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Seven Opportunities for a World of 7 Billion                                                                              ...
The State of World Population 2011This report was produced by the Information and External            Barcelona, Saturnin ...
state of world population 2011                                                  People and possibilities                  ...
Foreword     Seven billion people will inhabit the earth on 31 October. During my lifetime,     I have seen world populati...
UNFPA Executive                                                                                                         t ...
iv   CHAP T ER 1 : a closer loo k at our world of 7 billion
CHAPTER               A closer look at our                      world of 7 billion           ONE                      The ...
family members behind, sometimes without                         These trends are sometimes obscured in                   ...
are priorities in the quest to make urban life   Governments can usher in urban growth            healthier and more susta...
deaths in 1,000 births in the 1950s to 46           fertility rate was about 6.7 children, while 61                       ...
an international expert on reproductive                              “Clearly we are living through an extraor-issues in A...
of the International Planned Parenthood          education as part of a broader human right:                              ...
Amsalu Buke (left)                                                                                                    t   ...
8   CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
CHAPTER                      Youth: a new global power                             reshaping the world         TWO        ...
In Nigeria, Fauziya Abdullahi, a resident      global economy through call-centre work,                                   ...
Statistics like these demonstrate that in        Economic and social developments affect-middle-income and some rapidly de...
Entering the labour force when                                                                                jobs are sca...
ployment and social exclusion.” Someyoung people who are unable to earn theirown incomes have to be financially sup-ported...
Olalekan Azeez-Iginla, Lagos state coor-      have not had significant input into policy-                                 ...
A youth mobilizer, Olalekan                                                                                               ...
Amsalu Buke and assistantt     begin their trek to bring     family planning to outlying     Ethiopian communities.     ©U...
child health and reducing HIV and AIDS,”                         In Mozambique, the balance of power in athe Population Re...
The Government of Mozambique out-            population growth. “The bride’s young age,                               lawe...
There is no youth centre where Amsalu         in giving young people a role and a stake inBuke, the peripatetic Ethiopian ...
who has been in charge of her health post          non-governmental organizations imple-                                  ...
Yolanda, 24, has come to the Maputooffice of the Family Planning Association ofMozambique—AMODEFA—for a check-upduring her...
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
State of the World Population Report, 2011
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State of the World Population Report, 2011

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State of the World Population Report, 2011

  1. 1. Seven Opportunities for a World of 7 Billion state of world population 2011 state of world population 20111 Reducing poverty and inequality can slow population growth.2 Unleashing the power of women and girls can accelerate progress on all fronts.3 Energetic and open to new technologies, young people can transform global politics and culture.4 Ensuring that every child is wanted and every childbirth safe can lead to smaller and stronger families.5 Each of us depends on a healthy planet, so we must all help protect the environment. People and possibilities in a world of 7 billion6 Promoting the health and productivity of the world’s older people can mitigate the challenges faced by ageing societies.7 The next 2 billion people will live in cities, so we must plan for them now.United Nations Population Fund605 Third AvenueNew York, NY 10158 USA People andTel. +1-212 297-5000www.unfpa.org©UNFPA 2011 possibilitiesUSD $24.00ISBN 978-0-89714-990-7sales no. E.11.III.H.1E/11,000/2011 in a world of 7 billion www.7billionactions.org Printed on recycled paper.
  2. 2. The State of World Population 2011This report was produced by the Information and External Barcelona, Saturnin Epie, Ann Erb-Leoncavallo, Antti Kaartinen,Relations Division of UNFPA, the United Nations Population Bettina Maas, Purnima Mane, Niyi Ojuolape, Elena Pirondini,Fund. Sherin Saadallah and Mari Simonen of UNFPA’s Office of the Executive Director.Editorial team Other colleagues in UNFPA’s Technical Division and Programme Division—too numerous to fully list here—also providedLead reporter: Barbara Crossette insightful comments on drafts, ensured accuracy of data andAdditional reporting and writing: Richard Kollodge lent focus on direction to the issues covered in the report.UNFPA Advisory Board: Rune Froseth, Werner Haug,Aminata Toure, Sylvia Wong The Population Division of the United Nations Department ofEditor: Richard Kollodge Economic and Social Affairs, the source of most of the data inEditorial associate: Robert Puchalik the report, guided the analysis and presentation of populationEditorial and administrative associate: Mirey Chaljub projections. Without their support, this report would not haveDistribution manager: Jayesh Gulrajani been possible. UNESCO’s Institute for Statistics, UNICEF, the World Health Organization, the Food and Agriculture Organization of the United Nations, the World Bank and theAcknowledgements UNFPA/NIDI Resource Flows Project and the Statistics DivisionThe editorial team is grateful to the report’s Advisory Board for of the United Nations Department of Economic and Socialguiding the conceptualization and development of the report Affairs also provided critical data. Edilberto Loiaza of UNFPA’sand for providing invaluable feedback on drafts. Population and Development Branch guided the selection and presentation of indicators.Heads or acting chiefs of seven UNFPA field offices (andtheir staff) set up interviews, arranged logistics and helped Thanks to generous financial support from UNFPA’s Technicalidentify story ideas and guided the reporting in each location: Division, this report features all original photography of theBernard Coquelin (China), Ziad Rifai (Egypt), Benoit Kalasa people and places mentioned in the narrative.(Ethiopia), Marc Derveeuw (India), Diego Palacios (Mexico),Patricia Guzmán (Mozambique), Agathe Lawson (Nigeria), Original photography in each location by Guo Tieliu (China);and François Farah and Tatjana Sikoska (the former Yugoslav Matthew Cassel (Egypt); Antonio Fiorente (Ethiopia); SamiRepublic of Macedonia). UNFPA’s regional directors provided Sallinen (Finland); Sanjit Das and Atul Loke (India); Ricardovaluable support to the development of the report: Hafedh Ramirez Arriola (Mexico); Pedro Sa Da Bandeira (Mozambique);Chekir (Arab States), Thea Fierens (Eastern Europe and Akintunde Akinleye (Nigeria); and Antonin Kratochvil (theCentral Asia), Nobuko Horibe (Asia and the Pacific), Bunmi former Yugoslav Republic of Macedonia).Makinwa (Africa) and Marcela Suazo (Latin America andthe Caribbean). Hilkka Vuorenmaa, senior advocacy officer The editorial team also wishes to thank the individuals who toldof Väestöliitto, the Family Federation of Finland, laid the their stories for this report.groundwork for reporting in that country. Cover photo:Invaluable guidance was also provided by Safiye Çagar, Director ˇ Geography class, Eduardo Mondlane University,of the Information and External Relations Division; Neil Ford, Maputo, MozambiqueChief of the Media and Communications Branch; and Delia ©UNFPA/Pedro Sá da Bandeira UNFPA, the United Nations Population Fund, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV, and every girl and woman is treated with dignity and respect. UNFPA—because everyone counts.
  3. 3. state of world population 2011 People and possibilities in a world of 7 billionForeword page ii1 5 A closer look at Decision to move: the power our world of 7 billion page 1 and impact of migration page 652 6 Youth: a new global power Planning ahead reshaping the world page 9 for the growth of cities page 773 7 Security, economic strength Sharing and sustaining and independence in old age page 29 Earth’s resources page 934 8 What influences The way ahead: fertility? page 43 finishing the Cairo agenda page 101Indicators page 110Selected sources page 124 ©UNFPA Antonio Fiorente
  4. 4. Foreword Seven billion people will inhabit the earth on 31 October. During my lifetime, I have seen world population nearly triple. And 13 years from now, I will see another billion added to our numbers. In my grandchildren’s lifetimes, there could be as many as 10 billion people in our world. How did we become so many? How large a communities to make the most of our world number can our Earth sustain? of 7 billion. These are important questions, but per- Some of the trends are remarkable: Today, haps not the right ones for our times. When there are 893 million people over the age of we look only at the big number, we risk being 60 worldwide. By the middle of this century overwhelmed and losing sight of new opportu- that number will rise to 2.4 billion. About one nities to make life better for everyone in in two people lives in a city, and in only about the future. 35 years, two out of three will. People under So instead of asking questions like, “Are the age of 25 already make up 43 per cent of we too many?” we should instead be asking, the world’s population, reaching as much as “What can I do to make our world better?” 60 per cent in some countries. or, “What can we do to transform our grow- This report provides a snapshot of how ing cities into forces for sustainability?” We China, Egypt, Ethiopia, Finland, India, should also ask ourselves what each of us Mexico, Mozambique, Nigeria, and the former can do to empower the elderly so they can Yugoslav Republic of Macedonia are facing play a more active role in their communities. diverse demographic challenges, ranging from What can we do to unleash the creativity and ageing populations to high fertility rates, and potential of the largest youth cohort human- from urbanization to the emergence of new ity has ever seen? And what can we do to generations of young people. Some of these remove barriers to equality between women countries are coping with high fertility rates and men so that everyone has the full power and others are facing rates so low that govern- to make their own decisions and realize their ments are already looking for ways to increase full potential? population size. Some countries with labour The State of World Population 2011 shortages are looking to migrants to fill jobs, looks at the trends—the dynamics—that are while others are relying on the remittances sent defining our world of 7 billion and shows back home by citizens working overseas to buoy what people in vastly different countries their economies. And while some countries are and circumstances are doing in their own attracting more people to emerging mega-citiesii FORE WORD
  5. 5. UNFPA Executive t Director Babatunde Osotimehin. ©Brad Hamiltonwhere jobs are plentiful and the cost of living is Our record population size can be viewedhigh, others are seeing waves of migration from in many ways as a success for humanity:city centres to peri-urban areas where the cost People are living longer, healthier lives. Butof living may be lower but basic services and not everyone has benefited from this achieve-jobs may be in short supply. ment or the higher quality of life that this This report makes the case that with plan- implies. Great disparities exist between andning and the right investments in people within countries. Disparities in rights andnow—to empower them to make choices that opportunities also exist between men andare not only good for themselves but for our women, girls and boys. Charting a path nowglobal commons—our world of 7 billion can to development that promotes equality, ratherhave thriving, sustainable cities, productive than exacerbates or reinforces inequalities, islabour forces that can fuel economic growth, more important than ever.youth populations that contribute to the We all have a stake in the future ofwell-being of economies and societies, and humanity. Every individual, every government,a generation of older people who are healthy every business, is more interconnected andand actively engaged in the social and interdependent than ever, so what each of useconomic affairs of their communities. does now will matter to all of us long into the In many parts of the developing world, future. Together we can change and improvewhere population growth is outpacing the world.economic growth, the need for reproductivehealth services, especially family planning,remains great. The attainment of a stable We are 7 billion people withpopulation is a sine qua non for accelerated, 7 billion possibilities.planned economic growth and development.Governments that are serious about eradicatingpoverty should also be serious about providingthe services, supplies, information that women Babatunde Osotimehinneed to exercise their reproductive rights. Executive Director, UNFPA T H E STAT E OF WORL D POPU L AT ION 20 1 1 iii
  6. 6. iv CHAP T ER 1 : a closer loo k at our world of 7 billion
  7. 7. CHAPTER A closer look at our world of 7 billion ONE The milestone of 7 billion is marked by achievements, setbacks and paradoxes. While women are on average having fewer children than they were in the 1960s, our numbers continue to rise. Globally, people are younger—and older— than ever before. In some of the poorest countries, high fertility rates hamper development and perpetuate poverty, while in some of the richest countries, low fertility rates and too few people entering the job market are raising concerns about prospects for sustained economic ordinary people who live there, the national growth and about the viability of social experts who study demographic trends and security systems. While labour shortages the policymakers who must make decisions threaten to stymie the economies of some based on local conditions talk directly about industrialized countries, unemployed their lives and work: China, Egypt, Ethiopia, would-be migrants in developing countries Finland, India, Mexico, Mozambique, are finding more and more national bor- Nigeria and the former Yugoslav Republic ders closed to them and the expertise they of Macedonia. may have to offer. And while progress is Together, the people profiled from being made in reducing extreme poverty, these countries form a collage of the diverse gaps between rich and poor are widening human experiences, aspirations and priori- almost everywhere. ties that illustrate the diversity in our world The State of World Population 2011 population and the trends behind it. explores some of these paradoxes from the In conversations with people living and perspective of individuals and describes working in these countries, it does not take the obstacles they confront—and over- long to discover that no population issue is come—in trying to build better lives for now seen as unconnected to others. The lives themselves, their families, communities of ageing citizens, for example, are universally and nations. bound up with trends among youth. In many Through personal stories, this report developed and developing countries, younger Pedestrians in sheds light on the real-life challenges we face job-seekers are migrating from rural areas tot Mexico City. in our world of 7 billion. It is mainly a report cities or to other countries where employ- ©UNFPA/Ricardo Ramirez Arriola from the field, from nine countries where the ment prospects are better, often leaving older T HE STAT E OF WORL D POPU L AT ION 20 1 1 1
  8. 8. family members behind, sometimes without These trends are sometimes obscured in the support they need to carry out their daily discussions about population size, yet it is lives. In some of the richer countries, smaller only when scrutinizing them that many of numbers of young people mean uncertainty the immediate challenges and opportunities about who will care for the old in future years become apparent. and pay for the benefits seniors enjoy. China’s Shaanxi province, for example, is Each of the countries featured in the looking for ways to shelter and support grow- report is seeing in their specific popula- ing numbers of older people. In a mega-city tion trends, such as urbanization, longer life such as Lagos, Nigeria, planners are trying to expectancies and rapidly expanding working- redevelop neighbourhoods and create more age populations, not only big challenges but cohesive, manageable and livable communities. also enormous opportunities to seize these In Mexico City, people-friendly parks, roadside804 moments and turn them into good news. green spaces and more public transportation Years when world population reached increments of 1 billion 10 Billion The rapid growth of the world population is a recent phenomenon. About 2,000 years ago, the population of the world was about 300 million. It took more than 1,600 years for 9 Billion the world population to double to 600 million. The rapid growth of the world population started in 1950, with reductions in mortality in the less developed regions, resulting in an 8 Billion estimated population of 6.1 billion in the year 2000, nearly two-and-a-half times the popu- 7 Billion lation in 1950. With the declines in fertility in most of the world, the global growth rate of population has been decreasing since its peak of 2.0 per cent in 1965-1970. 6 Billion Source: Population Division of the United Nations Department of Economic and Social Affairs. 5 Billion 4 Billion 3 3 Billion 2 1959 1 1927 2 Billion 1804 1 Billion YEARS TO ADD 1 BILLION PEOPLE 123 32 15 1800 1850 1900 1950 2 CHAP T ER 1 : a closer loo k at our world of 7 billion
  9. 9. are priorities in the quest to make urban life Governments can usher in urban growth healthier and more sustainable. that boosts economies and creates jobs while Nations like the former Yugoslav using energy more efficiently and making Republic of Macedonia and Finland, where social services available to more people. fertility is lower and childbearing later than People under 25 make up 43 per cent of in most other parts of the world, are look- the world’s population. When young people ing for ways to support women who have can claim their rights to health, education and more children. Nations like Ethiopia and decent working conditions, they become a India have launched campaigns to end child powerful force for economic development marriages and prevent life-threatening and positive change. Throughout the adolescent pregnancies. developing world, social scientists and Cities are growing almost everywhere. policymakers want to make the most of With good planning and thoughtful policies, large youthful populations, for the sake of hopeful young people themselves as well as in the interests of economic growth and development. Yet this opportunity of a “demographic dividend” is a fleeting moment that must be claimed quickly or lost. In the poorest countries, extreme pov- erty, food insecurity, inequality, high death rates and high birth rates are linked in a 7 vicious cycle. Reducing poverty by invest- ing in health and education, especially for 6 2011 women and girls, can break this cycle. As liv- ing conditions improve, parents can feel more 5 1999 confident that most of their children will survive. Many then choose to have smaller41974 1987 families. This allows for greater investment in each child’s health care and education, improved productivity and better long-term prospects—for the family and for the country. Celebrating achievements, planning for the future There is much to celebrate in world popula- tion trends over the last 60 years, especially the average life expectancy, which leapt from about 48 years in the early 1950s to about 13 12 12 68 in the first decade of the new century. Infant mortality plunged from about 133 2000 2050 T H E STAT E OF WORL D POPU L AT ION 20 1 1 3
  10. 10. deaths in 1,000 births in the 1950s to 46 fertility rate was about 6.7 children, while 61 per 1,000 in the period from 2005 to 2010. years later it dropped to 2.6, a half percent- Immunization campaigns reduced the preva- age point above the population “replacement lence of childhood diseases worldwide. level” of 2.1 children, one of them a girl. In In addition, fertility, the number of chil- East Asia the total fertility rate in 1950 was dren a woman is expected to have in her about 6 children per woman and today is reproductive years, dropped by more than 1.6, well below replacement level. In some half, from about 6.0 to 2.5, partly because of parts of Africa, however, there has been only countries’ economic growth and development a modest drop in total fertility, which today but also because of a complex mix of social remains at more than 5 children per woman. and cultural forces and greater access by But despite global fertility declines, about women to education, income-earning oppor- 80 million people are added to the world tunities and sexual and reproductive health each year, a number roughly equivalent to services, including modern methods the population of Germany or Ethiopia. of contraception. Considerable population growth continues In some regions, the total fertility rate today because of the high numbers of births declined drastically between 1950 and today. in the 1950s and 1960s, which have resulted In Central America, for example, the total in larger base populations with millions of young people reaching their reproductive years over succeeding generations. China and India: the billionaires The Population Division of the United China and India recently released the findings of their latest censuses, Nations Department of Economic and Social giving the world a glimpse of how these two population behemoths are Affairs, in its World Population Prospects: The realigning in numbers and rates of growth. Below are the two countries 2010 Revision (published in May 2011) fore- in numbers, using official figures or United Nations projections. sees a global population of 9.3 billion people According to projections by the Population Division of the United at 2050, an increase over earlier estimates, Nations Department of Economic and Social Affairs, in 2025, India, with 1.46 billion people, will have overtaken China, with 1.39 billion, as the and more than 10 billion by the end of this world’s most populous nation. China’s population will then, based on a century—and that scenario assumes lower medium variant, decline to about 1.3 billion by 2050. India will continue to fertility rates over time. With only a small grow to about 1.7 billion by 2060 before beginning to decline. variation in fertility, particularly in the more populous countries, the total could be higher: China India 10.6 billion people could be living on Earth Total population, 2011 1.35 billion 1.24 billion by 2050 and more than 15 billion in 2100, the Population Division estimates. “Much Increase 2001–2011 69.7 million 170.1 million of this increase is expected to come from the Fertility rate 1.6 2.5 high-fertility countries, which comprise 39 in Africa, nine in Asia, six in Oceania and four in Year population likely to stabilize 2025 2060 Latin America,” the United Nations reports. Source: Population Division of the United Nations Department of According to John Cleland of the London Economic and Social Affairs. School of Hygiene and Tropical Medicine,4 CHAP T ER 1 : a closer loo k at our world of 7 billion
  11. 11. an international expert on reproductive “Clearly we are living through an extraor-issues in Africa, sub-Saharan Africa is “the dinary period in human history, an era ofone remaining region of the world where unprecedented growth in our species,” saysthe population is set to double or treble in Steven Sinding, who has observed popula-the next 40 years.” The reason for demog­ tion trends over the years as director of theraphers’ increasing focus on the region is office of population at the United Statesclear, he said: “The escape from poverty Agency for International Development,and hunger is made more difficult by rapid professor of population and family healthpopulation growth.” at Columbia University and director-generalEstimated and projected population by major area,medium variant, 1950-2100 (billions) 5.5 5.0 4.5 4.0 3.5 3.0billions 2.5 2.0 1.5 1.0 0.5 0.0 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100 Asia Africa Latin America and the Caribbean Europe Northern America OceaniaAsia will remain the most populous expected to add another billion in just and Oceania) amount to 1.7 billion in 2011major area in the world during the 21st 35 years (by 2044), even as its fertil- and are projected to rise to nearly 2 bil-century but Africa will gain ground as ity drops from 4.6 children per woman in lion in 2060 and then decline very slowly,its population more than triples, passing 2005-2010 to 3.0 children per woman in remaining still near 2 billion by the turnfrom 1 billion in 2011 to 3.6 billion in 2100. 2040-2045. of the century. Among the regions, the In 2011, 60 per cent of the world pop- Asias population, which is currently population of Europe is projected to peakulation lived in Asia and 15 per cent in 4.2 billion, is expected to peak around the around 2025 at 0.74 billion and declineAfrica. Africa’s population has been grow- middle of the century (it is projected to thereafter.ing 2.3 per cent per year, a rate more than reach 5.2 billion in 2052) and to start adouble that of Asias population (1 per slow decline thereafter. Source: Population Division of thecent per year). The population of Africa The populations of all other major United Nations Department of Economicfirst surpassed a billion in 2009 and is areas combined (the Americas, Europe and Social Affairs. T HE STAT E OF WORL D POPU L AT ION 20 1 1 5
  12. 12. of the International Planned Parenthood education as part of a broader human right: Federation. “The pace of growth poses enor- the right to have an education,” he says. mous challenges for many of the poorest Gabriela Rivera, a programme associ- countries, which lack the resources not only ate in UNFPA’s office in Mexico City says to keep up with demand for infrastructure, there is “wide evidence” about the benefits of basic health and education services and job rights-based sexuality education. Successful opportunities for the rising number of young programmes, she says, provide timely, suf- people, but also to adapt to climate change.” ficient and scientific information, tailored Stabilizing population growth, especially to the needs of each age group. “Evaluation in the poorest countries, requires better and studies have shown that sex education has more universal access to reproductive health an impact in delaying the age at the first services particularly family planning for sexual intercourse, in increasing the use of the countries. These services must be based contraception methods and condoms, and on and reinforce human rights and should in decreasing the levels of violence against include sexuality education for young people, young girls,” she says. “The above implies the particularly adolescent girls. reduction of early and unwanted pregnancies, José Ángel Aguilar Gil, the director of and the decrease of HIV/AIDS.” Democracia y Sexualidad, A.C., a Mexico- based non-governmental organization that 7 billion: it’s about people promotes sexual health and reproductive While much of the world will undoubtedly rights, says that adolescent and young women be focusing on numbers on 31 October, the “have the right to access integrated sexuality day demographers estimate that the world’s population reaches 7 billion, this report Gabriela Rivera, t National programme focuses on individuals and the analysts who associate on sexual study the trends that affect people’s everyday and reproductive health lives. It looks at the decisions that individuals for young people and vulnerable populations, make—or would like to make, if they UNFPA, Mexico. had the opportunity. ©UNFPA/Ricardo Ramirez Arriola At the International Conference on Population and Development in 1994, nations agreed that progress in addressing population issues could be better achieved through empowering women and girls to participate in their societies and economies on equal footing with men and boys and to make fundamental decisions about their lives, including decisions related to the timing and spacing of pregnancies and births. By the time delegations to Cairo issued their historic Programme of Action, abundant research and6 CHAP T ER 1 : a closer loo k at our world of 7 billion
  13. 13. Amsalu Buke (left) t and assistant. ©UNFPA/Antonio Fiorenteexperience from many countries had already PopUlation and Povertydocumented that when women have equalrights and opportunities in their societies andwhen girls are educated and healthy, fertil- Excerpts from the International Conference on Population and Development’s Programme of Actionity rates fall. The Programme of Action alsomade it clear that empowerment of women …Persistent widespread poverty as well as serious social andis not simply an end in itself, but also a step gender inequities have significant influences on, and are in turntowards eradicating poverty. influenced by, demographic parameters such as population The State of World Population 2011 begins growth, structure and distribution…. Efforts to slow down popula-with a sampling of young people and a look tion growth, to reduce poverty, to achieve economic progress, toat what their growing populations mean in improve environmental protection, and to reduce unsustainabledifferent settings. The chapters that follow consumption and production patterns are mutually reinforcing….then explore ageing populations, migration, Eradication of poverty will contribute to slowing populationthe interrelationship among fertility patterns, growth and to achieving early population stabilization.reproductive health services, gender and therights of women and girls, the managementof vast urban areas and environmental strains. In this report thoughtful, visionary indi-viduals around the world talk about thechallenges and opportunities they have inshaping their societies and the global popula-tion for this century and beyond. Many ofthem are young, and conscious of the demo-graphic fact that they will be designing the21st century world. T HE STAT E OF WORL D POPU L AT ION 20 1 1 7
  14. 14. 8 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  15. 15. CHAPTER Youth: a new global power reshaping the world TWO Ethel Phiri, a 22-year-old peer educator at the Family Planning Association of Mozambique, AMODEFA, one of the non-governmental organizations that implement the country’s Geração Biz youth-outreach programme, runs bancadas femininas, discussion groups at schools, markets or elsewhere in communities around Maputo to support young people with issues of sexual and reproductive health and HIV prevention and teach them about women’s rights. Her groups “talk a lot about domination of women by across parched fields from hamlet to hamlet, men,” she says. “Women don’t have a voice in Amsalu, just 20 years old, brings family plan- the home. They want to change the culture, ning to women so eager for her help that they and they want the Government to pay more waylay her on her rounds, pleading discreetly attention to their issues.” Phiri says. for contraceptives. Young people in China find ways to learn In Skopje, the capital of the former about economic opportunities that lie ahead, Yugoslav Republic of Macedonia, a group of and try to position themselves to qualify for young women talked about the entrepreneurial them. Young Chinese migrant workers in opportunities they have seized in a transitional Xian, in Shaanxi province, described their economy to position themselves for success jobs in market stalls and factories as a way to in new businesses and services. Several of save money to return home and open busi- them had lived abroad and gained both skills nesses of their own. Han Qian, who is 21, and self-confidence, as many young migrants Ricardo Moreno first studied medicine, then drifted into phar- do, whether they travel to work beyond bor-t and Sara Gonzalez macy and got a job testing drugs. Bored, she ders or to cities within their own countries. in Mexico City. The became fascinated by a tea market nearby and One of the new entrepreneurs in Skopje, couple, who are engaged, have decided is saving her earnings to accumulate enough Marina Anchevska, returned from work in the jointly that they will capital to start a tea shop. Netherlands to establish herself as a personal wait until she has In the isolated Ethiopian village of Tare, and business coach, with yoga classes a specialty. finished her education and has a job before Amsalu Buke, with a box of medical supplies She wants to change the atmosphere of offices they marry and on a strap slung over her shoulder, is a quiet and boardrooms as the once-socialist country have children. ©UNFPA/Ricardo revolutionary to the women who live in this appeals for foreign investment and international Ramirez Arriola region without doctors or roads. Walking economic partners to help it develop. T HE STAT E OF WORL D POPU L AT ION 20 1 1 9
  16. 16. In Nigeria, Fauziya Abdullahi, a resident global economy through call-centre work, of the vast city of Lagos, is an organizer of an hoping to make that the first step towards urban-based campaign that registered young an advanced technology career. people to vote in recent national elections These are all young people with hope, in Africa’s most populous country, where 70 ambition and commitment to improve their per cent of the population is under 35 years own lives and those of their peers, neigh- of age. Her campaign—Buggie the Vote, bours, communities and countries. Their inspired by a television show for youth called success, however, will depend on their abil- School Buggie—promoted political debate ity to take advantage of educational and and involvement under the slogan “Youth economic opportunities as they arise and to negotiating the future with their votes.” overcome obstacles to their sexual health and In Mexico, the food production and ser- reproductive rights. vice industries are seen as good prospects for a career. Sixteen-year-old Leo Romero, paus- More young people, more potential ing to talk amid the din of skateboarders and Although people 24 years old or younger bicyclists roaring down ramps built for them make up almost half of the world’s 7 billion under a city overpass, said his aim is to study population (with 1.2 billion between the at a culinary arts institute for a career in ages of 10 and 19), their percentage of the gastronomy. A part-time musician who earns population in some major developing coun- money working with a salsa band, Romero tries is already at its peak, according to the says he tells friends to stay in school and not Population Division of the United Nations marry until they have good jobs. Department of Economic and Socialt A youth mobilizer, Pauzia Abdullahi, in Lagos, Nigeria. And in India, many thousands of youth- Affairs in its World Population Prospects: ©UNFPA/Akintunde Akinleye ful university-level graduates have joined the The 2010 Revision. In fact, the percentage of young people—ages 10 to 24, accord- ing to United Nations classifications—has begun to decline in many places, not only in developed industrial nations but also in middle income countries. In Mexico, where fertility has decreased significantly in recent decades, the country’s population “pyramid” has been steadily shrinking at the bottom, with the birth-to-14 age group down from 38.6 per cent of the total national count in 1990 to 34.1 per cent in 2000, and then to 29.3 per cent in 2010. The country’s median age has consequently risen from 19 to 26 in two decades. The bulge moves upward into middle age, and the pyramid is reshaped.10 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  17. 17. Statistics like these demonstrate that in Economic and social developments affect-middle-income and some rapidly developing ing youth in India, with 1.2 billion people, arelower-income countries the number of years of particular interest to many demographersin which a large, young working population because the country is on course to overtakecan be counted on to fuel development may China, now with about 1.3 billion, as the t “You can say no to sex,be fleeting, and governments and the private world’s most populous nation by 2025 and its but never to condoms!,” says a brochuresector need to act expeditiously to prepare size will affect the global population profile. presented by Ethelthe young for productive roles and create In India, where the fertility rate, at 2.5 Phiri, an activist atjobs for them early in their working lives. children per woman, is still well above the AMODEFA, in Maputo, Mozambique. In sub-Saharan Africa, where economic replacement level of 2.1, there are more than ©UNFPA/Pedro Sá dagrowth rates remain relatively high, govern- 600 million people who are 24 years old or Bandeiraments were warned in the 2011 EconomicReport on Africa by the United NationsEconomic Commission for Africa and theAfrican Union that this performance was notbeing translated into needed jobs. The reporturged more effective government interven-tion to create employment-building policiesand programmes. In Skopje, sociologist AntoanelaPetkovska of the Ss. Cyril and MethodiusUniversity, worries about the demoralizingeffect on young people when they study hardwithout much hope of satisfying careers.“Young people are very pessimistic towardstheir future, especially because of the highrate of unemployment,” she said. “Theydon’t have opportunities. So they are fight-ing for diplomas mostly, not for knowledge.”She looks to the Government for more helpin integrating young people into a widerEuropean intellectual community to broadentheir education, and wants the Governmentto upgrade the country’s higher educationsystem, including scientific research, to makeuniversity exchanges possible. “I’m very, verysorry for my students sometimes because theyare smart young people, they just have to besupported in some of their needs.” she said.“We have really very big possibilities.” T HE STAT E OF WORL D POPU L AT ION 20 1 1 11
  18. 18. Entering the labour force when jobs are scarce Secure jobs that offer a decent wage are in short supply almost everywhere today, especially for young people. The International Labour Organization, the ILO, reported in 2010 that 81 million of the 620 million economically active youth from ages 15 to 24 globally—or 13 per cent of that age group—were unemployed the year before, largely because of the world financial and economic crisis. At the peak of the economic crisis, the Young Egyptians near younger. Indian government officials have global youth unemployment rate saw its larg-t Cairos Tahir Square. ©UNFPA/Matthew Cassel expressed confidence that this large cohort of est annual increase ever—from 11.9 per cent youth and children will be good for the econ- to 13.0 per cent between 2007 and 2009. omy for years to come. Demographers and Young women have had more difficulty social scientists are skeptical, however, asking than young men in finding work, the ILO how many young people will be ready to lead adds. The female youth unemployment rate productive lives in an ever more complex and in 2009 stood at 13.2 per cent compared to sophisticated economy when more than 48 the male rate of 12.9 per cent. The situation per cent of India’s children are malnourished, is especially “dire” in the Arab States, and only 66 per cent complete primary school “can only be made worse as the economic and half or fewer attend secondary school, crisis closes even the few doors open to those according to UNICEF’s State of the World’s who seek to gain some income and satisfac- Children 2011. tion through employment,” states the ILO, C. Chandramouli, Registrar General adding that there is “a gross waste of the and Census Commissioner of India, argues productive potential of young women.” that there is still time to be optimistic about Even under the best of economic condi- industrial growth because India’s large work- tions, young women generally have more ing-age youth population has the potential difficulties finding work than young men. to fuel the economy for decades. Economists When they do find a job, it is often lower outside India see this factor, and a democratic paid and in the informal economy, where political system capable of policy corrections, there is no job security or social benefits. as indicators that India’s strong economic Youth unemployment and situations growth will continue. But Chandramouli where young people simply give up look- adds a caution. “Now the question is how ing for work “incur costs to the economy, the ‘youth bulge’ is handled,” he said. “What to society and to the individual and their kind of skills do you give them? How do you family,” warns the ILO, adding “there is a make them into assets?” demonstrated link between youth unem-12 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  19. 19. ployment and social exclusion.” Someyoung people who are unable to earn theirown incomes have to be financially sup-ported by their families, leaving less forspending and investments in their house-holds. Societies lose their investments ineducation. Governments miss out on contri-butions to social security systems. “All thisis a threat to the growth and developmentpotential of economies,” says the ILO.Creating income-earning opportunities isimperative because young people are notonly the generators of ideas and innova-tion, but are also “the drivers of economicdevelopment” in a country. “Foregoing thispotential is an economic waste.” In 2011, amid revolutions on the streetsof Arab countries, the ILO also suggestedthat a 23.4 youth unemployment rate in theArab world was a major contributor to theuprisings. “It’s hard to be a young person inMozambique,” says Rui Pedro Cossa,a 24-year-old geography student at theUniversity Eduardo Mondlane in Maputo.“Normally in youth, you‘re supposed to gainexperience for the future,” he says. “But here for young people with the establishment Fernanda Manhique, t a geography studentyou have more problems than opportunities. of the National Youth Parliament, which at Eduardo MondlaneThere’s no way to overcome the obstacles.” the federal Government designed to teach University in Maputo, Cossa’s classmate Fernanda Paola through participation how laws are writ- Mozambique. ©UNFPA/Pedro Sá daManhique agrees, adding the employment ten, budgets planned and policies devised. Bandeiraprospects for young people are “difficult.” With more than 100 members, the Youth As hard as it may be now for Cossa Parliament, which meets in the capital,and Manhique to find a job in their field, Abuja, in the halls of the Nigerian Nationalthe situation is likely to be even worse for Assembly, is tasked with passing advisoryjob-seekers without a higher education in resolutions for the Government to consider.the years ahead. In its first year it proposed a number of mea- Young people try to take the lead in sures that have since been adopted at federalexpanding opportunities many places. In Government level, among them a nationalNigeria in 2008, a formal role was created youth employment plan. T HE STAT E OF WORL D POPU L AT ION 20 1 1 13
  20. 20. Olalekan Azeez-Iginla, Lagos state coor- have not had significant input into policy- dinator of the National Youth Network on making and governance. He keeps a directory HIV-AIDS, Population and Development, of qualified youth who “want to help plan is already working on the employment issue. the future they will be part of.” His goal is to He says that until recently, young people ask the governor of Lagos, a state as well as a city, to find or create jobs for up to a million qualified young people. Youth labour force participation rate, by region and sex, 2010 Many young people having smaller families Labour force participation rates for young women are lower than for Today’s young women and men—a large young men in all regions except East Asia, mainly reflecting differing number of them still adolescents in least cultural traditions and the lack of opportunities for women to com- bine work and family responsibilities not only in the developing world developed countries—are demanding better but also in the industrialized world. In many regions, gender gaps in education, good health care and ultimately youth participation rates have narrowed over the past decade, but jobs to support themselves and their fami- they remain large in South Asia, the Middle East and North Africa. In lies. In many countries of the global North, the latter region, the female participation rate decreased faster than young women and men are marrying later the male rate, actually increasing the gender gap. and having fewer children, and the same trend is emerging, if slowly, in many devel- Total % Male % Female % oping nations. The trend is linked not only World 50.9 58.9 42.4 to improved education and jobs, but also Developed Economies 50.2 52.6 47.7 to unfettered access to reproductive health, and European Union including contraceptives. Central and South- 41.7 47.7 35.5 In Ethiopia, a low-income country with Eastern Europe 39 per cent of its 82.9 million people liv- (non-European Union) ing below the international poverty line of and the CIS $1.25 a day, according to the World Bank, East Asia 59.2 57.0 61.6 hardship rather than rising expectations and South-East Asia and the 51.3 59.1 43.3 better living standards may be the major fac- Pacific tor in motivating young women and men South Asia 46.5 64.3 27.3 in cities when family choices are made. Assefa Hailemariam, the former director of Latin America and the 52.1 61.3 42.7 the Population Studies and Research Centre Caribbean at Addis Ababa University’s Institute of Middle East 36.3 50.3 21.5 Development Studies, said that young urban- North Africa 37.9 52.5 22.9 ites are bringing fertility rates down very fast Sub-Saharan Africa 57.5 62.7 52.2 for economic reasons. “Urban life is demanding,” Hailemariam said. “You can’t count on relatives to look Source: Global Employment Trends for Youth. International Labour Organization after your kids. You can’t have too many—14 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  21. 21. A youth mobilizer, Olalekan t Azeez-Iginla speaks during an interview at the UNFPA office in Lagos, Nigeria. ©UNFPA/Akintunde Akinleyebringing them up, taking care of them. younger. In her four years at her postAlso urban people have access to commu- in the village of Tare, she said, she hasnications [media] so they are aware that seen child marriages declining. “Thirteenhaving a smaller number of kids is better and 14 year olds used to marry,” shefor their future—you can educate your said. “Now because of advocacy by localchildren, buy them clothing and so on.” women’s organizations, the practice is Nationally, Ethiopia’s fertility rate disappearing.”has been 3.8 for the period of 2010–2015. In Addis Ababa, the capital,Hailemariam said, the rate has fallen The economic case forbelow 1.5. “In 2000 it was 1.9 or so; investing in youthnow we expect that it would be much Adolescence is an important time to acquire the skills, health, sociallower,” he said. “This is not necessar- networks and other attributes that form the social capital needed for aily just because of contraceptive use, fulfilling life. The fact that the human capital formed during adolescencealthough contraceptive use has played a and in youth is also an important determinant of long-term growthrole, but because of a number of devel- makes a strong macro-economic argument to support investing more inopment issues—a higher age of marriage young people. Social investments in young people’s education, health and employ-in Addis, education, health improve- ment can enable countries to build a strong economic base, therebyment, contraceptive access.” reversing intergenerational poverty. Enhancing young people’s capaci- ties can yield larger returns during the course of their economicallyPromoting later marriage active lives.Very young herself, Amsalu Buke, who Young people are also an enormous resource for growth in the short run. Having young people sit idle is costly in foregone output… The lossbrings family planning to outlying of income among the younger generation translates into a lack of sav-Ethiopian communities where access is ings as well as a loss of aggregate demand.—Excerpted from The Caselimited, has become an astute observer for Investing in Young People as Part of a National Poverty Reduction Strategy.of the lives of girls in their teens and UNFPA, 2010. T H E STAT E OF WORL D POPU L AT ION 20 1 1 15
  22. 22. Amsalu Buke and assistantt begin their trek to bring family planning to outlying Ethiopian communities. ©UNFPA/Antonio Fiorente Ethiopia, where half the girls are married tries outside that region are Nepal, where by age 18, is one of several countries where 7 per cent of girls are married by age 10 child marriages—which effectively end a girl’s and 40 per cent by age 15, and Bangladesh. chances of education and may destroy her Several states in India also rank high in health or end her life—are declining, accord- child marriages. In India, the Centre for ing to UNFPA and the Population Reference Health, Education, Training and Nutrition Bureau, an independent research organiza- Awareness, a non-governmental organization tion in the United States. But in the Amhara based in the state of Gujarat, battles wide- region and some other parts of Ethiopia, the spread anemia among girls, which weakens practice remains a stubborn problem and them and contributes to an estimated 6,000 continues to rob girls and young women of deaths in adolescent pregnancies annually, their rights, education and health. many because of early marriage, according Of the ten countries with the high- to a recent report by Swapna Majumdar of est child marriage rates, according to the Women’s eNews. Population Reference Bureau’s 2011 survey, “Child marriage undermines nearly Who Speaks for Me? Ending Child Marriage, every Millennium Development Goal; it is eight are in Africa, and Niger is at the top, an obstacle to eradicating poverty, achiev- with three-quarters of girls married before ing universal primary education, promoting the age of 18. The remaining two coun- gender equality, improving maternal and16 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  23. 23. child health and reducing HIV and AIDS,” In Mozambique, the balance of power in athe Population Reference Bureau survey relationship in favour of the man is tipped evensays. It adds that because young girls are further by early marriage, which also chips awayoften married to older men who may have at a young woman’s right to determine her ownhad numerous sexual partners, their chances reproductive destiny and often resulting in earlyof HIV infection are greater than those of and numerous pregnancies. A young woman’sunmarried sexually active girls. decision-making power may be additionally Forcing a child into marriage for any rea- diluted in polygamous settings, in which aboutson is a violation of the Convention on the one in four Mozambican women is involved.Elimination of All Forms of Discrimination According to a study by Mozambique’sAgainst Women and the Convention on National Statistics Institute, more than halfthe Rights of the Child. Gender inequal- of women between ages 20 and 49 say theyity is an underlying cause of child marriage, were married before the age of 18, and aboutsays UNFPA gender expert Gayle Nelson. one in five say they married before age 15.“And without addressing this issue, it will be In Mozambique as in many other countries,impossible to eradicate this or other discrimi- early marriage is more common among girlsnatory harmful practices.” with little or no formal education. Countries with high adolescent birth rates are concentrated in sub-Saharan Africa and Latin America and the Caribbean 100+ 50 < 100 20 < 50 <20 No data since 2000 Adolescent birth rates by country, most recent estimates The designations employed do not imply the expression of any opinion on the part of (Number of births per 1,000 women aged 15-19) UNFPA concerning the legal status of any country, territory, area or its authorities, or the delimitation of frontiers or boundaries. The dotted line represents approximately Source: Population Division of the United Nations Department of the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The Economic and Social Affairs. final status of Jammu and Kashmir has not yet been agreed upon by the parties. T HE STAT E OF WORL D POPU L AT ION 20 1 1 17
  24. 24. The Government of Mozambique out- population growth. “The bride’s young age, lawed marriage before the age of 16, and often combined with the older age of her since 2004 when a new Family Law went partner, intensifies power differentials in the into effect, a child may not marry before relationship,” the report states. “Her young reaching 18 without parental consent, which age is indicative of a relatively low level of is often granted by fathers who are eager to education. Her lack of knowledge and skills have their daughters marry as early as pos- may make her more reliant on high numbers sible. Furthermore, the law is difficult to of children for security with the marriage, as enforce, particularly in remote areas. And the well as long-term social security.” law can do nothing to stop girls from enter- ing into a relationship outside of marriage. Integrated services targeted to About two in five women who are married or youth by youth in a partnership are involved with men who In Ethiopia, where the median age is 18.7 are 10 or more years older than they are. and half the population is between the A report from UNFPA and the ages of 15 and 29, young people are visiblet Amsalu Buke visits Population Council in 2003 describes the everywhere helping to run a variety of pro- an outlying community “demographic consequence” of child mar- grammes for youth. In Addis Ababa there in Ethiopia. ©UNFPA/Antonio Fiorente riage: short spans between generations and are 56 youth clubs or centres and another 50 under construction, with a range of govern- ment programmes supported by UNFPA and UNICEF, among others. At one busy youth club, Dawit Yitagesu of the Addis Ababa HIV/AIDS Prevention and Control Office listed services young people can find in these centres, including HIV testing and counsel- ing, reproductive health services, livelihood programmes and business training, credit and savings help and in at least one large centre, a well-stocked library, packed with young people reading in silence, away from homes where studying is difficult. Boys dominate the youth clubs and vastly outnumber girls in centres’ activities, so programmes are being designed to attract girls, including young domestic workers who, isolated and confined to their jobs in other peoples’ homes for long hours, rarely have time to look for help and advice. Youth centres draw them into life-skills sessions and discussion groups.18 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  25. 25. There is no youth centre where Amsalu in giving young people a role and a stake inBuke, the peripatetic Ethiopian health worker, national programmes that matter to every-makes her rounds near Debre Tseige, south- one, regardless of age.east of the capital. But her cheerful, youthful In some primary care health posts, Fissehapresence makes her approachable to young said, solar-powered DVD players are installed,women with questions about reproductive with videos on various health, nutrition andhealth as well as older women seeking contra- lifestyle issues. “The DVDs are meant to beceptives or anyone who needs something to kept on when patients come,” he said. “Thecure a stomach upset, diarrhea or a headache. community owns the system, and civil societyShe vaccinates village people, keeping track has the privilege of using it.” A DVD playermeticulously on her home-made wall chart of has not yet come to her health postevery inoculation given to prevent meningitis, in Debre Tseige, but Amsalu has placedtetanus, polio and tuberculosis. prominently on her desk a drawing of a The Tare Giorgis health post, Amsalu’s woman receiving an injectable contraceptive,base, has no running water or electricity. a widely requested method of contraceptionVaccines are stored in a small, generator- in sub-Saharan Africa.powered refrigerator given to her byUNICEF in one cramped room of the three- "The bride’s young age, oftenroom clinic built of mud and straw. Themain room has space for only a desk and a combined with the older age of herfew chairs. Beside it is the maternity room,just big enough for an examination table partner, intensifies power differentialsequipped for birth deliveries and a small side in the relationship."table for basins and basic medical instru-ments. Amsalu also delivers babies in homes,reaching villages by foot, horse or donkey— Amsalu, who has a young assistant to helpunless she is lucky enough to hitch a ride on keep records and make the rounds of villages,a passing vehicle when she gets to a road. has only a secondary school education and a Amsalu Buke is one of more than 37,000 year of primary health-care training, includ-health extension workers positioned around ing instructions needed to become a midwife.the country is recent years, according to Her monthly net income is 570 EthiopianFisseha Mekonnen, executive director of the birr (about $34).Family Guidance Association of Ethiopia, Fisseha said that there are plans towhich is working with the Government to upgrade the education and training of healthimprove health and expand access to family extension workers, at least to professionalplanning in rural areas and nursing services paramedic level. In the meantime, he said,in cities. The corps of health extension work- “We feel they are doing their level best.”ers, many of them very young, is viewed as They know when more expert help is needed,a basic model for other developing nations and are expected to send patients to hospitalswith scant health coverage; it is also a model at the first signs of serious illness. Amsalu, T H E STAT E OF WORL D POPU L AT ION 20 1 1 19
  26. 26. who has been in charge of her health post non-governmental organizations imple- for four years, is lucky to have a hospital less ment the programme, with technical than five miles away in the nearest town, support from Pathfinder International and but that can seem very far when there is no UNFPA, which also provides financial ambulance, or even a taxi of sorts, to call in support along with Denmark, Norway an emergency. and Sweden. Today, almost half of the Mozambique’s Through Geração Biz, the ministries population is 24 years old or younger. of health, education and youth and sports Young people have the potential to jointly provide youth-friendly sexual and bring positive change to any country and reproductive health services, school-based contribute to a vital economy, but in information campaigns about contraception Mozambique, youth are more often than and HIV prevention, and community-based not “among the hardest hit” by the chal- information to reach young people who are lenging economic, educational and health not in school. conditions, says Emidio Sebastião Cuna, a The need for services targeted to youth UNFPA-Mozambique staff member who became acute after the country’s civil war, oversees Geração Biz (“busy generation,” when thousands of unemployed young in Portuguese), a Government programme people poured into cities looking for oppor- that aims to reduce the incidence of early tunities to earn a living. But jobs weret Ester Cabele, nurse at pregnancy and prevent HIV and other scarce because of the weakened economy AMODEFA, in Maputo, Mozambique. sexually transmitted infections among and social services could not keep up with ©UNFPA/Pedro Sá da Bandeira adolescents. Three ministries and national the demand for them. One of the results of this wave of rural-to-urban migration was a large number of sexually active young peo- ple with little or no access to information about sex, pregnancy or the risk of sexually transmitted infections. “Traditionally it is a taboo to discuss sexual health with adolescents” said Julião Matsinhe, a UNFPA adviser in Mozambique. “In no area did lack of information on sexual and reproductive health prove more cata- strophic than in the context of HIV/AIDS.” HIV today affects 11.5 per cent of the popu- lation between the ages of 15 and 49. Through a network of 5,000 peer coun- selors, Geração Biz is moving beyond taboos by breaking the silence and providing non- judgemental, confidential information and services to Mozambique’s youth.20 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  27. 27. Yolanda, 24, has come to the Maputooffice of the Family Planning Association ofMozambique—AMODEFA—for a check-upduring her first pregnancy. AMODEFA is oneof the non-governmental organizations thatimplement the Geração Biz programme andprovides free services to anyone 24 or young-er. Yolanda started coming to AMODEFAseveral years ago for information about con-traceptives and preventing HIV. “Here it’seasier to talk about these difficult topics,like HIV. It’s easier here than at home.” Ester Cabele, a service provider atAMODEFA, says that every month, shesees about 120 new clients—almost all ofthem women—who want contraceptives.She offers each a free HIV test, and in April2011 alone, six of them were found to be culture comes from the man. If a woman Jossias Chitive, HIV t activist and supervisorpositive. Cabele says that AMODEFA’s ser- wants her male partner to use a condom, of activities andvices are more popular than those available he will suspect she is HIV-positive.” student, Eduardoat Government-run health centres because At at N´ cleo de Mavalane, another u Mondlane University. ©UNFPA/Pedro Sá dathey are less crowded, have staff who are implementer of Geração Biz, Jossias Chitive, Bandeiratrained to work with young people, and 28, runs door-to-door information cam-offer advice and services in a safe environ- paigns about HIV prevention. The youngment. Without AMODEFA’s services, men he meets “don’t like to talk aboutCabele says that more young people would condoms” but notes that the organization’send up with unplanned pregnancies or free-condom dispenser out front must beHIV infections and end up dropping out of refilled every morning.school, jeopardizing their futures. Getting young men and women to talk At Coalisão, another non-governmental about sex remains a challenge, despite theorganization that implements the Geração abundance of information and services nowBiz programme, Maria Feliciana, 26, coor- available to them, says Fenius Matsinhe, adinates information and outreach about youth counselor at the Boane Health Centresexual and reproductive health, but also halfway between Maputo and the borderabout life skills and income generation. She with Swaziland. “Both boys and girls havethinks many young women become pregnant a hard time to be open with each other,” hebecause they lack information about contra- says. Still, experience with the Geração Bizception or are ill-equipped to negotiate with programme shows that attitudes and behav-their partners about using condoms. “It’s iours can change as people become moredifficult because all sexual initiative in this informed about their choices and rights. T H E STAT E OF WORL D POPU L AT ION 20 1 1 21

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