Family Planning in Peru
Miranda Velikoff
Total Fertility Rates
Total Fertility Rates Cont.
Potential Effects of Population
Growth
Two popular theories…
Malthusian Theory: A population grows exponentially,
while food production is linear. With this pattern, in
the future there will no longer be enough food to
sustain the population.
Demographic Transition Theory: A country will go from
high to low birth and death rates as they develop
more sophisticated systems for education,
industrialization and urbanization.
Map of South America
Ideal Number of Children
Table 2. Number of Ideal Children Reported in Survey Compared to Actual
Total Fertility Rate
Ideal Number of
Children
Total Fertility Rate
---
1986
1991
1996
2000
2004
---
---
2.7
2.5
2.5
2.4
2.4
---
1980-1985
1985-1990
1990-1995
1995-2000
2000-2005
---
2005-2010
4.65
4.10
3.57
3.10
2.80
---
2.60
Peru’s Diverse Population
• 45% Amerindian and 37% Mestizo
• 81.3% of the population is Roman
Catholic
• National Languages: Spanish and Quechua
– 84.1% of the population speaks Spanish
– 13% of the population speaks Quechua
Contraceptive Methods
o Modern Methods:
•
•
•
•
•
•
•
Contraceptive pill
Intra-uterine device
Injection
Condoms
Sterilization
Norplant
Emergency pill
o Traditional Methods:
• Periodic abstinence
• Withdrawal
• Folk methods
Total Fertility Rate (children/woman)
Table 3. By Education Level
Total
Illiterate
No Education
Incomplete
Primary
Complete Primary
Complete
Secondary
Superior
1981
4.7
6.3
2000
2.9
5.2
1991
3.5
--7.1
---
4.5
5.1
4.0
3.6
3.1
3.1
2.4
2.3
---
1.9
1.8
1.5
1981
1991
2000
2004
4.5
3.5
5.5
8.1
3.5
2.5
3.1
6.3
2.9
2.0
2.2
4.3
2.4
1.9
2.0
3.6
5.1
2004
2.4
--4.3
---
Table 4. By Location
Total
Lima
Urban Other
Rural
Knowledge of at Least One Method of
Contraceptive (by percentage)
Table 5. By Education Level
Total
Illiterate
No Education
Incomplete
Primary
Complete
Primary
Complete
Secondary
Superior
1981
81
54
--82
1991
96.9
--83.5
---
2000
99.0
--93.6
---
2004
99.4
--92.5
---
83
95.8
98.5
99.4
94
99.7
100
99.9
---
100
100
100
1991
96.9
99.8
98.2
91.1
2000
99.0
100.0
99.9
97.4
Table 6. By Location
Total
Lima
Urban Other
Rural
1981
81
96
84
60
2004
99.4
100
100
98.2
Actual Use of at Least One Method of
Contraception (by percentage)
Table 7. By Education level
1981
1991
2000
2004
Total
Illiterate
No Education
41
18
---
59.0
--34.9
68.9
--50.2
70.5
--51.4
Incomplete
Primary
Complete
Primary
Complete
Secondary
Superior
36
---
---
---
46
51.3
63.5
66.6
60
65.6
74.6
73.7
---
73.2
75.5
75.4
Table 8. By Location
Total
Lima
Urban Other
Rural
1981
41
56
46
21
1991
59.0
72.7
66.1
41.1
2000
68.9
73.4
73.0
61.5
2004
70.5
74.6
74.8
62.7
Proportion of Modern to Traditional Methods
of Women Using at Least One Contraceptive
Table 9. By Education Level
Total
Illiterate
No
Education
Incomplete
Primary
Complete
Primary
Complete
Secondary
Superior
Modern
(1981)
Traditional
(1981)
Modern
(1991)
Traditional
(1991)
Modern
(2000)
Traditional
(2000)
Modern
(2004)
Traditional
(2004)
43
29.0
---
57
71.0
---
55.6
--32.1
44.4
--67.9
73.1
--65.7
25.4
--30.3
66.2
--46.7
31.2
--48.1
31.0
69.0
---
---
---
---
---
---
48.0
52.0
46.8
53.2
69.0
29.0
56.6
38.9
49.0
51.0
56.3
39.6
76.0
23.2
70.0
27.8
---
---
65.4
34.7
77.0
22.9
75.9
24.0
Table 10. By Location
Modern
(1981)
Traditional
(1981)
Modern
(1991)
Traditional
(1991)
Modern
(2000)
Traditional
(2000)
Modern
(2004)
Traditional
(2004)
Total
43
57
55.6
44.4
73.1
25.4
66.2
31.2
Lima
49
52
65.2
34.6
80.1
19.2
74.0
24.7
Urban Other
45
55
60.1
40.0
76.8
22.3
72
26
Rural
23
77
37.7
62.3
65.5
32.2
52.9
41.9
Summary of Survey Results
Total fertility rate is lower among women with
high levels of education and living in urban
areas. These women are also more likely to
know about and use contraceptive methods.
The contraceptive method they choose is
more likely to be a modern method.
The Government and the Catholic Church
Both institutions have had influence on the
policy and perception of contraceptives to the
Peruvian people throughout their history.
Government 1963-1968
President Fernando Belaúnde Terry
1964|Created the Center of
Population and
Development (CEPD)
1967|Association of Family
Protection (APPF)
1970|Peru Demographic Report
Catholic Church 1963-1968
1930|Pope Pius XI’s encyclical Casti Connubii
1966|Responsible Parenthood Program in the
Barriadas of Lima
1967|Program spread to
multiple parishes
Catholic Church 1963-1968
Jul. 1968|Pope Paul VI encyclical De Humanae
Vitae
“Project for Conjugal and Family Promotion in
Peripheral Neighborhoods”
Sept. 1968|Latin American Episcopal Conference
of Catholic Bishops
Government 1968-1975
General Juan Francisco Velasco Alvarado
1971|National Development plan
did not include family
planning
1975|APPF network completely
shut down
Catholic Church 1968-1975
Continuation of the Project for Conjugal and
Family Promotion in Peripheral Neighborhoods
1974|Family and Population written by Catholic
Bishops of Peru
Government 1975-1980
General Francisco Morales Bermúdez Cerruti
1976| Guidelines of Population Politics
“With respect to fertility, the
government recognizes that
the final decision and the
direct responsibility fall to the
parents of the family.”
Catholic Church 1975 - 1980
Catholic Bishops influence government policy of
family planning
The project for Conjugal and Family Promotion
in Peripheral Neighborhoods begins to lose
funding
Government 1980 - 1985
President Fernando Belaunde Terry
Nov. 1980|National Population Council
Dec. 1980|Family Planning Rules
1983|The government provides
Family Planning Services
Government 1990 - 2000
Alberto Ken’ya Fujimori
1991-1995|National Population Program
1995|Conference on population and
development
1995|Sterilization legalized
Catholic Church Response
Challenged Fujimori’s sex education programs
in schools
Provided responsible parenthood programs
Target Population
“The fertility rate among poor women is 6.9 children –
they are poor and are producing more poor people.
The president is aware that the government cannot
fight poverty without reducing poor people’s fertility.
Thus, demographic goals are a combination of the
population’s right to access family planning and the
government’s anti-poverty strategy.”
- Program manager at the Ministry of Health, 1998
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Sterilizations
Ministry of Health estimates that at least 277,793
women were sterilized during Fujimori’s
sterilization campaign
Ligations
Figure 5. Tubal Ligations Performed by the Ministry of Health
of Peru from 1993 to 2000
Year
Comparison of Contraceptive Methods
Catholic Church Response
Accused Fujimori of a sterilization agenda
against the indigenous population
Cardinal Augusto Vargas expressed concerns
publically on television
Coerced into sterilization
“We were required to perform a certain number of
sterilizations each month. This was obligatory
and if we did not comply, we were fired. Many
providers did not inform women that they were
going to be sterilized – they told them the
procedure was something else. But I felt this was
wrong. I preferred to offer women a bag of rice
to convince them to accept the procedure and
explained to them beforehand what was going to
happen.”
- Doctor who formerly worked for the Ministry of Health
Coerced into Sterilization
“These women are ignorant. We just bribed
them; they consented to sterilization if we
gave them money for their basic needs.”
- Doctor who formerly worked for the Ministry of Health
Coerced into Sterilizations
Of 157 cases of sterilization, a consent form was
filled out correctly only 11 times and in 112
cases no consent procedure was even
presented.
16 deaths were uncovered as a result of poorly
executed sterilization procedures.
The Downfall of the Family-Planning
Program
Fujimori lost foreign support and funding for the
Family-Planning Program
1998-2002|National Population Plan
Ministry of Promotion for Women and Human
Development
Peruvian Truth and Reconciliation
Commission
Investigated Fujimori’s alleged crimes against
humanity between 1980 and 2000
68,841 people were “disappeared” during this
time. Of these, 90% were from the poorest
regions of the country and over 70% were
native Quechua speakers
Sterilizations were not mentioned in the
Commissions final report
Genocide?
Convention on the Prevention and Punishment of the Crime of Genocide in
1948 by the United Nations
Article 1
The Contracting Parties confirm that genocide, whether committed in time of peace
or in time of war, is a crime under international law which they undertake to prevent
and to punish.
Article 2
In the present Convention, genocide means any of the following acts committed with
intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as
such:
(a) Killing members of the group;
(b) Causing serious bodily or mental harm to members of the group;
(c) Deliberately inflicting on the group conditions of life calculated to bring about its
physical destruction in whole or in part;
(d) Imposing measures intended to prevent births within the group;
(e) Forcibly transferring children of the group to another group.
(Convention on the Prevention and Punishment of the Crime of Genocide.
United Nations. 1948)
Still Demanding Justice
Women for the Broad Women’s Movement
traveled from Cuzco to Lima in protest,
demanding compensation for their suffering in
June 2001.
Government 2001-2006
President Alejandro Celestino Toledo Manrique
2001|The 5-year Sectorial Strategy Plan included
universal healthcare
Appointed two conservative Ministers
of Health who restricted the supply
of information and resources of
contraception
Consequences of Conservative Stance
Between 2002-2003, only 34% of workers stated
that contraceptive supply was continuous. In
2003-2004, the number had dropped to 6%
Use of artificial contraceptives dropped by 26%
between 2002 and 2004
Proportion of Modern to Traditional Methods
of Women Using at Least One Contraceptive
Table 9. By Education Level
Total
Illiterate
No
Education
Incomplete
Primary
Complete
Primary
Complete
Secondary
Superior
Modern
(1981)
Traditional
(1981)
Modern
(1991)
Traditional
(1991)
Modern
(2000)
Traditional
(2000)
Modern
(2004)
Traditional
(2004)
43
29.0
---
57
71.0
---
55.6
--32.1
44.4
--67.9
73.1
--65.7
25.4
--30.3
66.2
--46.7
31.2
--48.1
31.0
69.0
---
---
---
---
---
---
48.0
52.0
46.8
53.2
69.0
29.0
56.6
38.9
49.0
51.0
56.3
39.6
76.0
23.2
70.0
27.8
---
---
65.4
34.7
77.0
22.9
75.9
24.0
Table 10. By Location
Modern
(1981)
Traditional
(1981)
Modern
(1991)
Traditional
(1991)
Modern
(2000)
Traditional
(2000)
Modern
(2004)
Traditional
(2004)
Total
43
57
55.6
44.4
73.1
25.4
66.2
31.2
Lima
49
52
65.2
34.6
80.1
19.2
74.0
24.7
Urban Other
45
55
60.1
40.0
76.8
22.3
72
26
Rural
23
77
37.7
62.3
65.5
32.2
52.9
41.9
Abortion Problems
Complications from unsuccessful abortions
treated by the Ministry of Health:
2000| 35,000
2001| 35,000
2002| 38,851
2003| 41,993
Government 2006 – 2011
President Alan Gabriel Ludwig García Peréz
Addressed the decline of contraceptive use
Created two programs:
Conditional cash transfers
Social insurance programs
Conclusion
While the TFR in Peru has been steadily
decreasing, it is important to remember that
the TFR is an average and is not homogeneous
throughout the population. The socioeconomic conditions of different populations
affects is directly relate to the TFR as well as
the actions of the Catholic Church. It is
important to look at all of these aspects when
investigating the situation of the country.
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