Over population remains a major challenge to
Africa and its peoples due to poor policies and implementation of family
planning programmes. Dr. Leticia Adelaide Appiah, the Executive Director,
National Population Council, the highest advisory body to the government of
Ghana on population and related issues, in this interview with CHIOMA UMEHA,
speaks on the far-reaching consequences of escalating population in many
African countries including Nigeria and Ghana. Excerpts:
What is over population?
Over population is an undesirable condition where
numbers of existing human population exceed the carrying capacity of the earth.
This is because of reduced mortality rate, better medical facilities,
industrialisation and improved public health and high fertility levels.
Currently, Africa’s problem is the extremely rapid population growth rate that
makes it extremely difficult for governments to supply the needed social and
economic programmes to improve quality of life. For example, the total population in Nigeria was estimated
at 191 million people in 2017 and a net increase of about 14, 000 people
(21,000 births and 7,000 deaths) daily or about five million annually.
In 1960, Nigeria had 45.1 million people. The United Kingdom on the other hand had a population of
52.2 million people in 1960 and was estimated at 66.2 million people in 2017,
according to the latest census figures. Though UK had more people than Nigeria
in 1960, Nigeria has about three times more people compared to UK in 2017.
Such high population growth rates lead to
widespread food shortages, malnutrition, crowded and sub-standard schools,
crowded hospitals, teeming slums, inadequate water supply, inadequate
electricity supply, failing banks and security threats among others. Afterall, nation building is by the
people and for the people. There is therefore the need to balance the
reproduction and production capacities of the citizenry through effective
policies and programmes with the welfare of the people as the paramount goal.
Healthy people are more productive while unhealthy, malnourished, stunted,
poorly skilled people consume more than they produce.
Would you like to mention a few countries that
have achieved success in population control?
Thailand within 15 years from 1971 halved its
growth rate from 3.2 per cent to 1.6 per cent and increased use of
contraceptives among married couples from 15 per cent to 70 per cent within the
same period and number of births per woman reduced from 6 to 2 The population
of Thailand in 1970 was about 37 million and increased gradually to about 68
million in 2016 with GDP per capita increasing from $570 in 1960 to $ 5901 in
2016. In effect, Thailand produced
fewer, healthier, happier and more educated people for national development.
Rwanda is another country which places emphasis on
the harmonization of population growth in its Economic Development and Poverty
Reduction vision 2020. The reduction of the main causes of mortality, reducing
total fertility rate, decreasing infant and maternal mortality and ultimately
reducing population growth as the thrust of the vision. The vision identified high population
growth rate as a major challenge and singled out Family Planning (FP) as a key
intervention crucial for reducing birth rates and improving quality of life.
The programme has so far been successful that the
contraceptive prevalence rate among married women increased from 4 percent in
2000 to 10 percent in 2005 to 45 percent in 2010 ( RDHS, 2005 & 2010) and
the total fertility rate decreased from 6.1 per woman in her lifetime in 2005
to 4.6. In 2010, maternal mortality ratio reduced from 750 per 100,000 live
births in 2005 to 487 per 100,000 live births in 2010 underscoring the
important role of FP in addressing population growth and improving quality of
life.
What are the major causes and consequences of this
challenge?
The population growth rate which is a function of
birth rate, death rate and migration acts as the supply of labour force for a
country and the economic situation -the demand factor. An imbalance between the supply of
labour and demand gives rise to unemployment, underemployment and poverty. A
vicious cycle generated by a high dependency burden associated with a young age
structure leads to low savings and investment per capita by families and
nations which in turn lead to low economic growth and a low standard of living.
High fertility rates in turn heightens the
dependency burden perpetuating the cycle putting pressure on governments to spend
more just to maintain quality of life. Some economists have stated that at one
per cent population growth rate, nations need between 6.5 per cent and seven
per cent of GDP to maintain the same quality of life. This is termed running to
stand still. With Nigeria growing at over two per cent growth rate, how much of
GDP is needed just to maintain quality of life?
What should be done to curb these negative trends?
This vicious cycle can be broken at only two
points. First, is by introducing an effective family planning program and at
the stage of low economic growth by adopting policies to accelerate economic
growth. To be successful, both actions must be pursued simultaneously.
Balancing reproduction and productivity is key to national development. Unfortunately,
some of our leaders focus only on the productive part of education and job
creation with little attention to the reproductive needs of their citizens
thereby keeping a lot of women and girls under the bondage of involuntary
reproduction and nations bearing the consequences thereof.
What is the situation in Ghana and Nigeria in
terms of public acceptability and use of contraceptive?
Contraceptive use and unmet need for family
planning are key to effective fertility management, improving reproductive
health and ultimately health of all citizens worldwide. Contraceptive use helps
couples and individuals realize their basic right to decide freely and
responsibly if, when and how many children to have and remain a sustainable
family. The use of contraceptive methods not only results in improvements in
health-related outcomes such as reduced maternal mortality and infant mortality
but also educational, employment outcomes and in reaping demographic dividend.
According to the world trends in contraceptive
2015 report, globally, the contraceptive prevalence rate for modern methods is
57 per cent. Within Africa, countries with contraceptive prevalence of 50 per
cent or more are mainly islands (Cabo Verde, Mauritius and Réunion), or located
in the north of the continent along the Mediterranean coast including Algeria,
Egypt, Morocco and Tunisia as well as
in Southern Africa such as Botswana, Lesotho, Namibia, South Africa and
Swaziland.
Five countries in Eastern Africa including Kenya,
Malawi, Rwanda, Zambia and Zimbabwe also had contraceptive prevalence levels of
50 per cent or more in 2015. In contrast, 17 African countries including
Nigeria had contraceptive prevalence levels below 20 per cent with high unmet
need for family planning and corresponding high dependency ratio and pregnancy
related morbidities and mortalities.
Ghana is doing relatively better than Nigeria because the population is
far less and the fertility rate is also lower. Nonetheless, the government of
Ghana also needs to reposition family planning to reduce fertility and
dependency ratio for accelerated socio-economic development.
Advocating for the acceptability of contraceptives
in Sub-Saharan Africa should be a socio-economic empowerment agenda spearheaded
by our political leadership enlisting the support of all stakeholders including
the religious leaders, traditional leaders, health workers, teachers, civil
society, private sector, the media, school children and the international
community. Reducing fertility through increased contraceptive uptake reduces
expenditure in all sectors and set the stage for accelerated economic
development of families and ultimately nations. Focusing on family planning
education and access in an enabling environment should therefore be an agenda
for African leaders. Afterall, good politics improves human lives, reproductive
health rights and responsibilities also improves human lives, therefore
improving reproductive health and rights in a responsible way is good politics.
India and China recorded huge successes in
shrinking their demographics through giving incentives to families with one or
two only children. Do you think that this approach can be adopted in this
region?
Yes, China and India implemented population
policies that worked for them though some aspects were unethical by forcing
people or through coercion. Currently, China has a fertility level that is
below replacement of 2.1 per woman and therefore has relaxed its policy to
allow women to have at least two children. Population policies differ from
country to country and at times within countries, like weight management. Just
as people who are overweight should reduce their weight to within a normal BMI
range, so should countries with high fertility rates have policies that gives
incentives and encourages fertility reduction as most countries in SSA.
Countries with fertility rates below replacement level fertility of 2.1 should
have policies serving as incentives and encouraging women to increase their
fertility to the replacement level and countries with fertility levels at the
replacement level should maintain whatever they are doing.
Governments drive everything through the policies
they implement. An example is Iran. In December 1989, the government of Iran
introduced a family planning program with three major goals. First to encourage
women to space their pregnancies between three and four years, discourage
pregnancy among women younger than 18 years and older than 35 years and
limiting pregnancies to three per woman. Iran therefore fashioned its policy
around reducing high risk pregnancies through advocacy and free supply of
contraceptives. In as much as citizens had the right to have as many children
as they wish, the government made them responsible by making citizens bear the
full cost of additional births after the third child. The total fertility rate
declined from 5.2 births per woman in 1989 to 2.8 in 1996. There was reduction
in maternal and infant morbidity and mortality, improvement in health care and
educational outcomes among other advantages.
What roles should ECOWAS and AU play in
strengthening member countries on adoption of more stringent policies and
legislation in this campaign?
ECOWAS and AU member countries should support each
other in breaking the poverty cycle by simultaneously implementing an effective
family planning program in addition to all the economic activities. After all, the World Bank talks about
GDP per capita. This means, nations should help their citizens reproduce
themselves healthily and work effectively and efficiently to improve the GDP
per capita. ECOWAS and AU must focus on reproductive health rights and
responsibility as equally as they focus on economic interventions because one
cannot afford to forget the per capita part of GDP per capita and meet the SDG
goals or the Africa Agenda 2063. Nigeria being the most populous African
country with a high population growth rate with massive population momentum,
should be targeted for support by ECOWAS to reposition family planning as a
critical socio economic intervention to improve human lives in this generation
and set the stage for improved life for the next.
What is your advice to population control agencies in Nigeria and other countries?
Nigeria is Africa’s most populous country. It has
over 40 percent of its population below 15 years and has a net annual increase
of about 5 million people. That is about the population of Norway being added
to Nigeria’s population annually. This is certainly not sustainable for
sustainable socio-economic development.
Population growth dramatically increases the need
for all services including job creation. Linden, writing in the New York Times
in 2017, illustrates the burden of exploding population. He said per the
population structure of the United States, on average 129,000 new jobs monthly
were created in 2016 but an America-size Nigeria would have to produce 319,000
jobs monthly, without cease. How can we sustain this? Let us know that the might
of a nation is not necessarily in its size but in the might of its people that
is the human capital.
What are your final thoughts on these issues?
I believe that every pregnancy should be wanted,
and every child cherished and nurtured to be a productive and proud citizen of
nations. That is the only way any nation can develop since quality human
capital accumulation is key for manufacturing durable assets for common good.
Adequate investment in children from infancy through adolescence till they
become productive is expensive and time consuming but that is the only way to
transform our human resource to human capital for development. Investing in reproductive health and
rights have huge returns not just in terms of preventing high risk and
unintended pregnancies, unsafe abortions and complication, but also improves
nutrition for women and children, reduces risk of anaemia for women and
children, increases survival and better health for mothers and children and
fewer orphaned children. Investing in reproductive health in addition to
reducing heath bill, frees up money for quality education of the citizens,
thereby improving the status of all including women to contribute to economic
growth. Investing in reproductive health saves money and helps nations produce
healthy productive citizens for sustainable socio-economic development. The
Africa we want, where no one is left behind.
As the former President Olusegun Obasanjo said on
TV once, “if you don’t see what you should see, and you don’t do what you should
do, you will become a victim of what you don’t like” .
I totally agree with him and urge all of us to see
the importance of reproductive health rights and responsibilities as a
developmental agenda and focus on it to enable us get the results we so desire.
Let us see what we should see and do what we should do to get the results we desire.
Comments
Post a Comment