Introduction
Population in the Development Paradigm

Yves CHARBIT

CEPED, University of Paris, France

I.1. Population and development

This book assumes that the reader has some background knowledge of demographic dynamics. In fact, these have been studied in a complementary volume1, the chapters of which focused on major demographic variables (fertility and its regulation, especially nuptiality, contraception and abortion; mortality and morbidity; and finally, international migrations), as well as on their interactions. The current prevailing paradigm of the demographic transition and a more recent theoretical development - the demographic dividend - completed this earlier volume.

In this work, population is considered in relation to major development issues. Within the scope of this brief introduction, it is impossible to account for the immense field of theories analyzing the relationships between population and development. A simple empirical illustration, based on four single indicators, is therefore proposed: one related to development and the other three to demography. The United Nations database (UN DESA 2019) provides five-yearly average values for these indicators, calculated since 1950 for all countries, continents and sub-regions.

Figure I.1. Population growth rate (in %) by income level (2015-2020 average) source: UN DESA (2019)

The development indicator provided by the World Bank ranks countries according to their income level: high (73 countries), upper-middle (54 countries), lower-middle (50 countries) and low (32 countries). In July 2020, the income brackets, in dollars, were as follows: low-income: <1,036; lower-middle income: 1,036-4,045; upper-middle income: 4,046-12,535; high-income: >12,535. The three demographic indicators are population growth rate (Figure I.1), infant mortality (the number of deaths in the last year among children under one year) (see Figure I.2) and the number of children per woman (see Figure I.3). It is important to note that there is a strong relationship between development - as measured by a country's income level - and the three demographic indicators. When wealth increases, the growth rate decreases, while infant mortality and fertility decrease. For the first two indicators, the decrease is regular across different income brackets. In contrast, low fertility in high-income countries (2.6 children per woman) diverges from the other three categories, whose comparable levels (between 5.5 and 6.6) are twice as high.

Figure I.2. Infant mortality by income level (2015-2020 average) source: UN DESA (2019)

Figure I.3. Number of children per woman by income level (2015-2020 average) source: UN DESA (2019)

Beyond this purely empirical initial observation, the broad question of the factors underpinning the relationships between population and development must be addressed through two questions. How can development reduce mortality? How can it reduce fertility?

I.1.1. Development and the decline in infant mortality

Infant mortality is particularly sensitive to poverty and, more generally, to family living conditions. It is important to draw a distinction between two levels, that of macroeconomic development, which is analyzed at the state level, and that of social development, where the relevant unit of analysis is the family.

At the state level, development enables investment in health, whereas in the absence of development, this is generally not prioritized over other forms of investment. Improved healthcare provision results from the creation of infrastructure: hospitals, health centers and mobile teams to support the most isolated populations. Indeed, in the absence of development, healthcare services are concentrated in large cities, to the detriment of small towns and rural areas. The creation or improvement of transportation, as well as access to drinking water and a functioning sewage and wastewater disposal system all contribute to the reduction of gastrointestinal infections. Finally, if there are more healthcare workers who are better trained and better paid, healthcare can improve significantly.

Figure I.4. a) Drying of surgical gloves. b) Wastewater disposal problem. source: Charbit For a color version of this figure, see www.iste.co.uk/charbit/population.zip

At the family level, development influences the demand for healthcare. There are a number of positive impacts on children's health from increased incomes. This could be achieved provided that wealth created through development is not monopolized by certain groups at the expense of the mass of the population who could be left in poverty; and further, that families have sufficient resources to be able to devote part of them to their children's health, in terms of vaccination, medical visits, purchase of medicines, etc. Another positive outcome is the quantitative and qualitative improvement of food: a higher daily calorie intake and increased animal protein in the diet helps to strengthen children's resistance to disease, thereby increasing their chances for survival. For all of these reasons, infant mortality decreases when economic development occurs. Figure I.4 illustrates the wider problem of infection risks, particularly in urban areas: on the left, poor aseptic techniques (drying of surgical gloves in front of a health center in Guinea); on the right, issues with wastewater disposal (Senegal).

I.1.2. Development and the decline in fertility

As with infant mortality, the development of infrastructure contributes to the reduction of fertility in developing countries, particularly if governments are committed to implementing family planning programs that promote the use of modern contraception methods. However, availability is not sufficient if it does not correspond to demand from the population, because the acceptance of contraception by women and couples involves a fundamentally economic and sociological dimension. Indeed, decline in fertility generally occurs in a context of economic and social development, characterized by a change in women's status: education, urbanization and the development of the workforce gradually help them to move away from their traditional role in the reproductive sphere. It becomes socially acceptable to use contraception to restrict fertility, especially in cases where the four characteristics of western societies are met: a secularized mentality, confidence in science and technology and, above all, women's decision-making autonomy.

With economic and social development, women will see their status change and, over time, will no longer limit their aspirations to reproduction. Educated women oppose the traditional roles assigned to them and are instead most interested in personal development. Moreover, since education allows them to access jobs in the modern sector, they will have a salary and will therefore be able to negotiate greater autonomy with respect to their husband, and with respect to their parents in the case of single women. On the other hand, (non-religious) schooling systems convey more egalitarian models, putting these same women in contact with the western nuclear family model, more so than their illiterate counterparts. Finally, from a "technical" point of view, educated women, with better knowledge of their physiology, use modern contraception methods more effectively. For all of these reasons, educated women will be pioneers in their society: some of them are co-decision makers with their husbands on the use of contraception; others often use contraception against the will of their husband and relatives, who see it as a dangerous factor of sexual emancipation.

Figure I.5. a) A pioneer woman. b) A restricted nuclear family source: UNFPA

Figure I.5(a) illustrates - almost to the point of caricature - the profile of these pioneering, educated, urban women who are well integrated into the modern employment sector, and whom others imitate in a process of diffusion. Figure I.5(b) shows that the process in Iran has led to a restricted nuclear family model. Currently, fertility is almost at replacement level (2.15 children per woman in 2020), despite a strict natalist Islam, which has long been hostile toward contraception, abortion and female labor.

This brief mention of the relationship between development and health, and between development and education, certainly does not exhaust the complexity of interactions. The chapters that follow detail the complex and wide-ranging nature of "development issues".

I.2. Major development issues

Chapter 1 is devoted to prominent authors of the past who, between the 16th and the 19th centuries, laid the foundations for the relationships between population and development. The seven chapters that follow deal with major issues: education (Chapter 2), employment (Chapter 3), gender inequalities (Chapter 4), poverty and social inequalities (Chapter 5), migration and transfers (Chapter 6), climate change (Chapter 9) and population policies (Chapter 10). Chapter 5 addresses the choice of a child's sex before birth and complements Chapter 4. Chapter 8 focuses on the intergenerational transfers...