Urban growth and water access in sub-Saharan Africa: Progress, challenges, and emerging research directions.

For the next decade, the global water crisis remains the risk of highest concern, and ranks ahead of climate change, extreme weather events, food crises and social instability. Across the globe, nearly one in ten people is without access to an improved drinking water source. Least Developed Countries (LDCs) especially in sub-Saharan Africa (SSA) are the most affected, having disproportionately more of the global population without access to clean water than other major regions. Population growth, changing lifestyles, increasing pollution and accelerating urbanization will continue to widen the gap between the demand for water and available supply especially in urban areas, and disproportionately affect informal settlements, where the majority of SSA's urban population resides. Distribution and allocation of water will be affected by climate-induced water stresses, poor institutions, ineffective governance, and weak political will to address scarcity and mediate uncertainties in future supply. While attempts have been made by many scientists to examine different dimensions of water scarcity and urban population dynamics, there are few comprehensive reviews, especially focused on the particular situation in Sub-Saharan Africa. This paper contributes to interdisciplinary understanding of urban water supply by distilling and integrating relevant empirical knowledge on urban dynamics and water issues in SSA, focusing on progress made and associated challenges. It then points out future research directions including the need to understand how alternatives to centralized water policies may help deliver sustainable water supply to cities and informal settlements in the region.

First-ever social summit struggles with toughest issues.

PIP: More than one billion people live in extreme poverty, more than 120 million are officially unemployed, and the gap between rich and poor is increasing. Now that the Cold War has ended, we are more secure about international military security on the global scale, but less secure about personal and community-related issues and problems. In this context, the heads of state from around the world will convene in Copenhagen at the first World Summit on Social Development to discuss poverty, employment, and achieving the full participation of all groups in society. This summit will be the seventh of ten global conferences organized by the United Nations this decade, but it has garnered only minimal media attention. By early February, 102 heads of state had committed to attending, but it remains uncertain at what level the US will participate. The draft declaration specifies nine commitments to which countries will, in some form, assent in Copenhagen. These commitments express social goals such as achieving full equity and equality between men and women, promoting the social development of the least developed countries, reforming structural adjustment programs, and increasing the share of the world's resources devoted to social development. A tenth commitment assuring universal access to education and basic health services remains bracketed for decision in Copenhagen.^ieng

Population doubling time: looking backward.

PIP: Using population doubling time (the number of years it would take a population to double assuming a constant growth rate), to look backward to examine when today's population totals were half their current size reveals a striking divergence in patterns of change in Africa, Latin America, and Asia. In Africa, for example, the population has doubled from 1970 to 1994 and is expected to double again in the next 24 years. Ethiopia has doubled since 1967 and will double again in 23 years. Egypt has doubled since 1964 and will double again in 31 years at its current growth rate of 2.3%. Latin America doubled its population from 1864 to 1994 and will do so again in 38 years. Mexico will need 33 years to double, but Brazil will take 43 years. In Asia, the population doubled in 33 years and will probably double again in 39 years. Japan, however, doubled in 66 years and will not double again for 183 years. Bangladesh, on the other hand, has a current doubling time of 29 years. To understand the effect of fertility change on doubling time, it is instructive to consider that the population of the world was half its current size in 1957 with a growth rate of 1.85% which would have resulted in 40 million fewer people today were it not for a temporary boast in growth rate to 2.1% in the late 1960s. Short doubling times are expected to continue in developing countries at least until the beginning of the 21st century.^ieng

Clinton administration forging population-foreign policy links.

PIP: In the US, the Clinton administration has renewed the link between global population and national security issues. These so-called "soft security issues" receive attention from the Under-Secretary of State for Global Affairs, Tim Wirth, and the senior director of the Global Environmental Affairs branch of the National Security Council, Eileen Claussen. Wirth and Claussen draft the US response to soft security issues such as environmental security, refugee and migration movements, political instability, and religious and ethnic conflict as well as the other nonmilitary threats of illegal drug trafficking, terrorism, and international organized crime. Population was first considered a foreign policy concern in the 1960s. By 1965, President Johnson decided that the US would provide family planning supplies and technical assistance to any country which asked for help. The initial justification for assuming a leading role in developing innovative population strategies for less developed countries was a humanitarian desire to forward economic development, the self-interest of maintaining access to resources, and concern that rapid growth produced more communists. Today the US remains concerned about resource access and economic development and is also wary of spill-over environmental effects, economic migration, diminished US trade opportunities, political asylum seekers and refugees, and increasing demand for US peacekeepers. It is also believed that rapid population growth leads to political destabilization. Critics of these views blame the development difficulties of less developed countries on poor governing decisions (inadequate institutions, trade barriers, or indifference). Women's reproductive rights advocates fear that using security as a rationale for population assistance could lead to restrictions on women's rights to choose the number and spacing of births. Despite such objections, the belief that population growth is an underlying problem in imploding states like Haiti, Rwanda, and Somalia has turned the attention of US policy-makers to these soft security issues.^ieng

Spotlight: Ghana.

PIP: At independence in 1957, Ghana possessed one of the strongest economies in Africa. Ghana exemplifies the problems confronted by African countries with economics that are tied to the export of natural and agriculture products, large debts to foreign countries, and rapid population growth. Ghana's population of 16 million is the second largest in west Africa, behind Nigeria. 45% of Ghanaians are under age 15, providing a built-in momentum for population growth as these young people begin childbearing. The government first adopted a population policy in 1969, but only recently is much being done to implement it. Only 13% of married women of reproductive age use contraception, and only 5% use modern methods, according to a 1988 Demographic and Health Survey. The total fertility rate is 6.2 average lifetime births per woman. High fertility plus expensive school fees and economic pressures are raising the drop-out rate of girls. 2 recent studies found that many Ghanaian men opposed their wives' desire to use contraceptives to limit family size. Policymakers are encouraging a greater involvement for men in family planning with male-to-male outreach. The country faces a number of environmental problems. At the turn of the century, forests covered most of the country. At present they cover only about a third. Logging and land-clearing activities are also a threat to biodiversity. Laws do exist to protect wild species of plants and animals, but enforcement is understaffed. The underdeveloped water supply systems make water-borne diseases, such as diarrhea and bilharzia, serious health threats. Insect-borne onchocerciasis is also a problem. High unemployment rates have forced many Ghanaians to emigrate, and, in the mid-1980s, Ghanaians increasingly headed toward England and Canada. The net migration rate is -1/1000 population. Presidential elections held in late 1992 returned Jerry Rawlings to power.^ieng

Latin America: how a region surprised the experts.

PIP: In 1960-1970, family planning specialists and demographers worried that poverty, limited education, Latin machismo, and strong catholic ideals would obstruct family planning efforts to reduce high fertility in Latin America. It had the highest annual population growth rate in the world (2.8%), which would increase the population 2-fold in 25 years. Yet, the UN's 1992 population projection for Latin America and the Caribbean in the year 2000 was about 20% lower than its 1963 projection (just over 500 vs. 638 million). Since life expectancy increased simultaneously from 57 to 68 years, this reduced projection was caused directly by a large decline in fertility from 5.9 to 3. A regression analysis of 11 Latin American and Caribbean countries revealed that differences in the contraceptive prevalence rates accounted for 90% of the variation in the total fertility rate between countries. Thus, contraception played a key role in the fertility decline. The second most significant determinant of fertility decline was an increase in the average age at first marriage from about 20 to 23 years. Induced abortion and breast feeding did not contribute significantly to fertility decline. The major socioeconomic factors responsible for the decline included economic development and urbanization, resulting in improvements in health care, reduced infant and child mortality, and increases in female literacy, education, and labor force participation. Public and private family planning programs also contributed significantly to the decline. They expanded from cities to remote rural areas, thereby increasing access to contraception. By the early 1990s, Brazil, Mexico, and Colombia had among the lowest levels of unmet need (13-24%) in developing countries. Other key factors of fertility decline were political commitment, strong communication efforts, and stress on quality services. Latin America provides hope to other regions where religion and culture promote a large family size.^ieng

Spotlight: Iraq.

PIP: Largely due to government-sponsored pronatalist measures, Iraq possesses the highest natural increase rate of any country, 3.9% a situation that could lead to serous problems in the future. Iraq's population currently stand at 19 million (75-80% are Iraqi Arabs, 15-20% Kurds, and 5% other minorities), but at the present rate of growth, it could double in less than 20 years. Prior to its recent invasion of Kuwait, Iraq was also host to about 1 million foreign workers. About 95% of the country's revenues come from oil export; agriculture accounts for only 10% of its Gross National Product. With Saddam Hussein's rise to power in 1979, Iraq embarked on a plan of rapid population growth, seen as necessary step to better exploit the country's agricultural and mineral resources. Among the pronatalist measures, the government grants women 100% paid maternity leave during the first 10 weeks and restricts access to contraceptives. The aim is for married women to have at least 4 children. Besides increasing fertility, the government has also succeeded in lowering mortality levels by improving maternal and child health care. The dramatic rise in population growth could have serious consequences. Iraq could face serious water shortages in the near future, once Turkey completes its Ataturk dam in the Euphrates river. A greater population will only place a greater demand on the availability of water.^ieng

Mexico.

PIP: Results of Mexico's 1987 National Survey of Fertility and Health (ENFES) shows significant changes in total fertility rates (TFR) and contraceptive prevalence rates. These changes are due i large part to the institutionalization of a population policy enacted in 1972 that has continued to receive strong support from the government. The TFR declined from 6.3 to 3.8 with urban rates falling 50% and rural rates 3/4. Between 1976-86 use of modern contraception doubled, going from 23-45%. Use of the pill declined while female sterilization increased for 9-36%; IUD's remained the 2nd most popular method at 18%. Contraceptive prevalence rates mirror changes in desired family sizes; women between 15-19 now desire 2.6 children while women at the end of their reproductive cycle expect to have 4. Infant mortality rates dropped from 85 to 47/1000 between 1970 and 1987. 62% of illiterate women wish to stop childbearing as compared with 49% of women with secondary schooling. This difference is related to differences in the ages of the 2 groups; as education has spread, women without any schooling tend to be older and have higher parity; and in spite of wanting to stop childbearing, they are 10 times less likely to use contraception than their more educated counterparts. 67% of the women interviewed received prenatal care from a doctor, with higher rates among the urban population. Between 80-90% of women breastfed their children, with higher rates among the rural poor.^ieng

Mauritania.

PIP: Mauritania is a West African country with a population of 2.0 million as of mid 1989. It has a land area of 397,950 square miles yielding a low density of 5 persons/square mile. The birth rate is 46/1000 and the death rate is 20/1000, yielding a rate of growth of 2.7% annually. The fertility rate is 6.5 children/woman and the infant mortality rate is 132/1000 live births. The country is divided ethnically between Moors, people of Arab descent, and blacks, people of African descent. This creates tension and the country has suffered from racial violence. Following several years of drought, the population has shifted from the rural areas to the more populated areas. The resultant reduction in food production has caused Mauritania to become increasingly dependent on imported food and international aid. Currently the government has no official family planning program short of attempting to reduce infant mortality. Further, it welcomes population growth as a tool in aiding development. Currently only 1% of women use contraceptives; although a recent proclamation by the Islamic leaders has removed any moral or religious objections to the widespread use of contraceptives.^ieng