Population Policy Options in the Developing World

Author(s): John Bongaarts

Source: Science, New Series, Vol. 263, No. 5148 (Feb. 11, 1994), pp. 771-776
Published by: American Association for the Advancement of Science
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 A
ARTI LE s Xi

Population Policy Options in the Developing World

John Bongaarts

The population of the developing world is currently expanding at the unprecedented rate and many governmentswere reluctant to
of more than 800 million per decade, and despite anticipated reductions in growth during intrudein the sensitiveand privatematters
the 21 st century, its size is expected to increase from 4.3 billiontoday to 10.2 billionin 2100. of human reproductionand sexuality. In
Past efforts to curb this growth have almost exclusively focused on the implementation of addition, religious (mainly Catholic) and
family planning programs to provide contraceptive information, services, and supplies. conservativegroupsstronglyopposedbirth
These programs have been partiallysuccessful in reducing birthrates. Furtherinvestments control.
in them will have an additional but limited impact on population growth; therefore, other By the 1960s population growth had
policy options, in particularmeasures to reduce high demand for births and limitpopulation acceleratedto more than 2.5% a year, and
momentum, are needed. rates of growth were greaterthan 3% in
many developingcountries (6). The main
cause was a decline in the death rate as a
result of improved nutrition and public
The arithmetic of global population living standardsof additionalbillionsin the health measuressuch as immunization,an-
growth has become numbinglyfamiliar:1 decadesahead.As a consequence,in recent tibiotics, and better sanitation. Birth rates
billion in 1800, 2.5 billion in 1950, and5.5 decadesconcertedeffortsto curbpopulation remainedhigh in much of the developing
billion today. In the pastfourdecadesmore growthhave been undertakenin much of world. The threat of food shortagesin the
people have been addedto the globe than the developingworld. An estimated$4 to mid-1960s caused alarm about the race
in all of history before the middle of this $5 billion peryearis now spentby the world betweenfood supplyand populationgrowth
century. And growth continues unabated. on population programsin Africa, Asia, and providedan impetusfor strongergov-
The world'spopulationis now expandingat and Latin America (4). ernmentaction, increasedfundingfor pop-
the unprecedentedrate of nearly 1 billion In this article I review past approaches ulationprograms,and the establishmentin
per decade, and the United Nations and to populationpolicy and assessalternatives 1967 of the U.N. Fund for Population
the World Bank project an additional 6 availableto governmentsof the developing Activities (UNFPA).
billion inhabitantsby the end of the next countries.Such questionswere discussedat Governmentsconcernedaboutthe pros-
century(1, 2). Virtuallyall of this growthis the United Nations (U.N.) Conferenceon pects of large increasesin populationtypi-
expected to occur in Africa, Asia, and Environmentand Development(the "Earth cally responded by implementing family
Latin America;therefore,in this article I Summit")in Rio de Janeiroin 1992 and planning programsto provide information
focus on the developingworld. will be a focus at the U.N. International about and access to contraceptives.Newly
Concern about the adverse effects of Conference on Population and Develop- available contraceptivemethods, such as
populationgrowth on human welfarewas ment in September1994 in Cairo. the birth control pill and the intrauterine
expressednearly 200 yearsago by Thomas device, greatly facilitated the delivery of
Malthuswho concludedthat "the powerof Population Policy Since 1950 familyplanningservices.The rationalefor
populationis indefinitelygreaterthan the this approachwas largelyprovidedby re-
power in the earth to producesubsistence The potentialmagnitudeof the population searchon attitudestowardbirthcontroland
for man" (3). The result, he predicted, problembecameclearto demographers and on knowledge and use of contraception.
wouldbe increasingdeprivationand starva- a smallgroupof developmentplannersand Surveysof women of reproductiveage in
tion as exponentiallygrowingpopulations activistsin the early 1950s. Populationhad the 1960s found that manywomen wanted
outstrippedtheir food supply.Malthuswas, grownslowlyover previouscenturies,but a to limit familysize or space births but did
of course, not without his critics who be- large expansion was expected after 1950. not practice contraception (7, 8). This
lieved that increasesin human knowledge Although projectionsmade in 1951 by the informationreassuredpolicy-makersof the
and technologicalinnovationwouldenable newly created PopulationDivision of the acceptabilityof action programs.
humankindto provide rising standardsof U.N. considerablyunderestimatedthe ac- By the early 1970s concern about the
living for growingpopulations.This debate tual courseof growth(5), they led to strong adverseconsequencesof populationgrowth
has continued until today, with the opti- concern about adverse effects of a large had increased to the point that family
mists pointing to the notable successesin expansion of the human population on planningbecamea worldwidesocial move-
improvingthe welfareof much of human- social and economic development in the ment. Severalbooks as well as the exten-
kind, whereasthe neo-Malthusiansempha- developingworld. sive mediacoverageof the firstU.N. Con-
size the widespreadpoverty in the Third In response, organizationssuch as the ference on the Human Environmentheld
World and the many signs of stressin our InternationalPlanned ParenthoodFedera- in Stockholmin 1972 raisedglobal aware-
environment:air, water,and soil pollution; tion (to link familyplanningprogramsap- ness of populationand environmentissues.
globalwarming;and depletionof renewable pearingin many countries)and the Popu- This led to strongsupportfor action and a
and nonrenewableresources.Despite sharp lation Council (to serve as a scientific large increase in funding from the devel-
disagreementsaboutfutureprospects,there resourcefor the field)werecreatedin 1952. opedcountries,especiallythe United States
is broadagreementthat a reductionin rapid India became the firstcountryto adopt an (9). In addition, the health and human
populationgrowthin the developingworld officialpolicy to reducepopulationgrowth rightsrationalesforfamilyplanningbecame
will enhance the prospectsfor improved by promotingfamily planning. However, increasinglyimportant.Numerousgovern-
on the whole, progresswasslow initially, in ments initiated family planning programs
The author is director of the Research Division, The
Population Council, One Dag Hammarskjold Plaza, partbecausebirthcontrolactivistswerenot even though this approachremainedpolit-
New York, NY 10017, USA. respected by the political establishment, ically sensitive and was a sourceof contro-
SCIENCE * VOL. 263 * 11 FEBRUARY 1994 771
versy. However, at the 1974 U.N.-spon- few (for example, China and Bangladesh), projected to more than double to 6.5
sored World PopulationConference, gov- the effect of familyplanningprogramspre- billion by 2100. Africa is projected to
ernmentsfromthe developingworldresist- dominates,whereasin many others socio- experience by far the largest relative
ed setting targetsfor loweringpopulation economic developmentis more important. growth:a nearlyfivefoldincreasefrom0.6
growthand insteadarguedfor a new inter- By 1990 most governmentsof develop- billion to 2.8 billion between 1990 and
nationaleconomicorderto stimulatedevel- ing countrieshad adoptedpoliciesto reduce 2100. Latin America is the smallestof the
opment. In the decade between the 1974 populationgrowth, and 85% of the Third three regions, and althoughits population
and 1984 World Populationconferences, World'spopulationnow lives in countries size is expected to double to 0.9 billion
governmentsthat were initially reluctant in which the government considers the over the same period, the absolutegrowth
came to accept the importanceof reducing fertilityrate too high (12). Most of these is substantiallysmaller than in Asia and
populationgrowthby implementingfamily countries have implementedfamily plan- Africa.
planningprograms(10). The Chinese gov- ning programs,but the effortsand resources The projected trend in population
ernment became so concerned about the devoted to them varywidely (13), and the growth shown in Fig. 2 indicates that we
consequencesof populationgrowththat it coverage and quality of services in many are now at the climaxof an unprecedented
adopteda controversialone-childpolicy in familyplanningprogramsneed to be greatly periodof populationexpansion(2). Overall
1978. improved. patternsof changein absoluteannualaddi-
The implementationof familyplanning tions to the populationof the developing
programshas in most countriesbeen a key Demographic Projections world (Fig. 2A) are similarto those in the
factor in assistingindividualsin changing rate of growth (Fig. 2B): At the beginning
their reproductivebehavior. In the devel- Despite rapidchanges in reproductivebe- of this century,growthwas low and it will
opingworldas a whole, the averagenumber havior during the past quarter century, againbe low at the end of the next century,
of children born per woman has declined population growth in the Third World but there is rapidgrowthduringthe inter-
from6.1 in the mid-1960sto 3.8 in 1990, continues at an unprecedentedpace (Fig. vening years. Absolute annual population
and the proportionof couplesusingcontra- 1). The population of the developing increments have been rising throughout
ception has risen sharply from less than worldis expected to growfrom4.1 in 1990 this century, and during the 1980s, 774
10%to 50% (6, 11). These averagescon- to 8.6 billion in 2050 and 10.2 billion in million people were added to the Third
ceal wide variationsamong regions (Table 2100, according to projections made by World (6). More importantly,growthwill
1). The most rapidchangeshave occurred the World Bank (2). In 1990 Asia (ex- likely exceed this level for the next three
in EastAsia wherefertilityhas declined to cluding Japan, Australia, and New decades, adding 830 million in the 1990s
2.3 birthsperwomanand contraceptiveuse Zealand)had 3 billion inhabitants,nearly and about the same again in the first two
is now at 750/o-a level usuallyfound in three quartersof the total of the develop- decades of the next century, before a de-
developedcountries.In contrast,reproduc- ing world, and the population there is cline is expectedto occuras fertilityreaches
tive behavior has changed little in sub- low levels.
SaharanAfrica, althoughthere arenotable Although the peak in absolute growth
exceptions(forexample,Botswana,Kenya, 10 - Developingworld will occur in the next three decades, the
South Africa, and Zimbabwe)wherefertil- rate of growth already reached its maxi-
ity declines are now under way. These mum in th-e late 1960s and has been
trends in reproductivebehavior are also . 8- Asia declining since then. A declining growth
attributableto rapid social and economic rate is consistent with a growingabsolute
development,which has reducedthe moti- increment in populationbecause the base
vation for largefamilies.The relativecon- 1990 population to which the growth rate ap-
tributionsof familyplanningprogramsand plies keeps growing. When the fact that
socioeconomicdevelopmentto fertilityde- 26 _ _ _ I
the growthrate had peakedbecamewidely
clines vary widely among countries. In a IL known in the late 1970s, some observers
~~~~~~~~~~Africa
concluded that we had defusedthe popu-
lation bomb (14). That conclusion is ob-
Table 1. Estimates of total fertilityrate and
contraceptiveprevalence rateforregionsof the 0 |I LatinAmerica viously incorrect because population will
developing world, from 1960 to 1965 and in 1950 2000 2050 2100 likely more than doublebefore stabilizing,
1990 (6, 11). Year but the declining growthrate is good news
and it is consistent with the claim that
Totalfer- Contracep- Fig. 1. Projections of population size for regions efforts to reduce population growth have
tive preva- of the developing world, 1990 to 2100 (2). had an impact.
tilityrate lence rate
tbiritys
pr (%of mar-
(birtsnpe
Country woa) ried-women) 3.0 Fig. 2. Estimatesand pro-
0, 100 A B1990 jections of (A) annualpop-
1960 1960 1990 2.5 - ulation increase and (B)
tn
to 1990 to 1990 5 80 l population growth rate of
1965 1965 the developing world (2,
1900 2000 2100 1 6).
Africa 6.8 6.1 5 17 g .260 Ye 1.5 Y
East Asia* 5.9 2.3 13 75
South Asiat 6.0 4.3 7 41
0C4
CL0 40- I.-
~~~~1.0
0.
LatinAmerica 6.0 3.5 14 61 0
All developing 6.1 3.8 9 50 20- 0.5-,
countries
0 0l
*ExcIudingJapan. tincluding
Southeast
andWest 1900 2000 2100 1900 1950 2000 2050 2100
Asia. Year Year
772 SCIENCE * VOL. 263 * 11 FEBRUARY 1994
 ARTICLE

Future Policy Options family planning services; (iii) side effects ily planning programsby making a hypo-
and inconvenienceof contraceptivemeth- thetical projection of future population
The alreadydifficulttask of reducingpov- ods; (iv) disapprovalof husbands, family growth in which all unwanted fertility is
erty and bringingabout sustainabledevel- members,and others;and (v) cost of con- eliminatedafter1995. An estimated20%of
opmentin Africa,Asia, and LatinAmerica traceptivecommoditiesand travel. fertility in 1995-2000 will be unwanted
will be made even more difficultby the Several of these problemscan be ad- (19), and I assumed that the trend in
expected additionof 6 billion people over dressed if family planning programsare wantedfertilityin the futureis the sameas
the next century. Increasedeffortsto slow strengthenedby expandingcoverageto un- the trend in total fertilityprojectedby the
this populationexpansionare thereforede- servedor underservedareas,improvingser- World Bank, that is, a slow decline to
sirable.Three broadpolicy options can be vice quality, providingmore understand- replacementfertility in the middle of the
pursued. able contraceptiveinformationthroughthe next century (2). The results (Table 2)
1) Reduce unwanted pregnancies by media and in one-to-one communication imply that the elimination of unwanted
strengthening familyplanningprograms.The with service providers, and giving ready births after 1995 would reducepopulation
most direct way to bring about significant access to a wider variety of birth control growthand that the populationsize of the
furtherfertilitydeclinesis by the implemen- methods including abortion. In addition, developingworldwouldreachan estimated
tation of comprehensiveand high-quality existing programsneed to reach out to 7.5 billion in 2050 and 8.3 billion in 2100.
familyplanningprogramsin all countries. groupssuch as adolescentsand the sexually This projectionis considerablybelow the
Althoughpasteffortshave been substantial, active unmarriedwho are now often ex- standardprojection of the World Bank.
servicesare still poor and limited in cover- cluded. With the implementationof these The differencebetweenthe two projections
age in many countries. It is thereforenot measures, programscan substantiallyin- provides an estimate of the demographic
surprisingthat recentsurveysin developing crease the demand for contraceptionand impact of unwanted fertility: 1.1 billion
countries have found that many women reduceunmet need. (8.6 minus 7.5) in 2050 and 1.9 billion
who wish to delay or stop childbearingare As a consequenceof this unmetneed for (10.2 minus 8.3) in 2100. It should be
not practicingcontraception(15). Analysis birthcontrol, manywomenbearmorechil- emphasizedthat these projectionsare the-
of these findingssuggeststhat one in six drenthan they want. Approximatelyone in oretical upper limits on what can be
marriedwomenin the developingcountries fourbirthsin the developingworld(exclud- achieved. In practice,resourceconstraints,
outsideChina has an unmet need for con- ing China) is unwanted(17). In addition, imperfect technology, human error, and
traception-a total of about 100 million there are approximately25 million abor- reluctanceof governmentsto takeappropri-
women (16). Estimatesforunmarriedwom- tions annually,a largeproportionof which ate action pose limits on the impact of
en are not as readily available, but their take place under illegal or unsafe condi- family planning programs.Even in coun-
needs are no doubt also substantial.The tions, or both (18). Manyof these undesir- trieswith good programs,a significantpro-
unmet need for contraceptionis highest in able pregnanciescan be preventedif wom- portion of women are reluctant to adopt
countriesof sub-SaharanAfrica (averaging en are given greater control over their methods because of concerns about their
near 25%), but even in Asia and Latin sexualand reproductivelives. health and other side effectsand pressures
America, where services are much more The centralgoal of familyplanningpro- from spouses and other family members.
accessible,unmetneed levels of about 15% gramsis to providewomen and men with However, there is no doubt that improve-
are typicalin the countriesfor which data the informationand meansto control fully ments in the quantityand qualityof these
areavailable.These estimatesareconserva- their fertilityand thus eliminate mistimed programscan bringaboutsubstantialfuture
tive becausethey arelimitedto womenwho and unwantedpregnancies.In addition to reductions in fertility and population
are currentlynonusers.There are, in addi- directlybenefitingwomen and their fami- growth. In addition, strengthenedsupport
tion, substantialnumbersof contraceptive lies, the absenceof unwantedchildbearing for family planning will bring substantial
userswho are not satisfiedwith their cur- would have a substantialeffect on fertility social and health benefits to women and
rent method or who practicerelativelyin- andhence on populationgrowth.I estimat- children.
effectivemethodsthat put them at risk of ed the potentialdemographiceffectof fam- 2) Reducethe denmndfor largefamilies
contraceptivefailure. throughinvestmentsin humandevelopment.
The causesof this unmet need for con- Botswana
Although family planning programsnow
traceptioninclude (i) lack of knowledgeof Burundi Sub-Saharan claimthe bulkof the attentionandresources
Ghana Afric
contraceptivemethodsor sourcesof supply; Kenya of populationpolicy-makers,the potential
Liberia
(ii) limited access to and low quality of Mali effect of programsthat provide supplies,
Ondo State
Senegal services,andinformationis limitedto reduc-
Togo
Uganda ing the unmet need for contraception.Be-
Table 2. Projections of the population size of Zimbabwe
cause such programsare voluntary, they
the developing world with and without unwant- Egypt
ed births. Morocco cannotreducefertilitybelowthe level want-
N Africa
Tunisia
Indnnena _and Asia ed by couples (20). As a consequence,this
Projected
Sri Lanka
Thailand so-called"supply"approachcannot reduce
population size Bolivia
population growth to zero in countries
Projection (billions) in year Brazil
Colombia
where, on average,desiredfertilitystill ex-
Dominican Republic
Ecuador[an Latin ceeds two. This is apparentlythe case in
2050 2100 ElSalvador Ameica most developing countries. An extensive
Guatemala

Standard* (with 8.6 10.2

Mexico
Peru
surveyprogramconductedin 27 countriesin
unwantedbirths) Trinidad and Tobago Africa,Asia, and LatinAmericain the late
Withoutunwanted 7.5 8.3 0 2 4 6 8 1980sfoundno countrywith a desiredfamily
births Desiredfamily size size at or close to two (21). These surveys
Effectof unwanted 1.1 1.9 Fig. 3. Average desired familysize among ever documented a preference for large numbers
fertility marriedwomen in selected developing coun- of children in sub-Saharan Africa, and the
*WorldBankprojectionas quoted in Bos et al. (2). tries, 1986 to 1989 (15). average desired family size was close to six

SCIENCE * VOL. 263 * 11 FEBRUARY1994 773

 (Fig.3). Althoughthe averagedesirednum-
ber of survivingchildren in countries of
LatinAmerica,Asia, and North Africawas
much lower, it still exceededthree in most
cases. These preferencesfor high fertility
remain one of the fundamentalcauses of
high birth rates and rapid population
growth.
A slow decline in fertilitypreferencesis
observablein most developing countries,
and the expectationis that desiredfertility
will drop to aroundtwo children as these
societies proceed through the transition
from their -traditionalagriculturalbase to
modem industrializedeconomies. Because
this transitionmay take a long time, some
policy analysts have advocated measures
that reducethe demandfor births through
affirmativesocial and economic policies.
The generalobjectiveis to changethe costs
and benefitsof child rearingso that more
parentswill recognizethe value of smaller
familieswhile simultaneously increasingthe
investmentin children.Examplesof factors
potentially under governmentcontrol in-
clude affecting(i) educationlevels, (ii) the
statusof women, and (iii) child mortality.
With regardto education,in traditional
societieswith largelyagricultural economies,
childrenare a valuablesourceof labor.The
provision of educational opportunities,
whichrequireschoolattendance,lowersthe
laborvalue of childrenand raisestheircosts
(for example, for books, uniforms, and
school fees) (22). Of all the social and
economicfactorsthat have been studiedfor
theirpotentialeffecton reproductive behav-
ior, the level of educationstandsout as the
most consistent (23, 24). This relation is
attributable to shiftsin the costsandbenefits
of childrenbut also, and perhapsmore im-
portantly, to an accelerationin cultural
change and the adoption of new, mostly
westem values that are facilitatedby the
introductionof massschooling(22).
Improvementsin the economic, social,
andlegalstatusof womencan reducedesired
fertilityin severalways.Such improvements
raisethe cost of childrenby makingnonma-
temal roles more important.They also in-
crease the willingnessof women to make
independentreproductivedecisionsand en-
couragethemto engagein innovativecontra-
ceptivebehavior.Empowering womenis also
likelyto leadto reductionsin the dominance
of husbands(or other householdmembers)
overwomen,the societalpreferenceformale
offspring,andthe valueof (andthusneedfor)
childrenas insuranceagainstadversity(for
example, in old age) and as securersof wom-
en's positions in families. Although the pre-
cise role of each of these effects varies among
and within societies, there is little doubt that
the overall effect of increasinggender equality
significantlyinfluences reproductivebehavior
(25).
774
A high death rate among children en-
courageshigh fertility for several reasons
(26): (i) It makesthe planningof families
difficultbecausethe numberand timing of
futuredeaths are unpredictable,thus con-
tributing to fatalism. (ii) It discourages
investmentsin children'shealth and educa-
tion. (iii) It requiresexcessbirthsto ensure
that at least the desirednumberof children
will surviveto adulthood.All these effects
can be counteractedby the implementation
of public health measuresto reduceinfant
and child mortality.The potentiallyimpor-
tant role of this variableis demonstrated
empiricallyin that no population in the
developing world has experienced a sus-
tained fertilityreductionwithout firsthav-
ing gone througha majordecline in infant
and child mortality.
Improvingthe educationsystem,raising
the status of women, and reducingchild
mortalityare policymeasuresthat are desir-
ablein theirown right.Indeed,mostgovem-
ments alreadypursuethese sociallydesirable
objectivesindependentof theirpotentialrole
in loweringthe rate of childbearing.The
demographic benefitsstrengthenthe rationale
forintensifyingthesesocialpolicies.
Additionalstepscan be takento encour-
age lower fertility. For example, monetary
incentivesfor the adoptionof specificbirth
controlmethodsand disincentivesfor large
familiesare featuresof populationpolicies
in a few countries(27-29). Although these
measurescan be successful,they raise seri-
ous ethical concems and many govem-
ments are reluctant to adopt them (29).
Another potential option for bringing
aboutchangein reproductivebehavioris to
increasea population'sexposureto different
life-stylesthroughthe media.Modemcom-
municationsystems(radio,newspaper,and
television) are powerful instruments for
conveyingideas and messagesabout differ-
ent nontraditionalbehaviors,familyroles,
and life-stylesthat are less compatiblewith
largefamilies(30). Although this exposure
to mostly westemrideas is considered a
crucial element in ongoing fertility de-
clines, it is rarely consideredas a policy
optionbecauseit wouldundermineincreas-
ingly populareffortsto strengthennational
and ethnic identitiesof countries.
The potentialdemographiceffect of ad-
ditionaleffortsto implemeritpolicies to re-
duce fertilitydemandcan be assessedby a
comparisonof populationprojectionswith
and without such efforts.For this compari-
son I usedthe secondprojectionin Table 2
becauseit assumesthat-highwantedfertility
is the only reason for fertility'to exceed the
replacement level in the future. I also made
a hypothetical new projection to simulate
the potential effect of additional demand
policies. In this new projection, the success-
ful implementation of such policies is as-
SCIENCE * VOL. 263 * 11 FEBRUARY 1994
12 - Causes of
population
growth
, 10 - 1.0;>t (1) Unwanted
o / fertlity
3 8 -. (2) High desired
_I size
family
.N 6 1995 (3) Population
XA _j momentum
a.~~~~~~~~~~~.
4 -
0
ffi 2L /
0 l
1900 1950 2000 2050 2100
Year
Fig. 4. Alternative projections of the population
size for the developing world, 1995 to 2100,
and three causes of population growth.
sumedto reducefertilityin all countriesto
the replacementlevel of two survivingchil-
dren per woman after 1995. Accordingto
the resultsfromthese two projections,sub-
stantialfurtherreductionsin futurepopula-
tion size, up to 0.6 billion in 2050 and 1
billion in 2100, are achievableby stronger
measuresto lower desiredfamily size (Fig.
4). The relative role of demandfor large
families as a cause of population growth
varies among countries and regions; it
would,forexample,be muchlargerin Africa
than is the case in the decompositionfor all
developingcountriesshownin Fig. 4.
Accordingto the standardprojectionof
the World Bank (top graphin Fig. 4), the
populationsizeof the developingworldwill
increasefrom 4.5 billion in 1995 to 10.2
billion in 2100. Aside fromunwantedfertil-
ity and high desiredfamilysize, population
momentumis responsiblefor the remaining
growthover the next century(Fig. 4).
3) Addresspopulationmomentum.Popu-
lation momentumis the tendencyof popu-
lation size to increasefor some time after
fertilityhas reacheda level consistentwith
long-rangepopulationstability(31, 32). As
a result of the momentum, population
growth would continue even if fertility
could immediatelybe brought to the re-
placementlevel of two children per wom-
an. Populationmomentumis primarilythe
consequence of a young population age
structure(futuremortalitydecline among
adultsis another, less important,cause of
continuedgrowth).Adjustmentsin the age
structureafter a decline in fertility take
severaldecadesto be completed, and it is
only then that populationsizegrowthceas-
es. Unless effortsare made to reduce this
momentum,the populationof the develop-
ing world will grow to at least 7.3 billion.
Attention to this neglected issue is essential
because population momentum accounts
for nearly half of the projected growth over
the next century (Fig. 4).
There are two basic ways to bring about
 ..........
Table 3. Simulated effect of delayed childbearing on population momentum if replacement fertility
was reached in 1995.
Average age at Population
childbe arngeamomentum* (billions)
childbearing
No change 2.8
Increase of
2.5 years 2.2
5 years 1.6
estimates includeeffect of futuremortalitydecline.
*Momentum
Table 4. Average of median ages at marriage
of ever married women ages 30 to 34 in 23
developing countries obtained from demo-
graphic and health surveys (36).
Median Median
Level of age at age at
education marriage first birth
(years) (years)
None 17.6 19.3
19.1 20.2
Primary
Secondary 21.7 22.8
reductions in population momentum. The
first involves additional declines in lifetime
fertility to below the replacement level. In
theory it is even possible to stop population
growth completely by reducing fertility to
the level needed to balance the number of
births and deaths (assuming no migration).
This is, of course, an undesirable option to
implement because it would leave many
women with only one birth, which is sub-
stantially fewer than most women want. It
is unlikely that desired family size will drop
substantially below two in most developing
countries even with the demand measures
discussed earlier.
A second option that has thus far re-
ceived little attention is to raise the average
age of women at childbearing. Research on
the causes of fertility change in the United
States has clearly demonstrated that the
fertility in a given year is significantly af-
fected by shifts in the timing of births.
When successive age cohorts of women
start their childbearing earlier and space
their births closer together, fertility for that
period temporarily rises. For example, Ry-
der concluded that much of the temporary
rise in U.S. fertility in the 1950s (the "baby
boom") was caused by changes in the tim-
ing of fertility rather than by variation in
the desired fertility (33). Conversely, a
delay in the onset of childbearing and wider
spacing of births leads to a temporary de-
cline in period fertility and hence in the
population growth rate.
To determine the potential demographic
effect of a rise in the age at childbearing, I
used a simulation based on hypothetical
population projections. I assumed that
.. ... ......
. ..
.............
Population in 2100, Reduction
momentum only resulting from
(billions) delay (billions)
7.3 0 because spacing only affects subsequent
6.7 0.6
6.1 1.2
womenover theirlife cycle bearchildrenat
the replacement level of two surviving
birthsperwoman,but that the mean age at
childbearingis raisedslowlyover a 25-year
period,from 1995 to 2020. Two postpone-
mentsin timingwereconsidered:2.5 and 5
years (34). The results (Table 3) indicate
that without changesin timing, the popu-
lation momentum equals 2.8 billion in
populationgrowthbetween 1995 and 2100,
that is, the differencebetween the 1995
populationof 4.5 billion and the 7.3 billion
projectedfor 2100 if fertilityis kept at the
replacementlevel (Fig. 4). This momen-
tumwouldbe reducedto 2.2 billion and 1.6
billion for delaysof 2.5 and 5 years,respec-
tively. Clearly, this approachto reducing
populationmomentumhas the potentialfor
a substantialimpact.
Govemmentsthat wish to encouragelat-
er childbearinghave severaloptionsat their
disposal.Legislationto raisethe age at mar-
riagehas been moderatelyeffectivein a few
countries(for example,Tunisiaand China
in the 1970s). However,legislationof this
type has the drawbackthat it attemptsto
force ratherthan encouragechangesin so-
cial customs. Indirect noncoercive ap-
proachesarepreferable.An exampleof such
an approachis greaterinvestment in the
educationof girls,particularly at the second-
arylevel. The longergirlsstayin school, the
laterthey marryand the greaterthe delayin
childbearing.Forexample,in 23 developing
countries, the median age of marriageof
women with secondaryeducationexceeded
that of womenwith no educationby 4 years
(Table4). This educationaldifferencein age
at marriagetranslatesinto a similarimpact
on the age at childbearing.
Another potentially effective approach
is to addressthe neglectedissuesof adoles-
cent sexuality and reproductivebehavior.
Manyadolescentsdo not use contraception
or use it sporadicallywhen they become
sexually active. As a result, childbearing
often startsearlierthan wouldbe the case if
young women had better informationand
services.Governmentshave been reluctant
to addressthese problemsof adolescentsfor
social and politicalreasons.
Delays in childbearing can also be
achieved by an increase in intervals be-
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ARTICLE
tween births. In general, however, the ef-
fect of a given incrementin birth spacing
on the meanage of childbearing(andhence
on population momentum) is somewhat
smallerthan can be obtainedby the same
increment in the mean age at first birth,
births.Lengtheningbirthintervalsalsopro-
vides substantialhealth benefitsformothers
and children; therefore, it should be en-
couragedfor health as well as for demo-
graphicreasons.
Outlook
Past debateson alternativepopulationpol-
icy approacheshave frequentlybeen con-
tentious, with supportersof the supplyand
demandapproacheseach emphasizingtheir
particularperspectives.In reality each of
these approachescan be effectiveand nei-
ther of them should claim predominance.
Moreimportantly,the differentapproaches
complement and reinforce one another.
Reductionsin demandfor children or de-
lays in childbearingthat are achieved (for
example,by increasinglevels of education)
do not by themselves reduce fertility. In-
stead, they raisethe demandfor contracep-
tion, andonly if this demandis satisfied(for
example,by servicesprovidedthroughfam-
ily planningprograms)will lowerfertilitybe
obtained. The fertility impact of the de-
mand and delay strategies, therefore, de-
pends to a significantextent on the avail-
ability of contraceptive information and
services. Conversely,familyplanningpro-
gramsare more successfulin meeting cou-
ples' needs for contraceptionin societies
with high levels of human development.
For example, in a given supply environ-
ment, well-educatedwomen satisfy their
demandfor contraceptionmore effectively
than their uneducatedcounterparts.The
reasonsfor this are not entirely clear, but
they presumablyrelateto the greaterability
of educatedwomen to control their lives as
well as their superiorknowledge of the
fertilityregulationmethods and sourcesof
supply.As a consequence, investmentsin
family planning programsproduce larger
reductionsin unwantedfertilitywhensocial
conditions such as education and gender
equalityare favorable.
A comprehensiveeffortto implementall
availablepolicy options is requiredif hu-
mankind is to prevent the potentiallyse-
vere, adverse consequencesof continued
rapidpopulationgrowth.If the broadrange
of approachesproposedhere is vigorously
pursued,large reductionsin futurepopula-
tion growthcan be achievedwithoutresort-
ing to the types of coercive measures that
are objectionable to the majority of the
world community.
775
 REFERENCESAND NOTES
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776
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55, 17, and 2 births per 1000 women per year.
20. Some family planning programs also try to en-
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through information and education campaigns.
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35. L. B. Williams, Fam. Plann. Perspect. 23, 212
(1991).
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are derived from computer data files for each
country with a demographic and health survey.