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Published online by Cambridge University Press: 31 July 2008
The performance of population programmes suggests that even the more successful ones have acceptance rates that are only a fifth or so of what is needed to reduce population growth rates to the 1% a year that permits significant improvements in income per head. It is also clear that no programmes use bonuses at anything approaching the monetary values per recipient that are justifiable. There is no guarantee that such bonuses will produce the number of acceptors that are needed, but it is fairly evident that without larger bonuses there will not be enough acceptors.
Briefly, if bonuses are to become an effective and acceptable feature of national family planning programmes, they must meet at least the following requirements:
(1) The various bonuses must be an integral part of an evolving and expanding system, and such bonuses must be evaluated in terms of the same criteria used to evaluate the overall family planning programme.
(2) Bonuses should be substantial, equal to perhaps one-half or more of the maximum that society, through government, can afford to pay for reduced fertility.
(3) Bonus qualification and administration should be reasonably cheat-proof, and the majority of couples using contraceptives should not be able to collect more than one kind of bonus.
(4) Selective discrimination among acceptors, at least by age, should be attempted by government to reduce payments of unnecessarily large bonuses to those who would practise effective contraception for a smaller bonus.
(5) Bonuses should be used to gain the acceptance of more cost-effective methods, or of more fertile couples, even during early stages when a family planning programme is generally supply constrained.
Finally, because in a real sense transfer payments are less costly than more customary activities incurring resource costs, bonuses should be used whenever their budget cost is no greater than more traditional expenditures that are equally effective in terms of reducing births. As such bonuses are really a form of compensation, paying for valuable services undertaken at some inconvenience and sacrifice, there is nothing morally reprehensible in paying them. Moreover, inasmuch as poorer people are most likely to respond, there is a favourable income redistribution effect and, of course, a prospect of higher average incomes because of the fertility reduction.
