Third Copenhagen Consensus: Population Growth Assessment, Kohler

Assessment Paper

In research for the third Copenhagen Consensus, Hans-Peter Kohler of the University of Pennsylvania focuses on assisting sub-Saharan African nations that make the dominant contribution to world population growth resulting from high fertility countries. These nations are among the poorest and most vulnerable in the world, often having weak institutions and capacities to manage population growth. The working paper used by the Expert Panel is available for download here, the finalized paper has been published in Global Problems, Smart Solutions - Costs and Benefits by Cambridge University Press.

Current ‘high fertility’ countries account currently for about 38% of the 78 million persons that are added annually to the world population, despite the fact that they are home to only 18% of the current population . After 2060, world population is projected to grow exclusively as a result of population growth in the current high fertility countries. 

Kohler notes that the overall Sub-Saharan African population increase  peaked in the early 1980s and has been declining from its peak of 2.8% in 1980–85 to 2.5% in 2005-10, although growth remains more than twice as high as the global rate. 

The overall growth rate masks substantial differences. There are nine countries that are expected to more than triple their population between 2010 and 2060, with population growth rates between 2.2 and 3.0 percent: Burkina Faso, Niger, Zambia, Malawi, Somalia, Tanzania, Uganda, Mali, and Madagascar. 

Many high-fertility Sub-Saharan African countries have a considerable—and possibly growing— “unmet need” for family planning: women who are not using any method of contraception, but do not want any more children, or want to delay the next child. Around 25 percent of sexually active women would like to limit their fertility but do not use family planning methods.

Family planning programs that facilitate a decline in fertility and a reduction in population growth rate would seem potentially highly beneficial interventions that should be expanded. And yet, as Kohler outlines, this conclusion has been subject of a long-standing and sometimes heated debate, often questioning the very basic pillars of this conclusion: 

This debate has sometimes raised more questions than answers: how detrimental, if at all, is population growth for economic development, individual well-being and the attainment of development indicators such as the Millennium Development Goals? Do family planning programs have causal effects towards reducing fertility, or would observed declines in family planning program areas also have been observed in the absence of these programs? Is there a window of opportunity in coming decades in which declines in population growth rates as a result of reduced fertility could provide a “demographic dividend” that would facilitate the social and economic development in some of the world’s most developed countries?

In the last two decades, a growing body of research has substantially strengthened the case for family planning programs—documenting for example significant effects of these programs towards reducing fertility, increasing education for mothers, improving women’s general health and longer-term survival, increasing female labor force participation and earnings, as well as child health . 

However, the attempt to obtain reasonably reliable estimates of the benefits and costs of these programs remains very challenging.

Kohler draws on recent estimates to find that expanding family planning services to all women with unmet needs—a total of 215 million women—would require an additional annual expenditure of $3.6 billion, bringing the total cost to $6.7 billion annual. Three-quarters of these additional expenses would be required for program and other systems costs related to expanding family planning services, while only 16% would be required for the supplies and contraceptive commodities. 

Kohler finds that a reduction in the SSA population growth rate by 1 percentage point during 2005–50 would entail discounted family planning costs in the order of magnitude of about $27 billion . 

The benefits are large. Reduced fertility, increased child spacing and possible reductions in unwanted fertility are likely to reduce infant and maternal mortality, each year leading to 150,000 fewer maternal deaths and 600,000 fewer children who will lose their mother. These effects alone, Kohler estimates, are worth more than $110 billion, meaning that each dollar spent will achieve $30 to $50 dollars of benefits.

But moreover, it is also estimated that reduced fertility will lead to higher levels of female education, increases in female labor force participation and earnings. At the same time, fewer children and more men and women in the work force will lead to a demographic dividend, increasing economic growth over the coming decades. Essentially, reductions in fertility and population growth rates would result in sustained increases in GDP per capita over several decades. This is estimated to lead to an extra benefit of perhaps $60 for every dollar spent.

With the caveat that knowledge about the interactions between population and development remains limited and heated discussion takes place about many assumptions, Kohler’s research suggests substantial benefit-cost ratios for family planning programs. In total, he finds that every dollar spent in this area could result in benefits worth around $90 to $150. 

Kohler’s analysis adds further weight to earlier analyses that have argued that family planning programs are a good economic investment, especially in light of continued population growth in the world’s worst-off countries.