1' Outline

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1. Outline

• Some MDGs (less child mortality, womens
  non-education, poverty)?lower family size norms?
  lower fertility? faster growth, more equal
  distribn ?less pov, mort, under-educn. Evidence
  on size of effect underlying household decns,
  role size of demog bonus fert decline?fall
  in dependency ratio (dependants/prime-agers
  15-64). Bonus pov impact were/are big in Asia
  SSA potential?
•  Fert transition mass pov reduction under way
  in most poor areas, slower to start spread in
  SSA. TFR fell 1950/5-2000/5, from 5.9 to 2.5 in
  Asia, LA. Africa TFR 6.7 in 1950-5 1970-5
  fell only to 5.0 by 2000-5. 2005 162 m (of
  Africas 906 m, SSA 751m) lived in countries
  where fert transition had not begun. Link to
  SSAs lags on pov, other MDGs?

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1. Outline contd

• Fert reduction (and hence demog bonus) depends on
  policy - can stall (Kenya). If it happens,
  productive work (for the extra workers per
  dependent) needed for full pov-reducing benefits,
  as in E S Asia from 1970s (green revolution).
  So some SSA countries donors should engage more
  with financing popn policy family planning
  incentives conditions for its widespread use
  the (initially mainly farm-based) employment
  opportunities for mass gains from the resulting
  falls in dependency ratios. 

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2. Poverty effects of fertility change

• Growth Kelley Schmidt 1995 in 1960-90, fert
  fall in median devg country raised 15-year-later
  growth c. 1.4. Why? Past high fert, falling
  child mort, fert decline, raise working saving
  proportions of popln. Bloom Williamson 1997
  this explains 1.7 of East Asias 5.5 annual
  growth, 1970-90. Worked in E Asia (and after 1980
  S Asia) because extra saving-per- GDP profitably
  invested, extra workers-per-dependant gainfully
  employed.
• Distribution Eastwood Lipton 1999 45 dvpg
  countries growth dist effects of lower fert
  each explain 20-25 per cent of 10-yr-lagged
  variance in pov fall. Why? (a) poor rely most on
  labour-inc, so gain most if dep-ratio falls (b)
  slower pop g raises wage or cuts unemp,
  restrains food price (Malthus), (c) more scope
  for dep-ratio falls for poor.

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2. Poverty effects of fertility change- contd

• Conversion effect high fert v poors conversion
  effic.
• Total effects of high fertility on pov Eastwood
  Lipton (1999) typical country had 18.9 pov
  1980 had it only cut fert 5 per 1000, 1980-90,
  pov would fall by 6.3, 1990-2000 - more, if
  impact via public consumption conversion
  efficiency measurable.

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3. The bonus

• Malaria and malnutrition fall?IMR falls sharply.
• Fewer new-borns, but persons from higher
  birthrate times join workforce ? 15-20 yrs of
  DepR rise
• DepR stabilises/falls slightly, as growing
  cohorts of child-survivors reach working age.
• Meanwhile, fert slowly adapts to falling IMR
  TFRs fall, and 10-15 years later (due to
  momentum) CBR falls. Then newborns, and therefore
  DepR, fall sharply the demographic bonus.
• Huge in Asia, predicted huge in Africa, but both
  the bonus and its benefits depend on policy.

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3. The bonus contd

• SSAs projected falls in DepR of 20-30
  2005-2039, 40-50 2005-50, could transform
  economies. Boost fading in Asia (more over-65s),
  but almost all SSA projects little old-end DepR
  rise by 2050.
• Projected SSA young-end dep-ratio fall requires
  mechanistic assumptions of continued - or started
  - fertility behaviour change. Specially where
  CBRs havent started to fall (parts of W/Central
  SSA), big policy action, mostly rural (cut IMRs
  by free preventive health transmit to TFR/CBRs
  by family planning, womens ed) needed for demog
  bonus to work as projected. Everywhere, action to
  raise demand for labour, in early decades mainly
  in farming, needed to turn any bonus into poverty
  reduction.

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4. Projecting the bonus credibly Bangladesh

• Bangladesh IMR tumbled 200 (1950-5), 104
  (1985-90), 59 (2000-05) projection 23 (2025-30),
  13 (2045-50). TFR 6.7-6.8 1950-65, halved to 3.25
  by 2000-2005 (projected 1.94 2045-50). CBR stable
  upwards 1950-5 (46.6) to 1960-65 (47.3), crawled
  down to 1975-80 (41.1), then crashed to 27.6 by
  2000-5 (projected 18.5 2025-30, 145.1 2045-50).
  So DepR rose 29 from 70 (1950) to 90 (1965,
  70,75) while IMR crashed, CBR crawled.
• Then, as CBR crashed but earlier-born kids
  reached working age, DepR fell 29 to 64
  (1975-2005). Almost all change at young end.
• Projection 24 DepR fall, 64 to 49 (2005-30)
  stable 2030-50 old-DepR rise offsets young-DepR
  fall.

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4. Projecting the bonus credibly Bangladesh
contd

• Past CBR trends - due to long-falling IMR to make
  parents confident improved female education and
  employment family planning efforts make
  Bangladeshs projected continued fall in CBR and
  TFR, and hence the DepR bonusto 2030, credible
  (but, due to ageing, DepR window shuts after
  2030).
• Also past irrigation and ag research and
  labour-intensive export growth - make it credible
  that Bangladesh can use extra workers and savers
  productively, turning the bonus into continued
  poverty reduction.

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5. Plausible African projections, given effort
Kenya

• DepR fall of 25 2005-25, 38 2005-50 big
  potential bonus but projections need policy to
  work.
• IMR fell 134 (1950-5) to 67 (1985-90) then
  trend-less (68 in 2000-5) yet projected to fall
  to 43 in 2025-30, 27 in 2045-50. Needed to keep
  TFR falling.
• TFR rose from 7.5 (1950-5) to 8 (1970-5), then
  fell to 5.0 (1995) but stagnated to 2005 renewed
  fall projected to 3.22 (2025-30) , 2.39
  (2045-50).
• CBR crawled down from 51.4 (1950-55) to 45
  (1985-90), fell to 37.5 (1995-2000), but then
  stabilised (38.8 in 2000-05) projected to renew
  fall, to 27 in 2025-30, 20 in 2035-50.

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5. Plausible African projections, given effort
Kenya contd

• DepR therefore first rose 78 (1950), 111-112
  (1975, 1980, 1985) , then fell 25 to 84 (2005)
  projected 63 (down 25) 2030, ?52 (down 38)
  2050. All young-DepR change (Old-DepR 6-7,
  1950-2030 ?10 in 2050). Perhaps if IMR fall
  restarted CBR fall, and hence TFR fall, with
  family planning campaigns and female-ed growth,
  will resume? DepR falls - but policy-dependent.

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6. More and less credible SSA bonuses

• Nigeria IMR 184 in 1950-5, ?20/decade to 127
  (1980-5), then slowed to 7 per decade to 100 in
  2005. TFR stayed 6.8-6.9 1950-90, ?to 5.9,
  2000-5. CBR stable c 48, 1950-90 only ?to 42,
  2000-5. DepR 81 (1950), 94-6 (1985-90-95), 90
  (2005).
• Yet projected CBR fall at 6/decade underpins
• DepR projected ?32 2005-30 (90-62), 49 1995
  -2050 (96-49). All young-DR fall 1995-2030.
• CBR?DepR projs hopeful feasible? If so, oil v.
  ag to employ extra 15-65s, get poverty down?

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6. More and less credible SSA bonuses contd

• Ethiopia IMR 200-100, 1950/5-2000/5 ? slowing.
• TFR, CBR crawled ?to 1985-90 some speedup DepR
  (89 (1950), 92-5 (1975-2000), 90 (2005))
  projections assume 6/decade CBR? as workforce?
  67 (2030 26?2005-30), 52 (2050 43?2005-50).
• Using any bonus against poverty like Kenya, one
  of SSAs better ag support systems but big water
  (and policy) problems in raising ag-based
  employment.
• DR Congo IMR 167(?more)-117, 1950-75, then
  static to 2005. TFR 6 (1950-5) ?to 6.7, stable
  1980-2005. CBR stable c 48, 1950-2005. So DepR 90
  (1950) to 98-102 (1985-2015). Yet model assumes
  IMRs, CBRs crash, so DepR projection 102 (2005),
  88 (2030) (?14), 62 (2050) (?40) wishful? If
  it happens, how to turn bonus into poverty
  reduction?

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7. Summary and conclusions

• Fertility reduction is highly effective to cut
  poverty.
• There is a virtuous circle, as with some other
  MDGs.
• IMR??TFR??CBR??DepR? is the main path.
• This explains much of the Asian miracle.
• But it requires policy to GET and USE the bonus.
• Fertility transition is well under way in
  countries with 80 of SSAs people.
• But its much slower, especially in rural areas,
  than in Asia. IMR, TFR and CBR cuts have been
  later, slower, halting, even sometimes reversible.

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7. Summary and conclusions contd

• Realising SSAs projected bonuses will require
  as it did in Asia - strong policy on child
  health, female education work prospects, family
  planning access.
• Turning any SSA bonuses into poverty reduction
  so dramatic in Asia will require using the
  extra saving and workers (per dependant)
  productively.
• All experience suggests this starts with
  employment-intensive technical progress on small
  farms.
• It can be done but isnt automatic!

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Population, Poverty and the MDGs

• John Cleland
• London School of Hygiene Tropical Medicine

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• Whats the magnitude of the problem?
• What needs to be done?
• Can programmes be effective in poor countries?

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Population Growth, 2005-2050, by region
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Figure 3 Classification of 75 low and
lower-middle income countries by population
growth (2005-2010) and unmet need for
contraception
Low (lt10)
Medium (10 - 19
High (20)
Unmet Need
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Key indicators for Niger
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What needs to be done?

• Re-forge link between investment in FP and
  poverty-reduction that was broken in 1994 at
  Cairo.
• Stop cloaking FP in that obfuscating phrase
  sexual and reproductive health
• Recognise that priorities in poor countries are
  increasingly divergent population/fertility is
  a bigger problem than AIDS in most of Africa but
  not in Southern Africa.

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What needs to be done? Contd

• Fight myopia implicit in 2015 for MDG achievement
• Realise that leadership will not come from US
  administration
• Reverse decline in international FP funding

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Can programmes be effective in poor countries?

• Example of Bangladesh Nepal
• Patronising and false to believe that poor
  couples are not interested in controlling their
  family size
• Kenya - cause for hope and concern

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Conclusions

• Most poor countries already have appropriate
  population FP policies
• BUT they have received far too little
  encouragement from donor agencies to implement
  them with commitment.
• Donors must take much of the blame Excessive
  political correctness? Fads and fashions?
• Renewed emphasis on population stabilisation and
  FP and respect for reproductive rights are
  compatible