Attitudes of Iranian Women Toward Population Growth: A Questionnaire-Based Study.

Dear Editor,

Increasing population has remained a concern for human societies and is thus frequently discussed by experts and politicians (1). In the past three decades, Iran’s government policy has promoted a decrease in its population (2). To this end, the country’s parliament passed a bill on population control in 1989 and, thereafter, the ministry of health and medical education launched healthcare centers to provide contraceptive devices and encouraged family planning. As a result, the rate of population growth decreased from 4.1% in 1983 to 1.3% in 2013 (3). This trend however sparked serious concerns among policymakers about the possible outcomes (4), and led to a strategic conclusion that rolling out a policy promoting an increase in population growth should be considered (2).

Now, after a long period of encouraging families to reduce childbearing, the government is investing serious efforts to change the people’s attitudes and to promote childbearing. Therefore, a cross-sectional study was conducted to assess the attitudes of a sample of Iranian women toward population increase. In autumn 2014, 100 Iranian women were conveniently recruited among the women referred to Shahid-Beheshti, Golabchi, and Naqavi urban healthcare centers in Kashan, Iran. A researcher-made questionnaire was administered to the participating women. The questionnaire was designed through literature review; its content validity was confirmed by 10 faculty members of the Kashan University of Medical Sciences, its reliability was assessed through internal consistency method, with a Cronbach’s alpha of 0.92. Besides demographics, the questionnaire consisted of 41 items. One item enquired about the women’s desire to childbearing and 40 items queried their opinions regarding the benefits and disadvantages of population growth in the following five domains: social, economic, cultural, emotional, and healthcare consequences. Each domain included eight items. All items were assessed on a three-point Likert scale (agree, disagree, and have no idea). Descriptive statistics were used to analyze the study data.

Among the study subjects, 32% were 21 to 25 years old and only 13% were below 20 years; 40% had received academic education; 40% had no child and 27% had two children. For only 10% of the women, their family income was sufficient to meet their needs. In the healthcare domain, 76% of women believed that children and women will be more vulnerable to health risks if population increases. In the emotional domain, 64% of women disagreed with the item “a decrease in population size will increase the family relations.” In the cultural domain, 71% of the women agreed that, “increase in the number of young people would result in the country’s scientific development.” In the economic domain, 70% of women stated that overpopulation will significantly increase people’s housing problems. In the domain of social consequences of population growth, 73% of women agreed that, “a decrease in population growth will decrease the number of young people and the country’s productivity” (Table 1).

Table 1.

Advantages and Disadvantages of Population Growth From the Iranian Women’s Perspective (n = 100)

Items	Agree	Disagree	Have No Idea
Healthcare
Lack of childbearing makes me doubt my reproductive health	25	52	23
Family planning programs increase the rate of abortion	49	18	33
Children and women will be more vulnerable to health risks if population increases	76	12	12
Emotional
More elderly people will be rejected by their families with overpopulation	42	30	28
The rate of divorce will increase with overpopulation	19	69	12
A decrease in population size will increase family relations	20	64	16
Cultural
Childbearing will prevent me from continual education	30	50	20
With an increase in number of children, the chance of university education will decrease	28	57	15
Increase in the number of young people will result in the country’s scientific development	71	19	10
Economic
Food resources will not increase in proportion to the rate of population growth	19	60	21
If population decreases, family’s access to amenities will increase	52	34	14
Overpopulation will significantly increase people’s problems in housing	70	17	13
Social
The chance of juvenile achievement will increase if population decreases	24	59	17
The level of security will increase in the community if population decreases	26	54	20
A decrease in population growth will decrease the number of young people and the country’s productivity	73	15	12

Overall, 47% of the women were in favor of further childbearing, while 39% opposed it. Chi square test showed no significant relationship between women’s views and their personal characteristics.

Given the women’s attitudes, if appropriate strategies and policies are selected to improve public health and the community’s economic and cultural conditions, an increase in fertility and population growth would follow.