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Seven Opportunities for a World of 7 Billion                                                                                                                 state of world population 2011




                                                                                                           state of world population 2011
1         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 billion
6
          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 Fund
605 Third Avenue
New York, NY 10158 USA



                                                                                                                                                                                People and
Tel. +1-212 297-5000
www.unfpa.org
©UNFPA 2011




                                                                                                                                                                               possibilities
USD $24.00
ISBN 978-0-89714-990-7
sales no. E.11.III.H.1
E/11,000/2011




                                                                                                                                                                                 in a world
                                                                                                                                                                                of 7 billion
                                                                                www.7billionactions.org

  Printed on recycled paper.
The State of World Population 2011
This 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 provided
Lead reporter: Barbara Crossette
                                                                    insightful comments on drafts, ensured accuracy of data and
Additional 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 of
Editor: Richard Kollodge                                            Economic and Social Affairs, the source of most of the data in
Editorial associate: Robert Puchalik                                the report, guided the analysis and presentation of population
Editorial and administrative associate: Mirey Chaljub               projections. Without their support, this report would not have
Distribution 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 the
Acknowledgements
                                                                    UNFPA/NIDI Resource Flows Project and the Statistics Division
The editorial team is grateful to the report’s Advisory Board for   of the United Nations Department of Economic and Social
guiding the conceptualization and development of the report         Affairs also provided critical data. Edilberto Loiaza of UNFPA’s
and 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 (and
their staff) set up interviews, arranged logistics and helped       Thanks to generous financial support from UNFPA’s Technical
identify story ideas and guided the reporting in each location:     Division, this report features all original photography of the
Bernard 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); Sami
Republic of Macedonia). UNFPA’s regional directors provided         Sallinen (Finland); Sanjit Das and Atul Loke (India); Ricardo
valuable 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 (the
Central Asia), Nobuko Horibe (Asia and the Pacific), Bunmi          former Yugoslav Republic of Macedonia).
Makinwa (Africa) and Marcela Suazo (Latin America and
the Caribbean). Hilkka Vuorenmaa, senior advocacy officer           The editorial team also wishes to thank the individuals who told
of 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, Mozambique
Chief 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.
state of world population 2011
                                                  People and possibilities
                                                    in a world of 7 billion



Foreword                           page ii




1                                             5
     A closer look at                             Decision to move: the power
     our world of 7 billion        page 1         and impact of migration       page 65



2                                             6
     Youth: a new global power                    Planning ahead
     reshaping the world           page 9         for the growth of cities      page 77



3                                             7
     Security, economic strength                  Sharing and sustaining
     and independence in old age   page 29
                                                  Earth’s resources             page 93



4                                             8
     What influences                              The way ahead:
     fertility?                    page 43
                                                  finishing the Cairo agenda    page 101




Indicators                         page 110



Selected sources                   page 124




        ©UNFPA Antonio Fiorente
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-cities




ii     FORE WORD
UNFPA Executive




                                                                                                         t
                                                                                                             Director Babatunde
                                                                                                             Osotimehin.
                                                                                                             ©Brad Hamilton




where jobs are plentiful and the cost of living is       Our record population size can be viewed
high, 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. But
of 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 and
ning and the right investments in people             within countries. Disparities in rights and
now—to empower them to make choices that             opportunities also exist between men and
are not only good for themselves but for our         women, girls and boys. Charting a path now
global commons—our world of 7 billion can            to development that promotes equality, rather
have thriving, sustainable cities, productive        than exacerbates or reinforces inequalities, is
labour forces that can fuel economic growth,         more important than ever.
youth populations that contribute to the                 We all have a stake in the future of
well-being of economies and societies, and           humanity. Every individual, every government,
a generation of older people who are healthy         every business, is more interconnected and
and actively engaged in the social and               interdependent than ever, so what each of us
economic 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 improve
where population growth is outpacing                 the world.
economic growth, the need for reproductive
health services, especially family planning,
remains great. The attainment of a stable
                                                     We are 7 billion people with
population is a sine qua non for accelerated,        7 billion possibilities.
planned economic growth and development.
Governments that are serious about eradicating
poverty should also be serious about providing
the services, supplies, information that women                        Babatunde Osotimehin
need to exercise their reproductive rights.                           Executive Director, UNFPA




                                                                                    T H E STAT E OF WORL D POPU L AT ION 20 1 1   iii
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 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 to
t




    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
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, roadside
804
                                    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
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 smaller

4
1974
            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
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
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 of
one remaining region of the world where                          unprecedented growth in our species,” says
the 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 the
raphers’ increasing focus on the region is                       office of population at the United States
clear, he said: “The escape from poverty                         Agency for International Development,
and hunger is made more difficult by rapid                       professor of population and family health
population growth.”                                              at Columbia University and director-general


Estimated and projected population by major area,
medium variant, 1950-2100 (billions)
           5.5

           5.0

           4.5

           4.0

           3.5

           3.0
billions




           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             Oceania




Asia will remain the most populous                     expected to add another billion in just        and Oceania) amount to 1.7 billion in 2011
major 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 turn
from 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-         Asia's population, which is currently       population of Europe is projected to peak
ulation lived in Asia and 15 per cent in               4.2 billion, is expected to peak around the    around 2025 at 0.74 billion and decline
Africa. 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 a
double that of Asia's population (1 per                slow decline thereafter.                       Source: Population Division of the
cent per year). The population of Africa                  The populations of all other major          United Nations Department of Economic
first 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
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 and



6       CHAP T ER 1 : a closer loo k at our world of 7 billion
Amsalu Buke (left)




                                                                                                    t
                                                                                                        and assistant.
                                                                                                        ©UNFPA/Antonio
                                                                                                        Fiorente




experience from many countries had already
                                                  PopUlation and Poverty
documented that when women have equal
rights and opportunities in their societies and
when girls are educated and healthy, fertil-      Excerpts from the International Conference on
                                                  Population and Development’s Programme of Action
ity rates fall. The Programme of Action also
made it clear that empowerment of women           …Persistent widespread poverty as well as serious social and
is not simply an end in itself, but also a step   gender inequities have significant influences on, and are in turn
towards 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, to
at what their growing populations mean in         improve environmental protection, and to reduce unsustainable
different settings. The chapters that follow      consumption and production patterns are mutually reinforcing….
then explore ageing populations, migration,       Eradication of poverty will contribute to slowing population
the interrelationship among fertility patterns,   growth and to achieving early population stabilization.
reproductive health services, gender and the
rights of women and girls, the management
of vast urban areas and environmental strains.
    In this report thoughtful, visionary indi-
viduals around the world talk about the
challenges and opportunities they have in
shaping their societies and the global popula-
tion for this century and beyond. Many of
them are young, and conscious of the demo-
graphic fact that they will be designing the
21st century world.




                                                                               T HE STAT E OF WORL D POPU L AT ION 20 1 1    7
8   CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
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
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 Social
t 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
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, are
lower-income countries the number of years       of particular interest to many demographers
in which a large, young working population       because the country is on course to overtake
can 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 brochure
sector need to act expeditiously to prepare      size will affect the global population profile.
                                                                                                        presented by Ethel
the young for productive roles and create            In India, where the fertility rate, at 2.5         Phiri, an activist at
jobs 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 da
growth rates remain relatively high, govern-     600 million people who are 24 years old or             Bandeira

ments were warned in the 2011 Economic
Report on Africa by the United Nations
Economic Commission for Africa and the
African Union that this performance was not
being translated into needed jobs. The report
urged more effective government interven-
tion to create employment-building policies
and programmes.
    In Skopje, sociologist Antoanela
Petkovska of the Ss. Cyril and Methodius
University, worries about the demoralizing
effect on young people when they study hard
without much hope of satisfying careers.
“Young people are very pessimistic towards
their future, especially because of the high
rate of unemployment,” she said. “They
don’t have opportunities. So they are fight-
ing for diplomas mostly, not for knowledge.”
She looks to the Government for more help
in integrating young people into a wider
European intellectual community to broaden
their education, and wants the Government
to upgrade the country’s higher education
system, including scientific research, to make
university exchanges possible. “I’m very, very
sorry for my students sometimes because they
are smart young people, they just have to be
supported 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
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

     Cairo's 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
ployment and social exclusion.” Some
young people who are unable to earn their
own incomes have to be financially sup-
ported by their families, leaving less for
spending and investments in their house-
holds. Societies lose their investments in
education. Governments miss out on contri-
butions to social security systems. “All this
is a threat to the growth and development
potential of economies,” says the ILO.
Creating income-earning opportunities is
imperative because young people are not
only the generators of ideas and innova-
tion, but are also “the drivers of economic
development” in a country. “Foregoing this
potential is an economic waste.”
    In 2011, amid revolutions on the streets
of Arab countries, the ILO also suggested
that a 23.4 youth unemployment rate in the
Arab world was a major contributor to the
uprisings.
    “It’s hard to be a young person in
Mozambique,” says Rui Pedro Cossa,
a 24-year-old geography student at the
University Eduardo Mondlane in Maputo.
“Normally in youth, you‘re supposed to gain
experience for the future,” he says. “But here   for young people with the establishment                 Fernanda Manhique,
                                                                                                     t

                                                                                                         a geography student
you have more problems than opportunities.       of the National Youth Parliament, which
                                                                                                         at Eduardo Mondlane
There’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 da
Manhique agrees, adding the employment           ten, budgets planned and policies devised.              Bandeira

prospects 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 National
the situation is likely to be even worse for     Assembly, is tasked with passing advisory
job-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 federal
expanding opportunities many places. In          Government level, among them a national
Nigeria 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
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
A youth mobilizer, Olalekan




                                                                                                    t
                                                                                                        Azeez-Iginla speaks during an
                                                                                                        interview at the UNFPA office
                                                                                                        in Lagos, Nigeria.
                                                                                                        ©UNFPA/Akintunde Akinleye




bringing them up, taking care of them.       younger. In her four years at her post
Also urban people have access to commu-      in the village of Tare, she said, she has
nications [media] so they are aware that     seen child marriages declining. “Thirteen
having a smaller number of kids is better    and 14 year olds used to marry,” she
for their future—you can educate your        said. “Now because of advocacy by local
children, 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 for
below 1.5. “In 2000 it was 1.9 or so;            investing in youth
now we expect that it would be much
                                                  Adolescence is an important time to acquire the skills, health, social
lower,” he said. “This is not necessar-
                                                  networks and other attributes that form the social capital needed for a
ily just because of contraceptive use,            fulfilling life. The fact that the human capital formed during adolescence
although contraceptive use has played a           and in youth is also an important determinant of long-term growth
role, but because of a number of devel-           makes a strong macro-economic argument to support investing more in
opment 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, thereby
ment, contraceptive access.”                      reversing intergenerational poverty. Enhancing young people’s capaci-
                                                  ties can yield larger returns during the course of their economically
Promoting 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 loss
brings 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 Case
limited, 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
Amsalu Buke and assistant
t




     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 and



16       CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
child health and reducing HIV and AIDS,”                         In Mozambique, the balance of power in a
the Population Reference Bureau survey                       relationship in favour of the man is tipped even
says. It adds that because young girls are                   further by early marriage, which also chips away
often married to older men who may have                      at a young woman’s right to determine her own
had numerous sexual partners, their chances                  reproductive destiny and often resulting in early
of HIV infection are greater than those of                   and numerous pregnancies. A young woman’s
unmarried sexually active girls.                             decision-making power may be additionally
    Forcing a child into marriage for any rea-               diluted in polygamous settings, in which about
son 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’s
Against Women and the Convention on                          National Statistics Institute, more than half
the Rights of the Child. Gender inequal-                     of women between ages 20 and 49 say they
ity is an underlying cause of child marriage,                were married before the age of 18, and about
says 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 girls
natory 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
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 visible
t 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
There is no youth centre where Amsalu         in giving young people a role and a stake in
Buke, 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, Fisseha
presence makes her approachable to young          said, solar-powered DVD players are installed,
women with questions about reproductive           with videos on various health, nutrition and
health as well as older women seeking contra-     lifestyle issues. “The DVDs are meant to be
ceptives or anyone who needs something to         kept on when patients come,” he said. “The
cure a stomach upset, diarrhea or a headache.     community owns the system, and civil society
She vaccinates village people, keeping track      has the privilege of using it.” A DVD player
meticulously on her home-made wall chart of       has not yet come to her health post
every inoculation given to prevent meningitis,    in Debre Tseige, but Amsalu has placed
tetanus, 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 contraception
Vaccines are stored in a small, generator-        in sub-Saharan Africa.
powered refrigerator given to her by
UNICEF in one cramped room of the three-
                                                  "The bride’s young age, often
room clinic built of mud and straw. The
main room has space for only a desk and a         combined with the older age of her
few chairs. Beside it is the maternity room,
just big enough for an examination table
                                                  partner, intensifies power differentials
equipped 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 help
unless 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 Ethiopian
Fisseha Mekonnen, executive director of the       birr (about $34).
Family Guidance Association of Ethiopia,              Fisseha said that there are plans to
which is working with the Government to           upgrade the education and training of health
improve health and expand access to family        extension workers, at least to professional
planning 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 hospitals
with 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
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 were
t 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
Yolanda, 24, has come to the Maputo
office of the Family Planning Association of
Mozambique—AMODEFA—for a check-up
during her first pregnancy. AMODEFA is one
of the non-governmental organizations that
implement the Geração Biz programme and
provides free services to anyone 24 or young-
er. Yolanda started coming to AMODEFA
several years ago for information about con-
traceptives and preventing HIV. “Here it’s
easier to talk about these difficult topics,
like HIV. It’s easier here than at home.”
    Ester Cabele, a service provider at
AMODEFA, says that every month, she
sees about 120 new clients—almost all of
them women—who want contraceptives.
She offers each a free HIV test, and in April
2011 alone, six of them were found to be          culture comes from the man. If a woman                 Jossias Chitive, HIV
                                                                                                     t

                                                                                                         activist and supervisor
positive. Cabele says that AMODEFA’s ser-         wants her male partner to use a condom,
                                                                                                         of activities and
vices are more popular than those available       he will suspect she is HIV-positive.”                  student, Eduardo
at Government-run health centres because               At at N´ cleo de Mavalane, another
                                                                u                                        Mondlane University.
                                                                                                         ©UNFPA/Pedro Sá da
they are less crowded, have staff who are         implementer of Geração Biz, Jossias Chitive,           Bandeira

trained 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 young
ment. Without AMODEFA’s services,                 men he meets “don’t like to talk about
Cabele says that more young people would          condoms” but notes that the organization’s
end up with unplanned pregnancies or              free-condom dispenser out front must be
HIV 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 the
organization that implements the Geração          abundance of information and services now
Biz programme, Maria Feliciana, 26, coor-         available to them, says Fenius Matsinhe, a
dinates information and outreach about            youth counselor at the Boane Health Centre
sexual and reproductive health, but also          halfway between Maputo and the border
about life skills and income generation. She      with Swaziland. “Both boys and girls have
thinks many young women become pregnant           a hard time to be open with each other,” he
because they lack information about contra-       says. Still, experience with the Geração Biz
ception 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 more
difficult 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
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
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State of the World Population Report, 2011
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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

  • 1. Seven Opportunities for a World of 7 Billion state of world population 2011 state of world population 2011 1 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 billion 6 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 Fund 605 Third Avenue New York, NY 10158 USA People and Tel. +1-212 297-5000 www.unfpa.org ©UNFPA 2011 possibilities USD $24.00 ISBN 978-0-89714-990-7 sales no. E.11.III.H.1 E/11,000/2011 in a world of 7 billion www.7billionactions.org Printed on recycled paper.
  • 2. The State of World Population 2011 This 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 provided Lead reporter: Barbara Crossette insightful comments on drafts, ensured accuracy of data and Additional 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 of Editor: Richard Kollodge Economic and Social Affairs, the source of most of the data in Editorial associate: Robert Puchalik the report, guided the analysis and presentation of population Editorial and administrative associate: Mirey Chaljub projections. Without their support, this report would not have Distribution 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 the Acknowledgements UNFPA/NIDI Resource Flows Project and the Statistics Division The editorial team is grateful to the report’s Advisory Board for of the United Nations Department of Economic and Social guiding the conceptualization and development of the report Affairs also provided critical data. Edilberto Loiaza of UNFPA’s and 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 (and their staff) set up interviews, arranged logistics and helped Thanks to generous financial support from UNFPA’s Technical identify story ideas and guided the reporting in each location: Division, this report features all original photography of the Bernard 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); Sami Republic of Macedonia). UNFPA’s regional directors provided Sallinen (Finland); Sanjit Das and Atul Loke (India); Ricardo valuable 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 (the Central Asia), Nobuko Horibe (Asia and the Pacific), Bunmi former Yugoslav Republic of Macedonia). Makinwa (Africa) and Marcela Suazo (Latin America and the Caribbean). Hilkka Vuorenmaa, senior advocacy officer The editorial team also wishes to thank the individuals who told of 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, Mozambique Chief 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. state of world population 2011 People and possibilities in a world of 7 billion Foreword page ii 1 5 A closer look at Decision to move: the power our world of 7 billion page 1 and impact of migration page 65 2 6 Youth: a new global power Planning ahead reshaping the world page 9 for the growth of cities page 77 3 7 Security, economic strength Sharing and sustaining and independence in old age page 29 Earth’s resources page 93 4 8 What influences The way ahead: fertility? page 43 finishing the Cairo agenda page 101 Indicators page 110 Selected sources page 124 ©UNFPA Antonio Fiorente
  • 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-cities ii FORE WORD
  • 5. UNFPA Executive t Director Babatunde Osotimehin. ©Brad Hamilton where jobs are plentiful and the cost of living is Our record population size can be viewed high, 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. But of 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 and ning and the right investments in people within countries. Disparities in rights and now—to empower them to make choices that opportunities also exist between men and are not only good for themselves but for our women, girls and boys. Charting a path now global commons—our world of 7 billion can to development that promotes equality, rather have thriving, sustainable cities, productive than exacerbates or reinforces inequalities, is labour forces that can fuel economic growth, more important than ever. youth populations that contribute to the We all have a stake in the future of well-being of economies and societies, and humanity. Every individual, every government, a generation of older people who are healthy every business, is more interconnected and and actively engaged in the social and interdependent than ever, so what each of us economic 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 improve where population growth is outpacing the world. economic growth, the need for reproductive health services, especially family planning, remains great. The attainment of a stable We are 7 billion people with population is a sine qua non for accelerated, 7 billion possibilities. planned economic growth and development. Governments that are serious about eradicating poverty should also be serious about providing the services, supplies, information that women Babatunde Osotimehin need 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. iv CHAP T ER 1 : a closer loo k at our world of 7 billion
  • 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 to t 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. 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, roadside 804 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. 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 smaller 4 1974 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. 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. 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 of one remaining region of the world where unprecedented growth in our species,” says the 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 the raphers’ increasing focus on the region is office of population at the United States clear, he said: “The escape from poverty Agency for International Development, and hunger is made more difficult by rapid professor of population and family health population growth.” at Columbia University and director-general Estimated and projected population by major area, medium variant, 1950-2100 (billions) 5.5 5.0 4.5 4.0 3.5 3.0 billions 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 Oceania Asia will remain the most populous expected to add another billion in just and Oceania) amount to 1.7 billion in 2011 major 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 turn from 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- Asia's population, which is currently population of Europe is projected to peak ulation lived in Asia and 15 per cent in 4.2 billion, is expected to peak around the around 2025 at 0.74 billion and decline Africa. 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 a double that of Asia's population (1 per slow decline thereafter. Source: Population Division of the cent per year). The population of Africa The populations of all other major United Nations Department of Economic first 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. 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 and 6 CHAP T ER 1 : a closer loo k at our world of 7 billion
  • 13. Amsalu Buke (left) t and assistant. ©UNFPA/Antonio Fiorente experience from many countries had already PopUlation and Poverty documented that when women have equal rights and opportunities in their societies and when girls are educated and healthy, fertil- Excerpts from the International Conference on Population and Development’s Programme of Action ity rates fall. The Programme of Action also made it clear that empowerment of women …Persistent widespread poverty as well as serious social and is not simply an end in itself, but also a step gender inequities have significant influences on, and are in turn towards 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, to at what their growing populations mean in improve environmental protection, and to reduce unsustainable different settings. The chapters that follow consumption and production patterns are mutually reinforcing…. then explore ageing populations, migration, Eradication of poverty will contribute to slowing population the interrelationship among fertility patterns, growth and to achieving early population stabilization. reproductive health services, gender and the rights of women and girls, the management of vast urban areas and environmental strains. In this report thoughtful, visionary indi- viduals around the world talk about the challenges and opportunities they have in shaping their societies and the global popula- tion for this century and beyond. Many of them are young, and conscious of the demo- graphic fact that they will be designing the 21st century world. T HE STAT E OF WORL D POPU L AT ION 20 1 1 7
  • 14. 8 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  • 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. 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 Social t 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. 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, are lower-income countries the number of years of particular interest to many demographers in which a large, young working population because the country is on course to overtake can 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 brochure sector need to act expeditiously to prepare size will affect the global population profile. presented by Ethel the young for productive roles and create In India, where the fertility rate, at 2.5 Phiri, an activist at jobs 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 da growth rates remain relatively high, govern- 600 million people who are 24 years old or Bandeira ments were warned in the 2011 Economic Report on Africa by the United Nations Economic Commission for Africa and the African Union that this performance was not being translated into needed jobs. The report urged more effective government interven- tion to create employment-building policies and programmes. In Skopje, sociologist Antoanela Petkovska of the Ss. Cyril and Methodius University, worries about the demoralizing effect on young people when they study hard without much hope of satisfying careers. “Young people are very pessimistic towards their future, especially because of the high rate of unemployment,” she said. “They don’t have opportunities. So they are fight- ing for diplomas mostly, not for knowledge.” She looks to the Government for more help in integrating young people into a wider European intellectual community to broaden their education, and wants the Government to upgrade the country’s higher education system, including scientific research, to make university exchanges possible. “I’m very, very sorry for my students sometimes because they are smart young people, they just have to be supported 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. 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 Cairo's 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. ployment and social exclusion.” Some young people who are unable to earn their own incomes have to be financially sup- ported by their families, leaving less for spending and investments in their house- holds. Societies lose their investments in education. Governments miss out on contri- butions to social security systems. “All this is a threat to the growth and development potential of economies,” says the ILO. Creating income-earning opportunities is imperative because young people are not only the generators of ideas and innova- tion, but are also “the drivers of economic development” in a country. “Foregoing this potential is an economic waste.” In 2011, amid revolutions on the streets of Arab countries, the ILO also suggested that a 23.4 youth unemployment rate in the Arab world was a major contributor to the uprisings. “It’s hard to be a young person in Mozambique,” says Rui Pedro Cossa, a 24-year-old geography student at the University Eduardo Mondlane in Maputo. “Normally in youth, you‘re supposed to gain experience for the future,” he says. “But here for young people with the establishment Fernanda Manhique, t a geography student you have more problems than opportunities. of the National Youth Parliament, which at Eduardo Mondlane There’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 da Manhique agrees, adding the employment ten, budgets planned and policies devised. Bandeira prospects 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 National the situation is likely to be even worse for Assembly, is tasked with passing advisory job-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 federal expanding opportunities many places. In Government level, among them a national Nigeria 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. 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. A youth mobilizer, Olalekan t Azeez-Iginla speaks during an interview at the UNFPA office in Lagos, Nigeria. ©UNFPA/Akintunde Akinleye bringing them up, taking care of them. younger. In her four years at her post Also urban people have access to commu- in the village of Tare, she said, she has nications [media] so they are aware that seen child marriages declining. “Thirteen having a smaller number of kids is better and 14 year olds used to marry,” she for their future—you can educate your said. “Now because of advocacy by local children, 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 for below 1.5. “In 2000 it was 1.9 or so; investing in youth now we expect that it would be much Adolescence is an important time to acquire the skills, health, social lower,” he said. “This is not necessar- networks and other attributes that form the social capital needed for a ily just because of contraceptive use, fulfilling life. The fact that the human capital formed during adolescence although contraceptive use has played a and in youth is also an important determinant of long-term growth role, but because of a number of devel- makes a strong macro-economic argument to support investing more in opment 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, thereby ment, contraceptive access.” reversing intergenerational poverty. Enhancing young people’s capaci- ties can yield larger returns during the course of their economically Promoting 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 loss brings 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 Case limited, 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. Amsalu Buke and assistant t 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 and 16 CHAP T ER 2 : Youth : A New Global P ower Reshaping the World
  • 23. child health and reducing HIV and AIDS,” In Mozambique, the balance of power in a the Population Reference Bureau survey relationship in favour of the man is tipped even says. It adds that because young girls are further by early marriage, which also chips away often married to older men who may have at a young woman’s right to determine her own had numerous sexual partners, their chances reproductive destiny and often resulting in early of HIV infection are greater than those of and numerous pregnancies. A young woman’s unmarried sexually active girls. decision-making power may be additionally Forcing a child into marriage for any rea- diluted in polygamous settings, in which about son 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’s Against Women and the Convention on National Statistics Institute, more than half the Rights of the Child. Gender inequal- of women between ages 20 and 49 say they ity is an underlying cause of child marriage, were married before the age of 18, and about says 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 girls natory 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. 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 visible t 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. There is no youth centre where Amsalu in giving young people a role and a stake in Buke, 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, Fisseha presence makes her approachable to young said, solar-powered DVD players are installed, women with questions about reproductive with videos on various health, nutrition and health as well as older women seeking contra- lifestyle issues. “The DVDs are meant to be ceptives or anyone who needs something to kept on when patients come,” he said. “The cure a stomach upset, diarrhea or a headache. community owns the system, and civil society She vaccinates village people, keeping track has the privilege of using it.” A DVD player meticulously on her home-made wall chart of has not yet come to her health post every inoculation given to prevent meningitis, in Debre Tseige, but Amsalu has placed tetanus, 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 contraception Vaccines are stored in a small, generator- in sub-Saharan Africa. powered refrigerator given to her by UNICEF in one cramped room of the three- "The bride’s young age, often room clinic built of mud and straw. The main room has space for only a desk and a combined with the older age of her few chairs. Beside it is the maternity room, just big enough for an examination table partner, intensifies power differentials equipped 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 help unless 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 Ethiopian Fisseha Mekonnen, executive director of the birr (about $34). Family Guidance Association of Ethiopia, Fisseha said that there are plans to which is working with the Government to upgrade the education and training of health improve health and expand access to family extension workers, at least to professional planning 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 hospitals with 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. 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 were t 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. Yolanda, 24, has come to the Maputo office of the Family Planning Association of Mozambique—AMODEFA—for a check-up during her first pregnancy. AMODEFA is one of the non-governmental organizations that implement the Geração Biz programme and provides free services to anyone 24 or young- er. Yolanda started coming to AMODEFA several years ago for information about con- traceptives and preventing HIV. “Here it’s easier to talk about these difficult topics, like HIV. It’s easier here than at home.” Ester Cabele, a service provider at AMODEFA, says that every month, she sees about 120 new clients—almost all of them women—who want contraceptives. She offers each a free HIV test, and in April 2011 alone, six of them were found to be culture comes from the man. If a woman Jossias Chitive, HIV t activist and supervisor positive. Cabele says that AMODEFA’s ser- wants her male partner to use a condom, of activities and vices are more popular than those available he will suspect she is HIV-positive.” student, Eduardo at Government-run health centres because At at N´ cleo de Mavalane, another u Mondlane University. ©UNFPA/Pedro Sá da they are less crowded, have staff who are implementer of Geração Biz, Jossias Chitive, Bandeira trained 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 young ment. Without AMODEFA’s services, men he meets “don’t like to talk about Cabele says that more young people would condoms” but notes that the organization’s end up with unplanned pregnancies or free-condom dispenser out front must be HIV 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 the organization that implements the Geração abundance of information and services now Biz programme, Maria Feliciana, 26, coor- available to them, says Fenius Matsinhe, a dinates information and outreach about youth counselor at the Boane Health Centre sexual and reproductive health, but also halfway between Maputo and the border about life skills and income generation. She with Swaziland. “Both boys and girls have thinks many young women become pregnant a hard time to be open with each other,” he because they lack information about contra- says. Still, experience with the Geração Biz ception 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 more difficult 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