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(November 2004) Family planning programs have yielded dramatically positive gains over the past 50 years. In developing countries, about half of couples now use modern contraception. Since the 1960s, the average family size in developing countries has dropped from about six or seven children per woman to about three children. These trends have meant millions of lives saved and additional benefits for women and children who are healthier and can achieve greater levels of education and empowerment.

Despite these gains, contraceptive use is still low and need high in some of the world’s poorest and most populous places. At least three in 10 pregnancies are unintended in some regions, and millions of couples are still unable to effectively choose the number and timing of their children. Moreover, some developing countries (such as Bangladesh) that have substantially reduced their fertility levels in recent decades are in danger of seeing that progress halted or slowed.

These challenges are immense, but not insurmountable. The past 50 years demonstrate that successful family planning programs can be developed even under difficult circumstances. Use of safe, voluntary contraception is also accepted worldwide. In 1994, representatives from 179 nations met in Cairo at the International Conference on Population and Development and agreed to provide reproductive health care to all people by the year 2015—a goal that called for countries to meet the family planning needs of their populations and provide universal access to a full range of safe and reliable family planning methods.