World Development Report 1984

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FIGURE 8.2 upper Egypt want no more children but are not Fertility in relation to income: selected developing using contraception, and that more than half of countries in the Middle East and North Africa, 1972 these women would like to use a method. In Jen- douba, Tunisia, 46 percent of women who were Total fertility rate not using contraception wanted no more children, 8 and 22 percent said that they would like to space the next birth. When women in Marrakech, Jordan Algeria Morocco, were offered supplies of oral contraceptives through home visits, the rate of contraceptive 7 use rose from 18 to 43 percent. In the Sfax region of Tunisia, household distribution increased the rate \ 1972 from 7 to 18 percent. 6 \\ Tunisia * 1982 Continued progress in reducing fertility in these countries will depend both on better family planning services and on measures to improve the sta- Norm for 92 developing tus of women. countries, 1972 * Family planning programs. Access to services in 5 / rural areas is still restricted. The Tunisian program has had difficulty reaching a dispersed rural popu- Egypt lation, which includes half of the married women of reproductive age. Services in Morocco and 4 *Turkey Egypt rely heavily on physicians and are clinic- based with little outreach. In Egypt only physi- Norm for 98 developing countries,1982 cians may prescribe the pill and insert the IUD. The few outreach workers in place are not permit- 0 $1000 $2000 $30 ted to distribute contraceptives and are supposed Income per capita(1980dollars) to motivate only women who already have three children. In Morocco, nurses were only recently authorized to insert IUDs, and nonclinical distribution of the pill is still frowned upon. Yet experience in South and East Asia as well as in Latin America Despite these achievements, population growth indicates that carefully trained paramedical remains rapid and acceptance of family planning fieldworkers can deliver many methods and slow. Total fertility, although reduced, is still 4 to 5 increase contraceptive prevalence dramatically. in Egypt, Tunisia, and Turkey, and about 6 in Use of the media to promote family planning and Morocco. In Egypt and Tunisia, an increase in the small families has been limited in Morocco: not proportion of women of childbearing age has kept until 1982 were the Ministry of Public Health and the birth rate high. Mortality has declined, and the the private family planning association permitted rate of population growth has changed little. Pop- to broadcast family planning messages and show ulation pressure has been eased in both countries films. by emigration, but poor economic conditions in The limited range of contraceptives available Europe have reduced emigration from Tunisia and in Egypt and Morocco also restricts their use. caused many emigrants to return. The rate of con- Although the IUD and condoms are theoretically' traceptive use has remained at about 25 percent in available, both programs favor the pill. Only one- Egypt for several years; increases have been slow quarter of outlets in Egypt are staffed or suppliedin Turkey and Morocco. The number of new accep- to provide IUD insertions. Only one brand of pill is tors of family planning has barely risen in Tunisia offered. Sterilization is legal but not promoted by for about five years. the official program; abortion is prohibited. In con- There is ample evidence of unmet need for fam- trast, the Tunisian program has made the pill, IUD, ily planning services. Low and high estimates in female sterilization, and abortion (in the first three Egypt ranged from 12 to 22 percent of married months of pregnancy) more widely available. women of childbearing age in 1980. In certain areas * The status of women. Increasing the number of unmet need is even higher. One study found that educated women could do much to reduce fertility 82 percent of married women in rural areas of in the region. Enrollment rates for girls in 1980 168
FIGURE 8.3 Gross enrollment ratios by sex: selected countries in the Middle East Enrollment ratio Enrollment ratio and North Africa, 1960 and 1980 120 120 Egypt Morocco 80 M, 80 Mr -M Males, primary enrollment M, - Females, pnmary enrollment F F, Males, …----- secondary enrollment 40 , ,- ' 40 Females, ------ secondary enrollment ,- ,, 0 ~~~~~~~~~~~~F, 1960 1980 1960 1980 Enrollment ratio' Enrollment ratio Enrollment ratio 120 120 120 Tunsia M, Jordan M Entire region Mr 80 F, 80 m 80 F, FM. F, 40 40 ,, 40 -M, ____ --- - -- F, ; , 0 -- - - - - - - - - - -0 0 -- .- 1960 1980 1960 1980 1960 1980 a Enrollment ratio equals the number enrolled as a percentage of a particular age group. It can exceed 100 percent because some pupils are below or above the official primary-school age. b. Mean weighted by 1960 and 1980 population (includes high-income oil exporters). Sozxrce: UNESCO, 1983; World Development Report 1982. were still only two-thirds the rates for boys at both other legal changes are under discussion: the primary and secondary schools (see Figure 8.3); in repeal of a husband's automatic status as head of twenty years the gap has not narrowed. An impor- the family in favor of a system of "joint responsitant exception is Jordan, where primary-school bility of spouses" and abolition of a husband's education is now universal and about three-quar- right of consent for his wife to be gainfully ters of secondary-school-age children of both sexes employed. are enrolled. In Egypt, Morocco, and Tunisia universal primary schooling for girls has yet to Latin America and the Caribbean: be achieved. Female primary enrollment has reducing social inequities increased steeply in Tunisia, and the male-female gap has been somewhat reduced. In Egypt the Almost all of the countries in Latin America and increase in primary-school places has barely kept the Caribbean are middle-income, but with great pace with population growth; the primary-school demographic diversity. In four countries with per enrollment rate has remained low and access is capita incomes exceeding $2,500-Argentina, - particularly limited in rural areas, where fertility is Chile, Trinidad and Tobago, and Uruguay-popuhigh. At the same time, much has been invested in lation growth has slowed to below 2 percent a year expanding secondary schooling. and total fertility is nearing replacement level. The Women's status can also be improved by raising highest fertility in the region is in six lower-midthe minimum age of marriage and by changing dle-income countries: Bolivia, Ecuador, El Salvalaws that restrict women's social and financial dor, Guatemala, Honduras, and Nicaragua. Total rights. The legal minimum age of marriage for fertility in these countries exceeds 5 and populawomen in Tunisia was raised to fifteen in 1956, and tion growth ranges from 2.5 to 3.4 percent. Fertility then to seventeen in 1964. The legal minimum age is high in the Caribbean, with the exception of in Morocco and Turkey is still fifteen. In Turkey Cuba, but emigration moderates population 169
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Public Disclosure Authorized Public
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Oxford University Press NEW YORK OX
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labor markets. And they have a vest
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8 The policy agenda 155 Population
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Boxes 1.1 The arithmetic of populat
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Glossary Demographic terms informat
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I I
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countries regain their momentum of
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4 Box 1.1 The arithmetic of populat
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example. Between 1955 and 1980 inco
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ment-all the more so if human skill
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etween 1 and 2 percent-moderate com
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FIGURE 2.1 directions-with a lag in
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14 Distribution of product among se
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TABLE 2.2 Rates of growth in the re
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export restraints and orderly marke
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Box 2.2 Comparisons between the 193
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TABLE 2.6 indebtedness is denominat
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TABLE 2.7 Change in export prices a
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Burundi, Guinea, Mali, Malawi, and
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TABLE 2.9 Exports from developing c
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of rapid and painful adjustment for
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In many countries internal adjustme
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3 Prospects for sustained growth Wi
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TABLE 3.2 Growth of GDP per capita,
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TABLE 3.4 Current account balance a
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over time. The main focus of indust
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TABLE 3.6 Growth of trade in develo
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Box 3.3 Delinking from the world ec
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nal surplus. The resulting rise in
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Because the public sector in low-in
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developing-country creditworthiness
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themselves and, by caring for young
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fertility in a changing world is a
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nize contraceptive services. As wil
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Economic transformation: Europe, Ja
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scious control of family size, prob
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Box 4.3 The European fertility tran
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FIGURE 4.2 Birth and death rates an
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Box 4.4 Alternative measures of fer
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largest city in 1950, will not even
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FIGURE 4.4 Fertility in relation to
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government goal is a nationwide rat
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North America's population in 2000
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IBox 4.6 Three views of population
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TABLE 4.6 Population size and densi
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Box 5.1 Consequences of population
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implied by a simple division of tot
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and on farms. But the evidence on e
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get in GDP. Alternatively, all or p
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youths, who are presumably able to
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saving because they come from the c
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acre increased from 15.4 million to
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food they need. Although the amount
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is so scarce, they can do so only o
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from rural to urban areas mainly re
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other developing countries suggests
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emigration by providing information
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Box 5.7 Coping with rapid fertility
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6 Slowing population growth Experie
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feTtility; nor is it easy to judge
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the education of mothers increases
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etter education and health services
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TABLE 6.1 Total fertility rates and
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effectiveness of existing laws, ins
Page 132 and 133: in the 1950s and 1960s, fertility w
Page 134 and 135: FIGURE 6.6 Fertility dedine within
Page 136 and 137: Box 6.3 Mleasuring the value of chi
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Page 140 and 141: Box 6.4 A deferred incentive scheme
Page 142 and 143: Box"7.1 Family planning for health
Page 144 and 145: FIGURE 71 88 in Romania (1979). Res
Page 146 and 147: 132 Box 7.2 Birth planning technolo
Page 148 and 149: TABLE 7.2 Percentage of married wom
Page 150 and 151: TABLE 7.3 Discontinuation of contra
Page 152 and 153: may be delaying a first pregnancy,
Page 154 and 155: family planning and maternal and ch
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Page 158 and 159: Box 7.6 The impact of service quali
Page 160 and 161: medical examination was not always
Page 162 and 163: measuring social acceptability, or
Page 164 and 165: Box 7.7 Military versus social expe
Page 166 and 167: costs per user. Public cost per use
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Page 170 and 171: TABLE 8.1 Population policy indicat
Page 172 and 173: Box 8.2 China's census: counting a
Page 174 and 175: FAMILY PLANNING. In many countries-
Page 176 and 177: improving the availability of famil
Page 178 and 179: Box 8.4 Africa: how much land, how
Page 180 and 181: Box 8.5 Infertility: a challenge to
Page 184 and 185: growth. Fertility has declined in t
Page 186 and 187: Box 8.7 Changing policies and attit
Page 188 and 189: FIGURE 8.6 childbearing age have un
Page 190 and 191: able several types of condoms, pill
Page 192 and 193: housing schemes to parents with onl
Page 194 and 195: and training, data collection and a
Page 196 and 197: 9 Ten years of experience Much that
Page 198 and 199: ecause few effective methods are of
Page 200 and 201: Population data supplement The six
Page 202 and 203: Table 4. Factors influencing fertil
Page 204 and 205: 190 Births and total fertility =Ice
Page 206 and 207: Table 1. Population projections Rat
Page 208 and 209: Table 2. Population composition Low
Page 210 and 211: Table 3. Contraceptive use and unme
Page 212 and 213: Table 5. Status of women Number enr
Page 214 and 215: Table 6. Family planning policy _ _
Page 216 and 217: Bibliographical note This Report ha
Page 218 and 219: Background papers Note: Source refe
Page 220 and 221: -1984. "The Malthusian Case: Preind
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Page 224 and 225: Table 10. Structure of merchandise
Page 226 and 227: Key In each table, economies are li
Page 228 and 229: same order is used in all tables. T
Page 230 and 231: Population I~~~~ - * S: ~ -- ' X -
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Table 1. Basic indicators GNP per c
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Table 2. Growthi of production Aver
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Table 3. Structure of production GD
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Table 4. Growth of consumption-and
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Tadble 5. Structure of demand Distr
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Table 6. Agriculture and food Value
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Table 7. Industr Distribution of ma
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Table 8. Commercial energy Energy c
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Table 9. Growthi of merchandise tra
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Table 10. Structure of merchandise
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Table 11. Structure of merchandise
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Table 12. Origin and destination of
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Table 13. Origin and destination of
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Table 14. Balance of payments and r
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Table 15. Flow of public and public
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Table 16. External public debt and
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Table 17. Terms of public borrowing
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Table 18. Official development assi
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Table 19. Population growth and pro
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Table 20. Demographic and fertility
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Table 21. Labor force Percentage of
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Table 22. Urbanization Urban popula
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Table 23. Indicators related to lif
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Table 24. Health-related indicators
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Table 25. Education Number Number e
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Table 26. Central goverrnment expen
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Table 27. Central government curren
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Table 28. In-come distribution Perc
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Technical notes This edition of the
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difficulties in assigning subsisten
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series in national currencies are a
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Public loans are external obligatio
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estimates, the total fertility rate
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expenditure and current revenue sho
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Bibliography of data sources Nation
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World Development Report 1984

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