Indicadores de desempeño para la construcción y conservación

One family planning, maternal and child health program was designed as a social experiment in a remote rural area of Bangladesh, in the Matlab Thana. It was initiated in half of 141 villages for which there was already in place a reliable demographic surveillance system of the population, registering all births, deaths, marriages and population movements. The family planning program outreach effort was started in October 1977, which contacted in their homes all married women of childbearing age every 2 weeks, offering them various methods of birth control. The

populations were periodically censussed and then randomly sampled in a comprehensive socioeconomic survey in 1996. A census in 1974 confirms that the program treatment and comparison villages did not differ significantly 3 years before the program started in terms of their surviving fertility, approximated by the village ratio of children age 0-4 to women age 15- 49. A difference-in-difference change between the program and comparison villages preprogram and postprogram indicates that by 1982 surviving fertility is 17% lower in the program areas, and remained 16% lower in the 1996 survey after the program was in operation for nearly two

decades. Fertility is lower in the program areas only for women less than age 55, presumably because women over 55 were over 37 in 1977 when the program started, and these older women had essentially completed their childbearing at that time and hence their fertility did not respond to the program treatment (Joshi & Schultz, 2007).

With this social experiment, it is possible to estimate that women age 25-55 in 1996 had about one child less in the program villages compared with the comparison villages. These women in program villages were healthier measured by their BMI being 1.0-1.5 units higher than in the comparison villages, and their children experienced a death rate by their fifth birthday which was 25% lower in the program villages. The girls age 9-14 and 15-29 had obtained about one-third of a standard deviation more years of schooling for their age and sex in the program areas, whereas the boys had obtained about half a standard deviation more schooling. The estimated program effect on the boy’s schooling was statistically significant at the 5% level, whereas this schooling effect was not significant for girls. On the other hand, girls age 1-14 were reported to have a significantly higher BMI in the program villages, normalized for age, whereas there was no significant difference in BMI for boys (Joshi & Schultz, 2007). Women age 25-54

in 1996 report log monthly earnings a third higher in the program villages compared to the other villages, and the households in which women reside have proportionately more financial,

agricultural, nonagricultural, and housing assets, more consumer durables and jewelry and household tube wells in the program villages (Schultz, 2008b). The prediction of Malthusian diminishing returns to labor is not supported by the Matlab social experiment, in the sense that the wages of young men and women, age 15-24, are not higher in the program villages despite the tendency for there to be fewer children in these villages and they were more likely to attend school. Finally, the wage rates for adult males age 25-54 are no higher in program areas than in the higher fertility comparison villages, whereas in contrast the wages of adult women were at least one-third higher. Moreover these wage patterns are not affected when the selection of who participates among youth and adults into the wage labor force is jointly estimated with the wage function, allowing for the heterogeneity of workers. These findings suggest that women in the program villages who are likely to have had fewer unwanted births due to the efforts of the outreach program have also enjoyed disproportionate gains in their health, market earning opportunities, and household assets compared with comparable women in the comparison villages.

This single case study of the long-run consequences of policy-induced voluntary reductions in fertility suggest that in this poor rural South Asian region, a concerted outreach program achieved a significant decline in fertility and sustained lower levels of fertility for two decades, during which fertility has declined substantially in both groups of villages. This policy-induced reduction in fertility and allied improvement in child and maternal health is associated with women and children being in better health, sons receiving more schooling, and women earning proportionately more in the paid labor market, and living in households with proportionately greater assets. Whether these estimates of population policy effects would exist in other parts of the world remain an unexplored issue, because social experiments or even matching evaluation studies of family planning, reproductive health, and child health programs are rare. Multivariate regression studies of individual and community data suggest that where family planning

programs have been expanded more rapidly, birth rates, especially among older women, have declined more rapidly. Evidence from such countries as Taiwan, Thailand, Indonesia, and Colombia are reviewed elsewhere (Frankenberg, et al. 2003; Schultz, 2008a). There are,

they expand to serve all parts of a country, and birth control technology becomes widely understood and birth control supplies are competitively available in the private and public sectors.

9. INTERNAL MIGRATION, DEMOGRAPHIC