Tuesday, September 21, 2004

What Causes Birth Rates to Drop?

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What causes birth rates to drop?

The short answer is that while there are racks of data that show strong correlations with fertility decline, all of the models fail to establish predictive causality.

In short, while there are "theories" about the "demographic transition," there are no hard-and-fast rules, and quite a few important exceptions.

John Cleland of the London School of Hygiene and Tropical Medine has looked at countries with similar socio-economic profiles, for example, and found that many of them have very different track records.

Algeria and Tunisia, for example, had comparable proportions of literate people, city dwellers, and the exact same life expectancy in the mid-1980s. Algeria's GNP of $2,360 per head, however, was almost double that of Tunisia. So did Algeria's fertility decline faster than Tunisia's? No. In fact, Algeria's fertility decline started about 15 years later than Tunisia's.

Why?

The short answer, according to Cleland, is that the Algerian government regarded family planning as a tool of Western oppression, while Tunisia had a more positive attitude towards contraception. While the government of Algeria has since embraced a very successful family planning program, their 15-year delay will have a real cost -- a 2050 population that will be 20 million people higher due to governmental delay.

A similar story is told in Bangladesh and Pakistan, two nations that used to be one country. At the time of their 1971 split, Bangladesh was far poorer than its neighbor. So did Pakistan's fertility rate fall faster than that of Bangladesh? No. In fact, Bangladesh's fertility rate fell soon as a direct result of government resources put into meeting the unmet need for contraception in that country. In Pakistan, instead of focusing on family planning and health care, that government focused on saber-rattling and weapons procurement. As a result, Pakistan will have about 150 million more poor people in 2050 than it might have had if it had followed the Bangladesh model.

Cleland argues such comparisons show that the link between economic development and smaller families is "much weaker and more variable" than previously believed, and that "the empowerment of women ... will facilitate fertility decline but is not a precondition for it."

Ironically, Cleland's theory is challenged by the case of West Bengal, right next door to Bangladesh. The Muslims of West Bengal (which includes the city of Calcutta) have the highest levels of contraceptive use in India -- higher even than that of the Muslims of Kerala. The total fertility rate of West Bengal is expected to hit the replacement rate within the next two years.

What's odd here is that the state government of West Bengal "has been quite indifferent to population policy" according to Alaka Basu and Sajeda Amin, writing in the December 2000 issue of Population and Development Review. "West Bengal has never had the kind of aggressive or even efficient family planning campaign or program that many other parts of India have embraced at various times." According to Basu and Amin, both Bangladesh and West Bengal share a common language and a common culture that embraces change -- another element in the matrix of factors that influence the speed of fertility decline.

The bottom line seems to be that every country, every culture, and every couple need to be treated as individuals if we are to get to replacement level fertility rates as quickly as possible. While education, economic development, and government support for family planning programs are all important, there is not a single "silver bullet solution" that triggers rapid and sustained fertility decline in every country every time. Instead, the decision to have smaller families appears to be a complex decision that can be encouraged and facilitated by a wide variety of programs, developments and outside forces.

The good news is that countries that have been slow to embrace family planning often find that modern contraceptive methods can help to reduce fertility quickly.

The bad news is that time lost cannot be regained. Though fertility may fall, the base population will be higher and so too will be the population when it reaches stabilization.

For more information, see >> "The Determinants of Reproductive Change in Bangladesh: Success in a Challenging Environment" published by the World Bank and authored by John Cleland and Sajeda Amin, and; "Conditioning Factors for Fertility Decline in Bengal: History, Language Identity, and Openness to Innovations," Population and Development Review, December 1, 2000 by Alaka Basu and Sajeda Amin.