fallopian tubes (Retel-Laurentin, 1974). Tuberculosis

is an important contributor to morbidity and mortality in women of developing

countries, and may result in infertility in some women by producing a tuberculosis

salpingitis or endometritis (WHO, 1975).

The major infections of early childhood may be categorized according to

their apparent synergistic action with undernutritioti iti diminishing child

survival. In this way comprehensive approaches to the control of these diseases

through development strategies may be visualized. If we assume that a dimunition

in infant and child mortality is one requisite for diminished fertility, these

diseases must fall under the sway of development strategies if any fertility

effects are to be realized.

The diarrhea and dysentery syndrome is the prototype condition employed by

Scrimshaw et al., (1968) in their development of the concept of the synergism of

nutrition and infection. Mention has already been made of the role of seasonality

in determining the degree of impact of this syndrome on child growth and mortality

(McGregor, 1976). In essence, the number days per year a young child spends with

diarrhea, 72 according to Rowland's (1977) study in the Gambia is the major variable

which may determine the effect on growth, and thereby on survival. Diarrhea and

dysentery may thus be classified as having a highly synergistic relationship with

nutrition by reason of reduced caloric intake and increased caloric loss. Lower

respiratory infections, malaria, and pertussis all act in much the same way to

interfere with caloric intake and to increase caloric dissipation.


Measles and tuberculosis too, act in conjunction with undernutrition

to diminish child survival. Undernutrition on the one hand reduces cell-

based immune defenses essential to preventing the ravages of these diseases

(Chandra and Newberne, 1977). On the other hand, both diseases by means of

caloric dissipation and reduced caloric intake, may lead to various grades

of malnutrition.

Neonatal tetanus, the last of the major infections of young children to

be considered here, seems to relate to nutrition less directly. In this case

the infection itself is virulent enough to produce a high case mortality with-

out the contribution of a malnourished state.

The third factor having an immediate determinative role in relation to

maternal health and child survival is the availability and accessibility of

health services, and the quality of those services, as reflected in their

utilization and the appropriateness of their content and mode of delivery.

Only indirect evidence bearing on the influence of these factors on maternal

health status is available but seems to indicate that maternal mortality is

lower and maternal health status better, where physician/nurse/hospital per

population ratios are favorable (Bryant, 1969; United Nations, 1976). As

for utilization one can only infer from the improved maternal mortality rates

in villages where midwives were furnished with skills in aseptic delivery

techniques, that utilization depends on available and accessible services in

order to exert any effect on maternal health (Villod and Raybaud, 1965; Ampofo,

1975). Utilization is thus more of an outcome of the characteristics of health

services than it is itself a characteristic of the services. The implication

is that if maternity services are available, accessible, and of an appropriate

character, they will be used and thereby exert an influence on maternal health.

The same contention can be made regarding the influence of these character-

istics on child survival, except that the evidence is firmer, that where the


accent is put on combining preventive health and nutrition services, and

utilizing auxiliary workers as the means for extending these services to

populations, child mortality rates respond favorably (Satge, 1970; Morley,

1968; Gwatkin, 1977; Department of International Health, 1978a).

Proximal Determinants of These Immediate Determinants of Maternal Health
Status and Child Survival

In this section leverage points in the system upon which development

strategies may exert their effect are identified. Seven points or variables

are suggested:

1) Food availability
2) Information, beliefs, and customs
3) Environmental quality
4) Income
5) Management structure of health services
6) Health personnel supply
7) Community social structure.

Food Availability

One need only observe the seasonal variations in child growth and mortality

and disease severity in many parts of the world (McGregor, 1976; Morley, 1968;

Shiffman, 1976) to conclude that food availability is a major determinant of child

survival, since the season of greatest risk is that time of year when food supplies

are low. Food availability impinges on nutrition at two levels: the community

level where such factors as agricultural production and productivity, market

accessibility, and the social structure of the community play important roles; and

the household, where it is more a matter of custom regarding intrafamilial distri-


Information, Beliefs, Attitudes, and Practices

This group of interrelated factors appears to affect nutrition by means of

influencing intrafamilial food distribution (Satge, 1964), the prevalence and

incidence of infections through their impact on personal hygiene (Ogionwo, 1973),


and on the utilization of health services (Becker, 1975; Parker et al, 1978) or on

the local treatment of infection (Morley, 1967). These factors are subject to a

variety of influences from development strategies, particularly those which alter

social relationships (Herzog, 1975) or affect economic well-being (Department

of International Health, 1978a).

Quality of the Environment Including the Social and Occupational

Three aspects of the physical environment are considered: water quantity

and quality, sanitation, and housing quality. Water quantity appears to have

as much to do with the control of infections as water quality (Feacham, 1977).

Much gastrointestinal illness formerly considered due to specific water-borne

pathogens is now known to respond to simply having larger volumes of water avail-

able at the household level (White et al., 1974). A previous generation's pre-

occupation with bacteriologic potability standards has given way to a comprehensive

approach, embodying economic, technical, and socio-cultural criteria (World Bank,


Inadequate sanitation is related to diarrhea and dysentery and hookworm

infection, but also to the prevalence of malaria and filariasis where facilities

are either inadequately constructed or in disrepair. Small children pose a par-

ticular problem because they are frequently assumed to be noninfectious, and waste

disposal facilities are not constructed so as to accommodate their using them.

Where communities have been mobilized to improve the sanitary environment,

remarkable reductions in intestinal parasitic infection have been achieved (Flavier,

1970; Cunningham, 1970; Arole, 1972). On a larger scale in the Peoples Republic

of China, widespread decentralized programs of sanitary disposal and reuse of

human fecal material, protection of wells, and snail removal from canals and ponds,

have brought many perennial disease problems under control (Horn, 1971). The World

Bank is undertaking currently a worldwide study of low cost sanitation options

(World Bank, 1978).


Housing, the third aspect of the physical environment to be considered,

is much less discussed in the literature in relation to health status. What

evidence is available seems to point to a key role in lower respiratory infec-

tions and tuberculosis (Morley, 1973). The number of persons per square meter

of housing is apparently the key variable.

The social and occupational environment, particularly that of the mother may

also impinge on both nutrition and the incidence and prevalence of infections.

For example, in some societies mothers who carry their small children to the

rice paddies may expose them to an increased risk of malaria (Ciss6, 1967), but

if they leave their infants in the village in the care of others, they are more

likely to wean them early (Thompson and Rahman, 1967). If the mother is engaged

in nonagricultural employment she is less likely to breastfeed, and likely to do

so for a shorter duration (Butz and DaVanzo, 1977). Breastfeeding is in fact a

key behavioral intermediate resulting from the influence of development strategies

on the social and occupational environment, because it is a link between maternal

nutrition and health, and that of the child, and because it makes great demands

on the mother's energy, time, and spatial movements. Group norms also play an

important role with regard to breastfeeding and pregnancy spacing. In many

societies if a woman weans a child too early, she becomes an object of ridicule

by her peers (Thompson and Rahman, 1967; Zempleni-Rabain, 1967).


Income has a major relationship to nutrition and the utilization of health

services, to nutrition, because households must frequently purchase food in times

of shortage. Income appears however, to have little effect on nutrition if atten-

tion is not paid to food distribution (Gwatkin, 1978, Herzog, 1975). As for health

services utilization, where health service coverage is inadequate income may prove

to be a sizeable barrier to obtaining health care (Syncrisis, 1975). A comparison

of selected Asian countries (See Table 3) with differing per capital GNP for example,


Table 3


Per Capita per Physician Population
Country GNP in $ 1973 or 1974 per Nurse*

Nepal 90 36,450 35,880
Pakistan 120 3,970 11,106
India 120 4,160 6,525
Indonesia 130 18,160 3,074
Thailand 270 8,530 4,069
Philippines 280 2,990 3,054
South Korea 400 1,940 201
Malaysia (West) 570 7,300 1,786
Hong Kong 1,430 1,560 1,331
Singapore 1,830 1,400 379


Overseas Development Council.
Praeger, 1976.

The U.S. and World Development.

b World Health Statistics Report, Geneva: World Health Organization, 1976.

Includes all nurses in three categories: nurses, assistant nurses,
and midwives and nursing auxiliaries.


New York:

reveals sharply differing numbers of population per type of health personnel,

particularly nurses. Where deliberate attempts to distribute health care

equitably have been made, however, income drops out as a significant factor

(Gwatkin, 1978).

Management Structure of Health Services

Of particular importance to the availability, accessibility, and appro-

priateness of health services delivered to rural populations of developing

countries, is the quality of management of those services at the local level.

At this level the skills of management personnel need not be sophisticated, but

should incorporate aspects of planning, evaluation, supervision, and fiscal

accounting. To a very great degree, these skills are at present missing at the

district level in most developing countries, and their introduction will be

intimately dependent on the expansion of local government capacity in a more

general sense (Rondinelli and Ruddle, 1977). Critical to the introduction of

any innovation in management skills is the incorporation of the supervision of

special health projects into the local management scheme from the very first

(Isely, 1978).

Personnel Supply

Again this factor is critical to both the availability, accessibility,

and appropriateness of health services. In most instances this personnel will

be composed of medical and nursing auxiliaries (Habicht, 1973; Morley, 1973;

Fendall, 1972; Department of International Health, 1978a). This type of personnel

has been identified in fact as a key element determining the success of various

health service interventions (Gwatkin, 1979). Another key element, the inte-

gration of health, nutrition, and family planning services, appears to depend

squarely upon embodying both the concepts and practice of integration in personnel.

Despite the problems involved, evidence seems to point to the potential benefits

of such interventions if they can be achieved (Johnston and Meyer, 1977; Depart-

ment of International Health, 1978a; Delgado, 1979).


Community Social Structure

Understanding the social structure of a community is the first prerequisite

to adapting health service delivery to local conditions. Social structure will

have a major impact on distribution of income, goods and services in stratified

societies such as India (Department of International Health, 1978a). In any

society the structure by age, sex, caste, or other economic group will play a

key role in shaping the type of community participation in health possible

(Isely and Mvele, 1979).

Implications of Development Strategies for Fertility via Health and Nutrition

How can rural development strategies be shaped so as to influence maximally

the sequence of variables discussed above? Three types of approach to develop-

ment were examined in order to assess their potential to development planners:

Development strategies using a participatory model.

Development strategies having increased agricultural production
and productivity as a major objective.

Development strategies having increased income as a major objective.

Drawing heavily on the experiences of multiple health projects in developing

countries but particularly the Narangwal (Department of International Health,

1978a, 1978b), Danfa (Asante, 1978), and African Regional Public Health Training

Projects (Isely and Martin, 1977), and on the national or state experiences in

Sri Lanka, China, Cuba, Tanzania, and Kerela, as well as on the thought-provoking

reviews by Gwatkin et al., (1979), and Johnston and Meyer (1977), a tentative

set of conclusions can be suggested to guide planners:

1) Participatory approaches appear to be essential ingredients in
many successful development projects, and probably will eventually
prove to be essential to achieving desired health, nutrition, and
even fertility outcomes, but firm data as yet preclude making con-
clusive statements (Gwatkin, et al., 1979).


2) Increasing agricultural production and productivity depends
for its impact on health, nutrition, and fertility, on at least
two and possibly three factors. The first is the obvious need
to equitably distribute the economic benefits of the increases
(Department of International Health, 1978a). Secondly, the
improvements in particularly productivity, must extend to the
entire agricultural sector, including food production, the so-
called "unimodal" development model (Johnston and Meyer, 1977).
Thirdly, the health consequences of increasing agricultural
production and productivity will be exceedingly slow in occurring
unless specific programs of health, nutrition, and family
planning services are integrated into the program as a part of
its forward thrust (Johnson and Meyer, 1977). Thus the impli-
cations for health, nutrition, and fertility will be more rapidly
realized if specific integrated health programs are included.

3) Raising income depends for its effect on the availability of
food and health and educational services, dependent in turn on
their equitable distribution. Where these benefits are distri-
buted in a highly equitable fashion, as in Sri Lanka and Kerela
(Gwatkin, et al., 1978) raising income does not seem to be
necessary to achieve positive results in terms of health and
fertility. Where equity of distribution is neglected, as in
much of the world, income may be a significant factor especially
if it has passed a certain critical threshold. In the study of
Herzog (1975) in Senegal where raising income appeared to have
no effect on health and survival, that threshold had probably
not been reached.

A series of relationships leading to health outcomes in mothers and children

and thence to implications for fertility has been examined. At certain leverage

points in the system development strategies are seen to exert their influence.

Three distinct approaches to rural development have been examined: participation,

increasing agricultural production and productivity, and raising income. All are

important to some degree in affecting health outcomes, but the evidence seems to

be that raising income is the least important of the three. The effects of the


other two are dependent on certain conditions. Participatory approaches

require adequate policy and management backup. Increasing agricultural

production and productivity must be accompanied by an equitable distribution

of technology and benefits and specific health, nutrition, and family planning




Department of International Health

Malnutrition, Infection, Growth and Development: The Narangwal
Experience. Baltimore: The Johns Hopkins University, School
of Hygiene and Public Health.

Integration of Family
Narangwal Experience.
School of Hygiene and

Planning and Health Services: The
Baltimore: The Johns Hopkins University
Public Health.

Gwatkin, D.R.,

Herzog, J.K.

J.R. Wilcox, J.D. Wray
Can interventions make a difference? The policy implications
of field experiment research. A report to the World Bank.

"Population Change and Productive Activity Among the Serer of
Senegal: Some Hypotheses." Annual Meeting of the Population
Association of America. Seattle.

Johnston, B.F. and A.J. Meyer
1977 "Nutrition, Health and Population in Strategies for Rural
Development." Economic Development and Cultural Change,
26(1), October 1-23.

Joseph, S. and S. Scheyer
1977 Une Strategie de Sante. Composante du Programme de Developpement
du Sahel, Washington, Family Health Care Inc.

Newell, K.A.
1975 Health By The People. Geneva: World Health Organization.

Sai, F.T., et. al.
1972 "The Danfa Ghana Comprehensive Rural Health and Family Planning
Project--A Community Approach," Ghana Medical Journal 11:9-17.

Sidel, V. and

Ross, D.A.

R. Sidel
Serve the People: Observations on Medicine in the People's
Republic of China. Boston: Beacon.

"The Serabu Hospital Village Health Project." Contact, 49:1-9.

Singarimbun, Masri, and Terence H. Hull
1977 "Social Responses to High Mortality Which Act to Support High
Fertility," International Population Conference, Vol. I.




General Analytical Framework

Edward Vickery


Motivation for Presenting a General Analytical Framework

There are two common characteristics of the seven state-of-the-art

papers (SOAPs) which comprise Phase I of this project. First is that

they recognize the interdependency (or jointness) of fertility

decisions and several other household decisions. In other words,

decisions to have children involve implicit future commitments of time

and money. These perceived commitments are often weighed against

alternative uses of time and money. Such assessments mean that the

decisionmakers are involved in judgements (usually subjective) about

the relative net attractiveness of additional children versus

additional durable goods, education, leisure time activities, and other

trade-offs. Hence, an overall model of household decisionmaking,

instead of simply a model of fertility behavior, is most appropriate on

theoretical grounds.

Second is that all of the SOAPs contain the important insight that

rural development activities (RDAs) rarely impact directly on fertility

decisions. Instead, their impacts are transmitted by affecting one or

more of the determinants of fertility decisions. Some of those

determinates will be synonymous with or in competition with the other

household decisions or alternatives which off-set fertility behavior.


But the point remains. The impact of RDAs on fertility must typically

be observed indirectly, through their influences on the environment and

options confronting households.

The foregoing conclusions suggest that a general framework of

household decisionmaking must be specified in order to analyze the

potential impact on fertility behavior of a particular RDA. The

linkages between the various household decisions must be identified;

the external (to the household) influences on those decisions must be

specified. Only then can there be some hope of understanding the

likely net impact of RDAs on fertility behavior since their impact will

be transmitted indirectly by working through the matrix of influences

on household decisionmaking.

The emphasis on household decisionmaking means that each SOAP can

be considered as utilizing a variant of the general framework. It is

equivalent to offering a modular approach. If a particular RDA is

hypothesized to influence fertility decisions through only one type of

change, e.g. improved nutrition practices, it will probably not be

necessary to evaluate that project's indirect impact on fertility via

changes in other household decisions, such as migration, on the other

hand, if the RDA is a large multi-purpose project, the full household

decisionmaking model would probable be required.


Plan of the Presentation

As a preface to the presentation, Figure 2 and Tables 4-6 might

prove to be helpful. The relationship between macro rural development

programs, national and community factors and fertility through some of

the variables discussed in the SOAPs is depicted as a series of

concentric circles in Figure 2. Consistent with the two common

characteristics of the SOAPs, any type of RDA is believed to impact

first on one or more of five categories of "influences": income (II);

relative prices (12); household tastes or preferences (13); the

community environment (14); the national environment (15). The

resultant changes in these influences are believed to induce changes in

three categories of household decisions: fertility and fertility

control (Dl); money and time allocations to child quality vs. non-child

goods and services (D2); money and time allocations to adult quality

vs. childbearing (D3). Tables 4-6 indicate the interactive nature of

the household decisionmaking process by showing lines of influence from

one category of household decision to the others.

The presentation of the general analytical framework consists of

four parts. Part II is concerned with the fertility and fertility

control decisions and how they are influenced. Part III is concerned

with other household decisions (which interact with fertility

decisions) and how they are influenced. Part IV gives examples of how

six types of RDAs might influence fertility decisions, working through

the household decisionmaking framework presented in Parts II and III.


Figure 2

General Model of Fertility Decision Making*

SFertility \
- Contraceptive UI
- Birth Spacing

*This conceptualization was adapted from the Cost and Value of Children SOAP
(Turchi and Bryant) by L. Zivetz.


Table 4

Fertility and Fertility Control: Specification of Influences Which Determine

Decision Functions: FERTILITY CONTROL
-Oc 4-

-~u -

Ila: women's earnings Ila Ila
Ilb: men's earnings Ilb Ilb
Ilc: children's earnings alc
1.1.1. C- 1. 0-
0 -a C I 0l

Influence Categories: Dia Dib Die Did

Ila: women's earnings Ila Ila
lib: men's earnings lib lb
Ilc: children's earnings Ile

12a: price index for schooling I2a
I2b: price index for durable goods I2b
I2c: interest rate/borrowing terms

I3a: family or marriage type I3a
I3b: religion or religiosity I3b I3b
I3c: education attainment I3c I3c I3c I3c
I3d: age 13d I3d
I3e: experience with child mortality I3e
I3f: family status or prestige 13f I3f I3f
I3g: son preference I3g I3g
I3h: perceived status of women 13h I3h I3h

14a: index of trad. vs. modern attitudes 14a 14a 14a I4a
14b: access to land/other resources I4b I4b
14c: person-land ratio or size of
typical land holding 14c 14c
14d: avail, of family plan. advice
and modern contraceptives 14d I4d
14e: avail, of modern health facilities I4e
14f: inheritance system 14f 14f
14g: index of community attitudes
toward women's roles 14g 14g 14g 14g
14h: avail, of telephone service
I4i: transportation rates
14j: food availability
14k: friends/relatives in other community
141: improved data about job opportunities
14m: distance to nearest major urban area

15a: tax rate on rural producers
I5b: foreign exchange premium


Dla: desired no. of survive. children
Dlb: birth spacing
Dlc: contraceptive use
Dld: age at first marriage


Dla Dla Dla

Old Dld

D2a: invest, in child quality: education
D2b: use appropriate medical/nutritional
practices for maternal/child care D2b
D2c: invest, in durables/savings D2c D2c

D3a: added education/training: women D3a D3a D3a
D3b: off-farm employment: women D3b D3b D3b
D3c: migration to another community D3c D3c D3c

Note that decision Did is determined by influences which existed prior to the act of
marriage. Consequently, the elements shown in column Dld refer to values which were
current at the date of marriage. (74)

Table 5

Money/Time Allocations to Child Quality vs. Non-Child Goods: Specification
of The Influences Which Determine Decisions

Decision Functions: CHILD QUALITY GOODS

Influence Categories: D2a D2b D2c

Ilc: children's earnings Ilc Ilc

12a: price index for schooling 12a 12a 12a
I2b: price index for durable goods I2b I2b I2b
I2c: interest rate/borrowing terms I2c

13a: family or marriage type I3a
I3b: religion or religiosity I3b
I3c: 6dUcation attainment I3c I3c I3c
13d: age I3d I3d
13e: experience with child mortality I3e
I3f: family status or prestige I3f 13f
I3g: son preference I3g
I3h: perceived status of women I3h

I4a: index of trad. vs. modern attitudes 14a I4a I4a
I4b: access to land/other resources I4b I4b
I4c: person-land ratio or size of
typical land holding I4c I4c
14d: avail, of family plan. advice
and modern contraceptives I4d I4d
I4e: avail, of modern health facilities I4e
14f: inheritance system
14g: index of community attitudes
toward women's roles I4g I4g
14h: avail, of telephone service
14i: transportation rates
14j: food availability I4j
I4k: friends/relatives in other community
141: improved data about job opportunities
I4m: distance to nearest major urban area

I5a: tax rate on rural producers 15a
I5b: foreign exchange premium I5b


Dla: desired no. of survive. children
Dlb: birth spacing
Dic: contraceptive use
Dld: age at first marriage

D2a: invest, in child quality: education
D2b: use appropriate medical/nutritional
practices for maternal/child care
D2c: invest, in durables/savings

D3a: added education/training: women
D3b: off-farm employment: women
D3c: migration to another community

Dla Dla


D2b D2b D2b
D2c D2c

D3a D3a
D3b D3b
D3c D3c D3c


Table 6

Money/Time Allocations to Child Quality vs. Non-Child Goods: Specification
of The Influences Which Determine Decisions


ecis o Fee oon
a women ero -laaI

Ilb: men's earnings Il IlC


I2b: price index for durable goods
I2c: interest rate/borrowing terms

I3a: family or marriage type I3a I3a I3a
I3b: religion or religiosity
I3c: education attainment I3c I3c I3c
I3d: age I3d I3d I3d
I3e: experience with child mortality
I3f: family status or prestige 13f I3f I3f
I3g: son preference
13h: perceived status of women I3h I3h

I4a: index of trad. vs. modern attitudes I4a I4a
I4b: access to land/other resources I4b I4b
14c: person-land ratio or size of
typical land holding 14c 14c
14d: avail, of family plan. advice
and modern contraceptives
I4e: avail, of modern health facilities I4e
14f: inheritance system I14f
I4g: index of community attitudes
toward women's roles I I4g 14g 14g
14h: avail, of telephone service 14h
41i: transportation rates 14i
I4j: food availability
I4k: friends/relatives in other community I4k
141: improved data about job opportunities 141 141
I4m: distance to nearest major urban area 14m

I5a: tax rate on rural producers
I5b: foreign exchange premium


Dla: desired no. of survive. children
Dlb: birth spacing
Die: contraceptive use
Dld: age at first marriage


D2a: invest, in child quality: education
D2b: use appropriate medical/nutritional
practices for maternal/child care
D2c: invest, in durables/savings

D3a: added education/training: women
D3b: off-farm employment: women
D3c: migration to another community

Dla Dla Dla
Dlb Dlb Dlb

Dld Dld


D3c D3c



Household Decisions which Directly Affect Fertility

The SOAPs indicate that there are two basic types of fertility

decisions* made by households:

Dla: desired number of surviving children--Economists will recognize

this as equivalent to their concept of the "demand" for children.

The emphasis is on surviving children, not live births. This

decision represents a long-run equilibrium objective which,

according to the literature, shows a tendency to be modified over

time depending on whether parents' actual experience of raising

children yields the net benefits originally perceived.

Dlb: birth spacing--This decision is equivalent to the "supply" of

children over time. It represents how rapidly the couple decides

to attain their desired number of surviving children.

The above fertility decisions are viewed by the SOAPs as being

directly affected by two types of fertility control decisions:

Dlc: contraceptive use--This concept encompasses decisions to use the

most traditional form (abstinence) as well as the more modern

contraceptive devices. It also includes abortions. Obviously,

more continuous use of modern contraceptives is associated with

lower fertility.

*This decisionmaking framework even applies to households which are
infertile, since the possibility and fact adoption or raising the
children of relatives exist.


Did: age at first marriage--The literature considers this decision to

be the most obvious type of exposure to the risk of pregnancy. In

some regions, South America in particular, the definition of

marriage must be broadened to include consensual unions. The

literature finds that higher ages of first marriage are consistent

with lower fertility.

Household decisions D1-D4 represent that set of fertility and

fertility control decisions which are the targets for impact by RDAs.

To ascertain more clearly how to hit that target, it is necessary to

specify these decisions as functions of the influenced dabcribed


Household Decisions as Functions of Six Categories of Influences

The combined testimony of the SOAPs advances the hypothesis that

household decisions Dla-Dld are functions of (i.e. determined by) six

categories of influences. These categories are defined below, where

symbol Il denotes the income and wealth influence category, etc.:

II: income and wealth--This category is one of the SOAP topics.

Income/wealth is a pervasive influence which seems to affect most

decisions made by households. With regard to fertility decisions,

it is important to know which household members receive the

income. Increased income is hypothesized in several of the SOAPs

to have its most significant impact on reducing fertility if the

income recipients are women. An increase in women's wages


increases the cost of their time and leads to a reduction of

childbearing, a time-intensive activity with no monetary

compensation. Children's wages, of course, act in the opposite

direction, tending to increase fertility. The strength of the

income/wealth influence will vary over the life cycle, which

observation applies to all other influences as well.

12: prices of goods and services-Prices represent externally imposed

constraints to the household's objective of maximizing its overall

welfare within the limits of its available income and time. An

increase in the prices of goods and services which are involved in

having and raising children (i.e. an increase relative to prices

of other goods and services) would, according to the Income SOAP,

tend to have the effect of reducing fertility. The interest rate

is a price of particular concern, since it signals both the return

to financial assets and the cost of capital.

13: household tastes or preferences-This category of influence is

hypothesized in the SOAPs to be composed of (but not necessarily

limited to) the following mix of individual characteristics and


a. family and marriage types;

b. religion and religiosity;

c. education attainment (a SOAP topic);

d. age;


e. experience with child mortality;

f. family status or prestige;

g. son preference;

h. women's perceived status.

These kinds of cultural and social influences are believed to be

important moulders of knowledge, attitudes, and practices

affecting fertility and fertility control decisions. As the SOAPs

indicate, the relative importance of these characteristics and

experiences in shaping household tastes or preferences will

obviously vary from one area to another, and over time as

households move through the life cycle.

14: community environment--Immediate environmental quality and

characteristics make up this category of influences. They are

important conditioners of individual tastes or preferences, but

slightly less personal than the types of influences listed in

category 13. In other words, like the externally imposed prices

of category 12, other community factors represent the inherited

knowledge, attitudes, and practices of the immediate environment

where the household is located. The SOAPs hypothesize that the

following community factors should be considered to be important

influences on fertility and fertility regulation decisions:


a. prevalence of traditional versus modern community


b. access to land, capital, and other resources (part of the

Land Tenure SOAP);

c. person-land ratio and size of typical land holdings

(part of the Land Tenure SOAP);

d. availability of family planning information and modern


e. availability of health facilities (part of the Health

and Nutrition SOAP);

f. inheritance system (part of the Land Tenure SOAP);

g. community attitudes toward women's economic roles and

women's access to resources and jobs (part of the Role

of Women SOAP);

h. availability of telephone communications;

i. availability of good quality roads to main highways.

Any other characteristics which distinguish one community from

another could be added to the above list if they seem to be especially

relevant to the decisions being made by households.

15: national environment--Still another set of conditioning influences

on individual tastes or preferences involves the national or macro

environment. The literature testifies to the importance of the

two influences listed below. These are meant to be illustrative

of this category, not exhaustive:


a. taxation structure and other incentives or disincentives

to achieving higher economic productivity;

b. premium paid for and availability of foreign currency.

Other Household Decisions

The decisions listed below, all of which represent SOAP topics,

seem to be the set of other household decisions which impinge most

obviously on fertility decisions:

D2: Allocations to child quality vs. non-child goods and


D2a: Investments in child quality, especially education;

D2b: Use of appropriate medical and nutritional practices for

maternal and child health;

D2c: Investment in other types (non-child) of goods and


D3: Allocations to adult quality vs. childbearing.

D3a: Additional education/training for adults;

D3b: Women's participation in off-farm labor force;

D3c: Migration to another community

In the next part of the paper, the influences on these other

household decisions will also be explored. At this point,

however, they are of interest only as influences on the fertility

and fertility control decisions.


An Overview of Influences on Fertility and Fertility Control Decisions

The elements of these categories 11-15 that influence decisions

Dla-Dld are illustrated in Table 4. The columns labeled Dla and Dlb

represent the two types of fertility decisions, while Dci and Dld

represent the two fertility control decisions. The five influence

categories are listed down the left margin of Table 4. Each category

contains two or more elements (or potentially measurable variables)

which are hypothesized by the SOAPs to influence decisions Dla-Dld. A

judgement that a particular influence variable is likely to influence a

particular decision is indicated by the appropriate symbol (e.g., I3d

for age) placed in the column of the relevant decision functions,


Note in Table 4-5 the relatively greater importance of influence

categories II and 12 (income/wealth and relative prices) in decisions

Dla (desired number of surviving children) and Did (age at first

marriage) compared with decisions Dlb (birth spacing) and Dlc

(contraceptive use). This emphasis is due to the postulated dominance

of economic considerations in determining long-run demand for children

and the timing of marriage. For decisions Dlc and Did, sociological

and environmental influences are believed to deserve relatively greater



The reason columns D1a-Dld are referred to as "decision functions"

is that the SOAPs (and the literature they represent) emphasize that

fertility and fertility control decisions are functions of (are

determined by) the collection of influences summarized in Table 4.

Such decisions cannot be legislated or decreed; they must be induced

voluntarily through the decisionmaking processes of each household. It

is for this reason that the emphasis herein is on the indirect

influence of RDAs on fertility and fertility regulation decisions. The

impact of any RDA must be realized in two or even three stages: first,

by affecting one or more of the elements which influence decisions

Dla-Dld; second, by the effect that changes in those particular

elements have on the decisionmakers. The third stage is the

interactions among the various decisions which the household members

are continuously making.

These interaction effects are represented in Table 4 by the extent

to which decisions Dla-Dld are believed to be affected by elements in

the sixth influence category. To begin with, decisions Dla-Dld

influence each other, according to the literature surveyed by the

SOAPs. They are hypothesized to be further influenced by varying

combinations of other household decisions, D2-D3. This "third stage",

therefore, provides an influence path for RDAs through the mechanism of

other household decisions. The next part of the paper summarizes the

various influences on decisions D2-D3 in an attempt to sketch how such

decisions might be affected by RDAs.



D2: Money and Time Allocations to Child Quality versus Non-Child Goods

The SOAPS most concerned with these types of decisions are

education, cost/value of children, income/wealth, and health/nutrition.

They call attention to the tradeoffs between not only quantity vs.

quality of children, but also expenditures on children vs. durables and

savings. Once again, the interdependencies among various household

decisions are underlined. Each of these decisions represents a form of

investment, as noted below:

D2a: investments in child quality: education--The crucial insight

gleaned from the Cost/Value of Children SOAP is that both costs

and values of children are decision variables. They are not like

prices, which are externally imposed on the household. Rather,

the household must decide (in light of its knowledge about prices)

how much of its available time and money to allocate to children.

The prime representative of decisions to invest in higher child

quality is education. It prevents children from being available

as labor inputs and increases the probability of their migrating

to an urban area. But the perceived returns may be high in the

forms of old age security and household pride in children's


D2b: use of appropriate practices for maternal/child health and

nutrition--These two closely related decisions represent not only

another form of investment in child quality, but also investment

in the welfare of the mother. Since higher allocations of time


and money are involved in households' decisions to opt for better

maternal/child health and nutrition practices, such decisions

compete with child quantity decisions and complement other child

quality decisions.

D2c: investments in durables or savings-The Income/Wealth SOAP

hypothesizes that households choose the combination of child

quantity, child quality, and non-child expenditures that maximizes

utility subject to the constraints of household income/wealth and

externally determined prices. This view is consistent with that

of the Cost/Value of Children SOAP. Although there are clearly

some aspects of expenditures on durable goods and savings which

complement (rather than compete with) expenditures on child

quantity or quality, their immediate impact is to reduce the

resources available for the latter. Hence, decisions D2a and D2b

are viewed by the SOAPs as essentially competitive with decision


The same six categories of influences which were defined for the

fertility and fertility control decisions also apply to decisions

D2a-D2c. Such is the generality of the household decisionmaking model

recommended in this paper. In other words those six categories--income

and wealth, relative prices, tastes and preferences, community

environment, national environment, other household decisions--represent

an exhaustive set of influences which, in varying degrees, affect all

household decisions.


The elements of these categories 11-15 that influence decisions

D2a-D2c are illustrated in Table 5. The columns labeled D2a and D2b

represent the two main investments in child quality (education and

medical/nutritional practices), while column D2c represents the directly

competing decision to invest in non-child good (durables or savings). The

five influence categories are listed down the left margin of Table 5. The

list of elements in each category is identical to Table 4.

Since these three decisions interact so closely, they tend to be

influenced by many of the same types of elemdrtd6 The discussion in

the individual SOAPs add subtlety and precision in defining operational

hypotheses regarding patterns of influence on decisions D2a-D2c.

However, the main message should be clear: these decisions represent

the major tradeoffs made by households when weighing the net benefits

of investing time and money in child quality versus non-child goods and

services. Increased allocations of time and money to any of decisions

D2a-D2c tends to be directly competitive with child quantity decisions.

Thus, higher levels of investment in children's education, improved

health, or durables/savings will act to decrease fertility and increase

fertility control.

D3: Money and Time Allocations to Adult Quality vs. Childbearing

Another set of decisions which compete with childbearing is that

involving investments in adult quality (or quality-of-life). The three

SOAPs which are most concerned with such decisions are education, the


role of women, and migration. Similar to the foregoing discussion of

money and time allocations to child quality vs. non-child goods, the

adult quality decisions involve conflicts and tradeoffs with fertilty

and other household decisions.

D3a: additional education/training for women--The Education SOAP testi-

fies to the critical role played by educational attainment in

shaping fertility and fertility control decisions, attitudes

toward tradeoffs between child quantity vs. child quality, and

options for women's labor force participation. Higher levels of

education for women are associated with lower-levels of fertility,

increased investments in child and adult quality, and greater

labor force participation. Decisions to increase the level of

educational attainment (even non-formal vocational training) seem

to accentuate these central tendencies.

D3b: off-farm employment for women--The Role of Women SOAP underlines

the evidence that traditional (especially subsistence agriculture)

forms of labor force participation do not appear to be associated

with fertility reduction. Rather, it is off-farm employment,

whether urban or rural, which appears to induce lower levels of



D3c: migration--The Migration SOAP presents this decision as search for

not only economic gain but also a more appropriate quality of

life. Consequently, the migration decision is believed to affect

fertility in a variety of ways including delay of marriage,

exposure to a more modern urban environment, and enhanced upward

social, educational, and occupational mobility.

As with the other household decisions, the same six categories of

influences presented previously are postulated to determine the adult

quality decisions. The elements of these categories 11-15 that

influence decisions D3a-D3c are illustrated in Table 6. Column D3a

represents the decision function for additional education/training for

women; column D3b for off-farm employment for women; and column D3c for

migration. As with Tables 4 and 5, the five influence categories are

listed down the left margin of Table 6. The presence in columns

D3a-D3c symbol for a particular element indicates that the element is

believed to influence that decision.

Note in column D3a of Table 6 that women's decisions to seek added

education or training are hypothesized to be influenced primarily by

economic motives. A similar conclusion emerges from examination of

columns D3b and D3c regarding decisions in favor of off-farm employment

and migration. Because of the competitive nature of these three

decisions with respect to fertility decisions, they are shown to

interact with decisions Dla, Dib, and Dld. Note also the conditioning

role assumed for household tastes and preferences in all of these


decisions, and the importance of community environmental influences on

migration decisions.

Special mention should be made of another type of household

decision which might deserve inclusion in the above list: decisions to

participate in community development activities. When household

members decide to invest their time in such activities, it may have

some impact on fertility and fertility control decisions. First, when

women make such decisions, it enhances their perception of control over

their lives. Second, the investment of time in infldencing the quality

of life within the community might spread to analogous fertility

control decisions within the household. Third, increased commitment to

the community will probably inhibit out-migration. The effects of this

type of decision are considered in Part IV, since citizen participation

represents one of the high priority RDAs.



There are six categories of rural development activities (RDAs)

which have been assigned high priority by AID and which are perceived

to be managerially manipulable by means of policy instruments and/or

program interventions:

o Participation of the rural poor in the design, financing and

implementation of rural development projects, as well as

other projects aimed at achieving more equitable participa-

tion in the benefits of development, is envisaged here.

o Extension of social service activities implies the extension

of health care, education, and welfare services in rural


o Rural marketing systems focus on extending marketing

infrastructure, including agricultural co-ops, roads, and

storage facilities, to rural people.

o Area development focuses on regional problems and potentials

and on projects which are multi-purpose and affecting many


o Rural financial markets concern credit extension to farmers,

co-ops, small scale industry as well as economic planning in

rural areas.


o Off-farm employment concerns labor force participation

opportunities generated by small scale industry, craft

cooperatives, or other activities, especially for women.

In Part I the assertion was made that RDAs will typically not

impact directly on decisions regarding fertility or fertility control.

Rather, their impact will be transmitted through one or more of the six

influence categories defined in Parts II and III. The analysis of how

a particular type of RDA might affect fertility behavior must proceed

by means of a three-stage procedure:

(1) identification of the types of outcomes to be expected from

the rural development activity;

(2) judgement about how each such outcome might affect one of the

influence variables in the overall model;

(3) estimation of the net affect on fertility decisions when the

impacts are transmitted through the interrelated system

described in Tables 4, 5, and 6.

The objective in this part of the paper is to provide examples of

how to apply steps (1)-(3) in assessing the potential impact of RDAs

which represent the six high priority activities listed above.

Participation of the Rural Poor

One of the most familiar types of participation activities in

rural areas is the provision of self-help labor. Most of the develop-

ing countries implement some RDAs (especially the construction

component) using inputs of self-help labor from the rural communities

which will be affected by the project. The assembling of self-help

labor requires acquiescence by citizens of the community in the call

for volunteer labor and, therefore, serves as a frequently encountered

example of "participation".

The ultimate impact on fertility behavior depends upon the objec-

tive of the self-help activity. Consider two examples, construction of

an elementary school in a difficult-to-reach rural community and con-

struction of an all-weather road to that same community.

1. the school--this activity should definitely impact on fertility

behavior as sketched below:

a. The construction of a school will serve to lower the

perceived time and (perhaps) money costs of sending children

to school, since previously the children have had to travel

to neighboring communities for schooling. This means that

influence element I2a in Table 5 will fall relative to other


b. The reduction in perceived costs of children's schooling will

tend to attract some households to opt for increased school

attendance by their children (i.e. allow more children to

attend school, or allow a particular child to remain in

school for more years). In the context of Table 5, the

relative decline in influence element I2a will tend to induce

an increase in decision D2a.


c. The increased school attendance will typically yield higher

educational attainment for those children, which in itself

will tend to reduce fertility in the long run (during their

fertile years). This will come about by means of a rise in

influence element 13c which, according to Table 4, affects

all the fertility and fertility control decisions. Based on

the SOAPs, an increase in I3c will generally cause decreases

over time in Dla (desired number of surviving children), a

lengthening of Dlb (birth spacing), a rise in Dlc

(contraceptive use), and a rise in Dld (age at first

marriage). Of course, the rise in I3c will also influence

other household decisions, D2a-D2c, and the resulting

indirect or interactive effects from these decisions on

decisions Dla-Dld will tend to reinforce the conclusion

regarding decreased fertility.

d. If adult education programs are given in the school,

attendance by adults may result in the acquisition of new

skills (e.g., basic literacy) which could lead to increased

productivity of rural producers. The resultant higher income

will tend to marginally increase fertility if the income

recipients are males, and to decrease fertility if the

recipients are females. These conclusions flow from an

analysis of Table 4-6 when a rise occurs in influence

elements Ila or Ilb.


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