Iran: A Model for Family Planning?

Historically, family planning in Iran has had its ups and downs. The nation’s first family planning policy, introduced in 1967 under Shah Reza Pahlavi, was aimed at accelerating economic growth and improving the status of women.

It did so by reforming divorce laws, encouraging female employment — and acknowledging family planning as a human right.

Unfortunately, this promising initiative was reversed in 1979 at the beginning of the decade-long Islamic Revolution, led by Shiite Muslim spiritual leader Ayatollah Khomeini.

During this period, family planning programs were seen as undue western influences — and were dismantled.

Iran’s health officials were ordered not to advocate contraception.

During Iran’s war with Iraq between 1980 and 1988, a large population was viewed as a comparative advantage. Accordingly, Ayatollah Khomeini pushed procreation to bolster the ranks of “soldiers for Islam,” aiming for “an army of 20 million.”

This strong pro-natalist stance led to an annual population growth rate of well over 3 percent. United Nations data show that Iran’s population doubled in just 20 years — from 27 million in 1968 to 55 million in 1988.

But, during Iran’s post-war reconstruction period in the late 1980s, the economy faltered.

Severe job shortages ensued — and cities became overly crowded and polluted. Iran’s rapid population growth was finally viewed as an obstacle to development.

Receptive to the nation’s problems, Ayatollah Khomeini reopened dialogue on the subject of birth control. By December 1989, Iran had revived its national family planning program.

Its principal goals encourage women to wait three to four years between pregnancies, discourage childbearing for women younger than 18 or older than 35 — and limit family size to three children.

In May 1993, the Iranian government passed a national family planning law that effectively encouraged couples to have fewer children — by restricting maternity leave benefits after three children.

It also called for the Ministries of Education, of Culture and Higher Education, and of Health and Medical Education to incorporate information on population, family planning, and mother and child health care in curriculum materials.

In fact, the Ministry of Islamic Culture and Guidance was told to allow the media to raise awareness of population issues and family planning programs, and the Islamic Republic of Iran Broadcasting was entrusted with broadcasting such information.

Money saved from reduced maternity leave funds these educational programs. From 1986 to 2001, Iran’s total fertility — the average number of children born to a woman in her lifetime — plummeted from seven to less than three.

The United Nations projects that by 2010 total fertility will drop to two, which is replacement-level fertility. In contrast, had the Iranian population maintained its 1986 growth rate of 3.2 percent, it would have doubled by 2008 — topping 100 million instead of the projected 78 million.

Strong government support has facilitated Iran’s demographic transition. Under the current president, Mohammad Khatami, the government covers 80 percent of family planning costs.

A comprehensive health network made up of mobile clinics and 15,000 “health houses” provides family planning and health services to 80% of Iran’s rural population.

Almost all of these health care centers were established after 1990. Because family planning is integrated with primary health care, there is little stigma attached to modern contraceptives.

Religious leaders have become involved with the crusade for smaller families, citing them as a social responsibility in their weekly sermons.

They also have issued fatwas, religious edicts with the strength of court orders, that permit and encourage the use of all types of contraception.

These include permanent male and female sterilization — a first among Muslim countries. Birth control, including the provision of condoms, pills and sterilization, is free.

One of the strengths of Iran’s promotion of family planning is the involvement of men. Iran is the only country in the world that requires both men and women to take a class on modern contraception before receiving a marriage license.

And it is the only country in the region with a government-sanctioned condom factory.

In addition, over the past four years, some 220,000 Iranian men have had a vasectomy.

While vasectomies still account for only 3% of contraception — compared with female sterilization of 28% — men nonetheless are assuming more responsibility for family planning.

Rising literacy and a national communications infrastructure are facilitating progress in family planning.

The literacy rate for adult males increased from 48% in 1970 to 84% in 2000, nearly doubling in 30 years.

Female literacy climbed even faster, rising from less than 25% in 1970 to more than 70% today. Meanwhile, school enrollment grew from 60 to 90%.

And by 1996, 70% of rural and 93% of urban households had televisions, allowing family planning information to be spread widely through the media.

As one of 17 countries already facing absolute water scarcity, Iran’s decision to curb its rapid population growth has helped alleviate unfolding water shortages exacerbated by a recent severe drought.

An estimated 37 million people, more than half the population, do not have enough water. The lack of water for irrigation has helped push Iran’s wheat imports to 6.5 million tons in 2001, well above the 5.8 million tons of Japan — traditionally the world’s leading importer.

Iran’s fertility transitionhas resulted in universal access to health care and family planning, a dramatic rise in female literacy, mandatory premarital contraceptive counseling for couples, men’s participation in family planning programs — and strong support from religious leaders.

While Iran’s population policies and health care infrastructures are unique, its land and water scarcity are not. Other developing countries with fast-growing populations can profit by following Iran’s lead in promoting population stability.

For additional data and sources of information, please see http://www.earth-policy.org/Success/SS1.htm