Population Services International

The Domino Effect

Drop Caps 1

Population is on the world’s radar as we near the October 31 milestone of a planet with 7 billion people. Experts and agencies like the United Nations, World Bank and Population Reference Bureau (PRB) cite startling statistics on future trends in population growth. Developing countries are adding more than 80 million to the population every year, according to PRB.1 Data from the UN Population Division of the Department of Economic and Social Affairs show that 39 high-fertility countries in Africa, nine in Asia, six in Oceania and four in Latin America are driving this projected increase.2

Population has reappeared as a topic in the media and in blogs. National Geographic devoted its January cover to “Population 7 Billion” and is running a series on the issue this year. The U.K.-based Guardian’s environment blog has hosted a series with experts on population and its effects on the environment.

Science Magazine featured a special section, titled “Population,” in its July 29th issue. In his Science article, David E. Bloom, professor of Economics and Demography at the Harvard School of Public Health and PSI board member, writes, "Although the issues immediately confronting developing countries are different from those facing the rich countries, in a globalized world demographic challenges anywhere are demographic challenges everywhere."

Development organizations and governments are talking population as it relates to their respective priorities: climate change, poverty alleviation, family planning, food scarcity, women and gender equality – all of which we discuss in this issue of Impact.

The world’s population at 7 billion presents complex challenges. Actions taken now will have serious implications on societies and ecosystems for generations to come. As an organization that provides reproductive health services to women in developing countries, PSI sees family planning interventions as a central response to the population question.

The United Nations Population Fund (UNFPA) estimates that some 215 million women in the developing world want to avoid pregnancy but lack access to effective family planning.

“Behind the numbers are the faces of women, and their families, who want nothing more basic than to live a better life by being able to decide when to have children. By failing to listen to them, we are condemning them – women, their partners and their children – to lives of greater misery and poverty,” says PSI President and CEO Karl Hofmann. “Whether and when you consider the range of challenges facing the planet, it is a mistake not to start the response with family planning.”


According to World Bank statistics, there are currently seven countries – all in the less developed world – with fertility rates of six children per women or greater; that number jumps to 25 when taking into account all countries with fertility rates of five children or greater. High fertility rates in the developing world are a leading contributor to global population growth. For every 100 people added to the planet, 97 are from less developed countries.3

The UN projects fertility rates in high, medium and low projection variants. For long-term trends the medium variant is considered most likely. According to the medium variant, it will take 13 years to reach 8 billion and 40 years to reach the 10 billion.

Under the high projection variant – which is half a child more than the medium – the world would add a billion people every 10 or 11 years for the rest of the century. While the low variant – which is half a child less than the medium variant – produces a population that reaches 8.1 billion in 2050 and declines towards the second half of this century.4

Relatively modest investments in family planning can produce significant differences in the size of populations over time. A study from the Guttmacher Institute calculated the cost of meeting total needs would amount to US$6.7 billion annually – US$3.1 billion for current services and US$3.6 billion for extending those services to all women with unmet need for effective contraceptives.5

Family planning resources have failed to increase relative to the need in developing countries. UN estimates show that foreign aid for family planning and reproductive health has stagnated in the last 10 years. The U.S. has traditionally been the biggest donor, contributing US$648 million in FY2010. But a budget compromise in Congress earlier this year cut international family planning and reproductive health programs by 5 percent for FY2011, according to the Population Institute.

That “unmet need” for family planning is expected to grow by 40 percent in the next 15 years, according to UNFPA. In 2010, the Futures Group analyzed the demographic impact of meeting the unmet need for contraceptive services in 99 developing countries (excluding China) and the U.S., whose combined population in 2005 was 4.3 billion. According to the model, if unmet need were fully met, the average fertility rate would drop to just below the replacement level by 2050.6


UNFPA kicked off its global “7 Billion Actions” campaign in May. At the launch, Executive Director Babatunde Osotimehin said, “Whether we can live together on a healthy planet will depend on the decisions we make now. The date we reach the next billion – and the ones after that – depends on policy and funding decisions made now about maternal and child health care, access to voluntary family planning, girls’ education, and expanded opportunities for women and young people.”

A number of experts like Joel Cohen, professor of Populations at Rockefeller University, write that universal secondary education, particularly for girls, can play a significant role in influencing population growth.7 One PRB report on women’s education and family size found that women in many devel-oping countries who completed secondary school averaged as much as one child fewer per lifetime than women who completed only primary school.8

In Niger in 1998, for example, women who completed secondary education had 31 percent fewer children (on average, 4.6 per lifetime) than those who completed only primary education (6.7), as measured by the total fertility rate.9

India has seen similar trends. Although fertility rates are still high by Western standards, they are on a steady decline. “From 1965 to 2009, contraceptive usage more than tripled and fertility rate declined by more than half,˝ says Deputy Executive Director and Assistant-Secretary-General of UN Women Lakshmi Puri. “A good part of the fertility decline occurred in the southern states, which generally have higher rates of literacy and education along with greater equality for women.”

Political stability and the right comprehensive government strategies also play a role in population growth. The world’s least developed countries, which currently make up 12 percent of the global population, tend to be the most economically, socially, environmentally and politically fragile countries of the world, Bloom writes in Science.

Throughout the past several decades, the governments of some less developed countries have invested in family planning as part of their national economic development strategies. Through a comprehensive and non-coercive approach to family planning, governments have been able to significantly reduce fertility rates. Indonesia is one good example. In 1960, the fertility rate in Indonesia was 5.7 births per woman, which is about the same as Nigeria today.10

From 1966 onward, the fertility rate began a steady decline as the Indonesian government implemented a national family planning program. The program has evolved over time, but at no point was it compulsory. Through building village-level clinics, training field workers and creating demand through what now might be considered social marketing campaigns, Indonesia was able to sharply reduce its fertility rate. Today, Indonesia’s fertility rate stands at 2.1, which is considered long-range replacement level (absent of migration).

Lowering fertility rates required a generation-long commitment on the part of policy makers, NGOs and donors around the world. This shows that even in places where population growth is stubbornly high, non-coercive public policy interventions can markedly lower a country’s fertility rate. For countries struggling with their own demographic transitions today, the experience of countries like Indonesia should offer reason for hope.

“Lowering growth paths where the population is growing fastest is possible, and doing so is the difference between the planet having 8 billion people and 10 billion people before it stabilizes,” says Hofmann. “That is a huge difference.”

– By Mark Goldberg, freelance writer, Washington, D.C., and Mandy McAnally, Associate Manager, Communications, Washington, D.C.

  1. 1. 2010 World Population Data Sheet. (2010) Population Reference Bureau.
  2. 2. World Population Prospects. (2010) UN Population Division.
  3. 3. 7 Billion Actions. (2011) UNFPA.
  4. 4. World Population Prospects. (2010) UN Population Division.
  5. 5. Adding It Up. (2009) Guttmacher Institute.
  6. 6. World Population Prospects and Unmet Need for Family Planning. (2010) Futures Group.
  7. 7. Cohen, Joel E. (2008) Make Secondary Education Universal. Nature 456:572-573.
  8. 8. Women’s Education and Family Size in Selected Countries, 1990s. (2008) Population Reference Bureau.
  9. 9. Jejeebhoy, S. J. (1995) Women’s Education, Autonomy and Reproductive Behaviour: Experience from Developing Countries. Clarendon Press.
  10. 10. World Population Data Sheet. (2010) Population Reference Bureau.

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