Population growth and policy options in the developing world

John Bongaarts Vice President and Distinguished Scholar

Outline

• Population trends

• Evolving policy interest

• Policy options

o Family planning programs

o Beyond family planning

0

2

4

6

8

10

1900 1950 2000 2050 2100

Billions

Population projections

2010–2100

World (+3.2 billion) Asia (+0.4 billion)

Africa (+2.5 billion) Europe, L. and N. America

Source: United Nations 2011.

Population growth rates 2005-2010

Adverse effects of rapid population growth and high fertility

Governmental Inadequate investment in education, health services, and infrastructure

Economic Low wages, unemployment, poverty, inequality

Environmental Depletion of natural resources, climate change, pollution

Political Social and political unrest

Health High birth rate raises maternal and child mortality

0

200

400

600

800

1000

1995 2000 2005 2010

Millions $

International donor expenditures for family planning

Recent return of interest in population and family planning

• Sub-Saharan Africa expected to add

1 billion by 2050 despite AIDS epidemic

• Environmental concerns return: global warming, spikes in food and energy prices

• Economists discover the “demographic dividend”

Demographic dividend

0

1

2

3

4

5

6

7

8

1950 1975 2000 2025 2050

Bir

ths/w

om

an

Fertility trend Ethiopia

0

2

4

6

8

10

12

14

16

0-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80+

Millions

Age

2010 (50% <age 18) 1950

ETHIOPIA

Population by age, 1950 and 2010

0

2

4

6

8

10

12

14

16

18

0-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80+

Millions

Age

2050

2010

ETHIOPIA

Population by age, 2010 and 2050

45

50

55

60

65

70

1950 2000 2050

% o

f popula

tion

Percent of population of working age

Demographic

dividend

ETHIOPIA

Demographic dividend

Conclusions

• Rapid fertility decline results in large

changes in population age structure

• Rising proportion of workers leads to a

“Demographic dividend” for a few

decades

• Size of demographic dividend depends on

speed of fertility decline and on ability of

economy to productively employ workers

Population policy options

• Family planning programs

• Beyond family planning

Objectives of voluntary family planning programs

• Provide access to and information

about contraception

• Reduce “unmet need” for

contraception

• Reduce unplanned pregnancies and

their adverse consequences

0

10

20

30

40

50

60

2000 2005 2011

% o

f m

arr

ied w

om

en

Demand

Unmet need

Contraceptive use

Contraceptive use and unmet need, Ethiopia

0

25

50

75

100

Perc

ent

of all p

regnancie

s

Planning status of all pregnancies, East Africa 2008

Planning status

Unintended

Intended

Pregnancy outcome Abortion Unintended birth Intended birth

0

10

20

30

40

50

1974 1976 1978 1980 1982 1984 1986

Contr

aceptive u

se (

%)

Successful family planning experiment in Matlab, Bangladesh

Experimental area

Control area

0

1

2

3

4

5

6

7

8

1975-1980 1980-1985 1985-1990 1990-1995 1995-2000 2000-2005

Bir

ths p

er

wom

an

Fertility: Pakistan vs. Bangladesh

Pakistan

Bangladesh

0 2 4 6

IndonesiaPhilippines

IranJordan

BangladeshPakistan

KenyaUganda

RwandaBurundi

Births per woman

Fertility impact of family planning programs

Weak program

High quality program

Providing family planning to all women with an unmet need would prevent:

• 23 million unplanned births

• 22 million abortions

• 7 million miscarriages

• 1.4 million infant deaths

• 142,000 pregnancy-related deaths (53,000 from unsafe abortion)

• 505,000 children from losing their mothers

Source: Guttmacher Institute 2008.

Beyond family planning

0

50

100

150

200

1950 1975 2000 2025 2050 2075

Millions

Components of population growth, Ethiopia

Population increase 2010–2050

UN Projection

0

50

100

150

200

1950 1975 2000 2025 2050 2075

Millions

Components of population growth, Ethiopia

Effect of:

High fertility Momentum

UN Projection

Unwanted fertility

High wanted fertility

Momentum due to young age

structure

• Strengthen family planning programs

• Invest in human capital (e.g. girls’ education)

• IEC messages

• Delay first birth and space births

• Address the needs of adolescents

Causes of growth Policy options

0

1

2

3

4

5

6

7

No education Primary Secondary

Bir

ths p

er

wom

an

Wanted and unwanted

fertility by level of education

Unwanted fertility

Wanted fertility

10

12

14

16

18

20

22

No education Primary Secondary

Media

n a

ge

Median age at first marriage, Ethiopia (women aged 25–49)

0

50

100

150

200

1950 1975 2000 2025 2050 2075

Millions

Impact of 5-year delay in age at childbearing

174 million

142 million

5-year delay

0

1

2

3

4

5

6

7

8

1950 2000 2050 2100 2150

Billions

+0.5 birth -0.5 birth

Constant fertility

Medium

0.86 billion in 2010

Sub-Saharan Africa

Small fertility changes have large future population impact

Conclusions

• Population size of poorest countries is

expected to double between 2010 and 2050

• Substantial adverse health, socioeconomic,

environmental, and political consequences

• Policy options:

ostrengthen family planning/RH programs

o invest in human capital (girls education)

odelay childbearing, address needs of adolescents

• Potentially large demographic dividend