I recently had the opportunity to attend a meeting at the World Bank where global health and development leaders and finance ministers from rich and poor countries met to share experiences and learning about the demographic dividend.
The concept of the demographic dividend is that when fertility rates in a country decline, fewer births take place each year, and the size of the population of individuals who are dependent on the state grows smaller.
Because there are fewer youth dependents, governments and families can save on basic needs such as health care, education, and food. This creates the opportunity for investments to be made in health, education, nutrition, and building the capabilities of this youthful population for productive enterprise, so that as they age, they become a powerful engine for economic growth.
It is conceivable that within a generation or so, a country can be transformed economically and socially, as described by the Minister of Finance from Thailand at the World Bank meeting—and as observed recently in South Korea.
Last week, I had the opportunity to visit the work that the Urban Health Initiative (UHI) is doing in Uttar Pradesh, India. It’s a world away from the halls of the World Bank. However, the importance of the principle of the demographic dividend came home to me in a powerful and personal way that day, and gave me a new appreciation for the importance of the discourse we had had at the World Bank.
Our aim in Uttar Pradesh through the UHI is to increase the use of modern contraceptives in “urban engines of change,” where women are eager to take up family planning. Our hypothesis is that adoption of modern contraception in these urban centers will stimulate a cascade of change that will extend to semi-urban and on to rural areas throughout northern India.
In the very poor, unregistered, low-caste slum in the city of Kanpur, the project is working with “peer educators” to build their capacity for supporting women in slums to create demand for modern contraceptives, while helping them to negotiate the health system to obtain affordable services.
Peer educators are from the community, and they know the women there, as well as their customs, beliefs, dreams, and aspirations. They know how to talk with them in a way that appreciates their culture, and supports them to adopt new practices in their sociocultural context.
The women I met with in Kanpur benefit from—and are extremely appreciative of—the help they receive from the peer educators. Many of the women, in their early twenties with several children, were particularly eager for sterilization in order to limit the number of children in their families and give the children they have the best opportunities possible.
It was heartbreaking, then, when a very determined 10-year old girl named Sona kept asking me if she could go to school; they had no school there because the slum was not recognized by the government.
Sona dreams constantly of the day she can have a book, and learn to read and write. The women also pleaded for a school for their children.
“Even though I can now plan my family, without education, my children will end up just like me,” one woman eloquently implored.
Clearly, then, the principles of the demographic dividend apply at family and village level as well as at country level. This also served as a poignant reminder of why, in the foundation’s Family Health program, we are seeking to integrate solutions across a variety of disciplines and sectors.
In fact, we are now determined to kindle an engagement with the foundation’s Global Libraries group about how we can more effectively work together to meet the needs of women and children in Kanpur, and in poor communities the world over.