Part 6 - Solutions To The Population Problem

As the debate surrounding the 1994 United Nations International Conference on Population and Development demonstrated, no one has a monopoly on proposed solutions to the world's massive problem of population growth. The momentum of this growth is well recognized. Because of the age structure of the population, an immediate drop to replacement level fertility would not lead to zero population growth for half a century. By that time, population would have grown to well over 8 billion, assuming no dramatic increase in the death rate.

More rapid achievement of zero population growth would require that the world quickly achieve below-replacement level fertility, that is, less than two children per couple. Because all of the potential mothers and fathers for the next 15 to 20 years have already been born, it is possible to predict various scenarios of fertility rates and the corresponding trajectory of the population. For example, there would still be growth of the world's population with a one-child average for some time before the world reached zero population growth. But at that point, population size would start to decline.

How rapidly the world must achieve an end to population growth in order to avoid catastrophic environmental, political or economic consequences is a subject of endless debate. Some scientists believe the long-term carrying capacity of the earth is well below our current population of 5.6 billion, while others say that the world could manage to get by with as many as 8 billion people. Very few find the prospect of a doubling of the current population acceptable, and some believe that such a doubling is impossible because of natural limits like food and waste disposal capacity of the globe.

While studying these subjects is important, scientists may never fully resolve an answer to the question of carrying capacity before the earth informs the human population what its carrying capacity is through less than polite means of communication. It is important, therefore, for policy makers and activists to continue to focus on activities that hold promise of finding solutions to population growth.

The potential consequences of continued rapid population growth are too serious to merit anything but the most intense scrutiny and development of action plans based on the best data possible. As suggested above, there is an urgent need for controlled experimental designs that allow for effective measurement of proposed solutions so that their affects can be isolated from other things going on in society.

The urgency of such research cannot be overstated. As indicated throughout this paper, far too many policy and spending decisions have been made on the basis of weak cause-and-effect data. While many correlations in the population field seem to have plausible cause-and-effect relationships, the world is only slowly learning the expensive lesson that correlation does not equal causation.

Finding a solution to the population problem will not be simple or inexpensive. Probably no one intervention will bring about rapid reductions in fertility rates; certainly none has to date. But the overall framework for population stabilization lies in the following three areas:

1. Governmental policies that ensure the right to have access to comprehensive reproductive health care, including family planning information and services; the right of women and men to determine the number and spacing of their children; the right of girls, as well as boys, to be educated; the right of women to have equal opportunity for gainful employment; and the right of women, as well as men, to live free of violence and intimidation.

2. Provision of high quality, comprehensive reproductive health care, including family planning services, to all people who want it on a voluntary basis and, more broadly, provision of maternal and child health care.

3. A social/cultural climate that brings about strong self-motivation by people toward small family size norms and desires and that enables women, as well as men, to take the steps necessary to implement those desires.

Much of the effort over the last 30 years has focused on points 1 and 2 above: development of governmental policies and family planning medical service provision. Creating a social environment that motivates and empowers people to use family planning to limit family size has been a neglected part of the picture, as discussed above. There are many creative and innovative steps that can be tried towards increasing the level of motivation, such as motivational serial dramas. But such steps should not be seen as a panacea. There are many more things that can and should be tried.

There is broad general agreement that voluntary measures are not only preferable to coercion from an ethical and human rights standpoint, but that in the long run self-motivation will be far more effective at keeping fertility rates low than government- imposed mandates that are despised by the people. Even in non-democratic societies, unpopular governments have a way of disappearing sooner or later. In addition, in countries where involuntary population measures have been enacted by the government, people find ways of skirting the law, whether it be through non-registration of births or through obtaining illegal abortions and birth control measures.

In the field of mass media communications, there is much that should be done in each country, beyond the provision of one soap opera in which characters promote family planning and small family norms. Numerous programs on radio and television can address different aspects of the same theme. News and information programs should educate people about the realities of population issues and their relationship with economic development, environmental problems and social progress. Comic books and traditional media, such as traveling road shows, can find ways to incorporate messages that people will relate to. Such messages should not dwell on family planning methods, but on the "why" of family planning. People will be much more motivated to use family planning to limit family size if they know that it can lead to happier marriages, improved family harmony, greater health and well-being, and material progress for them and the nation as a whole, than they can possibly be motivated by learning how easy it is to use condoms or pills. For many women in the developing world, a shift in consciousness needs to occur that helps them understand that they can, in theory, exert control and influence over their own lives and that this is not only acceptable but desirable. Mass media and local media have a major role to play in bringing about such changes in cultural norms. National leaders can also play a significant role in changing the social climate on these issues, by speaking out.

Changes in cultural norms and accurate information are needed in order to reduce desired family size, slow population momentum and enhance the use of contraceptive services. The following seven elements are essential:

1. opportunities for gainful employment of women, especially outside the home, and cultural acceptance of the concept of women in the workplace;

2. lowering cultural norms with regard to ideal family size as viewed by men as well as women;

3. mandatory education of girls as well as boys, going well beyond literacy training;

4. enactment and enforcement of child labor laws to prevent exploitation of children by parents and others, and changes in cultural norms with regard to the acceptability of child labor;

5. changes in cultural norms with regard to age of marriage and age of onset of childbearing;

6. overcoming misinformation about the relative safety of using contraception as opposed to early and frequent childbearing; and

7. overcoming men's fears that contraceptive use by women will lead to infidelity.

If World Bank Senior Economist Lant Pritchett is correct that desired family size is the leading cause of differences in actual fertility rates among countries, then creative thinking is needed to arrive at interventions that reduce desired fertility and that are in harmony with voluntary and informed decision making by individuals and couples. People often raise the question of incentives as a way of enhancing motivation. Incentives can be tricky, because the recipient either can see them as a bribe to do something they would not otherwise do and resent them, or can see them as an added bonus for taking an action they are convinced is in their own interest. If, for example, a supermarket in the West offers shoppers a discount for trying a new brand of cereal, few people are offended. If, on the other hand, someone is offered money to do something they would not otherwise do for moral reasons, it can lead to deep resentment.

Similarly, in very poor countries, incentives can be subject to abuse. Women may be coerced into undergoing a sterilization by a husband who wants the monetary reward that may be the equivalent of an entire year's wages. Desperate people may feel that they are being bribed into doing something they do not want to do, but accept the bribe in order to survive. Incentives that are out of line with the cultural and economic realities of a country are likely to backfire and cause resentment and hostility toward the whole concept of family planning.

On the other hand, there are incentives that have been tried that have provided culturally acceptable and quite successful motivations for delaying onset of first pregnancy, limiting family size or using family planning. For example, Rocky Mountain Planned Parenthood in the United States experimented with a program that offered very small monetary rewards and participation in a group program for teens in Denver who remained free of pregnancy. The program was successful, and the participants experienced lower pregnancy rates than a similar group that did not have those benefits. According to the teen participants, the real motivator was the benefit of participating in the group gatherings, which provided a social outlet they were otherwise missing in their lives. The group itself provided peer pressure for success in the program.

An organization called Population Communication (based in Pasadena, California) has successfully run small-family clubs in various developing countries. Those who join the club are provided nominal discounts on purchases from participating vendors and receive a certificate announcing their club membership.

One of the problems with large monetary incentives is that they can become very expensive when made available on a nationwide basis in a large country. If people learn that cash or other material benefits are to be made available for those who limit their family size, even those who would have done so without incentives will apply for the reward. Quite apart from the ethical issues involved, the cost of providing incentives in a country the size of India (over 900 million people) can become exorbitant. In terms of birth averted per dollar spent, mass media communications are probably far more effective. This is particularly true with entertainment broadcasting where donor dollars only play a catalytic role and where commercial sponsorship underwrites the cost of air time and production. Using the leverage of commercial sponsorship, as little as $10 million a year in donor support--if spent properly--could lead to the development of highly effective motivational programs in all of the major developing countries of the world.

In addition to mass media and local media, another important communication channel in most countries is the network of non-governmental organizations, as well as schools and other institutions that serve large numbers of people. An effective campaign to change cultural norms with regard to family size should include membership organizations, education programs in the schools, outreach to workers in factories and on farms, and outreach through neighborhoods and villages via community leaders. Many non-governmental organizations, including environmental groups and women's organizations, are predisposed to carrying appropriate messages regarding family size and family planning. They need to be involved in developing the messages that will be sent to the people and then enlisted to help deliver those messages to their constituencies.

We don't know whether programs like family planning soap operas and small-family clubs will be successful in achieving replacement level (or lower) fertility in a short period of time. Funding for such strategies has been woefully inadequate, and research to measure the effects of such programs is only beginning to be taken seriously. But given the massive increases in funding being talked about by donor countries for population assistance, it is critically important that a much larger share be directed towards approaches that hold the promise to reduce family size desires throughout the world.

Whether we will ultimately succeed in stopping population growth in time to avoid a global environmental disaster remains to be seen. The more we can do now to quickly reduce fertility rates, the less likely it is we will experience a global catastrophe, or, at least, whatever crises we face may not be as severe.

Those who are interested in finding solutions must recognize that we cannot afford to wait until all the answers are in before taking action. Our best hope is if everyone, every government and every institution gives the population problem the attention and funding it deserves.

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