Population control: Prospects still bleak | The Daily Star
12:00 AM, December 11, 2010 / LAST MODIFIED: 12:00 AM, December 11, 2010

Population control: Prospects still bleak

The population of Bangladesh increased from 76.3 million in 1974, 89.9 million in 1981, 130.5 million in 2001 (Bangladesh Population Census, BBS) to 144.7 million in 2008 (sample Vital Registration System-SVRS 2008). The combined effects of continued high fertility rate, declining mortality rate, coupled with an increase in life expectancy have resulted not only in an increase in the population growth rate, but also in keeping Bangladesh's population very young, thereby sustaining its built-in momentum for growth.
The high rate of growth, which is likely to continue to increase further because of the projection of the young population in the country, threatens to reach overwhelming proportions due to declining trends in mortality, high fertility, youthfulness of the population, early marriage, as well as increased migration to the cities.
Though detailed time-series data of fertility and mortality rates are not available, there is ample evidence of steady decline in the death rate and general improvement in life expectancy, which is currently estimated to be 65.6 years for males and for 68.0 females. The rapid expansion in public health facilities in the recent past has contributed to this development, as has, no doubt, the governments' successful efforts to control small-pox, cholera and other communicable diseases. The birth rate has remained continuously high due partly to strong culturally related pronatalistic tendencies.
The age structure of population gives a high dependency ratio. The urban population growth rate is now 25.1% of the total and has a high annual growth rate. Much of this growth arises from migration of young single males and females seeking work opportunities, and these result in an urban sex-ratio of 106.0. Bangladesh is one of the most crowded lands on earth (980/square kilometer) and fertility is not projected to fall to replacement level until 2051. At that point, its population would be so predominately youthful that growth would continue until eventually there are 282 million Bangladeshis, twice the present population.
The total fertility rate (TFR) remains high, at an estimated 2.25 in 2010. However, the TFR has declined from 7 in 1971 as a result of a rapid increase in contraceptive prevalence rate (CPR) from 10% in 1975 to 49.5% today (Utilisation of Essential Service Delivery Survey SVRS 2008). There has been a remarkable consistency in fertility across spatial, urban, religious and educational distributions. Socio-economic differentials in fertility exists, with lower rate of women married to non-agricultural and white collar workers, though non-working wives and those with greater assets representing affluent rural families have higher rates.
We know that despite a long period of family planning activities in Bangladesh the results have been discouragingly low, and showed a dismal picture in terms of fertility regulation. A common and often repeated observation attributes this situation to the difficult socio-economic setting in which the programme has been operating.
Experience shows that among the factors associated with fertility declines are urbanisation, improvement of female status, education and employment, availability of modern contraceptive methods, economic factors, and not the least, the decline of mortality itself, and that the level of mortality will henceforward be a good indicator of the success of Bangladesh's development ameliorating the material condition in which most people live.
Recent studies have shown that the demand creation for family planning is a complex socio-economic and even political phenomenon. For policy purposes, considerable debate has taken place on those socio-economic variables which have a bearing on fertility behaviour. In the Bangladesh context, we can do that to achieve effective control over population explosion. We must adopt the following measures for programme development:
* A clearly defined population policy (since 1965, population control programmes have been operating but desired result has not yet been achieved);
* A compulsory birth/death registration system (the role of this birth and death register is very important in demographic analysis of population structure for economic and social reasons);
* Restriction of government benefits to 2 children per couple;
* Introduction of full pension for issueless couples so that they do not have to depend on the support of the children in old age;
* Raising the socio-economic status of women through education and employment;
* Improvement in the health and nutritional status of the people and a reduction of infant, child and maternal mortality;
* More effectively analysing and developing strategies to confront the large gap between knowledge and practice;
* Measuring the size and impact of various types of internal migration; and
* Integration of the family planning programmes with all development oriented programmes.
To summarise, the population prospects of Bangladesh are gloomy from almost any viewpoint. Even with aggressive family planning programmes, this picture is unlikely to change much, especially in the near future. With continuous high fertility comes higher dependency ratio, with all the health, social and economic consequences that these circumstances imply. Declining mortality will exacerbate this already bad situation, resulting in the need for more investment on all aspects of social development such as educational facilities, employment opportunities, housing, basic food supply and social services of all kinds.
In view of these facts, it is necessary to adopt a dynamic and positive investment policy for population control to achieve economic development, because development provides people with the incentives and motivations to limit their family size. But family planning programmes are needed to provide them with the technological means to avoid unwanted pregnancies. And where such motivation exists, well-executed family planning programmes can be an effective tool for accelerating fertility decline.

Mohammed Abul Kalam, PhD is a Principal Scientific Officer & Head, Department of Medical Sociology, Institute of Epidemiology, Disease Control & Research (IEDCR). E-mail: makalam@btcl.net.bd

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