2010年-世界发展银行全球_Determinants_and_Consequences_of__High_Fertility___A_Synopsis_of_the_Evidence_36页_1mb

Summary of "Determinants and Consequences of High Fertility: A Synopsis of the Evidence"

Core Content

This report examines the determinants and consequences of high fertility in developing countries, focusing on its impact on health, economic growth, and the natural environment. It highlights the complex interplay between fertility levels and broader socio-economic and environmental outcomes, and explores policy options to address high fertility.

Main Points on the Implications of High Fertility (Box 1)

• Child Health: Higher-order births and closely spaced pregnancies increase the risk of infant and early childhood mortality. Children born to mothers over 40 also face higher mortality risks.
• Maternal Health: Women with five or more pregnancies have a significantly higher risk of maternal mortality. Short inter-pregnancy intervals (less than 24 months) are associated with increased under-five mortality.
• Child Schooling: Children from large families tend to attain less education due to resource dilution. In high-fertility societies, the large number of school-age children can reduce per capita educational investment.
• Economic Growth: High fertility is negatively correlated with economic growth. A decline in fertility can lead to a demographic dividend, characterized by a larger working-age population, which increases productivity and economic growth.
• Natural Environment: High fertility contributes to population growth, which exacerbates water scarcity, deforestation, soil degradation, and air pollution. It is also a factor in biodiversity loss and global warming.

Main Points on the Determinants of High Fertility (Box 2)

• Supply of Children: High fertility is associated with a large number of births and short inter-pregnancy intervals.
• Motivation: Mortality reduction has led to increased fertility in some contexts, as children are perceived as a form of insurance.
• Demand for Children: Economic and social factors influence the number of children families desire. In high-fertility countries, there is often a high incidence of unplanned and unwanted pregnancies, early pregnancies, and closely spaced pregnancies.
• Costs of Fertility Regulation: Family planning programs are essential for reducing fertility, but their effectiveness depends on access, education, and economic incentives.
• Policy Options: A range of policy interventions are proposed, including improving access to family planning services, enhancing education and economic opportunities for women, and addressing institutional barriers to fertility regulation.

Consequences of High Fertility

Health Consequences

• Child Health: Higher-order births and short inter-pregnancy intervals increase the risk of infant and early childhood mortality.
• Maternal Health: Higher parity and short inter-pregnancy intervals are associated with increased maternal mortality. Avoiding high fertility can reduce lifetime maternal risk.
• Schooling: Children from large families tend to have lower educational attainment, often due to resource dilution. The demographic experiment in Bangladesh suggests that lower fertility correlates with higher schooling completion.

Economic Consequences

• Economic Growth: High fertility is negatively correlated with economic growth. A decline in fertility can lead to a demographic dividend, which is a positive impact on economic productivity and growth.
• Demographic Dividend: It occurs in Phase II of the fertility transition, when the working-age population increases relative to dependents. This can result in increased per capita productivity.
• Conditions for Dividend Realization: A demographic dividend requires human capital investment and favorable government policies that support savings and investment. Without these, a growing working-age population may lead to unemployment and social problems.

Environmental Consequences

• Land Use: Population growth, often associated with high fertility, leads to intensive land use, deforestation, and soil degradation. These effects are more pronounced in arid regions.
• Water Scarcity: High fertility contributes to population growth, which reduces renewable freshwater availability. Many high-fertility countries face water stress or scarcity, particularly in South Asia.
• Air Pollution: Urban and rural areas experience increased air pollution due to population growth and agricultural practices such as biomass burning.
• Biodiversity Loss: High fertility and population growth lead to habitat destruction and increased human contact with species, contributing to biodiversity decline.
• Global Warming: Population growth is a significant contributor to greenhouse gas emissions, especially CO2 from fossil fuel use. Fertility reduction through family planning is a cost-effective strategy to mitigate global warming.

Policy and Research Considerations

• The report emphasizes the importance of identifying causal effects in fertility-related research, noting that endogeneity complicates analysis.
• Family planning programs are a key policy tool, but their effectiveness depends on context-specific factors.
• Development assistance for population and reproductive health has been limited in high-fertility countries, despite their developmental challenges.
• International collaboration is essential, with the World Bank and external advisory groups playing a critical role in shaping policy and research.

Conclusion

High fertility has detrimental consequences across health, economic, and environmental domains. While fertility decline is expected in most high-fertility countries, the speed and extent of this decline remain uncertain. Policy interventions that address economic and social determinants of fertility, and promote family planning, are crucial for achieving sustainable development and improving well-being.