RAPID Presentation: Population and Development Version

1 November 2011

2

The Change We Seek:

Photo by Bill & M

elinda Gates Foundation

Raising Our Quali ty of Li fe

By Chief Samu'ila Danko Makama

Chairman of the National Population Commission (NPopC) Federal Government of Nigeria

November 2011

3

Nigeria’s Vision

How Fertility Affects Development

Two Paths

Our Choice

Outline

2

4

3

1

Phot

o by

Mik

e Bl

yth

A strategy to meet challenges posed by rapid population growth

Addresses linkages between population and development issues

4

Nigeria The National Policy on Population and Sustainable Development (NPPSD):

Photo by Pjotter

Source: Federal Government of Nigeria. National Policy on Population for Sustainable Development, 2004

5

Lower infant mortality to 35 per 1,000 live births

Lower child mortality rate to 45 per 1,000 live births

Lower maternal mortality to 75 per 100,000 live births

Achieve sustained growth, eradicate poverty, improve living standards

5

NPPSD’s 2015 Targets:

Phot

o by

Pjo

tter

Source: Federal Government of Nigeria. National Policy on Population for Sustainable Development, 2004

6

Photo by Mike Blyth

National Strategic Health Development Plan

Lower infant mortality to 30 per 1,000 live births

Lower maternal mortality to 136 per 100,000 live births

Adolescent births (teenage mothers): 90 per 1,000 birth mothers

Similar to NPPSD targets for 2015:

7

High Maternal Mortality Size of countries according to number of maternal deaths

Source: www.worldmapper.org

Nigeria

Mat

erna

l Mor

talit

y Ra

tio

Sources: Global estimates and 2008 Nigeria Demographic and Health Survey. Goal is from National Health Strategic Development Plan 2010-2015.

MDG #5: Lower Maternal Mortality Why is Nigeria failing to meet its goal?

8

9

High Child Mortality Size of countries according to number of child deaths


Nigeria

Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s

Sources: 1990, 1999, 2003, and 2008 Nigeria Demographic and Health Surveys

MDG #4: Lower Child Mortality Why is Nigeria failing to meet its goal?

10

11

Nig

eria

n Re

gion

Photo by Joachim H

uber

Source: 2008 Nigeria Demographic and Health Survey (NDHS)

Child Mortality Rates Child deaths (under age 5) per 1,000 live births

NPPSD Targets:

Reduce the national population annual growth rate to 2% or lower

Reduce the total fertility rate by at least 0.6 children every five years

Increase the modern contraceptive prevalence rate by at least 2 percentage points each year

12

13

World Population, 1960 Size of countries according to population size


Nigeria

14

World Population, 2050 Size of countries according to population size


Nigeria

15

Birth

s pe

r W

oman

(ave

rage

)

Sources: Most recent Demographic and Health Surveys

Fertility Comparison Nigeria and selected countries

Nigeria has very high fertility compared with other nations, whether they are Muslim, Christian, wealthier or poorer, larger or smaller …

16

Current Fertility by Zone Average number of live births per woman

Source: 2008 NDHS

North West 7.3

South West 4.5

North Central 5.4

North East 7.2

South East 4.8

South South 4.7

Nigeria 5.7

17

Perc

ent o

f Mar

ried

Wom

en o

f Re

prod

uctiv

e A

ge

Sources: Most recent Demographic and Health Surveys

Modern Contraceptive Use Fertility is high mainly because contraceptive use is low

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Why?

Life

Expe

ctan

cy a

t Birt

h (y

ears

)

Source: www.gapminder.org

Health Comparison, 2010 Countries with less wealth than Nigeria have achieved better health

Bangladesh

Nigeria Chad

Senegal

Guinea Ghana

Malawi

19

Nigeria’s Vision

How Fertility Affects Development

Two Paths

Our Choice

Outline

2

4

3

1

Phot

o by

Mik

e Bl

yth

Fertility Impacts Development Because . . .

20

Phot

o by

Jere

my

Wea

te

Fertility decline helps many families out of poverty

UNFPA: “Slower population growth has encouraged overall economic growth in developing countries”

Sources: Population Matters: Demographic Change, Economic Growth, and Poverty in the Developing World. UNFPA State of the World Population, 2002

21

The Effect of High Fertility After Four Generations

5

25

125 Total = 155 Offspring After 4 Generations

A Couple

To Achieve Vision 20:20, Nigeria Can Learn from East Asia

The “Asian Tigers” achieved unexpectedly rapid development …

6.4

5.5

3.5

2.3 332

537

798

1,427

0

400

800

1,200

1,600

0

2

4

6

8

1960 1970 1980 199023

Birth

s pe

r W

oman

(ave

rage

)

Source: World Bank Development Indicators

Thailand’s Example Fall in fertility helped boost economic development

GD

P per Capita

(constant 2000 US$)

Economic Benefits Of Slower Population Growth:

Greater emphasis on the quality of life of the population rather than sheer numbers… More educational opportunities

Lower dependency ratios allowed for more savings and investment… More investment in modern agriculture

24

Phot

o by

Nes

tlé

24

25

Nigeria in Perspective

Why Fertility Affects Health

Two Paths

Our Choice

Outline

2

4

3

1

Phot

o by

Mik

e Bl

yth

25

26

“Low Fertility” Scenario: Nigeria meets its NPPSD targets Contraceptive use rises 2

percentage points each year

Takes 10 years to meet current unmet need

“High Fertility” Scenario: Nigeria’s current path

Photo by Jeffrey Smith

Phot

o by

IITA

Imag

e Lib

rary

26

5.7 5.2

2.0

0

2

4

6

2010 2020 2030 2040

Birth

s pe

r W

oman

(ave

rage

)

Source: Spectrum projections for Nigeria

Two Paths Fertility projections under two scenarios

27

Low Fertility

High Fertility

160

359

281

0

100

200

300

400

2010 2020 2030 2040

Mill

ions

of P

eopl

e


Rapid Population Growth Rises quickly under both scenarios

28

Low Fertility

High Fertility

29

1. Education

2. Health

3. Agriculture

4. Economy

Development Sectors

Photo by Mike Blyth

National Security

30

Phot

o by

Car

la G

omez

Mon

roy

Education

16

33

20

0

10

20

30

2010 2020 2030 2040

Num

ber o

f Stu

dent

s (m

illio

ns)


Primary School Students Fewer students, more resources per child

31

Low Fertility

High Fertility

22

47

28

0

20

40

2010 2020 2030 2040

Num

ber o

f Sch

ools

(thou

sand

s)


Primary Schools Fewer students, less pressure to build new schools

32

Low Fertility

High Fertility

340

723

433

0

200

400

600

2010 2020 2030 2040

Num

ber o

f Tea

cher

s (th

ousa

nds)


Primary School Teachers Fewer students, less pressure on school resources

33

Low Fertility

High Fertility

318

676

405

0

200

400

600

800

2010 2020 2030 2040

Nai

ra (b

illio

ns)


Expenditures on Primary Education Fewer students, less pressure on budgets

34

Low Fertility

High Fertility

35

Tota

l fer

tility

Rat

e

(chi

ldre

n pe

r wom

an)

Source: 2008 Nigeria Demographic & Health Survey

Fertility Declines with Increase in Education Levels of Girls Educated women have fewer children, on average

36

Phot

o by

Mik

e Bl

yth

Health

36 36

37

Too closely spaced Too young Too old Too many


High-Risk Births Cause Poor Health Births are “high risk” when…

38

Too Closely Spaced

38

Phot

o by

Rai

ner W

ozny

, Hei

nric

h Bö

ll Fo

unda

tion

39

Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s


Birth Spacing Improves Health Longer spacing leads to fewer child deaths

Years Since Last Birth

40

Unmet Need for Spacing, Limiting

UNMET NEED: When a woman expresses desire to space or limit births, but is not using any method to do so

One in five married Nigerian women has unmet need

This is more than six million couples who are not receiving services


41

Too Young or Too Old More children die when mother is younger or older

Photo by Mike Blyth

Many Girls Marry By Age 15

Among Nigerian women ages 25 to 49 years,

one in four was married by age 15


Photo by Lindsay Mgbor/D

epartment for International D

evelopment

43 Source: 2008 Nigeria Demographic & Health Survey

Teenage Girls Who Experience Pregnancy Selected states

Nigeria 23%

Photo by BBC W

orld Service

44

Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s


Child Mortality Children of younger and older mothers are more likely to die

Mothers’ Age during Childbirth

Too Many

45 45

Photo by Teseum

46

Mat

erna

l Mor

talit

y Ra

te

Source: 115 Demographic and Health Surveys and WHO/UNESCO/UNFPA.

Fewer Children, Lower Maternal Mortality 115 developing countries illustrate this point …

Nigeria

Brazil

Chad

Ghana

47

Most of the developing world is leaving Nigeria behind.

Source: Gapminder World

Lower Fertility… Fewer Child Deaths

Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s (lo

g sc

ale)

400

40

100

0

10

Births per Woman (average) 2 4 6 8

48 Source: Gapminder World



Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s (lo

g sc

ale)

400

40

100

0

10


49 Source: Gapminder World



Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s (lo

g sc

ale)

400

40

100

0

10


50

Mill

ions

of D

eath

s, C

hild

ren

unde

r 5

Photo by Joachim H

uber

Sources: Spectrum and MDG Model projections for Nigeria

Meeting Unmet Need Prevents Child Deaths During the first decade (2011–2021), meeting unmet need prevents millions of deaths

1.5 million child deaths averted

0

51

Thou

sand

s of

Mat

erna

l Dea

ths



evelopment

Sources: Spectrum and MDG Model projections for Nigeria

Meeting Unmet Need Saves Lives Mothers’ lives would also be saved (2011–2021)

31,000 lives saved

52

Mill

ions

of M

othe

rs

Expe

rienc

ing

Mor

bidi

ty

Photo by Soumik Kar Sources: Spectrum and MDG Model projections for Nigeria

Meeting Unmet Need Averts Maternal Morbidity 2011–2021

700,000+ women avert

morbidity

0.0

93

210

164

0

100

200

2010 2020 2030 2040

Thou

sand

s of

Mid

wiv

es


Midwives Required Fewer births, less pressure on midwives

53

Low Fertility

High Fertility

16

36

28

0

10

20

30

40

2010 2020 2030 2040

Thou

sand

s of

Hos

pita

ls


Hospitals Required Fewer patients, less pressure on hospitals

54

Low Fertility

High Fertility

Cum

ulat

ive

Nai

ra (b

illio

ns)


Health Expenditures Fewer patients, less pressure on budgets

55

Low Fertility

High Fertility

Cumulative Savings: Naira 47 Billion

56

1.5 million child deaths averted (MDG Goal #4)

31 thousand maternal lives saved (MDG #5)

Lower maternal and child health complications

Less burden on midwives and other resources to meet ALL the MDGs

In Summary Lower fertility in Nigeria means during the next 10 years…

Photo by Jeremy W

eate

57

Agriculture

Phot

o by

Jere

my

Wea

te

58

Rice

(bill

ions

met

ric to

ns)


Rice Consumption Lower fertility, greater food security

Low Fertility

High Fertility

About 400 million fewer metric tons of rice in the year 2040

Num

ber o

f Hec

tare

s pe

r Per

son


Arable Land per Person High fertility, less land per person over time

59

Low Fertility

High Fertility

60

Gro

wth

and

Em

ploy

men

t

Economy

Phot

o by

Edu

ard

Gre

be

172

748

953

0

200

400

600

800

1,000

1,200

2010 2020 2030 2040

Thou

sand

s of

Nai

ra


GDP Per Capita Assumes 6% real GDP growth rate

61

Low Fertility

High Fertility

Percent of Total Population

Source: National Population Commission

Age Structure Nigerian population pyramid, 2010

62

Female Male

Age

Ran

ge in

Yea

rs

Working-age Nigerians support younger and older dependents

0.84 0.78

0.48

0.0

0.5

1.0

2010 2020 2030 2040

Num

ber o

f Dep

ende

nts

per W

orke

r


Dependency Lower fertility, fewer dependents per working-age person

63

Low Fertility

High Fertility

Nee

ded

Ann

ually

(mill

ions

)


New Jobs Required Fewer new job seekers, better security

64

Low Fertility

High Fertility

65

Nigeria in Perspective

Why Fertility Affects Health

Two Paths

Our Choice

Outline

2

4

3

1

Phot

o by

Mik

e Bl

yth

Better job security and food security

Better health and education

Higher per capita GDP

Better QUALITY of life

66

The Change We Seek:



evelopment

Mr. President, please help our people plan safer pregnancies. We need to provide commodities and services for birth spacing, timing, and limiting.

In the short term, we need: Signing of the National Health Bill to help fund primary health care in Nigeria

A permanent budget line item for family planning

Release of the committed 2011 MDG funds for family planning commodities

Please attend a RAPID event for the National Assembly

67

Let’s Take Action

Photo by by Banjii

68

Thank You

The Change We Seek: Raising Our Quality of Life

RAPID Nigeria

Photo by Kate Dixon

Documents

RAPID Presentation: Population and Development Version