Family Planning in Peru

1. Family Planning in Peru Miranda Velikoff

2. Total Fertility Rates

3. Total Fertility Rates Cont.

4. Potential Effects of Population Growth Two popular theories… Malthusian Theory: A population grows exponentially, while food production is linear. With this pattern, in the future there will no longer be enough food to sustain the population. Demographic Transition Theory: A country will go from high to low birth and death rates as they develop more sophisticated systems for education, industrialization and urbanization.

5. Map of South America

6. Ideal Number of Children Table 2. Number of Ideal Children Reported in Survey Compared to Actual Total Fertility Rate

7. Peru’s Diverse Population • 45% Amerindian and 37% Mestizo • 81.3% of the population is Roman Catholic • National Languages: Spanish and Quechua • 84.1% of the population speaks Spanish • 13% of the population speaks Quechua

8. Contraceptive Methods • Modern Methods: • Contraceptive pill • Intra-uterine device • Injection • Condoms • Sterilization • Norplant • Emergency pill • Traditional Methods: • Periodic abstinence • Withdrawal • Folk methods

9. Total Fertility Rate (children/woman) Table 3. By Education Level Table 4. By Location

10. Knowledge of at Least One Method of Contraceptive (by percentage) Table 5. By Education Level Table 6. By Location

11. Actual Use of at Least One Method of Contraception (by percentage) Table 7. By Education level Table 8. By Location

12. Proportion of Modern to Traditional Methods of Women Using at Least One Contraceptive Table 9. By Education Level Table 10. By Location

13. Summary of Survey Results Total fertility rate is lower among women with high levels of education and living in urban areas. These women are also more likely to know about and use contraceptive methods. The contraceptive method they choose is more likely to be a modern method.

14. The Government and the Catholic Church Both institutions have had influence on the policy and perception of contraceptives to the Peruvian people throughout their history.

15. Government 1963-1968 President Fernando Belaúnde Terry 1964|Created the Center of Population and Development (CEPD) 1967|Association of Family Protection (APPF) 1970|Peru Demographic Report

16. Catholic Church 1963-1968 1930|Pope Pius XI’s encyclical Casti Connubii 1966|Responsible Parenthood Program in the Barriadas of Lima 1967|Program spread to multiple parishes

17. Catholic Church 1963-1968 Jul. 1968|Pope Paul VI encyclical De Humanae Vitae “Project for Conjugal and Family Promotion in Peripheral Neighborhoods” Sept. 1968|Latin American Episcopal Conference of Catholic Bishops

18. Government 1968-1975 General Juan Francisco Velasco Alvarado 1971|National Development plan did not include family planning 1975|APPF network completely shut down

19. Catholic Church 1968-1975 Continuation of the Project for Conjugal and Family Promotion in Peripheral Neighborhoods 1974|Family and Population written by Catholic Bishops of Peru

20. Government 1975-1980 General Francisco Morales Bermúdez Cerruti 1976| Guidelines of Population Politics “With respect to fertility, the government recognizes that the final decision and the direct responsibility fall to the parents of the family.”

21. Catholic Church 1975 - 1980 Catholic Bishops influence government policy of family planning The project for Conjugal and Family Promotion in Peripheral Neighborhoods begins to lose funding

22. Government 1980 - 1985 President Fernando Belaunde Terry Nov. 1980|National Population Council Dec. 1980|Family Planning Rules 1983|The government provides Family Planning Services

23. Government 1990 - 2000 Alberto Ken’ya Fujimori 1991-1995|National Population Program 1995|Conference on population and development 1995|Sterilization legalized

24. Catholic Church Response Challenged Fujimori’s sex education programs in schools Provided responsible parenthood programs

25. Target Population “The fertility rate among poor women is 6.9 children –they are poor and are producing more poor people. The president is aware that the government cannot fight poverty without reducing poor people’s fertility. Thus, demographic goals are a combination of the population’s right to access family planning and the government’s anti-poverty strategy.” - Program manager at the Ministry of Health, 1998

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28. Sterilizations Ministry of Health estimates that at least 277,793 women were sterilized during Fujimori’s sterilization campaign Figure 5. Tubal Ligations Performed by the Ministry of Health of Peru from 1993 to 2000 Ligations Year

29. Comparison of Contraceptive Methods

30. Catholic Church Response Accused Fujimori of a sterilization agenda against the indigenous population Cardinal Augusto Vargas expressed concerns publically on television

31. Coerced into sterilization “We were required to perform a certain number of sterilizations each month. This was obligatory and if we did not comply, we were fired. Many providers did not inform women that they were going to be sterilized – they told them the procedure was something else. But I felt this was wrong. I preferred to offer women a bag of rice to convince them to accept the procedure and explained to them beforehand what was going to happen.” - Doctor who formerly worked for the Ministry of Health

32. Coerced into Sterilization “These women are ignorant. We just bribed them; they consented to sterilization if we gave them money for their basic needs.” - Doctor who formerly worked for the Ministry of Health

33. Coerced into Sterilizations Of 157 cases of sterilization, a consent form was filled out correctly only 11 times and in 112 cases no consent procedure was even presented. 16 deaths were uncovered as a result of poorly executed sterilization procedures.

34. The Downfall of the Family-Planning Program Fujimori lost foreign support and funding for the Family-Planning Program 1998-2002|National Population Plan Ministry of Promotion for Women and Human Development

35. Peruvian Truth and Reconciliation Commission Investigated Fujimori’s alleged crimes against humanity between 1980 and 2000 68,841 people were “disappeared” during this time. Of these, 90% were from the poorest regions of the country and over 70% were native Quechua speakers Sterilizations were not mentioned in the Commissions final report

36. Genocide? Convention on the Prevention and Punishment of the Crime of Genocide in 1948 by the United Nations Article 1 The Contracting Parties confirm that genocide, whether committed in time of peace or in time of war, is a crime under international law which they undertake to prevent and to punish. Article 2 In the present Convention, genocide means any of the following acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as such: (a) Killing members of the group; (b) Causing serious bodily or mental harm to members of the group; (c) Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part; (d) Imposing measures intended to prevent births within the group; (e) Forcibly transferring children of the group to another group. (Convention on the Prevention and Punishment of the Crime of Genocide. United Nations. 1948)

37. Still Demanding Justice Women for the Broad Women’s Movement traveled from Cuzco to Lima in protest, demanding compensation for their suffering in June 2001.

38. Government 2001-2006 President Alejandro Celestino Toledo Manrique 2001|The 5-year Sectorial Strategy Plan included universal healthcare Appointed two conservative Ministers of Health who restricted the supply of information and resources of contraception

39. Consequences of Conservative Stance Between 2002-2003, only 34% of workers stated that contraceptive supply was continuous. In 2003-2004, the number had dropped to 6% Use of artificial contraceptives dropped by 26% between 2002 and 2004

40. Proportion of Modern to Traditional Methods of Women Using at Least One Contraceptive Table 9. By Education Level Table 10. By Location

41. Abortion Problems Complications from unsuccessful abortions treated by the Ministry of Health: 2000| 35,000 2001| 35,000 2002| 38,851 2003| 41,993

42. Government 2006 – 2011 President Alan Gabriel Ludwig García Peréz Addressed the decline of contraceptive use Created two programs: Conditional cash transfers Social insurance programs

43. Conclusion While the TFR in Peru has been steadily decreasing, it is important to remember that the TFR is an average and is not homogeneous throughout the population. The socio-economic conditions of different populations affects is directly relate to the TFR as well as the actions of the Catholic Church. It is important to look at all of these aspects when investigating the situation of the country.

44. Works Cited Angeles, Gustavo, David K. Guilkey, and Thomas A. Mroz. "The Determinants of Fertility in Rural Peru: Program Effects in the Early Years of the National Family Planning Program." Journal of Population Economics 18.2 (2005): 367-89. EBSCO Host. Web. 11 Mar. 2011. BBC. "Fujimori Sentenced for Corruption." BBC News. BBC, 30 Sept. 2009. Web. 12 Apr. 2011. <http://news.bbc.co.uk/2/hi/americas/8283844.stm>. BBC. "Peru Election: Humala-Fujimori Run-off Set for 5 June." BBC News. BBC, 11 Apr. 2011. Web. 12 Apr. 2011. <http://www.bbc.co.uk/news/world-latin-america-13027410>. Belaunde, Fernando. La Conquista El Peru Por Loa Peruanos. 3rd ed. Lima: MINERVA, 1994. Print. Boesten, Jelke. "Free Choice or Poverty Alleviation? Population Politics in Peru under Alberto Fujimori." European Review of Latin American and Caribbean Studies 82 (2007): 3-20.  CELADE. "BoletinDemografico: America Latina: Poblacio Por Anos Calendario Y Edades Simples." CELADE 71 (2003): 1-285. Print. Centro De Estudios De Poblacion Y Desarollo (CEPD). Informe DemograficoPeru 1970. Lima: CEPD, 1972. Print.

45. Works Cited (cont.) "CIA - The World Factbook." Welcome to the CIA Web Site — Central Intelligence Agency. Web. 28 Mar. 2011. Coe, Anna-Britt. "From Anti-Natalist to Ultra-Conservative: Restricting Reproductive Choice in Peru." Reproductive Health Matters 12.24 (2004): 56-69. Print. Conaghan, Catherine M. Fujimori's Peru. Pittsburgh: University of Pittsburgh, 2005. Print. Crabtree, John. Peru under Garcia: An Opportunity Lost. Pittsburgh: University of Pittsburgh, 1992. Print. Estep, Raymond, and Documentary Research Division Aerospace Studies Institute Air University. The Role of the Military in Peruvian Politics. Montgomery: Maxwell Airforce Base, 1970. Print. Ewig, Christina. "Hijacking Global Feminism: Feminists, the Catholic Church, and the Family Planning Debacle in Peru." Feminist Studies 32.3 (2006): 632-59. Academic Search Premier. Web. 11 Mar. 2011. Getgen, Jocelyn E. “Untold Truths: The Exclusion of Enforced Sterilizations from the Peruvian Truth Commission's Final Report” 29 B.C. Third World L.J. 1 (2009): 1-34. Heinonline. Web. 11 Mar. 2011

46. Works Cited (cont.) Gribble, James N., Suneeta Sharma, and Elaine P. Menotti. "Family Planning Policies and Their Impacts On the Poor: Peru's Experience." International Family Planning Perspectives33.4 (2007): 176-81. Academic Search Premier. Web. 11 Mar. 2011. Hurtado, Graham, Guillermo Marco Del Pont, Fernandez Baca, TantaleonVanini, Vargas Caballero, Alberto Jimenez De Lucio, Morales Bermudez, and Juan Velasco Alvarado. "Plan Nacional De Desarollo." Oficina Nacional De Informacion 5 (1971): 52-64. Print. Instituto Nacional De Estadistica E Informatica, AlvaDavila, Luis Ulloa, and Zoraida Castro. PeruEncuestraDemografica Y De Salud Familiar. Comp. Rosario Cespedes. Lima: Instituto Nacional De Estadistica E Informatica, 2005. Print. Instituto Nacional De Estadistica E Informatica , Jorges Reyes, and Luis Ochoa. EncuestraDemografico Y De Salud Familiar 2000. Lima: Instituto Nacional De Estadistica E Informatica, 2001. Print. Instituto Nacional De Estadistica E Informatica. EncuestraDemografica Y De Salud Familiar 1991/1992. Comp. Alberto Padilla, Luis H. Ochoa, and Albert M. Marckwardt. Vol. 2. Columbia: Macro International, 1992. Print.

47. Works Cited (cont.) Instituto Nacional De Estadistica, Graciela F. Baca De Valdez, Eduardo M. Turner, and Yolanda C. Ascencio. Aspectos Demograficos Y Prevalencia De Anticonceptivos En El Peru. Lima: Ministerio De Salud Del Peru, 1983. Print. Instituto Nacional de Plantificacion. Lineamiento de Politicas de Poblacion en el Peru. DirectoSupremo No. 00625-76-SA. Lima-Peru. 1974. Klaiber, Jeffrey L. Religion and Revolution in Peru: 1824-1976. London: University of Notre Dame, 1977. Print. Lopez, Raul N. "Priests and Pillas Catholic Family Planning in Peru, 1967-1976." Latin American Research Review 43.2 (2008): 34-56. Project MUSE. Web. 11 Mar. 2011. Lopez, Raul. "La Asociacion Peruana de Proteccion Familiar y los inicios de la anticoncepcion en el Peru (1967-1975)". Histórica (Lima), 33.1 (2009): 87. AcademicOneFile. Web. 03 Apr. 2011. Martiniere, Margarita G. Historia General Del Peru: La Republica 1948-1980. Lima: Editorial Brasa, 1994. Print. IX.

48. Works Cited (cont.) Masterson, Daniel, and Instituto De Estudios Politicos Y Estrategicos. Fuerza Armada Y Sociedad En El Peru Moderno: Un Estudio Sobre Relaciones Civiles Militares 1930-2000. Lima: Instituto Politicos Y Estrategicos, 2001. Print. Pius XI. CastiConnubii.30 Dec. 1930. Population Council. "Peru's National Population Policy Law." Population and Development Review 11.4 (1985): 789-94. Web. Rahme, Juan S., Maita G. Trovato, Esperanza R. Solari, and Hilaria S. Huaman. "Comision Especial Sobre Actividades de AanticoncepcionQuirurgica Voluntaria (AQV)." Movimiento Amplio De Mujeres Linea Fundacional. Movimiento Amplio De Mujeres Linea Fundacional, June 2002. Web. 12 Apr. 2011. <http://www.mamfundacional.org/ef/Informe-Final.pdf>. Sobrevilla, Luis, and Mary Fukumoto, eds. Investigacion En Plantificacion Familiar Y Servicios De Salud. Lima: Consejo Nacional De Poblacion, 1984. Print.

49. Works Cited (cont.) "South America Map - Detailed On-line Map of South America." Greece Map | A Detailed Map of Greece. Web. 14 Apr. 2011. <http://www.greece-map.net/south-america.htm>. Turchi, Boone A. "Review: Latin American Fertility: Determinants, Policies, and Politics." Latin American Research Review 12.1 (1977): 183-91. JSTOR. Web. 13 Apr. 2011. Vargas, Henry G., and Ministerio De Salud, comps. "Compendio De Legislacion Ambiental Peruana." INAPMAS (1995): 1-135. Web. Velasco Alvarado, Juan, and Alejandro Augustine Lanusse. "Declaracion Conjunta." Oficina Nacional De Informacion 4 (1971): 28-35 Print. Velasco Alvarado, Juan, and Salvador Allende Gossens. "Declaracion Conjunta." Oficina Nacional De Informacion 3 (1971): 16-25 Print. Washington Office on Latin America. Peru in Peril: The Economy and Human Rights 1985-1987. Washington D.C.: Washington Office on Latin America, 1987. Print.