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Overcoming Pakistan’s Demographic Challenges
›Download Reaping the Divided: Overcoming Pakistan’s Demographic Challenges from the Wilson Center. Excerpted below is the introductory essay, “Pakistan’s Demographics: Possibilities, Perils, and Prescriptions,” by Michael Kugelman.
On July 11, 2010, Pakistani Prime Minister Yousaf Raza Gilani delivered a speech in Islamabad to commemorate World Population Day. He announced that in order to highlight the crucial connection between demographics and economic growth, 2011 would be designated “Population Year” in Pakistan. “All hopes of development and economic prosperity would flounder if we as a nation lose the focus and do not keep [the] population issue in the spotlight,” he declared.
Hopefully that spotlight comes with a long shelf life. Pakistan faces acute population challenges. If they are to be overcome, they will need to be illuminated for far more than a year.
Yet, there are exciting opportunities here as well. A long-term approach to managing the challenges presented by Pakistan’s burgeoning population, if accompanied by effective policies and sustained implementation, could spark a monumental transformation: one that enables the country to harness the great promise of a large population that has usually been viewed as a hindrance to prosperity. Indeed, demographers contend that Pakistan’s young, growing, and rapidly urbanizing population can potentially bring great benefits to the country. If birth rates fall substantially, and if young Pakistanis are properly educated and successfully absorbed into the labor force, then the nation could reap a “demographic dividend” that sparks economic growth, boosts social well-being, and promotes the rejuvenation of Pakistan.
The Young and the Rising
Because Pakistan has not conducted a census since 1998, estimating the country’s total population size is a highly inexact science. The Pakistani government lists the current figure at about 175 million people, while the United Nations believes the number is closer to 185 million. However, while the precise figure may be in doubt, the population’s rapid rise is not. Though no longer increasing at the 3 percent-plus rate seen in the 1980s, Pakistan’s population is still growing at a 2 percent pace. According to the UN Population Division’s latest mid-range demographic projections, released in 2009, the population will rise to 335 million by 2050. More than 60 million people are expected to be added in just the next 15 years.
This explosive increase, however, merely represents the best-case scenario, and will prevail only if the country’s fertility rates drop from the current average of about four children per woman to two. Should fertility rates remain constant, the UN estimates the population could exceed 450 million by 2050, with a total population of nearly 300 million as early as 2030.
Pakistan’s population is not only large and growing, but also very young, with a median age of 21. Currently, two-thirds of Pakistanis are less than 30 years old. As a percentage of total population, only Yemen has more people under the age of 24. Additionally, given that more than a third of Pakistanis are now 14 years old or younger, the country’s population promises to remain youthful over the next few decades. In the 2020s, the 15-to-24 age bracket is expected to swell by 20 percent. Pakistan’s under-24 population will still be in the majority come 2030. And as late as 2050, the median age is expected to be only 33.
Pakistan’s demographic profile contrasts with what is happening in much of the rest of the world. Sub-replacement level fertility rates (about two births per woman) prevail not only throughout the developed world, but also across much of Southeast Asia, the Middle East, and Latin America. As one commentator has noted, “the twenty-first century’s hallmark [demographic] trend appears to be a fertility implosion.” South Asia, along with sub-Saharan Africa, is one of the last regional bastions of youthful, rapidly proliferating populations. Yet even within South Asia, Pakistan stands out. Excluding Afghanistan, of all the member states of the South Asian Association for Regional Cooperation – Bangladesh, Bhutan, India, Maldives, Nepal, and Sri Lanka – Pakistan has the highest population growth, birth, and fertility rates; the youngest median age (tied with Nepal); and the largest percentage of people 14 years old or younger.
Continue reading “Pakistan’s Demographics: Possibilities, Perils, and Prescriptions,” or download the full report from the Wilson Center.
Michael Kugelman is a program associate with the Asia Program. -
Is Universal Access to Family Planning a Realistic Goal for Sub-Saharan Africa?
›“What do we require to ensure universal access to family planning services that are appropriate, affordable, accessible, and of good quality?” asked Michael Mbizvo, director of the Department of Reproductive Health and Research at the World Health Organization at the Wilson Center last month. [Video Below]
To talk about this difficult question and present research and programmatic evidence for sub-Saharan Africa, Mbizvo was joined by panelists Fred Makumbi, senior lecturer and head of the Department of Epidemiology and Biostatistics at Makerere University, Uganda; Oladosu Ojengbede, director of the Center for Population and Reproductive Health, University of Ibadan, Nigeria; and Frank Taulo, director of the Center for Reproductive Health and senior lecturer of obstetrics and gynecology at the University of Malawi.
Integrating Family Planning and HIV Services
Makumbi shared a number of findings on fertility preferences, behaviors, and contraceptive uptake in the context of HIV infection and care in Uganda. “Integrating family planning services into HIV services could help address the family planning needs of both HIV infected and uninfected,” he said.
According to new research conducted as part of the Rakai Community Cohort Study, despite significant gains in family planning use over time, there is still a high unmet need for contraception, irrespective of HIV status, in the Rakai district of central Uganda, said Makumbi. Male partner’s fertility desires were found to play an important role in pregnancy rates, and compared with previous studies conducted in the Rakai district, researchers saw an increase in pregnancy incidence and prevalence among HIV positive women, especially those on anti-retroviral therapy. HIV care that included voluntary counseling and testing was associated with significant increases in the use of family planning, and in particular, the use of condoms.
To effectively promote universal family planning in sub-Saharan Africa, “there is a need to strengthen family planning services in HIV care programs, with promotion of modern contraceptive methods, and with particular attention to women on anti-retroviral therapy,” said Makumbi. “Strategies to address desire for high fertility need to be developed, especially with regard to male involvement,” he added.
Multi-Pronged Approach to Universal Family Planning
“Family planning success in sub-Saharan Africa is a must for the region’s sustainable development,” said Ojengbede. “Poor commitment to women’s health in sub-Saharan Africa” has not only resulted in high fertility rates and poor maternal health indices but has also negatively impacted economic and human development in the region, said Ojenbede.
To increase access to and use of family planning, Ojengbede stressed the need to generate and sustain government commitment, promote legislation to support women’s autonomy, and implement policies to improve access to quality reproductive health services.
At the community level, Ojengbede said, the public health community must work to integrate family planning services into all reproductive health programs, including prevention of mother to child transmission; accelerate female empowerment programs; actively engage males in family planning access and uptake; and address social and cultural barriers that prevent widespread adoption of family planning.
“Traditional rulers can occupy a critical position to enact positive change in their communities and at the national level,” said Ojengbede. In Nigeria, for example, providing education about the health and economic benefits of family planning has helped traditional leaders embrace family planning and develop their own strategies to promote birth spacing in their communities.
“Universal family planning access must be achieved through a multi-pronged approach that should be colored with socio-cultural sensitivity, solid evidence, and sustainability,” concluded Ojengbede.
Eliminating Unmet Need: “Yes, We Can”
“It is time to prioritize issues that are affecting women and family planning is a very critical area,” said Taulo.
There are still many challenges to overcome before Malawi can achieve universal family planning access, including poverty, misconceptions and myths about family planning, lack of availability of reproductive health supplies, poor infrastructure, shortage of trained professionals, and religious and cultural barriers.
“Commodities are also very much dependent on the donor,” said Taulo, pointing to the challenges of insufficient funding and political will. “Failure to connect family planning to economic development and political stability is one of the main areas that we are struggling with,” he added.
“We have lots of challenges, but also many achievements,” said Taulo. Malawi has made important strides in expanding access to family planning by implementing community-based strategies and youth-friendly programs, developing public-private partnerships, engaging policymakers and traditional leaders, and encouraging media coverage of family planning issues.
“Education is another family planning product,” said Taulo. Moving forward, a “deliberate focus on girl child education” and promotion of women’s welfare can have a major impact on fertility reduction, he said.
“We can eliminate unmet need for family planning in Malawi, if we put our heads together, our thoughts together, and our energy together,” concluded Taulo.
Source: World Health Organization.
Image Credit: “Women’s Health Clinic” courtesy of flickr user advencap. -
Dividend or Deficit? The Economic Effects of Population Age Structure
›According to the latest projections, the global population will hit the seven billion mark later this year and perhaps nine billion by 2050. Yet, while the global population is growing, it is also aging, due to falling fertility rates and longer life expectancies. By 2050 the number of people aged 60 and over will reach two billion. At an event at the Wilson Center on April 1, Andrew Mason of the University of Hawaii at Manoa and the East-West Center and Ronald Lee of the University of California, Berkeley, discussed their research on the economic effects of an aging world with discussant Dalmer Hoskins of the Social Security Administration. [Video Below]
Changing Age Structures and Economic LifecyclesThere are three phases of age transition, Mason explained: during the first phase, high fertility rates and declining infant and child mortality rates increase the share of children in the population. In the second phase, the proportion of the working age population (those aged 15-64) increases, potentially providing a boost to production and consumption, and in the third phase, the elderly proportion increases due to lower fertility rates, decreasing production and increasing the burden on state support systems.
From 2010-2015, 85 countries are projected to witness the largest absolute increase in history of their populations aged 60 and over. This increase in elder populations is significant, Mason said, because it may mean slower economic growth.
Based on data collected through National Transfer Accounts, Mason and Lee’s economic lifecycle tracks the labor income and consumption rates of a population at a given age. In high income countries, consumption increases around the teen years as a result of investments in education, then dips slightly, and, finally, sharply rises around the age of 80 due to high health care expenditures. The consumption rate remains relatively flat in low income countries, with consumption differing the most in the older ages.
The support ratio measures the number of workers relative to the number of consumers, while taking into account age-specific variances in number of hours worked and level of consumption. Mason explained that China, after four decades of rapid growth, has reached the peak of its support ratio, with many workers relative to the number of consumers. However, China is rapidly aging, like much of Northeast Asia, and also because of its one-child policy. The resulting decline in its support ratio will likely limit its economic growth; however, Mason cautioned that it would be “rash” to say that its growth will bottom out completely.
The United States has an age structure that is “quite a bit more favorable” than other industrial countries, Mason said. Higher fertility, lower life expectancy, and a higher rate of immigration mean that aging is coming more slowly to the United States than other developed countries.
The Second Demographic Dividend: An Investment Opportunity
During the first demographic dividend, the labor force grows more rapidly than the dependent population, thus allowing more resources to be spent on economic growth. But what happens after that? As populations age, there is a “semi-automatic” increase in investment in human, physical, or financial capital, Lee explained; for example, as fertility falls, the amount invested per child increases. This second demographic dividend, said Lee, can help somewhat offset the decline in support ratio that comes in the third phase of the age transition – aging.
One response to the increased costs of an aging population, said Lee, is to reduce consumption in proportion to the decline in the support ratio. Another option would be adding more hours to the work day or pushing the retirement age back. In the United States, Lee said that to offset the declining support ratio entirely by postponing retirement would require postponement by eight years up to 2050, and 10 years by 2085.
Brazil, Lee said, is the “world champion” of pension generosity, where pensions make up 12 percent of the GDP. The United States, by contrast, relies on asset income from physical or financial investments for about two-thirds of its retirement income. Brazil’s challenge, when it begins to feel the effects of aging (it is still relatively young), will therefore be much greater than in the United States.
A “New Lens” on Aging
Aging, Hoskins said, is not the “catastrophe” that it has been portrayed to be in the media. Supporting an aging population is “something we can plan for and handle,” he said. It is possible “to do the right thing to make sure citizens have a decent life.” The problems come when a country waits too long or does not plan at all, such as in Nigeria and the Philippines where, Hoskins said, they have very underdeveloped social protection systems and the elderly have little to no income. Mason and Lee’s analysis of the work/consumption ratio, said Hoskins, offers a “new lens” into how the world will deal with aging.
Sources: Los Angeles Times, National Transfer Accounts, UNFPA, World Bank.
Image Credits: “Elderly couple – Meiji-jingu,” courtesy of flickr user Tom Spender. Chart courtesy of Ronald Lee and Andrew Mason, National Transfer Accounts. -
Carl Haub, Behind the Numbers
UN Releases Early Results of Global Population Projections
›April 18, 2011 // By Wilson Center StaffThe original version of this article, by Carl Haub, appeared on the Population Reference Bureau’s Behind the Numbers blog.
The United Nations Population Division has released preliminary results of its biennial series of population projections for the world’s countries for the 2010 revision. The projections are expected to be finalized later this month.While the global population for 2010 — 6.873 billion — is slightly lower than estimated in the 2008 revision (6.909 billion), the projected population for 2050 is now higher at 9.295 billion compared with the previous 9.150 projected in 2008. That can also be compared to the 2050 population of 9.485 billion on PRB’s 2010 World Population Data Sheet and 9.256 billion in the International Data Base of the U.S. Census Bureau.
The 2010 UN projections differ from the previous series in two significant ways. First, the projection horizon has been extended to 2100, quite far into the future. Second, the UN no longer assumes a uniform “ultimate” level of the total fertility rate (TFR) for all countries, such as the 1.85 level in its medium variant. Instead, multiple possibilities for each country’s TFR are projected with a probabilistic method based on fertility trends for the 1950-2010 period. Then, the median path of those “tracks” serves as the projected TFR for the medium variant series. The high and low variants, however, will be projected as in the past. Those variants have used an “ultimate” TFR of 2.35 and 1.35 for all countries, respectively.
The projected population of sub-Saharan Africa (SSA) in 2050, the world’s region with by far the largest potential for population growth, is now 1.963 billion, up from 1.753 in the 2008 UN projections. But, since the projections now run to 2100, we can now see beyond mid-century. By 2100, the UN projects that SSA would total an eye-popping 3.4 billion, nearly four times its present size and still be growing by 0.7 percent per year, adding 2 million annually at that time!
Continue reading on Behind the Numbers.
Sources: Population Reference Bureau, UN Population Division, U.S. Census Bureau.
Chart Credit: Data from UN Population Division, created by Schuyler Null. See full chart for interactive version (warning: it’s a lot of data – may slow or crash your browser). -
Youth Bulge, Demography-Security Dialogue, and NATO
PRB Discussion on Population and National Security
›April 14, 2011 // By Schuyler NullThe Population Reference Bureau (PRB) held an online discussion this week with demographer Jennifer Dabbs Sciubba of Rhodes College on the topic of “Population and National Security.” On tap were questions on sex ratios, youth bulge, the definition of “national security,” whether the United States should be giving population and health-related advice, and other demographic security topics. Click through to PRB for the full transcript, or check out some select questions from ECSPers Richard Cincotta, Geoff Dabelko, and Schuyler Null below:
Richard Cincotta: Jennifer, my concern is with the lack of specificity that seems inherent in the youth bulge model in terms of civil and ethnic conflict. In other words, the highest probability of civil conflict (often protracted) is associated with very young populations – the Afghanistan, Iraq, sub-Saharan African situations. But, there is also a situation that arises among populations that are demographically somewhat older that is associated with democratization (i.e., the North African situation). These seem to have been conflated by the press and political scientists, yet they are demographically and politically very different cases. Any thoughts on how to recognize these and separate them?Jennifer Dabbs Sciubba: Rich, I think that until we have a stronger theoretical foundation for understanding the conditions under which a “youthful” population leads to civil conflict (very young pop) or democracy (slightly older pop) it will be hard to relay the difference in these two structures to non-experts. The democratization connection, in particular, needs to be refined to move firmly away from correlation and into causation. Right now, it seems to me that we give the same theoretical reasoning to both conflict and democratization (motive, cohort crowding). Do you agree?
Geoff Dabelko: Is the security community, so accustomed to framing issues as threats, internalize your messages about opportunity? Is there a recognition that low cost interventions such as provision of voluntary family planning services could be part of a holistic sustainable security approach? What are the steps that would need to happen to gain more adherents to this perspective?
(Editor: Read more discussion between Cincotta and Sciubba here and here)Sciubba: I’m sorry to say, but no, not really. The positive perspective does not resonate much because most in defense and intelligence are tasked with imagining the worst-case scenario. Opportunities and happy stories just do not fit in this paradigm (or even most of their job descriptions). I’ve tried to figure out what needs to happen to get them to pay attention to prevention, and the only place I see some chance of breaking through is in discussing Afghanistan. Many realize the challenges posed by Afghanistan’s young and growing population and there is some recognition that family planning may be relevant there. I think that for a paradigmatic shift to occur, it would have to be top-down – the vision of the President, Secretary of Defense, etc.
Dabelko: What would be the benefits of demographers and population experts taking more seriously a dialogue with the security community? Your book shows why security sector actors should pay attention to demography. Why should demographers pay attention to security?Sciubba: Some in the security community don’t necessarily understand the assumptions behind demographic projections or other aspects of the data, which means they sometimes misuse the info or distrust it and discard it all together. I also think that scholars of any discipline have a responsibility to understand how their work is being used.
Dabelko: What will be the subject of your next book?Sciubba: I’ll be returning to the politics of population aging. I’m particularly interested in comparing how different regime types have dealt with these issues, including not just Western European states, but also states like Singapore and Russia.
Schuyler Null: There’s been a lot of talk about how aging populations in Europe will affect defense sectors there, in terms of shifting budget priorities. But there’s also the aspect of how aging might affect European decision-making processes when it comes to foreign intervention (perhaps less willing put boots on the ground, stay for long, etc.).
Can you speak to how aging might affect the decision-making process and behavior of European countries when it comes to conflict in the future? How might aging affect the operation of NATO or the UN?Sciubba: Isn’t France a puzzle right now given your question? France, a low fertility country with an aging population and HUGE challenges ahead in terms of paying for entitlements to seniors, has recently shown a greater willingness to contribute to military missions. There is no doubt that aging states in Europe will be under strain trying to meet their promises to seniors and also maintain defense. But, European states still feel that there are sufficient threats in the world to warrant maintaining a military. They are trying to reduce redundancies among themselves and increase their efficiency – great cost-saving measures. Technology can compensate a bit as well. I think European states are willing to use their militaries when the threat is sufficient. Aging, however, may raise the threshold for what qualifies as “sufficient” and US-European opinions on what qualifies may increasingly diverge.
See the full transcript of questions and Sciubba’s responses at the Population Reference Bureau. -
Watch: Elizabeth Leahy Madsen Explains the Demography-Civil Conflict Interface in Less Than Two Minutes
›April 12, 2011 // By Schuyler Null“We know that historically, as well as in the present, countries that have very young age structures – those that have youthful and rapidly growing populations – have been the most vulnerable to outbreaks in civil conflict,” said Elizabeth Leahy Madsen, senior research associate at Population Action International, in an interview with ECSP. “It’s not a simple cause and effect relationship, but we think that demographic trends and pressures can exacerbate underlying conditions.”
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Tunisia Predicted: Demography and the Probability of Liberal Democracy in the Greater Middle East
›In 2008, demographer Richard Cincotta predicted that between 2010 and 2020 the states along the northern rim of Africa – Morocco, Algeria, Tunisia, Libya, and Egypt – would each reach a demographically measurable point where the presence of at least one liberal democracy (and perhaps two), among the five, would not only be possible, but probable. Recent months have brought possible first steps to validate that prediction. [Video Below]
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Book Launch: ‘The Future Faces of War: Population and National Security,’ by Jennifer Dabbs Sciubba
›“Demographic trends by themselves are neither inherently good nor bad. It’s really a state’s ability to address these issues that can determine the outcome,” said Jennifer Dabbs Sciubba, the Mellon Environmental Fellow with the Department of International Studies at Rhodes College. At a book launch event at the Wilson Center on March 14 for The Future Faces of War: Population and National Security, Sciubba, along with Deputy Under Secretary Kathleen Hicks of the Department of Defense, discussed the national security implications of demography and its important role in understanding and managing conflicts around the world. [Video Below]
Demography as an Indicator, Multiplier, and Resource
Demography can be thought of in three ways, explained Sciubba: as “an indicator of challenge and opportunity; a multiplier of conflict and progress; and a resource for power and prosperity.”
A country’s age structure can pose a challenge, said Sciubba, because countries with a large percentage of their population under the age of 30 “are about two and a half times more likely to experience civil conflict than states with more mature age structures.” Tunisia’s recent revolution, she said, could be understood as a “story about demography.”
The 26-year-old fruit vendor Mohammed Bouazizi, who set himself on fire on December 17 after being hassled by police, was part of one of the largest age cohorts in Tunisia, those aged 25-29. There are some 64 million young men across the Middle East-North Africa region between the ages of 15 and 30, according to UN estimates. “If his death was the spark” for the unrest in the region, Sciubba said, “it’s the underlying demographic trends that were the fodder.”
Yet, Sciubba sees opportunity within this challenge. Citing the work of Richard Cincotta, she said that “states have half a chance – literally 50 percent – of becoming a democracy once their proportion of youth declines to less than 40 percent.” Tunisia has the best chance in the region of becoming a free democracy based on its demography, followed by Libya, where youth aged 15-29 are 43 percent of the adult population.
At the other end of the age structure, some of the world’s most powerful countries, such as Japan, Germany, Italy, France, Russia, and China, are rapidly aging. This aging will “somewhat decrease the ability of these states to project political, economic, and military power” due to a shortage of labor and a smaller pool of funding, said Sciubba.
Countries with transitional age structures, such as India, Brazil, and South Africa, face different security challenges. With a majority of their populations between 15 and 60 years old, there are more people contributing to the economy than are taking away, which could bolster these countries economically and politically (the “demographic dividend”). Global institutions will have to reform and include these countries, she advised, “or else become irrelevant.”
But the defining trend of the 21st century, said Sciubba, is urbanization. While great sources of economic growth, cities are also quite vulnerable to natural disasters and terrorism because of their concentrations of people, wealth, infrastructure, and bureaucracy.
In looking to the future, Sciubba called for continued support for family planning initiatives. “At least 90 percent of future world population growth will take place in less developed countries,” which are least equipped to handle the demands of that growth, she said. In addition, Sciubba recommended that the United States seek out partnerships with countries that have transitional age structures, particularly India, which could be a stabilizing force in a tumultuous region. She also called on the United States to partner with states in the Western Hemisphere and remain open to migration.
Defense and Demography
“Understanding population is critical to our success in being able to prevent conflict, and also managing conflict and crises once we’re involved,” said Hicks, describing the Department of Defense’s (DOD) interest in demography. However, the DOD does not “treat demographics as destiny,” she said, but instead as “one of several key trends, the complex interplay of which may spark or exacerbate future conflicts.”
Recent world events, such as those in the Middle East and North Africa, “have demonstrated how critical our understanding of population is for security practitioners,” said Hicks. Similarly, the recent earthquake and tsunami in Japan dramatically illustrate the vulnerability of large urban areas. Echoing Sciubba’s comments on population aging, she cited “incredible divestments in defense” in Europe, which, she said, “puts us, as a key partner in NATO, at a thinking stage.”
Under Secretary of Defense for Policy Michèle Flournoy is “deeply interested” in demographic issues, said Hicks. She identified other demographic areas of great interest for her office: the youth bulge in Pakistan, urbanization in Afghanistan, the role of highly educated women in Saudi Arabia, the Chinese diaspora in the Americas, Russia’s shrinking population, and various trends in China, including aging, gender imbalance, urbanization, and migration.
Image credit: “Iraq,” courtesy of flickr user The U.S. Army.
Sources: ECSP Report 12, Financial Times, The New York Times, Population Reference Bureau, UN Population Division.
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