Efforts to curb global poverty "won't get far" without more effective family planning efforts in developing countries with limited financial resources, New York Times columnist Nicholas Kristof writes in an opinion piece. "Global family planning efforts have stalled over the last couple of decades," resulting in "lost momentum" and increased poverty in nations such as Haiti, he says. Kristof profiles a 30-year-old Haitian woman who says she wanted two children but is pregnant with her 10th child. The woman has tried unsuccessfully to obtain reliable access to contraception through local clinics, and she has been unable to convince her husband to use condoms. There is "simply no way to elevate" families living in poverty "unless we help such women have fewer children," Kristof writes. "And yet family planning programs have been shorn of resources and glamour for a generation now," he says, adding that development efforts of the 1960s and '70s that focused on contraception have since "waned." According to Kristof, the focus on contraception was in part "tarnished by its own zealotry, including coercion in China and India," as well as by "abortion politics, which led to a cutoff in American financing for the United Nations Population Fund -- even though the upshot was more unwanted pregnancies and more abortions."

Kristof writes that the U.N. estimates that 200 million women worldwide "have what demographers call an 'unmet need' for safe and effective contraception. That is, they don't want to get pregnant but don't use a modern form of family planning." He continues that the U.N. estimates that this "unmet need" results in 70 million to 80 million unintended pregnancies annually, as well as 19 million abortions and 150,000 maternal deaths. According to Kristof, "family planning turned out to be harder than many enthusiasts had expected, for it requires far more than condoms or the pill." He continues that in Haiti, although "spending on contraception is fairly high, and women say they want fewer children ... only one-quarter of Haitian women use contraceptives." Citing a book titled "Reproducing Inequities," Kristof explains that the "effective strategies go beyond the contraceptive devices themselves to include better counseling, more dignity for women in clinics, a greater choice of methods that are completely free -- and a broad effort to raise the status of women." Educating girls and opportunities for women "to earn income through micro-loans, factory jobs or vocational training" are the best ways to elevate women, he says, adding, "It is sometimes said that the best contraceptive isn't the pill or the IUD, but education for girls." He also writes that there is "abundant evidence that when parents are confident that their children will live, they will have fewer and invest more in each of them." In addition, "mounting academic evidence underscores what is intuitively obvious in Haiti: unless family planning is more successful in poor countries, they won't be able to overcome poverty," according to Kristof. He notes that President Obama has restored funding to the U.N. Population Fund, giving the U.S. the "opportunity to lead a global effort to regain lost momentum for family planning" (Kristof, New York Times, 4/5).

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