Family Planning Still a Challenge for Many Poor Women

July 10, 2008

  • Average global birth rates have declined to 3 children per mother
  • Family planning still out of reach for many poor women
  • Education, economic opportunity also important for lowering birth rates

July 10, 2008—Over the last 30 years, birth rates have been falling steadily around the globe, but fertility levels and the pace of decline vary widely among and within countries, says a new World Bank report.

In most of the world today, women on average have three children or less.

However, in 35 of the world’s poor countries, birth rates remain high, with an average of more than five children per mother. Thirty-one of these countries are in Sub-Saharan Africa; the rest are Timor-Leste, Afghanistan, Djibouti, and Yemen. The same countries also have low levels of education, high death rates, and extreme poverty.

This year’s World Population Day, July 11, reaffirms the right and ability to plan when to start a family and determine freely and responsibly the number and timing of children.

But for many poor women, obtaining this control to plan their families remains out of reach. Women in developing countries experience 51 million unintended pregnancies each year because of lack of contraception, according to the World Bank report,Fertility Regulation Behaviors and Their Costs(pdf).

"Giving women access to modern contraception and family planning also helps to boost economic growth while reducing high birth rates so strongly linked with endemic poverty, poor education, and high numbers of maternal and infant deaths," says Joy Phumaphi, the World Bank’s Vice President for Human Development, and a former Health Minister in Botswana.

Education, economic opportunity also important

In addition to better health programs, Phumaphi says that improving girls’ education, giving women equal economic opportunities, and lifting families out of poverty are also important for lowering birth rates.

Getting an education—even if only at primary school level—is a good predictor of low fertility, according to Sadia Chowdhury, a co-author of the report and Senior Reproductive and Child Health Specialist at the World Bank.

"Promoting girls’ and women’s education is just as important in reducing birth rates in the long run as promoting contraception and family planning," says Chowdhury.

World Bank contribution to population and reproductive health

The World Bank continues to play a central role in ensuring access to all reproductive services through policy advice and financial assistance. In its policy discussions with client countries, the Bank continues to affirm its long-standing and strong commitment to the Cairo Consensus—the landmark 1994 agreement on family planning and sexual and reproductive health—and to provide countries with whatever financial and technical help they request in this area.

At the present time, the Bank is carrying out more than 90 population and reproductive health projects worth $965 million.

Birth rates have fallen fastest in Asia and have been lowest in Sub-Saharan Africa.

Regional Fertility Rates:

  • Sub-Saharan Africa: 5.2 children per woman
  • The Middle East, North Africa and South Asia: between 3.3 and 3.4 children per woman
  • Central Asia, Latin America and the Caribbean: between 2.5 and 2.6 children per woman
  • E. Asia and Pacific: 2.1 or less children per woman