There was a time when fertility levels in Brazil were among the highest in South America--a TFR of more than six as recently as the 1960s and still nearly four in the 1980s. And, of course, that is one of the reasons why Brazil has nearly 200 million people--almost twice the population of Mexico. Indeed, one in two South Americans lives in Brazil. Now, the story with respect to fertility is very different. Fertility has dropped below the replacement level. Why? An article by Cynthia Gorney in this month's National Geographic picks up the story:
Population scholars like José Alberto Carvalho maintain a lively argument about the multiple components of Brazil's fertility plunge. ("Don't let anybody tell you they know for sure what caused the decline," a demographer advised me at Cedeplar, the university-based study center in Belo Horizonte. "We'll never have a winner as the best explanation.") But if one were to try composing a formula for crashing a developing nation's fertility rate without official intervention from the government—no China-style one-child policy, no India-style effort to force sterilization upon the populace—here's a six-point plan, tweaked for the peculiarities of modern Brazil:
1. Industrialize dramatically, urgently, and late, causing your nation to hurtle through in 25 years what economists used to think of as a century's worth of internal rural-to-urban relocation of its citizens.
2. Keep your medications mostly unregulated and your pharmacy system over-the-counter, so that when birth control pills hit the world in the early 1960s, women of all classes can get their hands on them, even without a doctor's prescription, if they can just come up with the money. Nurture in these women a particularly dismissive attitude toward the Catholic Church's position on artificial contraception. (See number 4.)
3. Improve your infant and child mortality statistics until families no longer feel compelled to have extra, just-in-case babies on the supposition that a few will die young.
4. Distort your public health system's financial incentives for a generation or two, so that doctors learn they can count on higher pay and more predictable work schedules when they perform cesareans rather than waiting for natural deliveries. Then spread the word, woman to woman, that a public health doctor who has already begun the surgery for a cesarean can probably be persuaded to throw in a discreet tubal ligation, thus ensuring a thriving, decades-long publicly supported gray market for this permanent method of contraception.
5. Introduce electricity and television at the same time in much of the nation's interior, a double disruption of traditional family living patterns, and then flood the airwaves with a singular, vivid, aspirational image of the modern Brazilian family: affluent, light skinned, and small.
And, finally, number 6: Make all your women Brazilians.
There are many more details in the article--and a lot of food for thought. There is also an NPR video on this story that provides some good visuals.
No comments:
Post a Comment