u.s. population policies, development, and the rural poor of africa

U.S. Population Policies, Development, and the Rural Poor of AfricaAuthor(s): Edward GreenSource: The Journal of Modern African Studies, Vol. 20, No. 1 (Mar., 1982), pp. 45-67Published by: Cambridge University PressStable URL: http://www.jstor.org/stable/160375 .

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The Journal of Modern African Studies, 20, I (I982), pp. 45-67

U.S. Population Policies, Development, and the Rural Poor

of Africa

by EDWARD GREEN*

A I 980 World Bank study paints a bleak picture of the current economic situation in sub-Saharan Africa, where most countries are at the bottom of the development pyramid. They have low incomes per capita, and their rates of economic growth have fallen behind Asian countries of comparable low income. Moreover, population growth in Africa is accelerating while trends in other developing regions suggest a slowing down.'

A review of the available evidence in the continent shows that the vast majority of African governments have either weak policies that attempt to control population or none at all; a few, such as Cameroun and Gabon, are actually pro-natalist. The two countries with the oldest and strongest birth-control programmes, Kenya and Ghana, have had no measurable success: fertility rates rose during the I 970s, and the number of contraceptive users seems to be only between 5 and i o per cent of the eligible total, even by the most optimistic estimates.2 Further, it is clear that population growth is not yet recognised as a problem by most African governments, and that its relationship to development is not well understood by planners and leaders. Population-control programmes are, for the most part, seen as a form of foreign intervention rather than a legitimate national concern. At worst, they may be viewed as a neo-colonial, imperialist plot by the rich West to keep African nations poor and weak.

A number of questions arise: What exactly is the relationship between development and population growth? Do current trends in Africa portend further economic stagnation in the future? What is the role of special programmes designed to lower the number of births? What are the interests of the wealthier nations in reducing fertility rates elsewhere,

* Social Science Adviser, Health Education Centre, Ministry of Health, Mbabane, Swaziland. ' Ravi Gulhati, 'Eastern and Southern Africa: past trends and future prospects', World Bank Staff Working Paper No. 4V3, Washington, D.C., August i980.

2 U.S. Agency for International Development, Evaluating Family Planning Programs (Washington, D.C., I979)-



46 EDWARD GREEN

and what role should they play in this respect in Africa? Should donors continue to give development assistance to countries where any economic gains would seem to be 'eaten up' and thereby 'discounted' by incremental increases in the number of births? Can and should the United States influence population policies in Africa?

While this article is not intended for professionals in the population field, the above questions are by no means resolved by the experts. Nor do the strident voices of the 'population-bombers', the 'right-to-lifers', or other groups which have taken uncompromising positions, help create an atmosphere conducive to choosing rationally - and morally - among policy alternatives. I shall try to clarify the issues and choices by focusing on Africa, where there have been no tangible policy or programme successes as yet, making this continent perhaps the ultimate testing ground for population theories and strategies.

In order to understand contemporary issues and policy choices, it will be necessary first to review the arguments that have surrounded the question of population control since at least the nineteenth century.

THE MALTHUS-MARX DEBATE

The oldest and most fundamental population debate goes back to the Marx-Engels critique of Malthus.' In recent years the neo-Malthusians have seen over-population as the root cause of poverty, crime, social unrest, environmental deterioration, and the depletion of food, wildlife, and other resources. The more single-minded often advocate reducing the rate of population growth first, before tackling other problems associated with poverty - a view expressed by a number of U.S. Congressmen who would cut off development assistance to countries which cannot show evidence of lowered birth rates.2

On the other hand, the neo-Marxist, anti-imperialist, or radical position is that rapid population growth is a symptom rather than a cause

I Cf. Ronald Meek (ed.), Marx and Engels on the Population Bomb (Berkeley, I97i). Also S. Cereseto, 'On the Causes and Solution to the Problem of World Hunger and Starvation: evidence from China, India, and Other Places', in The Insurgent Sociologist (Eugene, Ore.), 7, 3, Summer I977, pp. 33-57; P. Stevenson, 'Overpopulation and Underdevelopment: myths and realities', in Social Praxis (Paris), 5, I-2, I978, pp. 87-1 I i; and James Brackett, 'The Evolution of Marxist Theories of Population: Marxism recognises the population problem', in Demography (Washington, D.C.), 5, I, I968, pp. I58-73.

2 For a worthwhile discussion and critique of this proposal, see Philip Hauser, 'Population Criteria in Foreign Aid Programs', Population Reference Bureau, Washington, D.C., I973,

selection 42.



U.S. POPULATION POLICIES AND THE RURAL POOR 47

of poverty. The analysis goes like this: capitalism is a system which is exploitative of the poor and of cheap labour. Because of their precarious social and economic position in society, the poor are insecure. Children are a major source of security, especially in the Third World, because they help to provide food and income when they are young, and they can look after their parents in old age. Since the poor are necessarily concerned with day-to-day and short-term survival rather than future trends or global impact, their rational response is to have large families.'

The radical remedy offered for rapid population growth is to significantly restructure power relationships - if necessary by revolution - in order to redistribute economic resources. With the elimination of poverty, birth rates will fall automatically - that is to say, without the technology or programmes of the family planners.

The advocates of this strategy note that, in the past, surplus population meant cheap labour and hence high profits for the ruling class. However, vastly improved death controls in the twentieth century - primarily public health measures and environmental sanita- tion - have resulted in 'too many people' for even capitalist exploitation. Surplus labourers became, in the words of one analyst, 'no longer even useful as a reserve army of the unemployed. Worse, they are a threat: idle hands for the devil's work of revolution and, if successful, competitors for their own markets and raw materials .2

The revolutionary potential of this 'surging humanity' provides an interesting point of departure in the analysis of some radicals. They charge that a 'population mafia', consisting of ruling-class elites and racists, has exaggerated and distorted the facts in order to sell its case for population control. Furthermore, this core group has disguised its real motives by presenting 'family planning' as a humanitarian programme that will elevate the status of women, ensure better maternal and child health and survival, and nip the root cause of poverty in the bud. By campaigning in this way, the 'population mafia' has convinced the American Government and the United Nations that population control is desirable and necessary.

But the actual motives behind family planning, the critics hold, are (i) fear of the revolt of the Third-World masses, with the accompanying loss of U.S. economic hegemony and political control; and (ii) fear of

1 Two of the better expositions of this argument are found in Frances Moore Lapp6 and Joseph Collins, Food First: beyond the myth of scarcity (Boston, I977), and Susan George, How the Other Half Dies: the real reasonsfor world hunger (Montclair, N.J., I977).

2 Steve Weissman, 'Forward', in Meek (ed.), op. cit. pp. ix-xxii.



48 EDWARD GREEN

the growing number of non-white people in the world.' As partial evidence they may cite the ex-head of A.I.D.'s Office of Population during a I977 newspaper interview:

[The] population explosion, unless stopped, would lead to revolutions... [and disrupt] the normal operation of U.S. commercial interests around the world . .. Without our trying to help these countries with their economic and social development, the world would rebel against the strong U.S. commercial presence. The self-interest thing is the compelling element.2

More recently, Senator Charles Mathias told a group of U.S. corporation executives that no group has more at stake in slowing global population growth than the business community.3

Radicals also point to the elite ruling-class status of the prime movers to control population, and to their interlocking connections with the establishment'. Let us examine this charge. The Population Council

grew out of the I952 conference convened by John D. Rockefeller in Williamsburg, Virginia, and its first vice-president was Fredrick Osborn, the author of Preface to Eugenics (New York, 1940), who had argued that the 'privileged' should breed more. Other charter members represented the Mellon Foundation, the Council on Foreign Relations, the Radio Corporation of America, and the Commerce Department.4

The movement gained momentum, supported by other influential groups, and eventually the Ford Foundation, the Population Council, and the Population Crisis Committee mounted a lobbying campaign to convince the U.S. Government to finance birth-control schemes in the less-developed countries of the world. Their efforts were successful: by i965 the U.S. Agency for International Development and the National Institutes of Health had become involved in what was euphemistically called 'family planning'. Within a few years, A.I.D. was channelling substantial amounts of population-control money into the Third World through a variety of international or private organisations, notably the United Nations Fund for Population Activities (U.N.F.P.A.), the International Planned Parenthood Federation (I.P.P.F.), the Family Planning International Assistance (F.P.I.A.), and the Pathfinder Fund.

I Steve Weissman, 'Why the Population Bomb is a Rockefeller Baby', in Ramparts (Berkeley), 8, 1970, pp. 42-7.

2 R. T. Ravenholt in the St. Louis Post Dispatch, quoted by Ehrenreich et al., 'The Charge: gynocide', in Mother jones (San Francisco), November 1979, p. 3I.

3 'Business Involvement is Urged in Slowing Population Growth', in Popline (Washington, D.C.), 3, io, October 198i, p. i.

4 Cf. W. Barclay et al., 'Population Control in the Third World', in Edward Pohlman (ed.), Population: a clash of prophets (New York, 1973), pp. 464-83, and Weissman, 'Why the Population Bomb is a Rockefeller Baby'.




According to the radical critics, this 'ruling-class money' is only spent on causes that buttress the privileges and position of western capitalists. Population control is said to serve their class interests since limiting fertility among the impoverished masses presumably forestalls revolution. Indeed, by touting over-population as the root cause of poverty and other fundamental world problems, the privileged elites can avoid even acknowledging the real causes of poverty: structured economic and political inequality, capitalist exploitation, and racism.' The 'ruling class' can here refer not only to entrenched elite interests in North America and Europe, but also in the less-developed countries. Speaking of the alleged appeal of population programmes in Africa, an observer notes: 'African elites would naturally be prone to ratify a set of priorities that draws attention away from the real issue, which is a perpetuation of a system that favors them.' 2

What are we to make of the modern rendering of the Marx-Malthus debate? As usual the truth lies somewhat between the two extremes since it is obvious that population and poverty interrelate dynamically. Over-population is not merely a cause or a symptom of poverty, it is both. We cannot examine the economics of development without conceding that rapid population growth is a factor that helps perpetuate poverty. A basic weakness of the argument advanced by the radicals is described by Richard Clinton:

From asserting that population growth is not the problem of the struggling areas, the exponents of the anti-imperialist line come to insist that population growth is not a problem. They ignore the uniqueness of present population trends and overlook the intimate interaction between demographic variables and the process of development.3

At the same time, the argument that over-population must be solved before trying to tackle poverty and the specific problems of economic development is cynical and self-defeating. First, it is clear that it will take several generations before anything approaching 'zero population growth' can be achieved in the developing world - fertility rates in Africa will probably continue to rise for at least a generation before they decline.4 Moreover, poverty does favour high birth-rates, resulting in a vicious circle whereby each accelerates the other. And even if fertility were sharply reduced in the developing world, poverty would not be

I For a summary of the argument over the existence of an elite or ruling class, see Edward Green, 'Knowledge, Power, and Policy Analysis', in Soundings (Nashville), LXIII, 2, I980, pp. 178-98.

2 Osman Ahmed, 'Population and Economic Development in Africa: a critical look at the current literature', in Richard Clinton (ed.), Population and Politics (Lexington, Mass., 1973), pp. I53-62.

3 Clinton, op. cit. p. 6o. 4 Gulhati, op. cit.



50 EDWARD GREEN

eliminated, or even greatly mitigated, in the absence of major structural reforms accompanied by considerable economic assistance.

On the other hand, we cannot accept the radical slogan of' revolution first' - or, from the more moderate wing, 'agrarian reform first' - the implication being that the population problem will then take care of itself. First, we have nothing like a guaranteed timetable of the 'whens ' and 'how longs' of revolutions or agrarian reforms, to say nothing of what happens when they falter or run amok. Secondly, we do not know that birth rates would fall sufficiently fast by themselves - that is to say, without programme assistance and birth-control technology. If such interventions can help reduce the number of births, it would again be cynical and callous to do nothing towards population control, and to allow poverty conditions, exacerbated by high birth-rates, to deteriorate while we hope for revolutions or radical reforms.

Further, there is reductionism on both sides of the debate. The neo-Malthusians reduce poverty to a population problem, ignoring the fact that the former has existed far longer than the latter, by anyone's reckoning. They tend to reduce the complexity and multiple-causality of virtually every major human and environmental issue to a population problem. The i969 'soccer war' between El Salvador and Honduras, they aver, was 'demographic' - nothing more, nothing less.' For their part, the neo-Marixsts tend to focus entirely on the poverty-population relationship, and in their onslaught on the Malthusian position, they find themselves either ignoring or using tortured logic to refute the relationship between population growth and environmental degradation, the socio-economic position of women, the health and survival of infants, etcetera. Such over-reaction seems to be due, in part, to the fact that some radicals fear, or even expect, the eventual use of coercive, genocidal population-control methods, such as the spraying of sterilants

from the air. By their reasoning, non-coercive techniques are doomed to failure given a capitalist/imperialist environment. The poor will continue to out-breed the rich until the ruling class decides to use more 'effective' measures to remedy the situation.

It is worth noting that some neo-Marxists, while placing great emphasis on women's rights, are often ambivalent on the whole question of birth control. This has led to conflict with feminist groups who regard control of fertility as a basic human right. A major reason for the lack of support - sometimes, even, outright opposition - for birth control,

1 For a refutation of this monolithic view, see W. H. Durham, Scarcity and Survival in Central America: ecological origins of the soccer war (Palo Alto, 1979).

2 Weissman, 'Forward', p. xix.



U.S. POPULATION POLICIES AND THE RURAL POOR 5I

has been the occasional 'dumping' of unsafe devices or drugs in the developing world. It has been documented that a number of American pharmaceutical companies have issued false promotional literature, lobbied U.S. regulatory agencies, and attempted to court A.I.D. officials and even bribe a few governments in order to market unproved or unsafe products in poor countries.' This, of course, is inexcusable, and no 'middle ground' exists on this question.

And what about the issues of elites status and the 'true motives' of the population 'establishment'? First of all, it should be noted that involvement in programmes of birth control nowadays goes far beyond the upper classes in America or Europe. Unless we believe that lower-income individuals and governments have all been co-opted by Rockefeller money and Wall Street interests, we must concede that the movement has objective merit. If so, does it matter what the motives are, or were, on the part of the groups that initially spearheaded these initiatives? I think it does, up to a point. If the population-reduction movement is effectively to serve just, humanitarian ends, it must avoid coercive or racist elements, and consciously overcome influences which would lead it in wrong directions. I think the radicals are correct in their assertion that some elite interest-groups may hide behind a screen of population programmes in order to avoid action in other areas of development. This has important implications for the policy issue of what proportion of the total assistance for development should go to birth-control programmes.

The hard truth is that the problem of poverty - in the L.D.C.s or elsewhere - cannot be tackled without genuine power and capital concessions on the part of the rich, and they are unlikely to make these easily. This is why the guidance and control of population or other programmes aimed at mitigating poverty must be broadly based, and as free as possible from privileged elite interests wherever these may be located.

THE DEVELOPMENT/FAMILY-PLANNING DEBATE

By the mid-I970s, the extreme positions in the population debate seemed to be expressed less frequently. Most advocates of control came to realise that rapid population growth is not the only cause of poverty or other world problems. And for their part, the radical critics softened their tone as they realised that many poor women in the Third World wish to regulate their own fertility - indeed, many see this as a necessary step towards emancipation from their traditional, subordinate role.

I Ehrenreich et al., loc. cit. pp. 28-3I.



52 EDWARD GREEN

Yet the debate continues in somewhat less ideological form in the argument over which has greater impact on reducing fertility: economic development or family planning?" In its more extreme form, the case is advanced that the latter can make no impact whatever in any country or sub-region unless a certain threshold level of development has been first reached.2 Put more moderately, it is conceded that family planning

(hereinafter F.P.) programmes have a slight impact - mostly on the

urban, middle-classes - but the costs are said to be unjustified. Some critics of F.P. programmes fear that economic development

may actually be inhibited by the inevitable diversion of funds that could have been used for more direct assistance. They allege that the so-called 'population problem' has become a scapegoat for failed U.S. policies and an excuse for inaction about genuine problems. Here are the facts:

A.I.D. population assistance increased from about $34 million in 1968 to an estimated $i90 million for i 98i, over 75 per cent of which is

earmarked for F.P. programmes. By the early I970s, 2 per cent of total

U.S. development assistance was spent on population activities, and this increased to about 3q6 per cent by I978 .3 Yet during the decade of the

I970s, there has been a levelling off or a decline in many other areas

of assistance. The sociologically-oriented Kingsley Davis suggests that the 'intense

preoccupation with contraceptive technology' characteristic of family planners as well as attempts to make this seem respectable, combine

to divert attention from the fundamental changes in social organisation that must precede significant drops in birth rates. These changes include

those that are basic enough to affect peoples' motivation for having

children.4 Socio-economic development is defined broadly by its proponents to

refer not only to social equity - namely a reasonably fair distribution of incomes and access to social economic opportunity - but also to

the improved status of women, higher mass literacy and educational

levels, reduced mortality rates, and better health care. Crude measure- ments of development, such as G.N.P. per capita, have not been found

I For recent reviews of this debate, see Rashid Faruqee, 'Sources of Fertility Decline: factor analysis of inter-country data', World Bank Staff Working Paper No. 3V8, Washington, D.C., February I979; Steven Sinding, 'Study of Family Planning Program Effectiveness', A.I.D. Program Evaluation Discussion Paper No. 5, Washington, D.C., April I979; and Carmen Miro and Joseph Potter, Population Policy: research priorities in the developing world (London, i980), PP. 104-I5.

2 Kingsley Davis, 'Population Policy: will current programs succeed?', in Pricilla Reining and Irene Tinker (eds.), Population: dynamics, ethics and policy (Washington, D.C., 1975), pp. 27-36.

3 U.N.F.P.A., Inventory of Population Projects in Developing Countries Around the World, I978/79 (New York, i980).

4 Davis, 10c. cit. p. 7 I, recognises a population problem but believes that F.P. programmes offer no solution.




useful in predicting a country's receptiveness to family planning. For example, Mexico has a relatively high rate of economic development in terms of G.N.P., but with little decline in fertility. Apparently the majority of the population is unready for F.P. because there has been little sharing of the benefits of economic development; among the rural poor, children remain an economic asset, and they provide other kinds of security for their parents.

The development proponents further cite examples from Europe in the nineteenth century, where birth rates declined significantly in the absence of F.P. programmes or even effective birth-control technology. Their argument is informed by the theory of demographic transition, which holds that countries necessarily go through three stages of economic development, regardless of birth-control interventions: (I)

high mortality and fertility, followed by (2) lowered mortality and continued high fertility, and eventually (3) a period of low mortality and fertility.1

The advocates of family planning argue that their efforts have a far more significant impact on fertility than does economic development. They may speak in supply-demand terms and advocate 'saturating' a country with F.P. programmes in order that a superabundant supply will create further demand for family planning.2 They may further argue that we cannot afford to wait for socio-economic development to take care of over-population 'in due course'; technical/programmatic interventions are called for without delay because the L.D.C. birth-rates are unprecedented in history. The lack of fertility decline in Mexico is explained by the alleged absence of any real F.P. efforts there, in marked contrast to the strong and successful programmes mounted in Taiwan, South Korea, Singapore, Costa Rica, and Columbia.

Against this line of argument it must be admitted that in each of these five relatively affluent and urban countries there has been a sharing of the benefits of growth. Moreover, Cuba and China are examples of countries where social equity and the emancipation of women, rather than economic growth per se, have led to fertility declines. Certainly China has had no external assistance in achieving its results, although it must be admitted that its F.P. programmes have been backed by strong governmental pressures.

' As Steven Beaver points out, demographic transition 'theory' is used as a paradigm and an empirical generalisation, as well as socio-demographic theory; Demographic Transition Theory Reinterpreted (Lexington, Mass., I1975).

2 See Sinding, op. cit. p. 3.



54 EDWARD GREEN

TOWARDS A BALANCED VIEW

Of course, economic development has gone on simultaneously with the introduction of most F.P. programmes, so that it is difficult to measure the separate effects of each. Furthermore, declines in fertility are related not only to a country's level of socioeconomic or F.P. programming, but also to the political will of a government and to its administrative capability and infrastructural base. The difficulty is that any reduction in fertility is also linked to such a host of cultural, psychological, and other factors that almost any analysis is bound to be incomplete.

Nevertheless, some ambitious studies have attempted to quantify the relative impact of socio-economic development and family planning on fertility. Parker Mauldin and Bernard Berelson demonstrated in 1978

that F.P. has a significant and independent effect on fertility decline even though socioeconomic factors are important.1 They emphasised the existence of a synergetic interaction between programmes for family planning and development, and suggested that both should be supported simultaneously.

A 1979 World Bank study used factor analysis and a multiple regression model to help isolate the separate effects of socio-economic and F.P. variables, using inter-country data.2 According to the findings, the variables for the level of development had about twice as much explanatory power as those for family planning:

This finding suggests that the level of development has a stronger influence on fertility than most of the empirical literature [using single variables to indicate the level of development] has revealed. One reason for this difference is that factor analysis makes it possible to isolate the effects of development and family planning inputs among a set of variables...

Our results are compatible with the argument that a higher level of living, operating through changes in aspirations about and family constraints on the number of children [that they would like to have or can have] triggers fertility decline.3

For its part, F.P. was shown to have only a weak role in triggering a reduction in fertility over time, yet it does help maintain a lower level than would otherwise be the case once fertility has begun to decline.

It is noteworthy that the level of development was not measured by income per capita alone, but also by the extent of urbanization, physician/population ratio, life expectancy, and the death rate - indices

I Parker W. Mauldin and Bernard Berelson, 'Conditions of Fertility Decline in Developing Countries', in Studies in Family Planning (New York), 9, 5, I978.

2 Faruqee, op. cit. 3 Ibid. pp- 32-3.




which approach the broad definition of socio-economic development already referred to above.1 A 1979 World Bank document acknowledges, with the cautious understatement that often characterizes quantitative studies, that 'aspects other than income are significant in affecting fertility behavior', and that 'Such a finding supports the argument that a strategy emphasizing a broad dispersion of benefits from development, rather than average income growth alone, is relevant to reducing fertility '2

The case of Kerala supports this conclusion, since this small, densely- populated state in India has seen a remarkable drop in fertility over the past 20 years, in marked contrast to the rest of the sub-continent which, as a whole, experienced one of the most extensive F.P. programmes in the world. Studies have shown that the fertility decline in Kerala has not been caused by high income levels - the average is low even by Indian standards - by special cultural factors, or by F.P. programmes. Rather it is attributed to agrarian reform measures that became effective in the I950S (including educational benefits for the poor majority), to a break-up of rigid caste distinctions and resulting socioeconomic mobility; and to an effective, decentralized health-care system which, among other things, helped reduce mortality rates. In short, the quality of life improved for the majority. It is true that F.P. programmes played a supportive role, but a 1974 study showed that the fertility decline began before their intensification in 1965. Further- more, Kerala ranks only fifth among Indian states in 'contraceptive acceptor rates'.'

The implications are clear: we cannot take shortcuts to development via the family-planning route, nor is it cheaper to invest in contraceptives because they nip the problems of poverty and underdevelopment in the bud. A certain level of both development, and the distribution of its benefits, must be reached before the supportive role of F.P. programmes becomes significant.

The U.S. Agency for International Development, which until recently was influenced by the 'contraceptive inundation' approach of certain advisers, seems to be approaching this conclusion. A 1979 A.I.D.

I J. Simon notes, 'From a forecasting viewpoint, education rather than income is the best single predictor of fertility decline, and even alone it is perhaps almost as good a predictor as a multivariate forecasting device'; 'The Effects of Income on Fertility', Carolina Population Center, University of North Carolina, Chapel Hill, I974. He also asserts that it is impossible to isolate the separate effects of income rise on fertility rates by statistical analysis.

2 Faruqee, op. cit. p. 36. 3 John Ratcliffe, 'SocialJustice and the Demographic Transition: lessons from India's Kerala

state', in International journal of Health Services (Farmingdale, N.Y.), 8, i, pp. I23-44. Beaver, op. cit. agrees that F.P. plays a facilitating role but does not cause lowered fertility.



56 EDWARD GREEN

conference on family planning reviewed recent empirical evidence, and noted the mutually-reinforcing effects of F.P. and development, suggesting that a middle ground had been reached in the debate.' As has been acknowledged by a recent World Bank study, there is 'now widespread recognition that family planning alone is not enough to reduce fertility sharply'.2

None of this is to say that we should be content to let development take its course while making no attempt to directly affect fertility rates. Since the development of so many countries is seriously hampered by high birth rates, the vicious circle must somehow be broken. Let us look at some of the effects of high fertility in Africa, notably the impact on the poor and the disadvantaged.

SOME EFFECTS OF HIGH FERTILITY ON DEVELOPMENT

First, it has been calculated that 4 per cent of a nation's G.N.P. would have to be reinvested in government spending for a one per cent population increase just in order to maintain the same income per capita. This estimate involves certain assumptions, of course, but does not even take into account rising expectations and consumption levels.3 Since the growing demands of elite segments within the L.D.C.s will no doubt be met, at least partially in the short-run, the poor will have corres- pondingly less, given high fertility and the absence of a radical redistribu- tion of power.4

Second, infrastructure costs, especially for education and health, absorb an increasingly high percentage of L.D.C. national budgets, thus leaving less money for other development programmes. Moreover, social, educational, and health services become spread so thinly that there is a decrease in the quality of these facilities, especially for the rural poor.

Third, high fertility rates create a youthful age distribution and a resulting high dependency ratio. Although a high proportion of depen- dents to producers would seem to inhibit savings, at least at the family level, economists have found this difficult to prove)' In fact, in a survey

1 See, for example, the conference paper by W. P. McGreevey and B. von Elm in Evaluating Family Planning Programs.

2 Kandiah Kanagaratnam, 'Population Policy and Family Planning Programs: trends in policy and administration', World Bank Staff Working Paper No. 41 1, Washington, D.C., August i980, p. 20. See also Faruqee, op. cit. and Timothy King (ed.) Population Policies and Economic Development (Baltimore, I974) . 3 Ahmed, loc. cit. p. 156.

4 Cf. Leslie Corsa and Deborah Oakley, Population Planning (Ann Arbor, 1979), p. 65. 5 R. Bilsborrow, 'Age Distribution and Savings Rates in Less Developed Countries', in Economic

Development and Cultural Change (Chicago), 28, I, October 1979, pp. 23-45.




conducted in rural Nigeria, parents with large families proved to be no worse off, financially or otherwise, than those with less children,' thereby providing support for the argument that it is economically rational to have large families in developing countries. Another problem in trying to measure the effects of dependency ratios in the L.D.C.s is that many people defined as 'producers' are actually unemployed, while many children and elderly persons are economically productive and not actually dependent.2 Still, a high dependency ratio means that a great deal of government spending must go into infrastructural costs.

Furthermore, it is undeniable that most African economies are not growing fast enough to accommodate the ever-expanding youthful cohorts that enter the job market each year; the result is a serious and growing problem of unemployment. A large labour force can be beneficial, but considerable capital is required if it is to be put to work. High unemployment - not to mention massive underemployment - means diminished productivity per capita, and this tends to ensure that fewer women will be educated.3 Although there is general agreement that meaningful job opportunities for women need to be created before fertility can be lowered significantly, few countries in the Third World can even absorb all the men entering the job market. Yet without additional career prospects for women, it is difficult for African economies to develop, because high birth-rates tend to outstrip economic gains. . . another vicious circle.4

It should be noted that employment here refers to off-farm opportunities, since a good proportion of Africa's arable land is already under cultivation. Indeed, given the fact that the present technologies cannot expand because of capital constraints, most areas of Africa have reached or exceeded their carrying capacities of human and animal populations. Any more growth will lead to further environmental deterioration, which in turn is likely to cause famines and additional suffering, especially for the poor.

Rapid population growth exacerbates disparities between the rich and the poor, as already noted. It leads to increased land values, more fragmentation of property, higher rents, and lower wages. Those who already possess land and capital tend to grow richer, while the poor are increasingly dispossessed and impoverished, especially in the absence of

I John C. Caldwell, 'The Economic Rationality of High Fertility: an investigation illustrated with Nigerian survey data', in Population Studies (London), 31, s, March 1977, pp. 5-29.

2 Ahmed, op. cit. p. I56. 3 Corsa and Oakley, op. cit. pp. .56-7. ' E. Chaney, 'Women and Population: some key policy, research, and action issues', in Clinton

(ed.), op. cit. pp. 233-46.



58 EDWARD GREEN

mechanisms that redistribute income. And population growth inhibits efforts to create more equitable allocation of resources, because it is difficult to improve the lot of the poor while at the same time trying to cope with a continuous heavy rise in the total population.1

These are all realities that cannot be ignored. All those who truly wish to improve the condition of the poor in Africa cannot deny the existence of a population problem. Certainly those concerned with the status of women cannot. While it may be that the motives of some in the 4 population establishment' are impure and self-serving, this should not become the preoccupation of radicals, nor should it lead to their over-reaction.

The problems associated with rapid population growth have by no means been exhausted by the foregoing summary.2 I have only touched upon those that seem immediately relevant to the development/family planning debate. I hope to have established that there is a population problem, that F.P. efforts can only play a supportive role in keeping fertility rates down, that a certain level of socio-economic development must be reached before much can be done about the problem, and that high fertility itself impedes reaching this level of development.

It should already be clear that there are no simple, short-term solutions. Yet we still have not looked directly at cultural factors, a crucial dimension for understanding the population problem, especially in Africa. The fact that so many parents wish to create large families lies at the heart of the issue, and their motivations are culturally- conditioned, even when they seem to be rational responses to economic and other every-day factors.3 To understand motivations we must know something about the values, attitudes, beliefs, traditions, and social organisation of rural Africans. Certain generalizations are permissible as regards fertility-related beliefs and behaviour, despite the great cultural diversity in the continent.

1 Angela Mdlnos, Resourcesfor Population Planning in East Africa, Vol. II (Nairobi, I97I), p. 377, and King (ed.), op. cit. p. I.

2 The lay reader might be referred to Lester Brown et al., Twenty- Two Dimensions of the Population Problem (Washington, D.C., I975).

3 Richard Clinton, 'Population, Politics and Political Science', in Clinton (ed.), op. cit. pp. 5I-7I.




THE CULTURAL DIMENSION

Knowledge about reproductive physiology and modern birth-control methods is generally lacking in Africa.' However, until recently, a number of traditional fertility controls helped keep the size of the population stable, notably: (i) spaced births, aided by long breast- feeding periods (accompanied by lactational amenorrhea), sexual abstinence while nursing a new baby, and a degree of physical separa- tion of husbands and wives; (ii) delayed marriage, helped by the isolation of girls from boys - especially in age-graded societies of East Africa3 - and by enforced virginity before marriage, which in turn was aided by male and female circumcision customs; (iii) coitus interruptus and/or the use of herbal medicines to prevent pregnancy; (iv) abortion or infanticide in response to socially disapproved or otherwise unwanted births; (v) strong sanctions against extra-marital sex among many groups; (vi) widespread polygyny, and hence fewer children per married woman ;4 and (vii) various norms/beliefs that tend to limit the number of child-bearing years - for example, the idea that it is shameful for the mother of a married daughter to become pregnant.

Even more significant in terms of fertility limitation were the high rates of child and maternal mortality and infecundity resulting from untreated infectuous diseases and poor diet. In recent times, improved health conditions have led to sharp declines in mortality and to less fetal wastages and infecundity among women. Moreover, with modernization and culture change, many of the socio-cultural mechanisms that limited fertility are no longer effective. The result has been an increase in birth rates throughout Africa, soaring as high as nearly 8 children per family in Kenya and Rwanda, for example.

The theory of demographic transition predicts, and the experience of Asia and Latin America confirms, that many years must pass before the effects of socio-economic development and decreased child mortality are reflected in a decline in natality. This lag is due in part to the conservative nature of values which tend to change more slowly than technology or social structures.5 Given that Africa is the least-developed

1 See, for example, Molnos, op. cit. Vol. i. 2 Cf. Ronald Waife, 'Traditional Methods of Birth Control in Zaire', Pathfinder Fund, Boston,

December 1978; Barbara Furst, 'Culture and Fertility', in Evaluating Family Planning Programs; and Edward Greeley, 'Man and Fertility Regulation in Southern Meru: a case study from rural Kenya', Ph.D. dissertation, Catholic University of America, Washington, D.C., 1977.

3 Cf. Aylward Shorter, East African Societies (London, I974), and Greeley, op. cit. p. 5'. 4 It is not known for certain whether this is caused by greater spacing of pregnancies, the fact

that there were more infertile women in polygynous compared to monogamous unions, or some other reason. 5 Beaver, op. cit. p. 44.



6o EDWARD GREEN

continent and still with the highest mortality rates in the world, it is not surprising that demographic transition has not proceeded very far. In fact, for most of the rural masses, values and attitudes are strongly pro-natalist. It is worth enumerating some of the most important factors that relate to the wish to have many children.

As mentioned previously, children become economically useful at an early age, especially in rural areas, where they carry water and firewood, as well as perform other household and farm chores. They also provide for their parents' old age; the importance of this cannot be underestimated in societies lacking retirement-support arrangements. Even when there may not be enough inheritable land - as in many parts of Africa - children are regarded as a desirable investment since they may find urban employment and then send remittances to the family. And the intrinsic satisfaction of having sons and daughters, not to mention the pleasures of procreation, must not be overlooked.

Furthermore, infant/child mortality rates are still relatively high, although they are declining. Parents must feel confident that their children will survive before they will be receptive to ideas of limiting births. Actually, decreases in mortality, and in periodic catastrophies or famines - if these latter have decreased - are so gradual that they probably do not directly affect the way that families think.' In fact, the whole notion of planning a certain number of children, or even of counting them, is alien in many areas of traditional Africa.2

Next, the birth of a child is the primary means by which a woman validates her worth. In her traditional role, she is first and foremost a child-bearer. Barren women, or those who miscarry often, usually want children desperately - and they are quick to have as many as they can if conditions change to make this possible.

Additionally, there is tribalism and a recent history of inter-group warfare. Each ethnic group wants to grow and achieve strength and influence through numbers. Traditionally, numerical weakness meant the possibility of group extinction. Today it means that the aspirations and life-styles of minorities may be subordinated to those of larger ethnic groups.

Moreover, kinship systems based on unilateral descent - which account for all but a few African societies - seem to 'require' more attempts at child-birth than is the case in bilateral systems. At least two boys (in patrilineal systems) or two girls (in matrilineal systems) are

1 Ibid. For a critique of the notion of' insurance births', and of' rational' birth planning among the rural poor, see ibid. pp. 8 and 46.

2 Greeley, op. cit. p. 21.



U.S. POPULATION POLICIES AND THE RURAL POOR 6i

desired to ensure the continuity of the descent group; and to achieve two of the same sex, four children may have to be produced. Reinforcing the four-child family as a minimum acceptable size is a fairly common belief- at least in East Africa - that both sets of grandparents are 'reincarnated', or at least renamed, through children of the second- descending generation.' This illustrates one of several ways that having children is thought to commemorate the ancestors, and their veneration is important in African descent systems. Having children also confers social power because their eventual marriage will build new inter-group alliances.

Lastly, in most of Africa the land pinch is not yet felt. There are visible wide-open spaces, even some large uninhabited areas, which lead people to believe there is room for any number of new children.

All of the above influences are reinforced by ancestor veneration, magico-religious rituals, myths, proverbs, and other expressive dimensions of culture. Even if the prevailing conditions that reinforce pro-natalism were to disappear overnight, a period of time would be required for deeply-entrenched, religiously-sanctioned, and culturally- imbedded attitudes and values to change.

Needless-to-say, few villagers view population from the standpoint of national development, infrastructural costs, political stability, environmental degradation, resource depletion, and the like. Arguments that might convince national planners and administrators tend to have little meaning for rural farmers or herders. Yet, in fact, the case for birth control is by no means widely accepted by all the leaders of the governments, parties, and other modern organizations in Africa. It is worth noting some of the reasons for this if we wish to understand the success or failure of F.P. efforts.

THE POLITICAL/ADMINISTRATIVE DIMENSION

The idea of population control is foreign to Africans and it may threaten national pride. It may be seen as a 'neo-colonial plot' to emasculate the newly-emerging nations of black Africa by keeping them numerically weak. Population growth may, in fact, be regarded as stimulating the economy through augmenting both the labour force and the demand for goods. Indeed, this is how western-capitalist economists viewed population growth until relatively recent times. Increased population may also be seen as an improved tax base, at least potentially.

1 M6lnos, op. cit. Vol. Ill.



62 EDWARD GREEN

Furthermore, governments may wish to see uninhabited or under- inhabited areas of their countries populated. Empty tracts of land may be regarded as vacuums that may attract outside interference or incursion - as, indeed, in other parts of the world, including, for example, Australia. Viewed in this way, increased population growth can actually promote political stability and security.

We must face up to the fact that only a few public servants may see the need for reduced population growth - typically the first to do so are those who work with demographic data in ministries of labour and economic planning - and even they may not feel that population programmes deserve a high priority, given the range of other problems of more immediate consequence that face their governments.

Finally, the complex relationships between population growth and economic development are not well understood, and even those who do comprehend them may be reluctant to 'speak out' for fear of losing popular support and perhaps their positions. Moreover, it may be necessary to create the specialised administrative capability and insti- tutional frameworks for planning and implementing innovative outreach programmes, since these go beyond the normal, essentially law-and-order role of many governments in the early stages of national development.'

Thus it is unrealistic for foreign-donor organizations to expect African governments to move very fast in family planning. If outsiders exert too much pressure - indeed, if African government push their rural populations too quickly - there might be serious negative reactions that could set back these programmes by several years. This is a reality that may not be adequately appreciated by those who are unfamiliar with the total African context of population issues. Specifically, approaches that may be workable in the densely-populated areas of Asia, or in the relatively affluent countries of Latin America, may not be suitable for Africa at present.

Although not much is known about how population policies are formulated in the less-developed world, at least outside the circle of the principal actors, it seems clear that they emerge through a series of

stages. Generalising from the experience of a number of countries, Everett Rogers has identified four stages: (i) stimulation, when interest is sparked by economists who seem to realise that development is being inhibited by high population growth; (ii) initiation, when a private F.P. association initiates services (initially in urban areas), and tries to create

1 Everett Rogers, Communication Strategiesfor Family Planning (New York, I973), pp. I2-I3.




good public relations; (iii) legitimation, where in response to mounting pressure the chief executive or health minister proclaims a population policy, or expresses this as a five-year development plan; and finally, (iv) execution of policy, which is divided into the clinic sub-stage, inevitably tied to the health of mothers and their babies, and an eventual outreach sub-stage, when F.P. is emancipated somewhat from maternal and child welfare.'

In a similar exercise, Leslie Corsa and Deborah Oakley have recently identified five stages: (i) private sector interest; (ii) unofficial government interest expressed within the administration and/or the legislature; (iii) a gestation period in the public sector; (iv) adoption of a policy, by the executive and/or the legislature; and (v) oscillation of policy measures, and occasional changes in speed of implementation.2

It is true that these generalisations have been formulated mainly from the experience of other continents in the Third World, but there is no reason to expect that the stage-by-stage achievements in Africa will be much different - or much quicker. Regrettably, the population policies and programme timetables that appear in national development plans are often ideal expressions, and one reason for this is that positive, optimistic reports attract foreign-donor finance.

WHERE DO WE GO FROM HERE?

We have already seen that donor organisations must take into account both cultural and political/administrative constraints when promoting population programmes in Africa. There are also demographic limitations: because of the momentum for growth that is inherent in societies with a youthful age structure, the most that can be hoped for in the near future is a slow-down in the rates of natural increase. 3And clearly there is a timetable for socio-economic development: F.P. programmes will make little headway except among the urban, the educated, or women at the end of their child-bearing years, as long as most people want to have many children. Except for a few densely-populated areas in Africa, where the poor actually perceive a scarcity of arable land, the rural masses will continue to regard large families as desirable.

Bernard Berelson recently examined a number of socio-economic,

1 Ibid. pp. 9-13. See also, B. M. Stamper, Population and Planning in Developing Nations (New York, 1977), for a review of African population policies and the specific concerns they express.

2 Corsa and Oakley, op. cit. p. 183. See also, Kanagaratnam, op. cit. 3 King (ed.), op. cit. p. 134.

3 MOA



64 EDWARD GREEN

demographic, and other indicators from 29 Third-World countries in order to predict the likelihood of their achieving a crude birth-rate of less than 20/i,000 by the year 2000.1 He arrived at four categories: the Certain, the Probable, the Possible, and the Unlikely - which include the five sub-Saharan African countries examined. As already noted, it seems that fertility rates will continue to rise in the continent for another generation - perhaps even to the eight-child family currently found in Kenya - before they begin to fall.2

Those who have little understanding of the complexities of population dynamics - including those who see birth control as a technical problem, to be solved by finding the appropriate contraceptive and the right distribution strategy - may call increasingly for the use of coercive population-control measures in Africa. One proposal has been to reduce or cut off development assistance to those countries who show no 'progress', measured by the number of those who use contraceptives or in reduced births. Decreased assistance would clearly exacerbate the problems of both population and poverty to the point that the fears of some in the family-planning movement might well be realised: there would be such political and social chaos in Africa that western interests would be threatened, Soviet Communism would make great inroads, and coups detats would become even commoner than they are already.

What can be done? First, it would seem clear that the wealthier countries, especially the United States, must increase their levels of development assistance if poverty is to be ameliorated in Africa. Yet American Government aid to all nations has gone down since I978 in both absolute and relative terms; the total for i980 was estimated at $4-57 billion (i8-hundredths of one per cent of U.S. G.N.P.), compared with $5 55 billion in I978 (27-hundredths of one per cent of G.N.P.). Since the average aid for all industrial countries is 34-hundredths of one per cent of their G.N.P., it is small wonder that Robert McNamara recently called the U.S. effort to combat world poverty as 'disgraceful '.'

Going beyond funding levels, development must focus on increasing literacy levels, providing educational and employment opportunities for women, and improving health-care services for the poor, all of which will help to lower infant mortality rates. And development efforts must be directed primarily at the poorest of the poor, which in Africa usually means the rural masses.

Furthermore, as we have seen, unless incomes are redistributed more

1 Summarised in Sinding, op. cit. pp. 15-18. 2 Cf. Gulhati, op. cit. p. 2.

3 'McNamara Calls U.S. "Disgraceful"', in San Francisco Chronicle, i October i980, p. 9.




equitably - unless the benefits of development are shared much better than is the case currently - rises in G.N.P. or income per capita will have little, or even a negative effect on population. Therefore, development efforts must focus on the traditional sector, on labour-intensive and small/medium-scale industries, and on the education and employment of women. Capital-intensive projects which displace people, or dispossess them of their landholdings, should be avoided. And the poor must participate more actively in development planning, including the initial identification of their needs and priorities.'

Nothing that I am recommending has not already become the official strategy of A.I.D. and of U.N. development agencies in recent years. But the vigorous implementation of policies designed to improve or to overcome conditions of poverty would, in fact, shift wealth and power away from those who now enjoy these privileges. The wealthy nations of the world, as well as the elites in power in Africa, would have to make substantial concessions in violation of their self-interests, if population growth is to be stemmed and if true socio-economic development is to take place. African governments, for example, may have to insist on crucial agrarian reforms in order to break up entrenched local monopolies, even although a number of their own officials may stand to lose as a result of the changed economic relationships.

What is the likelihood of such concessions? Are the radicals right in their prediction that non-coercive attempts to control populations are bound to fail, given a capitalist/imperialist environment? These efforts may be doomed if the issues which relate to population growth are not faced squarely, and if appropriate development and assistance measures are not undertaken.

In addition, there is also a role for family-planning services. But both development and mortality set upper limits on the demand for F.P., and therefore the funding levels should be realistic - that is, not greatly in excess of existing demand. While some population programmes may be legitimately used for 'information, education, and communication', I hope to have shown that they will make little difference as long as people see large families as being in their self-interest. It may be the case that some of the most effective ways to reduce fertility actually require little

I Miro and Potter, op. cit. p. i i o, note that 'given the poor predictive power of existing fertility theory', there are insufficient scientific grounds to argue that the development focus described above will guarantee lowered fertility. They partly answer the question this raises by conceding that such a strategy is 'already desirable on other grounds', and that the alternative approach of re-directing development with the hope of lowering fertility - i.e. restructuring basic elements of a country's social organisation - is far less feasible.

3-2



66 EDWARD GREEN

or no funds. For example, some African governments are experimenting with economic incentives and disincentives as regards taxation and maternity leave.

It can be reasonably argued that the funding levels for population activities in some countries in Africa - although not for maternal/child care or other health areas into which F.P. has been integrated - may presently be in excess of what can take root and be effective. And disproportionate spending in population programmes may lull the United States and other donors into the complacent feeling that they are doing all they can to solve the problems of population - and by extension, of poverty and development also. Decreased development aid to Africa may be rationalized on the grounds that such assistance just 'goes down the drain' in countries with high birth rates.

Assistance for population activities is clearly worthwhile and desirable. But not at the expense of those other areas of development which could contribute to lowered fertility rates by themselves. It is time for the United States to review its total development assistance policy with this in mind.

Postscript The Reagan Administration has had over a year to formulate new

policies on development assistance to the Third World. It would seem that the President's conservative constituency is somewhat divided on the population issue: on the one hand, there is the population establishment with its big business ties described above; and on the other hand, there are the 'right-to-lifers' for whom abortion is a mortal sin and any birth control is questionable at best. The result may be an ambivalent attitude on the part of the U.S. Government towards involvement in population programmes. Funding for A.I.D. population activities in the fiscal year I982 was recently approved at U.S. $2II,000,000, which given inflation is about the same as the $ I 90,000,000

for i98i. This may suggest that the U.S. is reviewing its policies before embarking on any radical departures.

However, there have been some indications of policy shifts which have implications for fertility levels and development in Africa. First, there will be a greater emphasis on F.P. services in the urban areas. Secondly, the private enterprise sector will be encouraged to focus on population and other development activities; there seems to be an expectation that firms involved in trade with the Third World will recognise that rapid population growth is bad for business and will accordingly help fund




family-planning and other population programmes.' Thirdly, not only will the U.S. not support abortion for any reason, but it will also not fund research into anything related to pregnancy termination, such as 'morning-after' pills. Lastly, the Reagan Administration wants to see more tangible returns for dollars spent on population activities.

It may be too soon to interpret the meanings or motives behind these apparent policy changes. But if the shift in attention towards urban Africa or towards the private sector signals a backing away from a commitment to the rural masses, then U.S. development assistance will have a diminished impact on poverty and on high fertility rates in Africa.

I Cf. Editorial, 'New Responsibility for Corporations', in Popline, 3, IO, October 198I, p. 2.



u.s. population policies, development, and the rural poor of africa

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