Fertility and family well-being effects of an aggressive family planning policy in Peru in the 1990s

In the mid-1990s, the Peruvian government initiated an aggressive family planning programme to address widespread poverty in the country, and female sterilisation was a publicly stated element of the programme. This paper tries to find out who was affected by the sterilisation policy, and what impact the policy had on fertility and household well-being.

The paper indicates that anecdotal evidence suggests that health workers were given large sterilisation quotas and reportedly used bribes, coercion, and even force to meet them.

Findings include:

• it is evident that a large increase in sterilisations took place during the suspected policy window
• it is clear that the sterilisation policy involved egregious human rights violations
• the substantial decrease in fertility caused by the policy does not seem to be associated with substantial improvements in family well-being
• there were small improvements in height for age and school enrollment for girls whose mothers were sterilised by the sterilisation policy

The document concludes the following:

• the mere reduction of fertility is not necessarily associated with substantial improvements in welfare in the context of potentially coerced sterilisations
• in general, when birth control is imposed, the benefits of making choices about fertility may not accrue to women and their households
• future family planning policies should focus on improving the choices available to women and their families rather than imposing a single contraceptive alternative