According to the "demographic transition," after the industrial revolution death rates started falling more rapidly than birth rates causing an increase in population growth. When population growth drew the attention of scientists and policy makers in the 1950s, demographics and development in poor countries were the main concern but no real efforts were made to seek out solutions. Referred to as the World Population Conference, the first international meeting on population convened in 1954 in Rome. That year the Khanna study emerged as the first birth control program to have a control as well as a test population. Because the researchers expectations and schemas guided their perceptions and inquiries, biases plagued the Khanna study, which failed to show an effect of birth control on fertility rates.

Foreign to the culture of rural India but aware of the serious population problem, the researchers developed the Khanna study with the assumption that the Punjabi people needed to and wanted to reduce their birth rates. In his book Myth of Population Control, Mahmood Mamdani explains that there was "a significant gap between the [researchers] perceptions and the reality of the village"(Mamdani, 35). The researching staff members were all of the urban, educated, middle class; they viewed children as financial burdens and therefore, believed that controlling birth rates would help Punjab move ahead economically. However, according to the article "New Perspectives on Population: Lessons from Cairo," it is "economic insecurity [that] encourages people to have large families"(Ashford, 31). Indeed, this was the case in the rural villages of Punjab, where people believe children are an asset to the family; more children mean more working hands. "Except for two staff members, no one was willing to admit that the villagers might be acting rationally" when they choose to have many children (Mamdani, 48). Knowing and understanding the relationship of cultural, social, and economic factors in a population is clearly an integral part in forming successful assessments of and assistance to that population.

The Khanna study researchers took for granted that the women in the Punjab villages who accepted the contraceptives were in fact using them. "Although 39 percent of the fertile wives had used the foam tablets, only 8 percent had used them consistently for four months or more" (Mamdani, 31). The researchers did not anticipate this confusion between "acceptance" and "use" because in their world of experience there was no difference between the two. Why someone would accept something that is intended to help and then not use it was beyond their realm of understanding. From the villagers point of view however, it would have been impolite not to accept the researchers gifts. Also, each acceptance pleased the researchers so much that the villagers believed they were being helpful, even though they were not using the contraceptives.

Unaware of the villagers position, the researchers used a statistical analysis of the number of acceptances and refusals to conclude that there would be a decrease in birth rates. However, the follow up study in 1969 deviated tremendously from the expected outcome. There was no significant decrease in the birth rate and many of the births occurred in families that had accepted contraceptives; the Khanna study did not reach its goal.

However, the program did conduct "one of the few really careful studies of child mortality"(Cassen, 106), which proved to be a valuable resource of information on different causes of child death. Also, the failure of the Khanna study demonstrates the importance of understanding social and cultural influences on fertility rates, something that seems to have gained higher regard in today's efforts to control population.

Marking a major shift in the perspective on population, the International Conference on Population and Development met in 1994 in Cairo. Focus turned to individual well being, rather than just overall demographic goals. Of foremost importance is the realization of women's integral role in development and fertility. Many feminists and women's health advocates attacked population programs based on demographic targets and quotas in the 1980s. They argued that the programs "tend to emphasize numerical goals at the expense of the quality of services delivered"(Ashford, 7).

Elevating the status of women through education, employment opportunities, and greater equality for the girl child can be beneficial to the developing countries. "In many countries, women with a secondary education have about half as many children as those with no education"(Ashford, 18). Education however, is not the sole cause of lower fertility rates; it merely influences it by decreasing age at time of marriage, increasing employment opportunities, and increasing knowledge of available contraception. In an attempt to understand differences in fertility rates, possible social and cultural factors that may overshadow the positive influences of education have been observed. The Philippines' "strong opposition of the Roman Catholic Church to most forms of birth control" as well as Jordan's political "perceptions about population size and territorial rights" may have decisive roles in child bearing (Cleland and Jejeebhoy, 81). The decision of whether to use contraceptives can be much more complicated for individuals in developing countries than those in developed countries. For many women the costs involved in contraception are strong enough to prevent use. There is "the particular cost of the method, travel time, payments to service providers, and often more important, women's fears of adverse health effects and disapproval of their husbands or other family members"(Bongaarts, 270). Knowing the many factors involved in different countries fertility rates can help prevent the formation of overly simplistic ideas about the causes of and solutions for high fertility rates.

As demonstrated by the Khanna study, overestimating the commonality of ones own situation or world view can turn an attempt to help into a useless act of interference. Analysis of the status of women could help reveal the specific cultural, social, and economic experiences of a particular population. With this information population programs can be better designed to address the individual needs of different groups. Although efforts to lower fertility rates have come a long way since the 1950s, there still remains a high level of unmet need for contraception that can be addressed through a number of social interventions.
 

Works Cited

Ashford, Lori. "New Perspectives on Population: Lesson from Cairo." Population Bulletin 50.1 (1995): 1-22.
Bongaarts, John. "Trends in unwanted childbearing in the developing world." Studies in Family Planning 28 (1997): 267-277.
Cassen, R.H. India: Population, Economy, Society. New York: Holmes & Meier, 1978.
Cleland, John and Shireen Jejeebhoy. "Maternal Schooling and Fertility: Evidence from Censuses and Surveys." Girls Schooling, Women's Autonomy and Fertility Change in South Asia. Ed. Roger Jeffery and Alaka Basu. New Delhi: Sage Publications, 1996. 72-106.
Mamdani, Mahmood. The Myth of Population Control. New York: Monthly Review, 1972.