Family Planning in Asia and the Pacific - International Council on ...

Figure1980s <strong>and</strong> experienced a rapid decl<strong>in</strong>e <strong>in</strong> subsequentyears, characteristics similar to those of o<strong>the</strong>r countriesexperienc<strong>in</strong>g socio-economic <strong>and</strong> demographic transitions.The population growth rate dur<strong>in</strong>g <strong>the</strong> <strong>in</strong>tercensal period2001-2006 was 1.69 per cent.Various data <strong>in</strong>dicate that fertility rates <strong>in</strong> Maldives beganto decl<strong>in</strong>e <strong>in</strong> <strong>the</strong> early 1990s (MPND, 2002), a trend thatbecame more rapid <strong>in</strong> recent years (Niyaaz, 2002; Naseemet al., 2004). Fertility analyses of recent censuses <strong>in</strong>dicatethat Maldives experienced one of <strong>the</strong> most rapid fertilitytransitions <strong>in</strong> <strong>the</strong> region. The 1990 <strong>and</strong> 1995 censusesreported total fertility rates (TFRs) of 6.4 <strong>and</strong> 5.7 childrenper woman. Total fertility estimates for 2000 <strong>and</strong> 2006stood at 2.8 <strong>and</strong> 2.1 respectively.The contraceptive prevalence rate (CPR) showed a steady<strong>in</strong>crease over <strong>the</strong> period 1985-2006 (see Figure 1). Before<strong>the</strong> official launch of <strong>the</strong> child-spac<strong>in</strong>g project <strong>in</strong> 1984,which formally <strong>in</strong>troduced FP services <strong>in</strong> <strong>the</strong> country, totalCPR (<strong>in</strong>clusive of traditional <strong>and</strong> modern methods) wasestimated to be about 10 per cent. By 1999 it had <strong>in</strong>creasedto 42 per cent; however, it fell <strong>in</strong> 2004 to 39 per cent <strong>and</strong><strong>in</strong> 2009 to 35 per cent. More scientific data on CPR beganto emerge from a 1999 Reproductive Health Basel<strong>in</strong>eSurvey which <strong>in</strong>dicated a CPR of 33 per cent for moderncontraceptive methods. Correspond<strong>in</strong>g data <strong>in</strong> <strong>the</strong> 2004RH survey showed a CPR of 34 per cent, <strong>and</strong> <strong>the</strong> firsteverdemographic survey conducted <strong>in</strong> Maldives <strong>in</strong> 2009recorded a CPR of 27 per cent for modern methods.In view of <strong>the</strong> small size of <strong>the</strong> population, mortalityestimates often lack consistency <strong>in</strong> estimates ofdemographic parameters. However, because Maldivesconducts a census every five years, <strong>the</strong> reliability of <strong>the</strong> datacannot be questioned. Commensurate with <strong>the</strong> decl<strong>in</strong>e <strong>in</strong>fertility, mortality decl<strong>in</strong>ed significantly dur<strong>in</strong>g <strong>the</strong> periodunder review, contribut<strong>in</strong>g to <strong>in</strong>creased expectation of lifeat birth. Table 2 shows <strong>the</strong> decl<strong>in</strong>e <strong>in</strong> <strong>the</strong> <strong>in</strong>fant mortalityrate (IMR), under-five mortality <strong>and</strong> maternal mortalityratio (MMR) over <strong>the</strong> years. Accord<strong>in</strong>g to <strong>the</strong> data,Maldives seems to have already achieved MDG Target 4 ofreduc<strong>in</strong>g <strong>the</strong> under-five mortality rate, as well as reduc<strong>in</strong>g<strong>in</strong>fant <strong>and</strong> child mortality at <strong>the</strong> aggregate level, <strong>and</strong> Target5 of reduc<strong>in</strong>g MMR.As a result of decl<strong>in</strong><strong>in</strong>g fertility <strong>and</strong> mortality, <strong>the</strong> populationage structure <strong>in</strong> Maldives has changed significantly, eventhough it is still relatively young. The chang<strong>in</strong>g age structureis depicted <strong>in</strong> Figure 2 <strong>and</strong> <strong>the</strong> population pyramid <strong>in</strong>Figure 3. The percentage of population aged 0-15 years <strong>in</strong>1990 to <strong>the</strong> total population was about 47 per cent; thatproportion decl<strong>in</strong>ed to 31 per cent <strong>in</strong> 2006.This decl<strong>in</strong>e <strong>in</strong> <strong>the</strong> percentage of <strong>the</strong> population <strong>in</strong> <strong>the</strong> 0-15-year age group <strong>in</strong>creased <strong>the</strong> percentage <strong>in</strong> <strong>the</strong> work<strong>in</strong>g-agepopulation, push<strong>in</strong>g Maldives towards a position where itcould enjoy what is popularly known as <strong>the</strong> “DemographicDividend”, a w<strong>in</strong>dow of opportunity where <strong>the</strong> dependencyratio (number of dependents per work<strong>in</strong>g-age population)tends to be lowest <strong>in</strong> its demographic transition, enabl<strong>in</strong>g <strong>the</strong>country to benefit by utiliz<strong>in</strong>g <strong>the</strong> work<strong>in</strong>g-age populationfor economic development. The period is expected to lastfor about 30 years or so. If <strong>the</strong> country fails to benefit fromthis w<strong>in</strong>dow of opportunity, once aga<strong>in</strong> <strong>the</strong> dependencyratio is likely to become imbalanced <strong>and</strong> <strong>the</strong> work<strong>in</strong>g-agepopulation will decl<strong>in</strong>e, result<strong>in</strong>g <strong>in</strong> a higher dependencyratio. Maldives has achieved this “dividend” because ofits success <strong>in</strong> promot<strong>in</strong>g socio-economic development,<strong>and</strong> by <strong>in</strong>vest<strong>in</strong>g more <strong>in</strong> improv<strong>in</strong>g people’s access toFigure1Selected <strong>in</strong>dicators of fertility <strong>and</strong> family plann<strong>in</strong>g: modern methods40353025201510501985 1990 2000 2006 2009Source: Country Contraceptive Report, Maldives: prevalence ICPD+15 <strong>and</strong> rate Beyond: (%) Progress Achievements Total Fertility <strong>and</strong> Rate Challenges, 1994-2009. Government ofMaldives <strong>and</strong> UNFPA, 2009.156