[Family planning: the key to a better future]

World population growth began to accelerate rapidly only in the recent past. Total population doubled between 1950 and 1990 from 2.5 to 5 billion. It is now 5.5 billion with an annual increase of 97 million. Malthus in his 1798 work called attention to the potential problem of population growth. A sense of urgency about world population growth did not emerge until after World War II. In the early 1960s only seven governments had family planning programs but by the early 1980s more than 120 governments supported such programs. Between 1960 and 1990 contraceptive prevalence increased from 9% to 51% in developing countries. It increased from 13% to 70% in East Asia from 14% to 60% in Latin America from 7 to 40% in South Asia and from 5 to 17% in Africa. By 1987 nearly 390 million couples used contraception with 29% using female sterilization 8% male sterilization 20% IUDs 14% oral contraceptives 2% injectables 9% condoms 8% withdrawal 7% rhythm 1% barrier methods and 2% other methods. Contraception apart from its benefit of slowing population growth saves the lives of mothers and children. The great majority of developing countries agree that family planning along with maternal and child health services and control of sexually transmitted diseases is central to reproductive health policy. Some significant indicators of reproductive health demonstrate the progress yet to be made. Some 300 million couples lack access to contraception and another 60 to 80 million are sterile. Each year there are an estimated 45 to 60 million abortions half a million maternal deaths and nearly 13 million deaths of children under five. An estimated 250 million new cases of sexually transmitted disease occur each year. Of the 150 million pregnancies annually 40 to 60 million end in abortion another 45 million are associated with complications more than 50 million receive no obstetric care and postpartum complications occur in over 12 million. Most of the 12.6 million deaths each year in children under five are preventable. Poverty is a main factor contributing to world health problems. Today 1.1 billion people are estimated to live in absolute poverty. World per capita health expenditure is estimated at US $329. Developing countries contain 78% of world population but account for only 10% of the world health budget with the annual average per capita expenditure equal to US $41. The current rate of world economic growth and industrialization is not sustainable in the long term because of adverse environmental effects. The UN medium projection is for a world population of 11.6 billion at the end of the next century. To meet the medium projection it has been estimated that 900 million couples will need to be using contraception by 2025.