Ethical approaches to family planning in Africa

Africa has historically provided the geographical flashpoint of ethical issues relating to family planning programs. Until recently in Sub-Saharan Africa, advocacy of family planning by non-Africans was unacceptable and by Africans politically inadvisable. This has changed in the 1980s. The health rationale for family planning is backed by strong evidence, especially in Africa, where infant and maternal mortality and morbidity rates are high. Population growth in many African countries impedes development, which cannot keep up with needs. Earlier attempts to offer family planning aid were often politically inept and endangered the needed partnership between donor and developing countries. Theoretical arguments and abstract demographic projections are less persuasive than carefully designed programs geared to the health and well-being of communitities that help plan them. Increased cooperation between donor and developing countries has helped resolve some of the ethical difficulties that beset family planning programs. This report summarizes many of the practical, ethical and cultural considerations in making family planning aid acceptable.