Family-Planning Efforts Succeed in Thailand

AREE SOMBOONSUK, the first Thai salesman of family planning, remembers when contraception was a hard sell.

Today, Thailand has its population-growth rate under control at 1.4 percent annually and is one of the world's leading success stories. But Dr. Aree, retired head of the Planned Parenthood Association of Thailand, says that wasn't always the case.

Thirty years ago, the British-educated physician asked the government to sponsor a family-planning clinic and was turned down. At the time, officials urged women to help rebuild the post-World-War-II population and even held contests rewarding prolificacy.

So the maverick doctor started his own facility to which buses of people from the countryside would come for free condoms. The clinic once inserted 500 intrauterine devices in one day.

The turning point came in 1957, when a World Bank warning that high population would produce high unemployment galvanized the country's leadership. Aree got the crucial backing of the revered Princess Mother Prasrinakhar, mother of the Thai king. Thailand's powerful military, also an important force in the country's economy, followed suit. In 1970, Thailand launched its now widely respected family-planning effort.

During the last two decades, the rate of population growth has eased from 3.5 percent to 1.2 percent in 1986. The average fertility rate has fallen from 6.8 children per mother in 1957 to 2.03 in 1991, Aree says.

In common with other successful family-planning efforts around the world, the Thai program has combined strong support from the top with innovative marketing techniques. One example: allowing non-physicians to distribute birth-control pills.

Another key to success has been unique to Thailand.

"Thai people are peculiar in that they are not reluctant to change to new attitudes. A modern way of living was easy for Thailand to absorb," Aree says. "There's a Thai proverb that if you have one more child, you will become poorer for seven years."

Ironically, a group of academics recently warned that Thailand may be the victim of its own success. The group warned that effective family-planning efforts could lead to a labor shortage, threatening the country's fast-growing economy. Other analysts disagree, projecting that the Thai labor force will continue to expand over the next three decades.

As in other East Asian nations, declining birthrates in Thailand have been closely associated with improving economic circumstances. Population experts acknowledge the synergism at work, but many say prosperity is more the effect than the cause of reduced fertility.

"The birthrates came down before the skyscrapers went up," says one United Nations population expert.