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  • Title: Interrelationships between child survival and fertility.
    Author: United Nations. Department of International Economic and Social Affairs. Population Division.
    Journal: Popul Bull UN; 1988; (25):27-50. PubMed ID: 12342007.
    Abstract:
    Theoretical considerations, largely supported by empirical research findings, confirm the interdependence of child survival and fertility. Levels and trends in child survival are negatively associated with levels and trends in fertility. However, the prevalent direction of causation, its mechanisms, time and strength, are not identical in different populations. Patterns of demographic transition show that improvements in child survival typically precede sustained fertility decline. Thus, interventions to improve the health of children will ultimately be followed by a decline in the birth rate. The actual fertility consequences of such interventions will depend not only on the type of intervention but also on the prevalent family-building strategy and the nature and scope of family-planning programs in a given location. In particular, the ready availability of family-planning services is seen to intensify any fertility decline resulting from improvements in child survival in most settings by providing parents with greater control over their fertility. In the family building by fate model for improvements in child survival the elements are breastfeeding and decrease in fertility through wider birth intervals (the physiological effects operating on the supply of births); this is also called natural fertility. Family building by design components include reduction in the prevalence of extra births by insurance and replacement effects operating on the supply of births and reducing the price of survivors by favoring the aspiration for fewer children of better quality operating on the demand for children--this is the controlled fertility through family planning model. To make the transition from natural fertility to controlled fertility fatalism must be eroded and family planning must be made meaningful.
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