A Holistic Approach Underpins the Islamic Republic of Iran's Success in Family Planning
The Islamic Republic of Iran is a textbook
example of how rapidly fertility rates can change in a supportive
environment. Elements of Iran's success in reducing fertility include
a strong national consensus (forged with the help of Islamic clergy)
to meet the economic needs of the population, strategic and concerted
policies that link resources to population dynamics, and accessible
reproductive health services offering a wide mix of contraceptive
options.
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The Islamic Republic of Iran's
success in family planning – which led to the dramatic decline in
fertility from more than six children on average in the early 1980s
to just over two births per woman in 2005 – has been called that
country's 'other revolution'. Many of the strategies mapped out
decades ago to address the country's swelling population – including
a strong network of rural health centres, mandatory pre-marital
counselling on family planning and free family planning services
and supplies – are still contributing to the general well-being
of Iranian families and to the health of mothers and children.
 Iran's success story in population and reproductive health is a vivid example of how political commitment, in its broad sense, can bring about a sea change in development in a record time
--Mohamed Abdel-Ahad, the UNFPA Country Representative |
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"Iran's success story in population and reproductive health is a vivid example of how political commitment, in its broad sense, can bring about a sea change in development in a record time," said Mohamed Abdel-Ahad, the UNFPA Country Representative. "The embrace of population programmes by political leaders since the 1980's has been the driving force for community mobilization, resource allocation and overcoming socio-cultural barriers to reproductive health and family planning," he added.
In the early 1980s, just after the Islamic revolution with the war with Iraq still unfolding, large families were considered an advantage and were encouraged by the Iranian government. Between 1979 and 1986, the population shot up from 34 to 49 million, due to the combination of high birth rates, reduced mortality and an influx of refugees. A huge 'baby boom', with long-lasting impact on the country's demographic structure, occurred during that period. Then came a 180-degree turnaround, in both government thinking and in fertility rates.
By 1988, the government planners had become convinced that high growth rates were undermining the country's ability to meet the needs of its people, especially given the costs of reconstruction following the war. A three-day seminar on population and development in 1988 helped convince the country's leadership, the clergy and the media that smaller families are good for individuals and society as a whole. A crucial element in the country's success was gaining the full support of Islamic clergy. Edicts from religious leaders declared that all methods of family planning, including sterilization, conformed to Islamic principles.
A broad media campaign encouraged couples to delay
their first pregnancy, space births and limit family size to three
children. High literacy rates made it easier
to spread the message. Pre-marital counselling, which includes information
about contraception for both men and women, was made a requirement
for registering for marriage. Population education was integrated
into all levels of the education system. Many of the economic incentives
for large families were removed.
At the same time, the country was able to take
advantage of its well-developed health infrastructure to provide
married couples with easy access to modern contraceptive methods.
They were available free of charge at public clinics. An innovative
rural health care network, staffed by local health providers, known
as behvarzes, helped meet the needs of the widely dispersed
rural population, and mobile clinics reached populations in very
remote areas. Women Health Volunteers managed to get family planning
information to other hard-to-reach segments of the population.
We have the religious leaders aware and involved, there is political will, there is programming and there is infrastructure
--Dr. M. E. Akbari, former Undersecretary for Health |
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The country's progress in reducing fertility is very much in line with the multi-pronged approach promoted by Dr. M. E. Akbari, former Undersecretary for Health and his predecessors in that position. Successful initiatives, Dr. Akbari noted, need to be broad-based and holistic, backed up by supportive policies and programming. That was the case for the country's success with family planning, he said. "We have the religious leaders aware and involved, there is political will, there is programming and there is infrastructure."
The slower growth in the Iranian population over the last 15 years has made progress on a number of other fronts possible. The country has been able to invest more in its primary health care system. Maintaining the new cultural norm for small families is important to avoid a second population surge as the Iranian baby boomers (those born between 1979 and 1989) enter their prime reproductive years.
UNFPA has long been a strategic partner of the Islamic Republic of Iran, providing financial and technical support to its ambitious family planning programme. With the country's fertility rate now close to, or even at, replacement level, UNFPA's support has shifted toward other issues, including addressing the reproductive health needs of men and unmarried adolescents, who are not covered by the current primary health care system, and improving information and services to prevent HIV and other sexually transmitted infections. However, the Government is aware of the need to maintain its success in family planning, especially because of the large numbers of young people in or approaching their reproductive years.
The country is also interested in sharing the lessons it has learned with neighbouring countries, said Mr. Abdel-Ahad. "UNFPA is working closely with the government and civil society to document Iran's experience and share it with the rest of the world utilizing south-south cooperation modalities," he noted.
Page last updated: 9 February 2006
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