World Population and Development WORLD

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INFORMATION ,,

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Rapid population growth aggravates already serious economic, social and environmental problems facing developing countries. High fertility raises health risks for mothers and children, and impedes poor families' efforts to escape poverty. Slower population growth helps governments invest more effectively in human resource development and buys them time to deal with issues such as debt and environmental degradation.

Our world is becoming more and more crowded. Population has more than doubled since 1950, from 2.5 billion to 5.5 billion. Most of the 90 to 100 million people added to the world population each year-the largest increases in history-are born in the developing countries.

Population growth rates have peaked, however, and since the late 1960s have been falling gradually as fertility rates have gone down. But population growth will continue even after couples have reduced their fertility to an average of two children. This is because high fertility in the recent past means that more and more young people will be entering into their reproduc­tive years for several generations to come. Not until the 22nd century is world population projected to stabilize-at which time it will number some 12 billion people.

No wonder these numbers have created concern about the earth's capacity to sustain its population, and about the ability of some of the poorest countries, where population growth is often greatest, to raise the living standards of their people. What can be done?

Why Population Is a Problem

The good news is that the rapid increase in popula­tion is partly due to steep drops in death rates, a welcome consequence of better health conditions. On the other hand, more people on earth means it is even more difficult for governments of many developing countries to achieve the already tough task of meeting basic human needs, reducing poverty and offsetting unsustainable pressure on natural resources.

This is why population issues are important to the Bank's central objective of poverty reduction being pursued both through equitable economic growth and through human resource development, namely basic education and health care.

As World Bank President, Lewis T. Preston said in

his 1992 Address to the Board of Governors: "Popu­lation policies are also linked to poverty reduction and environmental protection. Each year the world's population grows by about 100 million people. The population of some of the world's poorest countries will double within two decades. Experience in East Asia and elsewhere confirms that income growth­coupled with an emphasis on human resource develop­ment-can reduce fertility, poverty and environmental damage."

Putting Proper Policies in Place

As Mr. Preston noted, there is much to be learned from the experience of the last 30 years. A broad approach to population issues and a focus on the needs of the poor in most countries will provide the setting for sustained fertility decline. This is very much a question of putting in place proper policies and pro­grams conducive to fertility reduction. Such necessary policies include providing family planning services to allow couples to space and limit their families, and health and education programs that create the social and economic conditions that lead to desiring fewer children and having confidence in their survival.

Policies are also needed to protect the poor from the worst effects of unplanned growth. For instance, rapid growth in urban areas require policies to provide safe water, infrastructure, primary health care and education, etc.

Effective Family Planning Programs

Family planning programs, both public and private, have helped halve the time required for the transition from high fertility (six to eight children per woman) to low fertility (about two children per woman).

Programs have raised contraceptive use in coun-

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tries of varied cultures and levels of socioeconomic development. Even in adverse circumstances-low incomes, limited education and few opportunities for women-family planning programs have meant slower population growth and improved family welfare. But progress in stepping up contraceptive prevalence is more rapid when socioeconomic conditions-espe­cially female education-are also improving more quickly.

There is a high demand for contraception. At least 10 percent and as many as 40 percent of married women of reproductive age in each developing country surveyed recently want to avoid a birth but are not using contraception. Filling all unmet need would bring fertility down for most countries outside Sub-Saharan Africa to close to two children per woman.

During the past 20 years, there has been increasing evidence of the benefits that family planning provides to the health of mothers and children. In recognition of this, family planning and mother and child health services are usually offered together. During the 1980s, programs helped avert 250 million births in developing countries. It should also be noted that infant mortality rates, which were 7 4 per thousand by the end of the decade, would have been 10 points higher without family planning programs.

With 500,000 women losing their lives each year-virtually all of them in the developing coun­tries-due to maternity-related complications, family planning services help save women's lives. The need to space births, to upgrade skills of health providers to deliver maternal health services, to strengthen routine delivery and emergency obstetric services, post partum counselling, and nutrition are all being recognized in family planning programs.

The World Bank and Population Issues

The World Bank entered the population field in 1970 when concern about the negative consequences of rapid population growth on development was growing. At the same time, advances in contraceptive technology held out the possibility of controlling that growth.

Over time, in the Bank, as elsewhere, family planning activities were increasingly integrated with health and nutrition to encourage the mutually reinforc­ing benefits of these programs. When the Bank adopted a country focus in 1987, it encouraged the further integration of population issues into each country's assistance strategies. In fact, the Bank's involvement in all aspects of a country's development programs is its major comparative advantage for work in the population field.

Since its first $2 million loan to Jamaica in 1970, the World Bank has steadily increased the size and scope of its population lending. By fiscal 1992, there were about 60 projects in 43 countries, totalling more than $1 billion, under Bank supervision. These were either single purpose population projects, or health or social sector projects with a significant population component. Many Bank projects include grant assis­tance from other donors, or are designed to comple­ment the work of other donors in the country.

This direct support for family planning is rein­forced by lending in other human development fields . Bank assistance to the social sectors-chiefly educa­tion, health and nutrition as well as population-now accounts for about 15 percent of total Bank lending, a five-fold increase since the early 1980s. In these ways, the Bank is helping governments to provide the broad spectrum of programs that improve living standards and increase individual opportunities. (April 1993)

World Bank Information Briefs #G.01 .4-93

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