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| Splendidly Alive People Within Limited Environmental Resources | |
Part XII: The Two Warring Departments
Zanele Mfono, youth director for the Population Development Programme (PDP) can tell of the frustrations she has had in trying to get the family planning department even to see her, so that she can plead for more youth clinics.
This section describes the National Family Planning Programme (NFPP) and the PDP, and makes an assessment of their relative contributions to limiting the SA population.
Family Planning: Historical
1. The National Family Planning Programme (NFPP)
Until 1975 the only public family planning in South Africa was by municipalities. In 1974, the Family Planning Year of the United Nations, the South African government decided on a family planning programme. Natalie Stockton was appointed director. She started on 1 January 1975.
The department was given "big" money and was seen as the "golden cow". There was jealousy and attempts to undermine the programme. This programme operated only in the Republic of South Africa. i.e. it excluded all ten homelands. The goal was to provide a quality service.
Natalie Stockton trained:
3 000 full-time family planning nurses,
500 "Liaison Officers" (People with degrees in social work, communications etc.,
2 500 family planning "Advisers" (Standard 8).
There were 63 000 clinic points and downtown clinics in all towns.
The sterilisation service was growing.
In 1988 the family planning programme was transferred from National Health to the Provincial Authorities. According to Natalie Stockton this resulted in a dismantling of services and a drop in quality. She has written a thesis on this whole issue for RAU.
The drop in quality was confirmed to us by other family planning workers.
In 1991 the Cabinet specified that all family planning services be integrated into primary health care services. According to family planners this has resulted in less family planning overall.
The Homelands The ten homelands had their own health budgets. Nurses were, however, allowed to attend RSA family planning courses at no cost, but their transport to the courses was not paid.
In some cases, as in "Whites-by-Night" Pietersburg, there were problems with finding accommodation for black trainees.
2. The Population Development Programme (PDP)
This programme was started in 1984. Its main aim is to ensure a balance between the population size and the natural and socioeconomic resources of the country. To ensure this balance, a demographic objective was set for a total fertility rate of 2,1 by the year 2010.
Soon after this programme started the PDP was changed into a "Chief Directorate" and the NFPP was demoted. There was friction between the two programmes because the NFPP believed that women should only be motivated to "space" their children - for the sake of their own health. The PDP advocated the "two-child" family.
At the Western Cape Population Forum in June 1994, Dr Boet Schoeman, Deputy Director-general of the PDP said in his address:
In South Africa, the National Family Planning Programme was established in 1974 in order to fulfill the unmet need for family planning services. Although it did contribute to the lowering of fertility rates, the main purpose of the NFFP in the first instance was not to slow down population growth.
However, as policy-makers started perceiving population growth as a planning programme without the concomitant socioeconomic development was not sufficient to slow down population growth.
Under the NFPP the black total fertility rate (TFR) in the RSA dropped from 6.25 to 4.7 from 1974 to 1984, when this programme was at its most active. During the first ten years of the Population Development Programme the black TFR dropped from 4.7 to 4.4. (See table below.)
If the population growth rate drops because of a family planning programme, that somehow doesn't count, because it was not called 'Population Development'. At question time at this forum, Dr Schoeman was asked by Dr McClean:
"Can you tell us whether it was the PDP programme, with its needs approach, that has been responsible for the success in fertility reduction, of the delivery of family planning services?"
Dr Schoeman replied: "It is a combination. I am convinced that it is a combination in which the PDP played a very important role. We can make the results available if you really want to have a look at the awareness campaign, the results of this campaign and the attitudes of people as far as population growth is concerned."
SAPLER has no evidence that "awareness" has contributed to a drop in fertility. This awareness tends to be among people who already desire small families for personal reasons.
The HSRC gives the following total fertility rate figures for 1974 to 1994, i.e. the average number of children per mother. This table is published in the WHO report.
The total number of people covered in this table is 37 million (1990) - so it must be a table referring to the RSA plus the homelands.
| TFR | White | Indian | Coloured | Black |
| 1974 | 2.52 | 3.43 | 4.53 | 6.25 |
| 1984 | 2.05 | 2.79 | 3.14 | 4.7 |
| 1994 | 1.5 | 2.2 | 2.3 | 4.4 |
The very big drop in the coloured and black populations in the 1974 to 1984 period would seem to confirm that it was the presence of a strong family planning programme that was responsible.
The smaller drop in 'the next ten years can be ascribed either to a huge unmet need having already been met, or to the demoralisation of the family planning programme.
Statistics which include the homelands are however not thought to be reliable.