Amerika`nın aile planlaması yardımının arkasındaki politikalar

Abstract

HACETTEPE UNIVERSITY INSTITUTE OF POPULATION STUDIES Abstract THE POLITICS OF FAMILY PLANNING ASSISTANCE IN THE UNITED STATES by HALE EBİRİ The International Family Planning Policies of the United States have been a carefully planned driving force in many third world countries' efforts to curb fertility rates. This thesis reviews the U.S. Government's Family Planning Policies the changes in priorities and the effects of these policies in a historical perspective. The political environment behind the major advances, milestones, and setbacks of these policies are extensively discussed. The U.S. Government changed its policies at the three international conferences on population. The Bucharest Conference in 1974 firmly established the theme of 'economic development İs the best contraceptive' and American population aid expanded parallel to this understanding. However, the official U.S. statement to the Second International Conference on Population in Mexico City (1984), trivialized world population problems and urged free enterprise economics as the solution for `temporary` demographic pressures. As policy concessions to conservative religious groups, large family planning organizations were defunded over abortion issues and efforts were spent to eliminate population aid from the foreign assistance budget and funding levels dropped. At the Third International Conference on Population in Cairo, the U.S. has changed its policy to a larger issue of reproductive health of women. The Cairo Consensus sees social investment in health and education as the key to creating a2 favourable climate for voluntary fertility decline and eventual global population stabilization. New concepts such as safe motherhood, sexual and reproductive rights and health, education of women and girls and the elimination of unsafe abortions were put into the final document. Following this conference the U.S. State Department prepared and put into action a new strategic plan in September 1997, to carry out the Program of Action accepted in Cairo. The fact that very little work had been done on the topic of U.S. Family Planning Assistance (FPA) in Turkey led me to look into this subject more deeply. In the U.S. international aid and FPA are very prominent issues of the public opinion and the national press. Analyzing this topic would give me a better insight of American politics. The study has several objectives. Primarily, it tries to give the reader an idea of the domestic political environment surrounding the family planning assistance. Turkey, as a country on the receiving end of the assistance, directly confronts the shifting policies and finds the underlying reasons sometimes difficult to understand. Domestic controversies in the U.S. arising mainly from abortion, and its reflection on the policies, congressional debates, disagreements between Presidents and the Congress, the public's stand, both on abortion and assistance, are discussed in detail to reflect the other end of the picture and to inform readers who might not be familiar with the way American politics work. The study further looks at the effects and the accomplishments of family planning assistance worldwide and tries to answer the following questions: What has the U.S. Family Planning Assistance achieved in almost forty years? Has it contributed to dramatic declines in world fertility rates? How did the national family planning programs evolve over the years? Did the U.S. benefit from this policy and3 achieve the goals set by establishing this policy? What is the fixture for population assistance? This thesis includes a review of the Family Planning Program (FPP) of Turkey, as a case study on the receiving end of the assistance, and evaluates its achievements. As U.S. contraceptive donations approaches to an end, Turkey's efforts to become self-reliant on contraceptive needs of its FPP is a part of the review. The introduction is a brief overview of the U.S. FPA levels in the recent years with special reference to the present shape and priorities of the policy and the country's declining role compared to other donors. The rational behind the foreign aid in general and the FPA in particular are evaluated. Chapter I deals with the birth of FPA policy; groundwork laid by the demographers, international organizations, politicians, and the initial bipartisan support it received from the American people and its Congress. Major events in formulating the policy during four Presidents as well as the opposing arguments are discussed. Chapter II examines the major changes in the policy during presidents Reagan and Bush and the formulation of these changes known as the Mexico City Policy during the second International Population Conference. It looks at 12 years of politicization of the FPA policy process, at the activities of the hard-line Republicans to eliminate FPA altogether and at the weakening of public support. Chapter III is on the abortion issue. A major decision of the Supreme Court, legalizing abortion divided the country, creating two political camps and organizations battling one another. Although the crusade launched to reverse the4 decision could not achieve its goal, it lead to changes in the FPA policies. The significance of the historic decision, the nature of efforts to reverse it, the extent of the battle, perpetrators and the victims of it are examined in detail. Chapter IV deals with the battle between a pro-life and pro-FPA president and a Republican dominated Congress that is inclined to revive the Reagan era Mexico City Gag Rule. This chapter also deals with the public's view on abortions, foreign aid and FPA versus the views of the U.S. Congress. Excerpts from congressional debates on population assistance as well as recent research on public's perception about abortions and aid are included to give an idea on the dimensions of disagreements on these related issues. Chapter V deals with the accomplishments of donor assistance as a whole and the need for it. The role and the status of U.S. assistance among other donor contributions and the reasons for the continuation of assistance are reviewed. Chapter VI deals with effectiveness and the evolvement of national Family Planning Programs. Are they uniformly successful and could fertility declines be attributed to these programs? Chapter VII is about the Cairo Conference and the adoption of the Action Plan, which symbolizes the shift from pure family planning assistance to a new approach of reproductive health of women and children. The shift in U.S. policy from `population control` to `population stabilization` will be discussed. First actions of a newly elected Republican president on family planning is included in this chapter. Chapter VIII is on Turkey, as a country on the receiving end of assistance. The development of Turkey's family planning policies are discussed. Both the effects5 of the changes in the U.S. policy through the years and the final decision in 1995 to graduate Turkey from the contraceptive donation program are covered. The six years of activities to make the country's family planning program self-reliant on contraceptives and the formulation of a new cost recovery system (donation policy) are reviewed. The final Chapter, Conclusions wraps up the 40 years of FPA with its effects, reviews the world's present population situation, which once seemed alarming and explores whether or not donor assistance is still needed. This descriptive and analytical study is largely dependent on publications of the organizations related to aid, abortions, family planning programs and assistance. Exclusive interviews and a couple of unpublished reports are among the sources used. Congressional reports and other periodicals were reviewed. Daily developments related to the subject of the thesis are followed through the archives of several American newspapers. In-depth interviews were conducted both in Washington and in Turkey with experts of the issues covered by the thesis. Among those interwieved are Pınar Sanlet of American Embassy in Ankara, Roy Jacobsteen of USAID, Shanli Conti and Sally Athelton of Population Action International, Yaşar Yeşer of Family Planning Fund, Maureen Clyde and Zerrin Baser of The POLICY Project.