Demographic policies are among the most influential aspects of decision making in the health sector, but the values embodied in different choices are not commonly analysed.  

Population policies or “demographic engineering”, as some advocates have called it, is contentious, shaped by values and ideologies. Defined as “a specific set of governmental objectives relative to the population magnitude and/or composition together with the instruments by which it may be possible to achieve them”, population policies related to increasing birthrates are typically categorised as being pro-natalist , and those intended to decrease birthrates are anti-natalist, although population policies also consider issues of migration and mortality. Countries use targets (eg a one-child policy) or a series of incentives (eg cash or kind subsidies) or disincentives (eg discontinuation of benefits for larger families) or legislative actions (eg limiting access to contraception). However, there has been an increasing acknowledgement that it is important to address the factors influencing the number of children people wish to have. The International Conference on Population and Development (ICPD), held in Cairo, Egypt in 1994 highlighted the importance of taking a rights approach to reproductive health7. While strides have been made in access to reproductive health, there are underserved communities (eg differently abled groups) and given the increase in mean age of the first birth, the need for alternative reproductive service support.