Thailand provides an example. For the past 30 years the country has been changing rapidly. For example, in 1965 only 6% of villages had access to electricity; in 1980, 36%. The provincial road system expanded from less than 3,000 kilometers in 1965 to nearly 20,000 in 1984. Thailand's government was once pronatalist, as late as 1956 offering couples bonuses for having large families. Then, in 1970, the government changed course and began to promote family planning widely. Most Thais welcomed the change. For example, in focus-group discussions many Thais spontaneously expressed approval of the government's new family planning policy (89 ).

The most effective family planning programs operate where governments have a commitment not only to providing family planning but also to improving people's lives in other ways (45). Better child survival, women's education, and improved living standards may create more demand for family planning and facilitate delivery of high-quality family planning services. As programs in East Asia have demonstrated, political commitment to family planning most often leads to a rapid rise in contraceptive use when combined with strong support for other economic and social development activities (94 ).