Fewer children means better growth

Six years ago, the first truly nationwide survey of demographics and health revealed a wealth of information about the health and population of the country. It was the first to include northern Kenya as well as to look into issues like domestic violence, malaria, HIV and Aids, and others. The insights this provided into the national situation, and into regional disparities that informed it was invaluable.

Take the fertility rate: Nationally, this has fallen to 4.3 children per woman. But in North Eastern Province, the average is eight and the ideal 11 children. The survival rate for those under-five is very poor: Just last week, this newspaper ran a story about Ladhan Ali, who has buried seven of the nine children she has had. Another regional disparity unearthed.

The completion of a national population and housing census earlier this year, and the release of a demographic and health survey (KDHS 2009) yesterday, pave the way for a clearer national picture of these disparities. In these statistics lie the clues to what interventions are needed to transform Kenya into the prosperous, stable middle-income country it has the potential to be.

Two trends have our attention: the slow fall in the fertility rate in the last few years (from 4.9 child-ren per woman in 2003 to 4.3 last year) and a surprise drop in death rates for children under five (from 115 per 1,000 to 74). Both are welcome developments, but we must insist the former has to fall faster and further in coming years.

Social change

Countries where fertility rates are falling or have fallen are now booming economically. This week The Economist newspaper covers the phenomenon, writing: "Falling fertility in poor and middle-income societies is a boon in and of itself." South Korea, Brazil, Indonesia and parts of India, all nations that have reported robust or sustained growth, have seen dramatic drops in fertility rates. South Korea went from five children per woman to three in two decades, a transition that took 150 years in Britain. It is because of this social change, not just industrialisation, that per capita income has risen and prosperity been shared.

We have pushed for smaller families and increased access for all women to reproductive health information and facilities in these pages. We have also called on the leadership of the country, political and religious, to champion a renewed interest in family planning. With more than 40 per cent of pregnancies being unplanned (and in some cases unwanted), it is clear Kenyans are not in control of their future. They are counting on change in the economy alone to bring prosperity and should be warned of the danger of this.

Kenya is not a rich country. A look at available resources shows that when compared with others in Africa, the country’s resources are rather modest. Thus, expecting our largely arid and semi-arid land to support a larger population is a dangerous proposition.

This is not a Garden of Eden where people can "be fruitful and multiply" at will. Unless we can bring down the average number of children by each woman from 4.5 to something like three, impr-oving survival rates while we are at it, we can forget about security or prosperity. With a preponderance of evidence from developing countries following all stripe of economic policy that lowering fertility rates is beneficial, it has to rise to the top of the list of targets the country sets itself.

KDHS figures showing the use of contraceptives among married women at 47 per cent should not give us false comfort: It is women aged 15-20, who are usually unmarried and account for a third of all births, that we should worry about. If they have no access to contraception or information on safe sex, they will continue to add to those trapped in poverty.

Finally, the prevalence of female genital cutting is worrying. Clearly the campaigns to end the practice in various communities have only partially succeeded in some places and have driven the custom underground in others. It will likely take a generation to get rid of the practice, largely by winning over communities, not stiffer penalties. Education is key to this, and to lower fertility: Having a leader stand up for these changes today, with the payoff being a generation away, is a bold act of vision we would applaud.

 

 

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