World Population Day 2017: What can we learn from Bangladesh?

Today marks World Population Day and this year’s theme is “Family Planning: Empowering People, Developing Nations”. It is an opportune moment to reflect and continue the conversation on demographic trends that I started through my blog on fertility decline last month.

Close on the heels of my blog, a New York Times article asserted that the “population bomb” was ticking for Lesotho and that, along with a series of droughts, it would all but take the country down. Although this Ehrich-eque formulation acknowledges Lesotho’s fertility decline since the 1970s, it still places “population growth” as the source of many ills.   No doubt fertility levels in Lesotho are still high, underscoring the importance of accessible contraception for women. But Lesotho simply does not deserve the epithet of a “cursed nation” that the article confers upon it.

The New York Times article on Lesotho brought me back to the specter of doom that was created around Bangladesh at its birth in 1971, when it earned the epithet of “basket case” from Henry Kissinger.  By halving its fertility rate from a high of 6.3 children per woman between 1971 and 2004, Bangladesh showed the world that neo-Malthusian predictions don’t usually stand up to empirical scrutiny. 
 
While Bangladesh’s success in fertility decline has already been well-covered, it deserves repeating.  That’s because it holds a lesson for both high fertility countries in Africa and for those who portend a future of doom for those countries. 

In 2008, we wrote about how Bangladesh achieved its successes in fertility decline and other attendant outcomes, in a report on gender and social transformation in the country.  We noted that a robust family planning program provided door-step delivery of contraceptives to women who had traditionally been in seclusion. Female health workers, specifically recruited and trained for the purpose, went house to house, educating women and distributing contraceptives.  As a result, the use of contraception in Bangladesh rose from a mere 8 percent in 1975 to over 61 percent in 2011. Some studies have also made the link between the microcredit movement which relied on women’s groups that could be easily reached by family planning workers.  These groups were a ready vehicle for the dissemination of the idea of smaller families, contraceptive use and peer learning.
 
Access to birth control gives women more than control over their fertility – it gives them control over their lives and it gives them choice.  In Bangladesh, control over childbearing improved both women’s health and the health of their children. 
 
The government also implemented other programs in tandem – all with the objective of overall improvement in human development. For example, a successful immunization program kept children healthier and their mothers freer.  A total sanitation drive that had salutary impact on health, hygiene and privacy.  A drive against diarrhea was undertaken partly to control epidemics that followed extreme weather events like floods and cyclones that – unfortunately a regular feature in Bangladesh.   And an increase in girls’ education meant that younger mothers were better able to care for themselves and their children, compared to previous generations. 
 
In many ways, Bangladesh’s demographic transition was also a consequence of unanticipated events and the policy response to them.  The catastrophic famine of 1974 for instance, was a turning point in social policy.  From 1975, famine prevention emerged as a policy priority and led, among other things, to investments in rural infrastructure, that served as social safety nets during the lean season or during natural disasters.  As a result, the country developed a large network of rural roads.  This meant women could now travel to secure healthcare, education and markets. 
 
Finally, while Bangladesh’s famed non-government organizations (NGOs) are often credited with its successes in women’s empowerment and overall human development, an enabling state provided both the political space and the policy architecture for NGOs to function. The partnership made for the successes which Bangladesh builds upon today, and from which Lesotho, Uganda and fragile states can learn.  On World Population Day, the world would do well to look at the example of Bangladesh, where family planning went hand in hand with women’s empowerment more generally.