Are fewer children a route to prosperity?

For the past seven decades, high fertility and poverty have been strongly correlated, and the world’s poorest countries also have the highest fertility and population growth rates.

Lower birth rates, a major component of population growth (mortality and migration are other determinants), do not, by themselves, guarantee greater prosperity. But they do make economic gains more feasible. Smaller families improve economic prospects for the household, and longer birth intervals improve child and maternal health, generating benefits over children’s entire life course. In addition, smaller families enable more women to join the labour force or engage in other entrepreneurial activities.

At the aggregate level, lower population growth may reduce the pressure on national resources and the need for social investments. Over the longer term, smaller families change the age structures of both families and countries in which they live. The greater number of people in the work force compared to the number of dependents allows for greater saving and investment. In Brazil, the effect at the household level is estimated to account for as much as a third of recent poverty reduction.^[1]

Conversely, rapid population growth contributes to an increase of inequality. And, rising out of poverty is more difficult for larger than for smaller families.^[2]

At the country level, economic benefits from lowered fertility are possible because a larger proportion of people are of working age relative to older and younger people. When the working population is relatively large and policies foster job creation, countries can build human and physical capital. However, economists caution that these benefits are not automatic and that they depend on appropriate institutional environments.

The ability to plan how many children to have and when to have them is a recognized human right. However, universal access to contraceptives is not yet a reality — especially among the poorest. Worldwide, 200 million women would like to delay or prevent pregnancy, but are not using effective contraception. Simply meeting this ‘unmet need’ for contraception would go a long way toward lowering fertility.

Demand for family planning is expected to soar in the next 15 years as millions of young people become sexually active and smaller families become the norm in many countries. But funding for family planning is declining, and has been doing so for more than a decade.

As most developing countries recognize, committed and focused policies and programmes are urgently needed to moderate population growth as quickly as possible, thus enhancing economic growth and easing demands on social services.
 

Contents

• Get the Facts
• Benefits of Action
• What Must Be Done?
• Links between the ICPD and the Millennium Development Goals
• Real Stories
  
  • “Pregnant (Again) and Poor”
• Resources

Get the Facts

• World population is projected to rise by 2.3 billion people, from 6.8 billion in 2008 to 9.1 billion in 2050, assuming that fertility continues to fall in developing countries. Because of ‘population momentum’, rapid population growth will occur even if, as projected, smaller families become the norm worldwide.
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• If fertility remains constant, world population will reach 11 billion by 2050, with the population of less developed nations rising almost 2 billion (equivalent to the total world population in 1927) beyond the 7.9 billion currently projected for these countries.
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• From 2005-2010, the world population has been increasing by about 78 million a year -- almost the size of the population of Germany. Nearly all of the increase is in urban areas of the developing world.
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• Studies attribute about one-quarter of the ‘miracle growth’ in East Asia after 1960 and one-third of the increase in per capita income to a demographic ‘bonus’: a larger percentage of workers compared to dependents, resulting from fertility declines.^[3] In many countries of Africa, where fertility remains high, the dependency ratio has not yet begun to decline.
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• The 49 least developed countries have the fastest growth rate, averaging 2.3 per cent per year. In 1986, 24 per cent of the least developed countries considered their population growth to be too high. By 2007, the figure had risen to 78 per cent.^[4]
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• The high population growth in least developed countries is taking place in spite of high mortality, which also diminishes prospects for economic prosperity.
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• More than half of the developing countries have policies to lower fertility; of the least developed countries, 78 per cent have such policies.^[5] However, contraceptive use remains low in countries with high fertility, most of which are located in sub-Saharan Africa where contraceptive prevalence averages a low 22 per cent. In much of this region, social norms still favour large families.
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• Fewer than 20 per cent of sexually active young people in Africa use contraception. Barriers include insufficient knowledge, fear of social disapproval and side effects, and misperceptions about the partner’s opposition.
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• In Kenya, as a result of a diminished focus on family planning, the projected population in 2050 has been increased from 54 to 83 million. Some observers predict that an increase of this magnitude may lead to food scarcity and crumbling infrastructure.^[6]
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• In Latin America, the estimated poverty reduction effect of the elimination of unwanted fertility would be equivalent to a rise in per capita income of 10 to 20 per cent.^[7]
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• Some 215 million women worldwide say they want to delay or prevent pregnancy but are not using effective contraception.
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• Demand for modern contraception is expected to increase by about 50 to 75 per cent by the year 2020 in countries still reliant on donor assistance for implementing their programmes.^[8] Based on current trends, donor assistance will not keep pace.
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• In 2007, the total estimated cost for contraceptive care in developing countries was $17.1 billion. Although donor countries should have contributed about $3 billion, based on earlier pledges, they provided only about $500 million that year.^[9]
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• In 56 developing countries, the poorest fifth of women still average six births, compared to 3.2 in the wealthiest quintile.
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• Reproductive health issues, most of them related to pregnancy and childbirth, result in 250 million years of productive life lost each year and reduce the productivity of women by 20 per cent.^[10]
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• Total costs for sexual and reproductive health in developing countries, which include family planning and maternal health, are estimated at $27.4 billion for 2010.^[11]

Benefits of Action

• Each year, modern contraceptives help women prevent 215,000 pregnancy-related deaths (including 66,000 from unsafe abortions), 2.7 million infant deaths and the loss of 60 million years of healthy life.^[12]
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• People have the right to choose the number, spacing and timing of their children. The ability to fully exercise this right often leads to a significant reduction in the fertility rate.
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• Fulfilling the unmet need for family planning could reduce fertility by 35 per cent in Latin America and the Caribbean; 20 per cent in eastern and southern Africa and the Arab States, and 15 per cent in Asia and West Africa.
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• Having fewer, healthier children can reduce the economic burden on poor families and allow them to invest more in each child’s care and schooling, helping to break the cycle of poverty.
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• Expanding the number of women in the workforce by investing in their education could increase per capita income in some countries by as much as 14 per cent by 2020, and 20 per cent by 2030 in many developing countries.^[13]
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• Each dollar invested in contraceptive services will avoid between $1.70 and $4.00 in expenditures on antenatal, maternal and newborn health care in countries such as Bangladesh, Cambodia, Ghana, Tanzania and Uganda.^[14]
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• Each dollar spent on family planning can save governments up to $31 in health care, water, education, housing, sewers and other waste disposal.^[15]

What Must Be Done?

• Because population growth and poverty go hand in hand, interventions should attempt to address both issues simultaneously.
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• Meeting unmet need for contraception is a critical. But in many countries, where large families are still the norm, options for women need to be expanded so that they have valued social roles beyond motherhood.
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• Support child health initiatives. When people are convinced that all of their children will survive, they often desire fewer. Similarly, provide social safety nets so people do not need to rely on large families for security in old age.
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• Make sure couples have the ability to exercise their right to plan their families. This requires universal access to contraception education and materials, as well as to counselling in sexuality, health and reproductive rights.
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• Pay special attention to the needs of the poorest, who typically have the least access to information, services and supplies.
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• Energize high-level political and financial commitment to promote family planning at the global, regional, national and local levels. NGOs and civil society are crucial to this work.
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• Encourage governments in poor countries to follow through on the population and family planning policies that most have adopted, and, where appropriate, to work with governments and religious and community leaders to change social norms that favour large families.
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• Support data collection, analysis and research, so that information about population trends can inform policymaking.

Links between the ICPD and the Millennium Development Goals

The International Conference on Population and Development deals specifically with the many interconnecting and inextricable links between population, sustained economic growth and sustainable development.

While the Millennium Development Goals do not explicitly address population issues, high fertility is undermining prospects of reaching many of them. In most of Africa, high fertility and population growth rates pose a greater threat than HIV to reducing poverty and achieving the Millennium Development Goals. Rapid population growth will make the goals on poverty reduction (MDG1), universal education (MDG2), gender equality (MDG3) and environmental sustainability (MDG7) difficult for countries to achieve. At the household level, smaller families can directly improve prospects for gender equality (MDG3), fewer child deaths (MDG4) and maternal health (MDG5). Contraceptive services, especially male and female condoms, can contribute to HIV reduction (MDG6).

Real Stories

“Pregnant (Again) and Poor”

“For all the American and international efforts to fight global poverty, one thing is clear: Those efforts won’t get far as long as women like Nahomie Nercure continue to have 10 children. Global family-planning efforts have stalled over the last couple of decades, and Nahomie is emblematic both of the lost momentum and of the poverty that results”.

Read more: Op-ed from The New York Times, April 5, 2009. http://www.nytimes.com/2009/04/05/opinion/05kristof.html

References

1. Hakkert, Ralph. Potential Contributions to the MDG Agenda from the Perspective of ICPD: A Reference Guide to Evidence for Policy Dialogue in the LAC Region, 200, UNFPA, Ipea page 67
2. Hakkert, op cit page 57
3. Goldman Sachs: Women Hold Up Half the Sky, March 2008, accessed April 2009
4. World Population Policies (2007) UN Department of Economic and Social Affairs, Population Division
5. World Population Policies (2007) UN Department of Economic and Social Affairs, Population Division
6. The World in 2050 (The Fred Bixby Forum held in Jan, 2009)
7. Hakkert, op cit page 84
8. The baseline year is 2005. The lower number is the expected increase in demand based on projected fertility declines (UN median variant). The higher is required to eliminate unmet need for family planning in these countries. Of these projected increases, 33 per cent are due to population growth; the rest to expected increases in demand.
9. Guttmacher Institute, UNFPA. Contraception: An Investing in Lives, Health and Development. 2008 Series.
10. 2005 SWOP page 2
11. $64.7 Billion Needed for Population Programmes to Curb Poverty
12. Guttmacher Institute, UNFPA. Contraception: An Investment in Lives, Health and Development. 2008 Series.
13. Goldman Sachs, op cit
14. Guttmacher, op cit
15. Guttmacher, op cit