mass media and social networks can diffuse knowledge of and access to contraception and can help to ease fears about adverse health effects associated with the use of contraception. In many settings, they may be decisive in legitimizing birth control and family limitation.

Fertility decline is not the universal goal of all countries. But for the majority of developing countries that do wish to lower their fertility rates, what guidance can diffusion research offer? Currently, diffusion research may help to improve population policies in at least three ways. First, research indicates that family planning programs may be successful even in areas where structural conditions do not appear to be favorable to fertility change. Diffusion of new ideas about family planning may even lead to structural change. Program planners should not shy away from "underdeveloped" regions, but rather implement family planning programs in all types of settings. Strong political leadership in support of family planning may be key, especially in areas with low income and poor literacy. Second, diffusion research indicates there are powerful strategies for encouraging fertility decline that do not entail the use of incentives, targets, or coercion on the part of a government. Developing a communication infrastructure, for example, may help to contribute to fertility decline by helping to diffuse messages about "modern" ideas, such as smaller family sizes. Finally, some specific features of family planning programs may be especially influential because of diffusion dynamics. For example, providing information about potential health side effects from using contraception and their treatment can counteract the damaging effect of the informal spread of fears of side effects. Programs must provide clear, accurate information about these side effects, as well as providing appropriate follow-up treatment and counseling. In addition, family planning programs can gain from interpersonal communication by making use of clubs or discussion groups or enlisting community members as instructors. All such efforts should be informed by an understanding of the local social structure.

In conclusion, more research is needed on models of the diffusion of family planning knowledge and technology, on the measurement of diffusion effects, and on the implications of diffusion research for population policy and programs. The Workshop on Social Processes Underlying Fertility Change in Developing Countries was part of this ongoing exploration.



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