Driving from Kigali into rural Rwanda, the hills that flank either side of the paved road are covered with bananas, maize, coffee, and beans under cultivation. Most Rwandans are farmers, using any bit of available land to feed their families and generate income. In this country—the most densely populated in Africa—little arable land is left untended.

In Islamabad yesterday, Secretary of State Hillary Clinton acknowledged longstanding Pakistani concerns that the U.S.’s ongoing mission in the country is solely military in nature. However, Clinton asserted at the opening of the second U.S.-Pakistan Strategic Dialogue that the “future demands a comprehensive human security, a security based on the day-to-day essentials like jobs, schools, clinics, food, water, fuel, equal access to justice, [and] strong, accountable public institutions.” To that end, she announced a $500 million assistance package earmarked largely for new agricultural and hydroelectric infrastructure development, as well as the construction of new hospitals and other health infrastructure.

Leaders from 49 African countries are meeting today in Kampala, Uganda, at the start of a scheduled week-long African Union (AU) summit on maternal and child health. Uganda is a fitting location, as it faces some of the toughest health and demographic challenges in Africa, including a very young and rapidly growing population and poor maternal health services. However, with the memory of last week’s twin bomb blasts still fresh, peace and security issues will surely be on the agenda as well.

“The role of intergenerational transfers, land, and education in fertility transition in rural Kenya: the case of Nyeri district” in Population & Environment by Karina M. Shreffler and F. Nii-Amoo Dodoo, explores the reasons for a dramatic and unexpected decline in fertility in rural Kenya. In one province, total fertility rate (TFR) declined from 8.4 to 3.7, from 1978 to 1998. The study found numerous contributing factors for this decline, which occurred more quickly and earlier than demographers expected, but land productivity seemed to be the primary motivator. A growing population and the tradition of dividing family land among sons made continuing to have large families unrealistic for these Kenyan families. “Family planning is, therefore, not the primary causal explanation for limiting the number of children, but rather serves to help families attain their ideal family sizes,” the authors conclude.

Around the world, countries from Afghanistan to Papua New Guinea to the United States are taking part in their decadal census, leading the UN Population Fund (UNFPA) to select the theme “Everyone Counts” for World Population Day 2010, which was celebrated on July 11.

Everyone has the right to be counted, because “censuses and population data play a critical role in development and humanitarian response and recovery,” said UNFPA Executive Director Thoraya Ahmed Obaid in her World Population Day message. Obaid added that “with quality data we can better track and make greater progress to achieve the Millennium Development Goals, and promote and protect the dignity and human rights of all people,” especially among vulnerable populations like women, girls, the poor, and the marginalized.

USAID similarly supports quality data collection, which it says plays a critical role in advancing voluntary family planning in the developing world. For the last 25 years, USAID has funded the Demographic and Health Surveys (DHS) program, which collaborates with national health ministries to collect data on family planning, child and maternal health, disease prevalence, and other health indicators.

This invaluable data is made freely available for public use, which can foster new research in the field and stimulate innovative approaches to addressing public health issues. Praising the DHS program, Gapminder Foundation Director Hans Rosling told a Wilson Center audience last year that “statistics should be the intellectual sidewalks of a society, and people should be able to build businesses and operate on the side of them.”

Accurate census counts are also important elements of “good governance, transparency and accountability,” said UN Secretary-General Ban Ki Moon in his World Population Day message. “Population data helps leaders and policy-makers to make informed decisions about policies and programmes to reduce poverty and hunger, and advance education, health and gender equality,” he said.

But no one is suggesting that coming up with reliable population data is an easy task. As Sean Peoples and Elizabeth Leahy point out in the May/June 2009 issue of World Watch magazine, issuing population projections can be a risky business:

In the 2008 Revision of World Population Prospects, the UN Population Division projects that our planet will grow to 9.15 billion people by 2050. Yet this medium-variant projection is just one of several possible scenarios released in this latest round of number crunching. The low- and high-variant projections—7.96 billion and 10.5 billion, respectively—could instead become reality, given uncertainties in the developing world due to factors such as inconsistent data collection, weak health system infrastructure, and low government capacity.

The goal, then, is to make sure everyone counts.

A new documentary film released recently by Population Action International brings attention to the plight of women across sub-Saharan Africa who lack access to basic reproductive health supplies, such as condoms and contraceptives. Funded with the support of the Reproductive Health Supplies Coalition, “Empty Handed” documents the unmet need for family planning services in the region, which has some of the world’s highest fertility rates.

This Tuesday, Dr. Rajiv Shah, administrator for U.S. Agency for International Development gave a major speech at the Center for Strategic & International Studies on USAID’s Global Health Initiative. With $63 billion earmarked for GHI over the next six years, there are high expectations for the program.

Shah laid out some details of GHI’s main priorities, which include improving family planning services, enhancing nutrition initiatives, and building stronger and broader-based healthcare systems across the developing world, with special attention paid to the health needs of mothers and their young children. He offered a number of examples of the benefits of integrating family planning with other health services for women and children, including maternal health and nutrition.

Shah did not, however, mention integrating family planning with environmental programs, the benefits of which USAID-funded programs have amply demonstrated. He also did not delve into the emerging nexus of family planning, population growth, and climate change, a subject of much discussion at last month’s Women Deliver conference in Washington, D.C.

On the other hand, Shah did say that GHI’s emphasis on improving nutrition for the world’s poor will complement another major Obama administration outreach effort, the Feed the Future initiative—repeating a point he made at the recent launch of the food security effort.

Shah also highlighted the need for establishing benchmarks for measuring success that revolve around people, not diseases. He suggested one way of achieving this would be to ensure that clinics—particularly in rural areas—broaden their mandate to offer a variety of health-prevention services, rather than providing resources that treat primarily one type of illness.

For a full transcript of Shah’s speech, click here.

More analysis of Shah’s speech and USAID’s Global Health Initiative to come in the weeks ahead.

Photo Credit: “Statesman Forum: Dr. Rajiv Shah, USAID Administrator,” courtesy of flickr user CSIS: Center for Strategic & International Studies.

Pakistan is at a major demographic crossroads. With a youth-heavy population of some 180 million and an annual population growth rate around 2 percent, the country’s population is projected to swell to roughly 335 million by mid-century. Such explosive growth raises major questions about Pakistan’s future, from looming food and water scarcity, to yawning inequalities in the nation’s educational and economic systems. Some warn that these problems threaten to drive a new generation of disaffected Pakistani youth toward political and religious radicalization.

Recently, I asked a number of leading Pakistani demographers visiting the Wilson Center how their country could best achieve more sustainable population growth rates and effectively harness the economic potential of Pakistani youth.

Educate Girls

Zeba Sathar, Pakistan country director for the Population Council in Islamabad, told me empowering girls through education represents one of the most important means of reducing the total fertility rate, which currently stands at four. “When children are educated—particularly when girls are educated—they take care of their fertility and their family size themselves,” Sathar said.

Yet securing educational opportunity for Pakistani girls has often been an uphill battle, largely due to entrenched social norms. Yasmeen Sabeeh Qazi, Karachi-based senior country adviser for the David and Lucile Packard Foundation’s Population Program in Pakistan, pointed out that a traditional preference for male children in Pakistani society has meant girls do not often receive the same level of family resources as males. This phenomenon has historically fed gender inequality, she said.

“Since boys are preferred, girls are not given the same kind of attention and nutrition, especially in the poorer and less-educated families,” Qazi told me. “But as the education level goes up, you see that this divide starts narrowing.” For Qazi, one of the keys to heightening educational access for girls is to increase both the quantity and quality of schools in rural districts, where two-thirds of Pakistanis live.

Decentralize Family Planning Services

Others I spoke with emphasized improving access to reproductive health and family planning services in rural and urban areas. The federal government’s relatively recent move to delegate operational authority for family planning services to the provincial or district level has encouraged many, such as Dr. Tufail Muhammad with the Pakistan Pediatric Association’s Child Rights & Abuse Committee in Peshawar.

Muhammad said the ongoing decentralization—which he described as “a major paradigm shift”—is meant to increase ownership of population planning policies at the local level, and therefore lead to more effective implementation because “the responsibility will be directly with the provincial government.” Once capacity is established at the local level to design and implement those policies, Muhammad added, “supervisors, administrators, and policymakers will be very close to [family planning] services.”

Manage the “Youth Bulge”

Yet despite the fact that both the public and private sectors are taking steps to address Pakistan’s growth issues, the population crunch will intensify before it potentially eases. Even assuming that greater educational opportunity for girls and increased local control over family planning services help drop Pakistan’s total fertility rate, the sheer size of the current youth bulge—two-thirds of the country’s population is under age 30—means population issues will inform every aspect of Pakistani society for decades to come.

In discussing the current state of Pakistan’s education system, some speakers also asserted that the influence of madrassas, or religious schools, over the student-aged population has often been overstated. Shahid Javed Burki, Pakistan’s former finance member and recent senior scholar at the Wilson Center, said during the panel discussion that inaccurate enrollment estimates created “the impression that the system is now dominated” by those institutions. He noted that more recent figures place madrassa enrollment at just five percent of the total student population.

With a majority of Pakistani students enrolled in regular public schools, he insisted that “public policy in Pakistan has to focus on public education” in order to prevent those students from slipping through the cracks. The problem, he added, was that “the education that they are receiving is pretty bad. It really does not prepare them to be active participants in the workforce and contribute to the economic development of the country.”

Still, most of the experts sounded optimistic about Pakistan’s potential to mitigate some of the adverse effects associated with the near-doubling of the country’s population during the next 40 years. By starting to more openly address an issue that the government and the powerful Pakistani media have long preferred to ignore, they seemed to agree the country is taking a big step in dealing head-on with its looming demographic challenges.

“I don’t look at the Pakistani population as a burden, but rather as an asset,” remarked Burki. “But it has to be managed.”

Photo Credit: “School Girls Talk in Islamabad,” courtesy of flickr user Documentally.