Review of Contraceptive Distribution Strategy for the Korean National Family Planning Program

정부가족계획사업의 피임보급전략에 관한 소고

During the period of 1962 through 1981, a total of 11. 7 million cummulative acceptors have received contraceptive services under the national family planning program. The number of annual acceptors have steadly increased from 151, 200 in 1963 to 842, 200 in 1975, and since then it has maintained the range of 600, 000 to 800, 000 acceptors per year. From the beginning of the program, the IUD had been the principal method of contraception provided by the government program until 1976, at which time the government made female sterilization services available thorough the introduction of the laparoscopy method. The popularity of female sterilization has increased very rapidly during the last few years. Out of 614, 200 program acceptors in 1981, the proportion of female sterilization and IUD acceptors were virtually the same(26.8% and 27.2% respectively). Considering various anticipated problems such as a large proportion of contraceptive users for the fertility termination and the high discontinuation rates of IUD and other traditional method, the government has emphasized the distribution of female sterilization and deemphasized condom and pill contraceptives since 1978. However, the recent service statistics has revealed that the acceptance rate of female sterilization has steadly declined since 1979. Thus, the purpose of this analysis is to review the current government policy on contraceptive distribution with emphasis of female sterilization by estimating the prospect of sterilization acceptablilty. According to the Fifth Five-Year Plan for Family Planning Program(1982-1986) the annual average target of sterilization was set up to secure 230, 000 acceptors by the government sector during the period. If the sterilization target is to be met as planned, about 80 percent of exposed women aged 30-44 will be remained as sterilized women in 1985. This means the the high acceptance rate of sterilization shown in the past years can not be expected, unless the acceptors' age of sterilization is drastically lowered below 30 years. Accordingly, the current policy on contraceptive distribution with emphasis on sterilization should be gradually changed to encourage target population to use contraceptives for birth spacing by increasing access to such contraceptives as IUDs, pills, and condoms, and to improve continuation rates through better program management system including target setting, acceptors' follow-up, supervision, and evaluation system.