I am following up with my latest thoughts on the demographic transition that our continent is experiencing. We have posed the problem in its major trends in our last post, but it is also appropriate, I believe, to see how we can deal with this phenomenon.
One of the levers on which it is possible to act to better control the growth of the population is fertility. It has been said that this involves the education of girls and young women and raising awareness about the challenges of an uncontrolled population increase. Unfortunately, some leaders still view population’s growth as a mark of power, and rely on the so-called demographic dividend, but too often forget that this dividend is only possible if everything else follows, from infrastructure to health specialists and schoolteachers.
Let me explain: without effective education and health infrastructures, without decent jobs creation by the millions, younger generations will not be well trained, will not enter the labor market and will not be healthy. They will therefore be able to participate only at the margin in the national economic wealth creation, if these young people still live long enough to become active workers and find a job. Another growing phenomenon, due in large part to the lack of good education and health infrastructures, is the ever-growing illegal migration phenomenon. Indeed, it seems obvious that the tens of thousands of young people who cross the Sahara then the Mediterranean Sea at the risk of their lives and also take the risk of leaving everything, are part of this issue because they feel they have nothing to lose in this adventure. This message of despair must challenge us, because if the population continues to grow at this rate, emigrants will be more and more numerous.
Governments must therefore look at ways and means to lower the fertility rate. We have already ruled out coercion to achieve this goal. But there are other strategies, other public policies that can be tried or implemented. This has been seen in some countries, such as South Africa, Kenya and Malawi. In Ethiopia, for example, the government has set up a tight network of 42,000 community health workers. These have reduced the cost of health expenditures by 39% between 2005 and 2015, which is already a good achievement in itself, but they have also helped raise awareness among millions of women about birth control. This experience could be expanded to other countries, or even to the entire continent.
Another possible lever is family planning. In 2011, nine governments in West Africa, the United Nations Population Fund (UNFPA), the Agence Française de Développement (AFD) and several large private foundations signed an agreement, the “Ouagadougou Partnership”, intended to promote family planning. There are religious, political and social obstacles, but family planning remains one of the proven methods of reducing fertility, provided access to reliable contraceptive methods is available. In this area also public policies can be put in place. And if states do not want to engage directly, they can support and encourage free work on the part of some specialized NGOs.
According to the available studies, in 2013 worldwide, 63% of women aged 15-49 years who are in a couple used a contraceptive method, and 57% a modern method (pill, IUD or sterilization). But for sub-Saharan Africa, only an average of 20-25% of women had access to contraception, with some countries falling below 10%, such as Mali and Eritrea.
As such, North Africa is an exception on the continent. Algeria, Egypt, Morocco or Tunisia have experienced faster population transitions with a current fertility rate of between two to three children per woman. A figure that can be linked to the high proportion of contraceptive use: between 60% and 68%. South of the Sahara, only South Africa is getting near this global average with 60%.
This demonstrates that public policies can effectively address the challenge of reducing fertility. We just have to do it.