|Department of Public Information • News and Media Division • New York|
Commission on Population and Development to Discuss Impact of Growing Disparities
in Fertility Levels during Forty-Fourth Session, 11 – 15 April
World fertility has declined from nearly five children per woman in 1950 to 2.5 children per woman in 2010. The timing and speed of the decline in fertility has varied among countries. As a result, today, 42 per cent of the world population lives in low-fertility countries, 41 per cent in intermediate-fertility countries and 17 per cent in high-fertility countries. These are some of the findings reported in Fertility, reproductive health and development, a report issued by the United Nations Secretary-General. The report will be discussed by the Commission on Population and Development at its forty-fourth session, held at United Nations headquarters from 11 to 15 April.
Declining fertility slows population growth and induces beneficial changes in the age distribution of a population by ushering in a period when the number of potential workers grows faster than the number of dependants. These changes can boost savings, leading to a “demographic bonus”. Countries that have used those savings to increase investment and generate jobs and to improve the health and education of children have raised economic growth and improved human development. The medium-term effects of fertility reductions on economic growth in both developed and developing countries are estimated to account for about 20 per cent of per capita output growth between 1960 and 1995. Declining fertility has also contributed to poverty reduction. Between 1960 and 2000, demographic change alone accounted for a 14 per cent drop in poverty levels in developing countries and could produce an additional 14 per cent reduction during 2000 to 2015 if fertility decline accelerated in high-fertility countries.
Today, high fertility is related to poor development outcomes. High-fertility countries tend to have lower per capita incomes, higher levels of poverty, lower educational attainment, higher mortality and lower urbanization. In addition, the report documents that high-fertility countries tend to score poorly in most outcomes related to reproductive health.
Women in high-fertility countries usually marry earlier than their counterparts in other countries and have high adolescent birth rates. Because women who bear children at very young ages have a higher risk of complications from pregnancy and childbirth, delaying marriage until age 18 or later would be beneficial. Improving the educational attainment of girls and young women is another important policy to reduce early marriage and adolescent fertility. In 24 high-fertility countries in Africa, women aged 15 to 19 with no education had a birth rate four times higher than women who had at least a secondary education.
Use of contraceptives varies markedly among countries. In high-fertility countries, the percentage of women who are married or in a union and who use contraceptives is generally very low, generally not surpassing 30 per cent. Furthermore, a lower percentage still uses modern methods of contraception. Yet the evidence indicates that at least one in every six married women in virtually all the high-fertility countries has an unmet need for contraception, that is, she wants to postpone the next pregnancy or cease having children altogether, but is not using any method of family planning.
Maternal mortality remains high in high-fertility countries and, as a group, they are unlikely to meet the goal of reducing maternal mortality by 75 per cent by 2015. In addition, the group of high-fertility countries has an HIV/AIDS prevalence that is nearly triple that of intermediate-fertility countries (2.3 per cent versus 0.7 per cent) and an unsafe abortion rate that is 72 per cent higher than that of intermediate-fertility countries (31 versus 18 abortions per 1,000 women aged 15 to 44).
Both intermediate-fertility countries and low-fertility countries score better in reproductive health indicators than high-fertility countries, yet in nine low-fertility countries, modern contraceptive prevalence is below 30 per cent, and in several low- and intermediate-fertility countries, unmet need for family planning remains moderate. Furthermore, contraceptive use in most countries is dominated by very few methods, indicating that there is room for increasing the range of safe and effective contraceptive methods available.
The report notes that ensuring access to modern methods of family planning is an effective means of improving the health of mothers and infants and key to ensuring that people have the means to exercise their reproductive rights. Furthermore, by preventing unintended pregnancies, family planning can ultimately reduce the overall cost of providing health-care services to mothers and newborns. It is estimated that providing pregnant women and their newborns with the World Health Organization (WHO)-recommended package of maternal and newborn care would cost $23 billion annually (in 2008 dollars). Satisfying the unmet need for modern contraception would result in savings of $1.5 billion from the reduction of births. Simultaneous investment in family planning and maternal and newborn health care, therefore, is cost effective.
The report concludes that reductions in fertility have beneficial effects at the individual, family and national levels. Complemented by the right economic policies, fertility decline can contribute to raising economic growth. Many of the countries where fertility decline has been significant have benefited from the process, whereby lower fertility reduces the growth in the number of children and makes possible greater investment in productive activities and in the education and health of the young. As a result, those countries have achieved significant advances in many development indicators. In contrast, countries where fertility has declined slowly and is still high have lagged behind in terms of development outcomes.
Three keynote speakers will address the forty-fourth session of the Commission on Population and Development. John Bongaarts, Vice-President of the Population Council, will discuss fertility trends and their impact on development on 11 April; Amy Tsui, Professor at the John Hopkins University’s Bloomberg School of Public Health, will talk about improving family planning services to achieve universal reproductive health on 12 April; and Dr. Eunice Brookman-Amissah, Director of the Africa Alliance for Women’s Reproductive Health and Rights, will speak on addressing reproductive challenges on 13 April.
The Commission will also discuss three other important reports on sexual and reproductive health, donor assistance and current demographic trends, whose overviews are presented below.
Sexual and Reproductive Health
Providing sexual and reproductive health requires that constraints at all levels be tackled, notes the report of the United Nations Secretary-General on monitoring of population programmes, focusing on fertility, reproductive health, and development (document E/CN.9/2011/4). Prepared by the United Nations Population Fund (UNFPA), the report calls for adequate funding, firm political commitment, courageous and creative programming, and the involvement of diverse actors, including civil society, faith-based and private-sector partners.
The report provides an overview of the programmatic work of UNFPA to improve reproductive health. Key elements required to make progress in expanding sexual and reproductive health include: making sexual and reproductive health and reproductive rights national priorities; utilizing a human rights framework; taking a multi-sectoral approach; identifying and serving vulnerable groups; responding to the needs and realities of adolescents; building participatory processes; strengthening health systems; training health-care providers; maintaining the flow of sexual and reproductive health commodities; integrating sexual and reproductive health and HIV; increasing funding for sexual and reproductive health; and, improving planning, monitoring and evaluation.
Stalled Donor Assistance
Donor assistance for implementing the Programme of Action of the International Conference on Population and Development has been increasing gradually over the past few years, reaching $10.4 billion in 2008, says the report of the United Nations Secretary-General (document E/CN.9/2011/5). This was the first time that population assistance has surpassed $10 billion. However, the strong upward trend seen recently has stalled, and funding, which remained virtually unchanged in 2009, is expected to increase only slightly to just under $10.5 billion in 2010 and to $10.8 billion in 2011. Yet, even as greater funding levels are required than ever before, the report notes that the financial resources actually mobilized are not sufficient to realize the objectives of the Programme of Action and achieve the Millennium Development Goals. Of particular concern has been a decrease in the funds made available for family planning services. The report further examines in detail donor and domestic expenditures levels, reviews the major challenges in mobilizing financial resources and suggests a way forward by calling for a more efficient and timely monitoring system to report financial flows for population activities.
Current Demographic Trends Leading to Excessive Population Growth
Current population dynamics would produce excessive population growth if maintained over the long run, says the report of the United Nations Secretary-General on world demographic trends (document E/CN.9/2011/6). Through a series of projections, the report highlights the importance of declining fertility for attaining a population that is sustainable. The high scenario, which produces a world population of nearly 30 billion in 2300, even though its fertility remains mostly between 2.2 and 2.3 children per woman, validates the imperative of continuing to reduce fertility to replacement level or below in all countries whose fertility is still above replacement level. Efforts to reduce fertility rapidly are especially needed in the fast-growing countries of Africa and Asia. In both major areas, but particularly in Africa, current fertility levels, if maintained, would lead to unsustainable numbers of people in the long run. Even countries with intermediate fertility need to reduce it to replacement level or below if they wish to avert continuous population increases to unsustainable levels, and low fertility countries need to achieve comparatively small increases in fertility to avert rapid reductions of the population.
The 2010 report of the United Nations Secretary-General on programme implementation and progress of work in the field of population (document E/CN.9/2011/7), reviews the analytical work of the United Nations Population Division on fertility, mortality and international migration; the preparation of world population estimates and projections; the monitoring of population policies; the analysis of the interrelations between population and development; and the monitoring and dissemination of population information. The report also covers other major activities carried out by the Population Division, including the substantive servicing of intergovernmental bodies, the preparation of parliamentary documentation and technical publications, the organization of expert meetings and the dissemination of results, including through the Internet.
Background of the Commission on Population and Development
The Commission was established in 1946 by the Economic and Social Council (ECOSOC) and renamed the Commission on Population and Development by the General Assembly in 1994. The Commission, as a functional entity assisting ECOSOC, monitors, reviews and assesses the implementation at the national, regional and international levels of the Programme of Action of the International Conference on Population and Development held in Cairo in 1994 and of advising ECOSOC thereon. The Commission is composed of 47 members, who are elected on the basis of equitable geographic distribution and serve a term of four years. The members for forty-fourth session of the Commission are: Angola, Bangladesh, Belarus, Belgium, Benin, Brazil, China, Colombia, Cote d’Ivoire, Croatia, Cuba, Democratic Republic of the Congo, Equatorial Guinea, Finland, Germany, Ghana, Grenada, Guatemala, Haiti, Honduras, Hungary, India, Indonesia, Iran, Israel, Jamaica, Japan, Kazakhstan, Kenya, Luxemburg, Malawi, Malaysia, the Netherlands, Pakistan, the Philippines, Poland, the Russian Federation, Rwanda, Saint Lucia, Senegal, Spain, Sri Lanka, Switzerland, Tunisia, Uganda, the United Kingdom and the United States.
For further information, please visit http://www.unpopulation.org or contact Hania Zlotnik, Director, Population Division, Department of Economic and Social Affairs, tel: 212 963 3179; fax: 212 963 2147.
* *** *