The Population Reference Bureau (PRB) in Washington, D.C. recently released its latest population size and population growth estimates. The global levels and trends that the fact sheet presents are a bit dizzying, as any figures with so many zeroes are. PRB estimates that there are 7.4 billion (that is, 7,400,000,000) people in the world today and this is projected to rise to 8.5 billion in 2030 and 9.9 billion in 2050.
But it is the regional breakdowns that are the most interesting. This is so, not so much because of the regional population numbers, but because of some of the other statistics attached to these population numbers. For example, while much will be made by readers of the fact that Africa’s population is projected to grow by 2.5 billion in the next 35 years, one can argue about what this rise in numbers means for the economy and the environment in Africa as well as globally.
What one cannot argue about is the underlying situation of women that these large projected rises in population reflect and some of the related variables on health and well-being that accompany the PRB charts. All these variables underscore the need to drastically scale up reproductive health services in sub-Saharan Africa.
While reproductive health services cover a gamut of things, focusing especially hard on one particular service – access to good quality, safe, and affordable contraception – will address more than one of the reproductive health problems that the PRB data highlight.
To begin with, there is the demand for family planning to reduce unwanted pregnancies and births. While it is true that the high levels of fertility in many African countries are at least partly desired, it is also true that there is a high and rising “unmet” need for contraception: According to the World Bank’s World Development Indicators, 23% of married women aged 15-49 in sub-Saharan Africa have an unmet need for contraception; that is, 23% of the women in this category do not want a pregnancy, but are not doing anything to prevent one.
PRB’s data give us a glimpse of what some of the costs of this inability to use family planning might be. The Infant Mortality Rate in Middle Africa is still an unacceptably high 88 deaths per 1,000 live births; whereas it is now around 29 in Northern Africa, 36 in Southern Africa, 43 in South Asia, and 17 in South America. At least some of this excess infant mortality in Africa would disappear if women could time their pregnancies better and if they had fewer unwanted pregnancies – both these factors greatly increase the risk of infant death.
Maternal mortality is another negative fallout of poor contraceptive use. Maternal mortality ratios in Middle and Western Africa are more than four times those in the already high MMR regions of South Asia, the Caribbean and Southern Africa – again something that better timed and wanted pregnancy can effectively address.
Third, and the most desperate, is the still dramatically high level of HIV/AIDS in the African region. But here the intra-regional breakdown is confounding. Contrary to expectations, it is not Middle and Western Africa that have the highest levels of women with HIV/AIDS. In Middle and Western Africa, around 2.5 women aged 15-49 have HIV/AIDS and that figure is remarkably high when compared to levels of 0.3% in South America, 0.4% in Southeast Asia, and 1% in the Caribbean. But 2.5% pales into insignificance when compared to 23.7% in Southern Africa.
It is true that these high levels are partly the result of positive things – more women with HIV/AIDS survive today than did even in the relatively recent past, and therefore prevalence levels of the infection appear higher than they might have in the past.
But the Southern Africa numbers also tell us that family planning information, education, and access is crucial for Africa as a whole – in the central and western parts of the region, it will ameliorate infant and maternal mortality and bring down unwanted fertility, while in the southern part of the region it could help women protect themselves better from the risk of HIV infection.
PRB’s latest data sheets are a mine of information waiting to be downloaded, analyzed, and disseminated to set better priorities and policies for achieving the Sustainable Development Goals in particular and development in general.
[Photo: UNFPA/Pirilani Semu-Banda]