Time for Sweden to resume focus on international family planning aid

Recent research suggests lack of contraception and high desired family size both hinder population stabilization in Africa. We call on the newly elected Swedish government to prioritize international family planning aid, resuming a valuable Swedish tradition.    

By Frank Götmark, Nordhild Wetzler, Malte Andersson, Carl Wahren, Karl-Erik Norrman

An Op-Ed originally published in Svenska Dagbladet

In an agreement (“Tidöavtalet”) between parties in the new Swedish government and their supporting party, the Sweden Democrats, international aid must now also include “effective measures to reduce the root causes of migration”. For this, several forms of aid are needed, but extensive population growth and its resulting human suffering and migration, especially from Africa, can be reduced through family planning.

Sweden’s large international aid is widely discussed, including catastrophic aid, agricultural development, global health, environment and climate. But to effectively support the wellbeing of people and environment in developing countries, aid is also required to curb unsustainable population growth.

In many countries, the population is increasing rapidly. The UN’s forecast in July was that Africa’s population will increase from today’s 1.4 to 3.9 billion in 2100. The UN assumes in its demographic model that the birth rate will decrease strongly in the future. If today’s birth rate in Africa (4.3 children per woman) remains, according to the UN the continent could instead have 11 billion inhabitants in 2100 (the world’s population is now 8 billion). Even with 3.9 billion, an already critical food and supply situation would worsen greatly in Africa.

Faced with these prospects, support for reduced family size and an improved situation for girls and women may seem self-evident. But those in power shy away from the problem, while many religious leaders oppose women’s self-determination. Here there are great opportunities for Sweden to improve conditions for people, the environment and nature, through support for programs for family planning.

Africa has long suffered from undernourishment and famine, and there are no signs that conditions will improve. According to the FAO, 250 million people in Africa are now malnourished. Conflicts, wars, trade disruptions through pandemics, climate change and strong population growth mean that people and the environment are at increasing risk of disasters, with many more human victims than before.

Two women and a baby in a village near the city of Makeni, in the Northern Province of Sierra Leone. Photo: UN Photo/Martine Perret

Even relatively inexpensive measures can make a difference. Counseling on the economic benefits of smaller families, and on the best use of contraception, can lower birth rates in Africa as has happened in Latin America and Asia. We recently studied the views of citizens on this important issue, in Sweden and now also in Nigeria. According to the most recent projection from the UN, Nigeria is on track to increase from 215 to 545 million people by 2100. The birth rate has fallen in many developing countries since 1960, but in sub-Saharan Africa only from about 1980, and only slowly.

Which factor do people think has the greatest significance for falling birth rates in developing countries? In our survey in Sweden in April (1,000 Swedes), 60 percent indicated one of the following four factors: better living conditions including improved economy, increased education, lower infant mortality, and generally progressive development.

For information from Nigeria, we used Kantar’s (non-representative) web panel where high education predominates among the English-speaking respondents. In the country’s national development program, family planning and lower birth rates have been emphasized for several decades, but the goals are still distant. We asked, “For Nigeria, which factor do you think is most important for decline in birth rates (decrease in number of children per woman)?”, and we informed respondents that the average number of children per woman was 6.7 in 1985, and had decreased to 5.4 by 2020.

Of 1,500 respondents, 70 percent indicated one of three related factors as significant: poverty, poorer socioeconomic conditions, and poorer health. Birth rates are thus assumed to be falling mainly because economic conditions in Nigeria are generally getting worse, not better. Only 8 percent indicated the factors that Swedes emphasized. Women and men in southern and northern Nigeria responded in roughly the same way.

Demand for family planning satisfied by modern contraceptive methods among women aged 15-49 years, 2021. UN Population Division.

If conditions improve in Nigeria, will the birth rate rise or fall? Research suggests that it can level off at high levels, even in urban environments. But many of the responses testified to deteriorating conditions; improvements hardly occur during persistent rapid population growth.

An important clue to understanding the results can be found in the “Demographic and Health Survey” for Nigeria, where the “ideal number of children” is 7.2 and 6.1 for men and women respectively. And Nigeria is not unique: the desire for large family, 5 or more children, is still common in sub-Saharan Africa and seems to have even increased in recent years. As in Sweden 150 years ago, it hinders economic development, better health, and education for women. Population growth is gradually destroying ecosystems that people in Africa depend on.

Migration from Africa and some other countries is largely driven by population growth and its consequences. Even if catastrophic aid is required, aid must also focus on root causes, as emphasized in the agreement among parties in the new Swedish government. Large families and population growth undermine the efforts to improve schooling, health, maternity care, and not least the economy. It is now time to learn once again from programs for family planning, where Sweden was a leader for a long time and contributed strongly during the period 1960-1990.

Mechai Viravaidya, founder of the Population and Development Association in Thailand, and whose name means victory, showing V for victory, in this case meaning “Stop at two children”. He was a major proponent of family planning and contraceptives, nicknamed Mr. Condom, who used humor to spread awareness.

But the knowledge has almost been erased about how Sweden via Sida, the UN, and other organizations contributed to successful family planning in South Korea, Thailand, Indonesia, Sri Lanka and Tunisia, to take a few examples. In Africa there were partially successful programs, for example in Kenya (1984 – 1998) and in Ghana (1994 – ca 2000), which stagnated however, partly due to decreasing support from international donors. Rwanda now stands out as a forerunner and in Ethiopia, family planning seems to be gaining more support. With appropriate efforts, it is possible to influence the norm of large families.

Sweden can increase its support for the multilateral initiative FP2023, which cooperates with governments in 19 countries in Africa, and with 46 NGOs. Can Sweden also provide bilateral support to countries in Africa that are making an effort to reduce high birth rates? Many organizations work effectively with these issues, for instance the Population Media Center. We call on the Swedish government and the Parliament to prioritize support to family planning when the new policy for Sweden’s international aid is being implemented. Helping poor women in vulnerable countries to achieve full control over their childbearing should be a high priority in foreign aid policy, and it can reduce population growth, a root cause of emigration from such countries.

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9 thoughts on “Time for Sweden to resume focus on international family planning aid

  1. Interesting report and the idea of some areas promoting increased fertility rates reminded me of a study and book, “Population Politics,” By Virginia D. Abernathy PhD. It was found, developing countries bordering developed countries often experienced higher birth rates due to the idea that a way for more income for the family was through a member emigrating to the wealthier country and sending money home. The more kids the greater the chances.This is often a big source of income for families in developing countries. Evidently, this now includes developing countries in general. One group, I support, that deals not only with family planning (mainly surgical contraception) but also education especially for men is Engenderhealth.One program is called MAP (men as partners). https://www.engenderhealth.org/

  2. Thank you for good comment, Jack. Yes, there is much talk and emphasis on the beneficial effects of educating girls and women, but as important – or even more – is influencing and educating men. For instance in Africa, men often decides whether women in the family are allowed to use contraceptives. It also happens that women use them in secret. Many research reports about this. How to best deal with this? Will check the organization you mention. /Frank

  3. I of course agree we should offer and encourage family planning to high-birth rate countries; perhaps even make aid conditional on that, as controversial as it would be. But I always find it odd when I read these projections that say “the population of Africa will be x billion by…”. As if Africa was sealed off from the rest of the world. If it was, those new people would probably end up mostly killing each other, as is already happening with resource-based conflicts, or starving to death (also unfortunately happening). But Africa isn’t isolated from other continents.
    Europe is becoming more and more African by the day, even though it’s considered racist to point it out. Looking around in my small Italian hometown, I notice how fast things are changing. I knew almost no black people when growing up (I’m a “millenial”), and most of them were adopted, even though the possibility of adoption from poorer countries probably played a role in increasing population here. Black people were so rare a couple of generations ago that my great grandfather was asking my father, who was studying in Rome, what black people “were like”. He was curious, he had never seen one! Now it seems like everyday there’s more.
    Not in every area of the world you can tell who’s an immigrant and who’s not just by looking at them. But Italy is still one such place, with the partial exception of some European immigrants. And the change is palpable and very fast.
    So those billions of extra Africans won’t be just extra Africans, they will be extra Europeans. Whether Europe changing in appearance, culture, legacy is a good thing or not, that we can debate infinitely and is mostly a matter of personal preference. But the environmental and social outcome of such rapid change will be massive and very hard to avoid or even mitigate.
    So I think that such statistics should always be contextualised: we are not just projecting future African population growth.

    1. P.S. In case this sounds “racist” one can substitute many other races or ethnic group into this equation (white/Native American, Han/Tibetan or South East Asian, ethnic Russian/any group from the former Soviet Union…). Only the post was about African population projections.

  4. Gaia makes an important point.

    In 1950, Africa’s population was about 1/3 Europe’s.

    In 2050, Africa’s population is set to be 4X larger than Europe’s.

    That will put tremendous pressure on Europe to accommodate more immigration from Africa. Population growth in one part of the world isn’t just population growth in that part of the world.

  5. Good points, Gaia and Phil. But given increasing political resistance against immigration into Europe (and elsewhere I assume), I suspect that population growth in Africa will mainly cause huge problems within the continents. Most migration will be within Africa, with increasing conflicts as a likely result. The remaining natural ecosystems, in case they are useful for agriculture, will decrease strongly, as will large mammals and other biodiversity. Therefore, international family planning programs are extremely important, and even more important are leaders in the countries willing to start them (badly needed, foreign agencies cannot start them alone). SRHR, or “Sexual reproductive health and rights”, although it seems self-evident, is insufficient – now it has been tested for 25 years, and it does not work, just take a look at the news from Tanzania, about 10-year growth of the population there (check).

    1. I agree with the need to invest in family planning programs – I see them as a win-win. And I also agree that massive human population growth will be bad for Africa first and foremost. But I do not believe that any government in Europe will be able and willing to stop migration. They might at most slow it down.
      In Italy, they’re at it again. Stopping boats with migrants to make a fuss convince other European countries to take some. At most it’ll be sharing, but they will come, and they won’t be sent back. And if you don’t send people back – that’s the only way – they keep coming. The minister (I think of the interior?) the other day was saying that regular migration is good for the economy. Italians might think they have voted to stop immigration, but it won’t happen. Cheap labour is too addictive.
      Look at Britain, too. They won’t let them do that Rwanda thing.

  6. I tell American opponents of immigration to consider “the Norwegian Solution.” Norway sent 400,000 immigrants to the U.S.A. before 1930. Now net migration is near zero. Without border walls or enforcement costs. Cutting fertility rates helped Norway (and the rest of Europe) become prosperous. There were fewer people needing to move and less motive. European aid for family planning in Africa is a win-win. It will improve African’s lives and reduce excessive migration pressures. If anything smacks of racism, it is failing to help poor African woman have fewer children. Low fertility made European women better off and the same must happen in Africa to avoid ecological catastrophe and population collapse due to higher death rates.

    1. Yes but European migration to the US displaced the Native Americans, and it wasn’t a one-off thing, it went on for generations and did irreversible damage. Also Norway is a small country with a small overall population. Both Nigeria and Pakistan are well over 200 million already, and that’s just Nigeria and Pakistan.
      I believe we should make any aid contingent on family planning. But that would be very controversial.

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