The Cooperative Society Newsletter
May 2017, Issue 3
by E.G. Nadeau
The Capital Times (or Cap Times), a Madison, Wis.-based newspaper, published my op-ed, “A sustainable planet needs a sustainable population,” on Earth Day, April 22. You can read it in the sidebar at right. I’m following up on that article with a more detailed analysis of what we should and should not be doing to curb population growth in the remainder of the 21st century.
Access to birth control
A few years ago, I participated in several women’s group meetings in rural Kenya. The primary topics of discussion were reproductive health and HIV/AIDS. The women in these groups were knowledgeable about different kinds of birth control and shared concerns about the risks of getting infected by HIV and other sexually transmitted diseases.
Many of the women were worried about lack of access to birth control, including female condoms, which can prevent HIV transmission; birth control injections, which can prevent conception for months or even years; and morning-after pills, also known as emergency contraception.
One of their big complaints was that rural pharmacies didn’t consistently keep these birth-control resources in stock. We discussed the possibility of villagers forming their own cooperative pharmacies to ensure a more consistent and lower-cost supply of birth control, as well as other health-related items. At the time, the Kenyan government did not allow for this kind of pharmacy staffed by community health workers.
Education and reproductive health
Altogether, I visited about 20 Kenyan villages in 2008 and 2009, to review a community health program led by NCBA CLUSA, a U.S.-based nonprofit organization funded by the U.S. Agency for International Development. I came away extremely impressed by these village health sites. The program involved more than 2,000 villages – with over 2 million inhabitants – and operated in Kenya for more than a decade in the early 2000s. Reproductive health and HIV/AIDS education were only part of the broad health mission of the program.
The point of the story is that poor female villagers with little formal education, in remote areas of Kenya, were knowledgeable about reproductive health and made use of a variety of birth-control methods and HIV-prevention resources, when given the opportunity. The emphasis in that sentence is “when given the opportunity.”
This interest in birth control is echoed throughout the least-developed countries of the world. This quote from the 2015 UN World Population Prospects report underscores my personal observations:
To realize [a] substantial reduction in fertility . . . it is essential to invest in reproductive health and family planning, particularly in the least-developed countries, so that women and couples can achieve their desired family size. In 2015, the use of modern contraceptive methods in the least-developed countries was estimated at around 34% among women of reproductive age who were married or in a union. A further 22% of such women had an unmet need for family planning, meaning that they were not using any method of contraception, despite a stated desire or intention to avoid or delay childbearing.
Access to family planning for that 22% would mean an annual reduction of tens of millions of unwanted births per year, adding up to a significant reduction in world population growth.
Sadly, the Trump Administration is going backwards when it comes to population policy and reproductive health.
Setbacks in US legislation and funding
In the first 100 days of his presidency, Trump signed two executive orders and a piece of legislation undermining the goal of slowing the rate of population growth:
- In late January, he prohibited U.S. funding to any reproductive health organization that provides abortions or abortion counseling, including organizations that do not use U.S. governmental funds for these purposes. That comes to about $600 million of defunding during Trump’s first term.
- In the first week of April, Trump rescinded U.S. funding to the United Nations Population Fund, accusing it of supporting “coercive abortions” in China, despite strong denials by the UN. That comes to another nearly $130 million over the next four years taken away from reproductive health services.
- In the second week of April, the president signed legislation enabling states to defund Planned Parenthood programs of all kinds, even though Planned Parenthood uses no public funding for abortion-related activities. It is not clear what the dollar implications of this new law will be.
Implications for worldwide family planning
Health research organizations are gathering data that can be used to measure the impact of these policy shifts. For example, the Guttmacher Institute, a leading research and policy organization committed to advancing sexual and reproductive health and rights in the U.S., conducts collaborative research with organizations such as the World Health Organization, Columbia University and the United Nations Population Fund. Based on the institute’s data projections for the health consequences to women and children resulting from a reduction in reproductive health services, we estimate that about 100,000 children’s deaths and approximately 10,000 maternal deaths will result from the Trump Administration’s cuts to reproductive health programs during the next four years.
Numerous studies, including articles appearing in the prestigious British medical journal, The Lancet, indicate that family-planning services significantly reduce the number of abortions in developing countries. The main reason for this is obvious. The more knowledgeable women are about contraception and the better their access to birth-control options, the less likely they are to have unwanted pregnancies and to terminate those pregnancies through abortion. Ultimately, reducing funds to reproductive health organizations increases the number of abortions.
Forecast for the future
On the positive side of the ledger, there has been a dramatic reduction in the number of neo-natal deaths during the past couple of decades because of greater access by women in developing countries to reproductive health services. Women are much more likely than ever before to see a health professional during pregnancy, to deliver their babies with the assistance of a skilled birth attendant, to receive training in infant care, and to have access to support services when their children are young.
With the decrease in the funding of reproductive health services precipitated by the Trump Administration, we expect infant and maternal deaths (and abortions) to spike.
This reduced access to reproductive health services means a slightly faster world population growth rate, an increase in world poverty, more energy consumption, the likelihood of increased political instability, and more migration from poor countries to rich ones.
Faster population growth is not just a problem of poor countries; it’s a world problem. The current world population is about 7.5 billion people. The graph below shows a range of projections for population growth during the 21st century.
Population of the world: estimates, 1950-2015, medium-variant projection and 80 and 95% confidence intervals, 2015-2100.
The main factors responsible for continued high birth rates in developing countries include:
- High levels of poverty.
- Lack of access to birth control education and resources.
- Cultural beliefs that inhibit use of birth control. For example, Catholic and Muslim teachings against birth control; the belief by some ethnic groups in the value of large families; and the belief in some cultures that large families reflect the “manliness” of the husband.
As I discussed in “A sustainable planet needs a sustainable population,” reducing poverty, increasing knowledge about reproductive health, and increasing access to birth control resources are keys to reducing population growth.
This information shows that we, as a world society, have the ability to dramatically reduce population growth in the 21st century — not by coercive measures, but by improving economic conditions of the poor and by meeting the educational and resource needs of women and men who want to limit their family size. Slowing population growth will play an important role in creating a more sustainable and cooperative planet.