For many years birth control propaganda and the provision of clinics in the US was promoted primarily by private agencies such as the Planned Parenthood Federation, which is still highly active. Population control has also been accepted by the United Nations and by most of the countries of the world as a proper governmental concern.
Birth control clinics were usually initiated on a tentative, timid basis with a heavy medical emphasis and with little realistic effort to reach the less educated sections of the population. Often they did not provide sterilisation or abortion and sometimes their contraceptive services were limited as well.
Usually they quickly reached the better educated people but had difficulty in communicating effectively with the uneducated. The development of “the pill” was a boon to these agencies, since it was both simple and more effective than most other contraceptive methods.
With experience, the agencies became more effective both in communication and in their understanding of contraceptive methods. It soon became apparent that it was not enough to provide people with the means to limit the size of their families.
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Just as crucial is the matter of motivation. If people desire large families, then no method of birth control will have much appeal. Further, even skillful propaganda may be ineffective against the traditional belief that many children area proof of masculinity or femininity, a cheap family labour force, and insurance against poverty and isolation in old age. Presumably, these attitudes would change as countries became more industrialised (the demographic transition), but by that time population might have grown to catastrophic proportions.
Consequently some governments have begun to establish penalties and rewards to motivate the acceptance of smaller families. India, for several years paid men to accept a vasectomy. Districts in Taiwan have offered savings accounts as a reward for limiting family size.
The Philippines, where the average woman has several children, allows income tax deductions for only four children. Singapore, which has been highly successful in reducing the birth rate, has a combination of incentives.
These include delivery fees rising with consecutive children, income tax deductions for only the first three children, paid maternity leave for only two confinements, and highest priority for subsidized housing to those with two children or less.