The challenge of “population growth”

While the majority of the population is now estimated to live in regions with below-replacement fertility, high fertility, poor reproductive health outcomes, and relatively rapid population growth remain an important concern in several low-income countries. International and national spending devoted to family planning, however, has declined significantly in recent years. Recent research has brought about a revision in the understanding of the interactions between population growth and economic development, as well as the effects of family planning programs in terms of reduced fertility, improved reproductive health outcomes, and other lifecycle and intergenerational consequences. This chapter discusses recent evidence about the benefits of family planning programs and the interactions between population growth and developments, and it attempts to estimate BCRs for increased spending on family planning.

The demographic transition: an unfinished success story

The demographic transition in developing countries during the second half of the twentieth century is widely considered a “success story.” Between 1950–1955 and 2005–2010, the life expectancy in less-developed countries increased from 42.3 to 66 years (a total gain of 23.7 years, or an average annual gain of 0.43 years), and in least-developed countries it increased from 37.2 to 56.9 (a total gain of 19.7 years, or an average annual gain of 0.37 years). Fertility rates declined from a total fertility rate (TFR) of about 6.1 in less-developed countries in 1950–1955 to 2.7 children per woman in 2005–2010 (an annual decline of about 0.062), and TFR levels declined from 6.5 to 4.4 children per woman in least-developed countries during this time period (an annual decline of about 0.038). Global annual population growth rates declined from a peak of 2.07 percent in 1965–1970 to 1.16 percent in 2005–2010 (Figure 9.1). The growth rate in less-developed countries also peaked during 1965–1970 at about 2.5 percent per year, while growth rates in least-developed countries peaked during 1990–1995 at 2.75 percent. By 2005–2010, the growth rates had declined to 1.33 percent and 2.21 percent, respectively. The majority of the world population is now estimated to live in regions with below-replacement fertility (TFR ≤ 2.1) (Wilson, 2004), and the global TFR is projected to reach 2.1 – the conventional, albeit globally not ne-cessarily correct marker for replacement level fertility (Espenshade et al., 2003; Kohler and Ortega, 2002) – by 2070 (UN median projection, UN Population Division, 2010c).