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The Missing Links in the Demographic Dividend
›March 9, 2012 // By Elizabeth Leahy MadsenThe “demographic dividend,” a concept that marries population dynamics and development economics, is on the rise in policy circles – Rajiv Shah, Melinda Gates, and African government ministers have all discussed it recently in high-level forums. Most notably for demographers, World Bank Chief Economist Justin Yifu Lin wrote a blog post that focuses on the demographic dividend’s potential to give developing countries a powerful economic boost through declining dependency ratios and a proportionately large working-age population.
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Stuck: Rwandan Youth and the Struggle for Adulthood (Book Preview)
›Several years ago, I wrote that the central irony concerning Africa’s urban youth was that “they are a demographic majority that sees itself as an outcast minority.” Since that time, field research with rural and urban youth in war and postwar contexts within and beyond Africa has led me to revise this assertion. The irony appears to apply to most developing country youth regardless of their location.
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Afghanistan and Pakistan: Demographic Siblings? [Part Two]
›February 15, 2012 // By Elizabeth Leahy MadsenLate last year, Afghanistan’s first-ever nationally representative survey of demographic and health issues was published, providing estimates of indicators that had previously been modeled or inferred from smaller samples. My first post on the survey focused on the methodology and results, which found that Afghanistan is not as much of a demographic outlier as many observers had assumed. But perhaps the most surprising finding is how the results compare to those of Afghanistan’s neighbor, Pakistan.
The political future of each country depends largely on the other and, with Afghanistan making progress on reproductive health issues that remain stalled in Pakistan, their demographic trajectories are heading toward closer synchronization as well. In one key measure – use of contraception among married women – Afghanistan is almost identical to Pakistan. The modern contraceptive prevalence rate is 19.9 percent, slightly lower than the rate of 21.7 percent in Pakistan.
While Pakistan faces its own serious political instability, it is widely regarded as more developed than its neighbor. Afghanistan is included in the UN’s grouping of least developed countries, and Pakistan is not. Pakistan’s GDP per capita is almost twice as high. On the surface, this should suggest lower fertility. There is a general negative relationship between economic development and fertility, though demographers are quick to point out its complexities, and David Shapiro and colleagues have found that countries with larger increases in GDP actually experience slower fertility declines.
Pakistan’s fertility rate of 4.1 children per woman is in fact 20 percent lower than Afghanistan’s, but the similarities in contraceptive use, which is one of the direct determinants of fertility, suggest that this gap could be shrinking. If Afghanistan’s median age at marriage (18 compared to 20 in Pakistan) was higher and more women were educated (76 percent of women have never been to school compared to 65 percent in Pakistan), the two fertility rates might be closer.
Pakistan’s Entrenched Challenge
Why are these indicators closer than might be expected? Relative to the other countries in South Asia, Pakistan has had considerably less success in promoting family planning use. Bangladesh has a per capita income about half that of India and one-quarter that of Sri Lanka, yet the three countries’ fertility rates are identical. Nepal has the lowest income in the region – even slightly below Afghanistan – yet more than 40 percent of married women use modern contraception and fertility is three children per woman. And then there is Pakistan. Despite a per capita income 90 percent that of India, only 22 percent of married women use modern contraception and fertility remains persistently high at over four children per woman.
The weaknesses of Pakistan’s family planning program have been well-documented. Government commitment has been lacking and cultural expectations and gender inequities are a powerful force to promote large family size. The country’s most recent DHS report cited disengagement with the program among local agencies, low levels of outreach into communities, and weak health sector support as likely causes for the stagnation of contraceptive use. In summer 2011, the Pakistani government abolished the federal Ministry of Health and empowered provincial governments with all responsibilities for health services. This transfer of authority could pay dividends by increasing local ownership of health care, but some in and outside Pakistan have raised concerns about the loss of regulatory oversight and information sharing entailed in total decentralization.
Compared to the Afghanistan survey, the most recent Pakistan Demographic and Health Survey provides more detail on women’s motivations and preferences regarding fertility and family planning. Overall, 55 percent of married women in Pakistan have a “demand” for family planning; that is, they wish to avoid pregnancy or report that their most recent pregnancy or birth was mistimed or unwanted. More than half of these women are using family planning, while the remaining 25 percent of married women have an “unmet need.”
Unintended pregnancies and births play a major role in shaping Pakistan’s demographic trajectory. The DHS survey finds that 24 percent of births occur earlier than women would like or were not wanted at all. If unwanted births were prevented, Pakistan’s fertility rate would be 3.1 children per woman rather than 4.1. Yet 30 percent of married women are using no contraceptive method and do not intend to in the future. The most common reasons for not intending to use family planning are that fertility is “up to God” and that the woman or her husband is opposed to it.
Linked Destinies
Just as Afghanistan and Pakistan’s political circumstances have become more entwined, their demographic paths are more closely in parallel than we might have expected. For Afghanistan, given the myriad challenges in the socioeconomic, political, cultural, and geographic environments, this is good news; for Pakistan, where efforts to meet family planning needs have fallen short of capacity, it is not. While Afghanistan is doing better than expected, Pakistan should be doing better.
Regardless, both countries are at an important juncture. With very young age structures and the attendant pressures on employment and government stability, each government must reduce unmet need for family planning or face mounting difficulties to providing for their populations in the future. In addition to rolling out health services, turning the share of women without education from a majority into zero would be an excellent way to start.
Elizabeth Leahy Madsen is a consultant on political demography for the Wilson Center’s Environmental Change and Security Program and senior technical advisor at Futures Group.
Sources: Afghanistan Ministry of Public Health, Bongaarts (2008, 1978), Cincotta (2009), Embassy of Afghanistan, Haub (2009), International Monetary Fund, MEASURE DHS, Nishtar (2011), Population Action International, Savedoff (2011), Shapiro et al. (2011), UN-OHRLLS, UN Population Division, U.S. Census Bureau, The Washington Post.
Image Credit: Chart arranged by Elizabeth Leahy Madsen, data from MEASURE DHS. -
Afghanistan’s First Demographic and Health Survey Reveals Surprises [Part One]
›February 14, 2012 // By Elizabeth Leahy MadsenLate last year, Afghanistan’s first-ever nationally representative survey of demographic and health issues was published, providing estimates of indicators that had previously been modeled or inferred from smaller samples. It shows that Afghan women have an average of five children each, lower than most experts had anticipated, and that their rate of modern contraceptive use is just slightly lower than that of women in neighboring Pakistan.
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Political Demography: How Population Changes Are Reshaping International Security and National Politics (Book Launch)
›“The world’s population is changing in ways that are historically unprecedented,” said Jack Goldstone, George Mason University professor and co-editor of the new book, Political Demography: How Population Changes Are Reshaping International Security and National Politics. [Video Below]
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Caryle Murphy for the Middle East Program
Saudi Arabia’s Youth and the Kingdom’s Future
›Saudi Arabia is passing through a unique demographic period. …Approximately 37 percent of the Saudi population is below the age of 14. Those under age 25 account for around 51 percent of the population, and when those under 29 are included, young people amount to two-thirds of the kingdom’s population. (In the United States, those 14 years and younger are 20 percent of the population; those 29 and below make up 41 percent.)
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Papua New Guinea Youth Conflict Study Reveals Effects of Civil War on Young Men
›Demographic security is fast becoming a central concept in discussions about the relationship between youth and violence, and, although quantitative work has been the normal mode of research in the field, recent evidence from Papua New Guinea’s autonomous region of Bougainville shows the value of understanding local-level nuance.
Policies to support youth in post-conflict situations are important for building peace, particularly given the “youth bulge” thesis that suggests that large cohorts of marginalized young people are contributing to a demographic “arc of instability” across the developing world. However, the statistical evidence showing correlations between youth bulges and an increased risk of instability has been criticized for failing to account for the agency of youth themselves. For instance, Marc Sommers points out that there is “scant information on how and why most marginalized African youth resist engagement in violence even when it would seem to provide immediate benefits.” This lack of detailed, evidence-based knowledge can frustrate efforts to develop effective youth policies, particularly in post-conflict settings, where the risk of the persistence or even return of violence, is arguably increased by the presence of youth bulges.
Bougainville’s “Crisis Generation”
Hoping to address this lack of knowledge about how and why young people engage in peace or violence in post-conflict settings, I recently spent several weeks in Bougainville. My aim was to study how young men make lives for themselves in the social circumstances that exist nine years on from a civil war that lasted more than a decade and claimed more lives than any Pacific conflict since World War II. The qualitative evidence I collected on these pathways informed analysis in an article co-authored with Jon Barnett in the Journal of Political Geography, “Localising Peace: The Young Men of Bougainville’s ‘Crisis Generation’” (subscription required).
With a 2010 median age of just 20.4 years (projected to remain less than 25 until at least 2030) and more than 60 percent of its population less than 30 years old, Papua New Guinea is among the world’s youngest states, according to UN population data. Despite a wealth of natural resources, the state faces severe challenges to providing education, jobs, and security for a young population whose growth has for many years severely outpaced the capacity of its formal institutions. Papua New Guinea, and the region of Bougainville within it, is a state where demographic strains are reasonably expected to continue to pose risks to an already fragile state.
Bougainville’s 18-to-30-year olds, known among their peers and elders as the “crisis generation,” are those with living memory of the violence but who were too young to have fought on either side. They continue to face challenges with trauma, accessing education and work, achieving social standing, and escaping from histories of violence. These sometimes impede their capacity to participate meaningfully in local society and can lead them towards sporadic acts of violence.
Understanding the Pathways to Violence
For many young men in Bougainville, achieving critical social measures of success – such as amassing the wealth required for marriage – has become nearly impossible due to high unemployment and restricted access to education. Marriage matters, since land rights in Bougainvillean societies are generally derived matrilineally, and therefore young men who are unable to marry tend to lack secure access to land.
Education is a critical institution for young men in Bougainville. Unfortunately, the formal sector that might employ young men upon completing secondary education is very small, and therefore much of the time and money spent pursuing that education is wasted. The education system itself lacks the resources to meet the needs of all those who seek secondary education. To cope with the demand, youth are asked to sit for exams in grade 8 and again in grade 10, a practice which creates high failure rates and whittles down the student cohort from several thousand at primary level to only a few hundred at the completion of secondary schooling (few of whom then receive meaningful employment). For many, this failure to obtain a return on years of school fees places significant strain on the relationships between youth and their familial and social networks.
Some adapt to these challenges by “upgrading” their poor education through distance learning or by seeking out vocational training as a way to obtain skills relevant for rural life. But some are seen as wedged between a set of unworkable options: “Many of them are existing in a vacuum,” said one civil society leader. “They see things outside but they cannot grab them and they cannot ground themselves.”
As a result, many turn to homebrew alcohol and marijuana and a select few seek social standing by adopting displays and acts of violence that imitate the personas of former rebels. Of these choices, the first attracts the stigma of “lazy,” and the second, “dangerous.” In both cases, these stigmas risk overshadowing the legitimate challenges facing young men by distilling the complexity of the world into a simple morality crisis that itself creates divides both between and within generations.
Building Policy Prescriptions
Unfortunately, the sorts of life and trauma counseling services capable of engaging these young men remain under-supported. As one youth worker claimed of the youth who have no memory of life before the war, “They don’t know how it was before the Crisis. They think things have always been this way; that this is normal.”
In a more southern district, one young man explained of his more notorious peers, “It’s these guys roaming around, mixing with ladies and drinking, they cannot reason so they use the gun, the knife – offensive weapons. And when they are sober they regret. These people spoil the peace process here in Bougainville.”
Providing viable alternatives to these lifestyles is crucial and can only be achieved by asking young men themselves about their world, about the challenges they face, and about the strategies they take to maneuver through them. By understanding the social, cultural, and geographical specifics of a local context, this form of analysis provides a valuable starting point for determining and evaluating policy interventions that statistics alone cannot provide.
In Bougainville’s case, an expansion of vocational training and the provision of trauma counseling, regardless of whether a person was a combatant or not, are two desperately needed interventions that have the potential to increase the capacity of young men to achieve success through peaceful means.
Sources: Conciliation Resources, The Sydney Morning Herald, UN Population Division.
Photo Credit: “Mekamui/Panguna” and crossing from Buka to Bougainville, courtesy of flickr user madlemurs. -
Indonesia: Pioneering Community Outreach Creates Success Story
›January 31, 2012 // By Elizabeth Leahy MadsenThis is the third post in a series profiling the process of building political commitment in countries whose governments have made strong investments in family planning. Previous posts have profiled Rwanda and Iran.
While the two other countries profiled in this series, Rwanda and Iran, have only reinvigorated their family planning programs within the past 20 years, Indonesia’s story begins in the 1960s. In this respect, the world’s fourth most populous country is classified among the pioneers of family planning in the developing world and has been described as a “world leader” and “one of the developing world’s best.” An extensive community outreach program combined with a centralized government that made family planning a priority were key to Indonesia’s success story.
Jakarta Pilot and Religious Support Motivates National Scale-up
For a decade and a half after the struggle for independence from the Dutch ended in 1949, the government of President Sukarno ruled out any government support for family planning. According to a Demographic and Health Survey (DHS) report, the rate of contraceptive use among married women at the time was essentially zero. Fertility rose slightly during this period, from an average of 5.5 in the early 1950s to 5.6 children per woman a decade later. However, in 1965, Sukarno was overthrown, and the next year, a military general named Suharto assumed power in an uprising that left as many as half a million people dead.
Suharto’s regime would last until 1998. Though he operated with a “heavy hand” amidst personal corruption, Suharto also aggressively pursued economic development and brought about a policy shift towards promoting family planning. Despite initial reservations – Suharto believed that the people would oppose family planning on religious grounds – various domestic and international advisers convinced him otherwise.
General Ali Sadikin, the governor of Jakarta – a city of three million even then – was particularly influential in convincing Suharto. According to Australian demographer Terence H. Hull, who has written extensively about population issues in Indonesia, Sadikin was “quickly learning demographic lessons in his attempts to renovate a city with poor housing, schooling, transport, and basic services,” and he began to regularly speak out about the challenges that rapid population growth posed to his goals of urban development.
Sadikin decided to support the Indonesian Planned Parenthood Association, which had a network of clinics offering family planning, but lacked the funding to meet more than a small amount of demand. With the public support of Sadikin, a Jakarta-wide pilot program was operational in 1967.
Hull reports that a second integral event in the early years was a 1967 meeting between government officials and Muslim, Protestant, Catholic, and Hindu leaders representing four of the country’s major religions. Following the meeting, a pamphlet called “Views of Religions on Family Planning” was published, representing “a tipping point when national consensus around the morality of birth control was turning from strongly negative to strongly positive.”
A Strong Coordinating Board Reaches out to Communities
By late 1968, efforts were in place to scale up the family planning program in Jakarta to the national level. The National Family Planning Coordinating Board (BKKBN in Indonesian) was created and quickly became entrenched throughout the country thanks to generous funding, including from international donors.
The BKKBN’s emphasis on the community level, which ensured that family planning services and awareness-generating activities were reaching people around the country through multiple channels, was a key factor in the program’s achievements. The organizations involved in promoting family planning messages at the community level included youth, women’s and religious groups, employers, and schools, with high-level support reiterated regularly by the president. Hull described the BKKBN’s efforts as “a true collaboration because the program emphasized institutions not normally associated with family planning, but did so in a way that was both socially acceptable and socially invigorating.”
In the program’s first two decades, the contraceptive prevalence rate for modern methods rose from almost nonexistent to 44 percent, and fertility subsequently fell from 5.5 to 3.3 children per woman. These changes are widely attributed to robust government sponsorship from the highest levels, together with effective grassroots implementation that fostered support from nearly all sectors of society.
In subsequent years, Indonesia experienced rapid economic and social development. Per capita income increased more than 20 times over between 1966 and 1996, with initial growth largely due to oil revenues. Other development indicators also improved dramatically. The literacy rate is now over 90 percent, nearly all girls attend school, and half of women are members of the labor force. However, Hull cautions against proclaiming the family planning program the primary causal factor in these successes. Family planning and other development programs would not have been as effective, he says, without changes in the political structure, which steadily became more centralized and stable in its oversight of a very heterogeneous society.
A Recent Plateau
As Indonesia continued to develop and its political system evolved, the family planning program has faced some challenges in the past 15 years. Suharto resigned in the face of widespread opposition in 1998, after more than 30 years in power. While this brought positive movement towards democracy, the ensuring political uncertainty shifted the government’s energies away from reproductive health and other aspects of social development.
In the early 2000s, the family planning program was decentralized to district and municipal levels, in line with political reforms aimed at diminishing the role of central hierarchy nationwide. District leaders were charged with planning, budgeting, and implementing family planning and other primary health services. In accordance, BKKBN modified its strategies to become even more community-oriented. Still, observers judge the family planning program to have “weakened” following decentralization.
With strong logistics, popular support, and donor assistance, contraceptive use continued rising during the years of political transition. By 2002-2003, 57 percent of married women were using a modern contraceptive method and the fertility rate had reached 2.6 children per woman. However, these indicators remained unchanged in the next national survey, conducted in 2007. Fertility in Indonesia is at the median for Southeast Asia – higher than Thailand and Vietnam and lower than Cambodia and the Philippines.
The Program Moves Forward
As democracy became more secure in the early 2000s, the country’s next generation of leaders kept sight of demographic issues. In 2005, President Susilo Bambang Yudhoyono stated, “High population growth without rapid economic growth will result in poverty and setbacks … Large numbers of children and high populations will only bring advantages if they are skilled.” BKKBN and the Ministry of Health worked with USAID, public health researchers, NGOs and others to develop national family planning standards for quality of care, which were devised and implemented in the early 2000s.
Judging the program’s achievements to have been substantial and its momentum sustainable, USAID graduated Indonesia from population assistance in 2006, after 35 years. Though gaps remain, women’s fertility preferences are largely being met.
Today, 80 percent of all births are intended, and unmet need for family planning – the share of married women who wish to delay or prevent pregnancy but are not using contraception – stands at nine percent, two percentage points below the average for Southeast Asia and all developing countries. Meanwhile, Indonesia’s demographic profile looks much different than it might have. At the time of graduation, USAID reported that without its long-standing and well administered family planning program, Indonesia’s 2006 population would have been larger by 80 million people, or 35 percent.
Elizabeth Leahy Madsen is a consultant on political demography for the Wilson Center’s Environmental Change and Security Program and senior technical advisor at Futures Group.
Sources: Demographic and Health Surveys; Hull (2007); Management Sciences for Health; New York Times; UN Population Division; USAID.
Photo Credit: “Jakarta,” courtesy of flickr user frostnova.
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