In December 2015, Egypt's population hit 90 million. A year-and-a-half later in May 2017, the population meter on top of the Central Agency for Public Mobilisation and Statistics (CAPMAS) building in Cairo showed the population had reached 93 million. The problem is not so much the number as the rate at which the population has been growing. That growth has become faster since the 25 January Revolution. The population saw an increase of 10 million between 2011 and 2015, up from 80 to 90 million, whereas it took 50 years for it to increase from 10 million in 1900 to 20 million in 1950, according to CAPMAS statistics. But there are glimmers of hope. Despite the rapid increase in the population, there has been a drop in the number of births over the past two years, Hala Youssef, former minister of population and an advisor on population at the regional office of the United Nations Population Fund for Arab States (UNPFA), said. It is too early to find out why the population is dropping, she said, but socio-economic factors could be causing people to think twice before having another child, though it is in the rural areas that people have the most children. Since time is valuable, resources must go towards further efforts to make the rate drop further, and studies could follow or be done in parallel, she said. The government should make sure two things are in place: awareness on the part of all and proper health services at clinics, she stressed. “Awareness is not the responsibility of the Health Ministry alone. It is the responsibility of all stakeholders,” Youssef said. Efforts to control Egypt's population on the ground are not on an equal footing with the vision at a higher level. She pointed out that Egypt's constitution calls for a population-control programme. President Abdel-Fattah Al-Sisi has also been pointing to the dangers of uncontrolled population growth in speeches. However, Youssef is optimistic that the government has begun to take the population issue more seriously, pointing to a meeting with Prime Minister Sherif Ismail last week which brought together representatives of eight ministries to oversee the implementation of the National Population Strategy. Unless this issue receives more serious attention, resources will be further strained by the growing population, whether funds going towards education and healthcare, or natural resources such as water and agricultural production, Youssef stressed. For economic growth to be sufficient to serve the needs of the growing population, it would need to be more than three times larger than the present population growth. With the current population growth rate standing at 2.6 per cent, economic growth would need to be nine, she pointed out. The increase in the population growth rate over the past five years is also vitiating what had been achieved over more than 20 years of efforts in family planning. Survey results released in 2014 showed that the average number of children per woman of child-bearing age was 3.5, not three as was the case in the previous 2008 survey. The population growth rate was 2.6 per cent instead of 1.9. From 2009 to 2011, Egypt witnessed stalled fertility, meaning that the number of children a woman of child-bearing age would give birth to stalled at three over a long period of time. “There was a plateauing in fertility,” Youssef said. The government adopted a different approach to family planning in response in order to capitalise on missed opportunities to use birth control. But these efforts were interrupted in 2011 following the revolution, when services in local healthcare clinics were affected by the political situation, Youssef said. This prevented many women from going to clinics, which caused fertility to rise. Efforts to deal with population growth began again in November 2014 when then prime minister Ibrahim Mehleb launched a National Population Strategy under the auspices of President Al-Sisi. The strategy set population targets for 2030 in tandem with Egypt's Vision 2030 plan. A five-year action plan was also launched in 2015 with specific targets to achieve the strategy. The strategy targets a fertility rate of 2.4 children per family by 2030. It also targets population growth of two per cent instead of the current 2.6 per cent. These targets were based on existing resources and the ability to make birth control methods and services available, explained Youssef. The goals are achievable, Youssef said. “It is a matter of taking the decision to go through with them.” The strategy is already being implemented, but it needs to be faster and more forceful. Carrying it out should not be a piecemeal effort, but all initiatives should be carried out simultaneously, she stressed. The strategy works on various fronts, including healthcare, women, youth, education and the media. Women are important because the education of girls makes a difference in their eventual participation in the labour market. It empowers women, allowing them to decide on the number of children they want. Women who work have fewer children than non-working women, Youssef added, so it contributes to a series of factors that affect population growth. With 30 per cent of the population now aged below 29 years, young people are an important target in the strategy. They are the future, and they still prefer to have three or four children, she pointed out. She applauded the fact that Egypt has begun to look more closely at youth, including by the president focusing on youth with the launch of the Presidential Leadership Programme. His initiative had highlighted the fact that this age bracket needs more attention, but “that attention needs to be at all levels of government”. According to Youssef, a “demographic dividend” can be gained from targeting youth effectively consisting of the economic growth potential that could result from a population's age structure when the working-age population is the highest segment in society. To make the most of the demographic dividend, however, fertility must decline, Youssef explained. Greater investment must also be directed at young people. A similar policy was instituted in China, which slowed down its fertility rate while focusing on community awareness, education, employment and investment in youth. Egypt's strategy also targets the role of the media, including television, radio or social media. With the high cost of advertisements on the satellite TV channels that have the most viewers, Youssef suggested seeking help from the private sector to fund advertising campaigns. “The government cannot afford prolonged periods of ads, but the private sector can support it,” she said. Simultaneously, the government could support advertisements with personal contacts on the ground between local health visitors and women. In the past, there were two health visitors working in a radius of 5km, but the population has since increased and more health visitors are needed. She encouraged working with NGOs and the private sector to expand awareness outreach. “Awareness needs to be raised on more than one front through youth forums, mosques and churches, and to farmers and women in rural areas,” Youssef said, also suggesting that the Ministry of Social Solidarity tie in its Takaful and Karama programmes, which are conditional cash-transfer programmes aimed at the poorest families. It will be difficult to stop social support to families if they have more children because the children are precisely the ones most affected by poverty. However, Youssef said that more spacing between children could be a condition for the programmes to continue supporting these families. Besides raising awareness, Youssef said there needed to be revised laws governing the population. The child labour law needed to be revised, for example. “Children should not be allowed to work in agriculture or at home,” Youssef said, commenting on the fact that families in rural areas are known to prefer to have more children in order to help them with agricultural work. Other laws to ensure the proper implementation of measures to prevent child marriage were crucial to population control, she said. Family planning services are just as important as laws and awareness, and here it is not only a matter of availability of birth control methods but also about having the stock to last six months. There must be proper counselling services in health clinic, Youssef stressed. “If awareness was raised in tandem with the availability of birth control methods and the proper counselling services at health clinics, the contraceptive prevalence rate would increase,” she said. As far as funding is concerned, she said there was basic funding for activities to start. If more was needed, there could be enhanced cooperation with NGOs and the private sector. UNFPA was also ready to support the government on population issues, Youssef said. “We must not view the situation with pessimism,” as even entrenched cultural attitudes could change, Youssef said, referring to the current desire of many women in rural areas to have more children. She pointed out that in South Korea there had once been a preference for boys over girls, but that had changed, indicating that cultural preferences could change with time. Recent projections by the UN Population Division suggest that the population of Egypt might reach 151 million by 2050, according to a 2016 study entitled “A Population Situation Analysis” carried out by the Egyptian Centre for Public Opinion Research with the support of UNFPA and the National Population Council.
