1.3.1 Population growth
1.3.2 Fertility and health
1.3.3 Increasing HIV infection
1.3.4 Urbanisation
1.3.5 Displaced populations and refugees
Five major issues related to population influence the magnitude and quality of the educational development assistance problem. These are concerned with population growth, the related issues of fertility and child health, the impact of increasing levels of HIV infection, urbanisation, and the movements of displaced peoples and refugees.
Population growth remains the single most important factor in determining the long term growth of demand for educational services. It is intimately linked with the problems of providing adequate resources to meet expanded demand. Put simply in countries where the growth rate of the school age group exceeds the rate of economic growth it is clear that, ceteris paribus, larger and larger proportions of central government expenditure will have to be allocated to financing education to maintain current enrolment ratios. Without these increases, the expenditure per student will have to decline with probable consequences for the quality of what can be delivered and the access that can be provided to educational services. Improving levels of expenditure per student from their widely inadequate existing levels implies a concomitantly greater financial burden.
Population growth rates for the 6- 11 year old population in low income countries projected to the year 2000 have a weighted mean of 2.7% excluding China and India (Lockheed and Verspoor 1990:165). For Sub-Saharan Africa the weighted mean is 3.3% (World Bank 1988:158). If the school age population grows at 3.3% annually it will increase by 50% in about 12 years and double in 20 years. School age dependency rates (the number of 6-14 year olds compared to the 15-64 year old population) have generally been declining and now average about 33% across all developing countries. Sub Saharan Africa still has an increasing ratio which is approaching 50% implying that there are only two adults per school age child potentially available for employment. This has obvious implications for the resources available to support the education system. It also implies that a significant proportion of working age literate adults would have to become teachers if teacher pupil ratios are to be kept within reasonable bounds - as many as one in forty according to a recent estimate (UNESCO 1991:22).
In those countries with low population growth rates the problems of financing education systems are much less severe than elsewhere. An example is China which has achieved high participation rates partly as a result of favourable demographic changes without an excessive increase in the financing required (Lewin with Coldough 1993: Chapter 3). Overall population growth rates have fallen from 2.2% (1965-80) to 1.2% (1980-87) and are projected to remain at this low level into the next century (World Bank 1989 a: 214). More particularly the rate of growth of the 6- 11 year old age group declined from 3.3 % (1965-75) to 0.6% (1975-80). From 1980-85 the age group actually contracted at a rate of -3.9% (Lockheed and Verspoor 1990:165). This contraction is a direct result of family planning and the one child policy. The 6-11 year old age group is now expected to grow at only 0.8% for the rest of the decade.
The effects of demographic changes are still working their way through. If the projections of population growth made by the World Bank in 1984 (World Bank 1984: Table 3.3) became a reality the number of 7-12 year olds in China would reduce by 50 million between 1983-and 2000 (from 144 million to 94 million) and there would be a decline in total primary enrolments by 42 million. This would enable a gross enrolment ratio of 100 to be achieved with 70% less school places than were available in 1983. In fact the school age population has shrunk more slowly than anticipated in the early 1980's. A more recent projection (Lockheed and Verspoor 1990:165) suggests that the 6- 11 year old population will recover from a low of 122 million in 1985 to 137 million by the year 2000 - this is however comparable with the total number of school places provided in 1983. Even modest economic growth could therefore ensure rising levels of expenditure per student.
In another recent analysis we have modelled the effects of falling population growth on educational costs. A simulation model based on data derived from Sub-Saharan African education systems was constructed (Colclough with Lewin 1993: Chapter 5). In the basic model population growth was assumed as 3.3% the weighted mean for the region. Initially the model was used to show the costs of increasing primary GERs from their current value (69.5) to 100 by the year 2000 and maintaining them at this level until 2005. Primary recurrent costs increase by 100% in 2000 and by 137% by 2005. Reducing population growth lowers these costs to 71% and 87% of their 1990 values respectively potentially releasing more resources for improvements in quality. Significant reductions in the costs of secondary begin to appear after 2000 as the reduced cohort moves through the simulated system. In this model the proportion of the government recurrent budget that would need to be allocated to education in 2005 reduces by about 15% as a result of slower population growth. These effects are cumulative and ultimately, when the model returns to equilibrium, costs will grow at the new rate of population growth.
Reductions in population growth rate therefore ease the financial burdens of increased access to education and improve school age dependency rates. In those countries with very high growth rates and much lower expectations of economic growth, improving access to schools and preventing reductions in the per student expenditure on education are only likely to be possible if population growth rates moderate.
Population growth rates are closely related to fertility rates on the one hand and child survival rates on the other. A considerable body of research suggests that it is the education of females that has one of the strongest impacts on family size and on the nutritional and health status of children. More educated mothers tend to have smaller families, at least above certain thresholds of educational level (Cochrane 1979, Birdsall 1988). Claims that a secondary education for females reduces the average number of children from 7 to 3 (World Bank 1992:8) may be over optimistic but the direction of the association is no longer disputed. It may be that the conventional economic explanation stands up to analysis - that more educated women pay off higher child quality with child quantity recognising the opportunity costs of increased family size on quality, and are more efficient users of contraceptives and more productive in ensuring the quality of their siblings. This narrow view does not seem sufficient to explain the wide variety of forms that the association between maternal education and smaller family size appears to take. It is also noted elsewhere that there is an established relationship between enrolment disparities between boy and girls and overall low enrolment ratios. Closing this gap, by enrolling more girls, would potentially have the double benefit of increasing participation for what is in many countries one of the most educational underprivileged groups, and subsequently reducing the rate of growth of the school age population. These issues are discussed further in the section below on the education of girls and women.
Changes in the health status of children also have an impact on the number of school age children in ways which are likely to be complex. If more children survive the size of the age cohort will increase and if morbidity diminishes school attendance rates are likely to improve. Greater survival rates may encourage some parents to have fewer children. Which effect is dominant will depend on the interaction of several factors cultural, economic, access to family planning etc.
The greatest causes of death amongst children remain a relatively small number of preventable diseases and conditions. These are dehydration, pneumonia, tetanus, measles, and whooping cough. These five conditions will account for two thirds of all child deaths and over half of child malnutrition in the 1990's (UNICEF 1990:16). Low cost vaccines, oral rehydration therapy, and antibiotics could prevent the majority of these deaths. The technology to achieve this is widely available at reasonable cost levels. The problems are those of political commitment, access to primary health care, the provision of assistance to ease the flow of vaccines and drugs, and of education. Ignorance of simple procedures is responsible for far too many preventable cases of death and malnutrition. Oral rehydration requires no expensive ingredients, no instruments to administer, and only basic knowledge of procedure - yet it has been estimated that 2.5 million deaths occurred which could have been prevented by using ORT in 1988. Similarly much malnutrition is preventable if basic health information is widely disseminated and mothers are aware of the signs and causes. UNICEF (1990:30) reports studies which estimate that the rate of child malnutrition could be more than halved by the widespread use of simple procedures and knowledge of good practices over the next decade. The impact of malnutrition of growth and achievement is reviewed in Pollitt's (1990) recent book. The provision of basic health information, which also encourages hygienic living conditions and awareness of nutritional requirements, are central to educational development directed at poverty alleviation and the relief of unnecessary suffering.
A growing but as yet unquantified threat to public health, which may have a substantial impact on population growth, arises from the spread of the HIV virus and the subsequent development of AIDS. The number of HIV seropositive cases identified appears to be rising substantially in those countries worst affected. This presents a major challenge for educational development. A brief summary of recent research is available in the Institute of Development Studies research review Insights (Spring 1992).
If the worst prognostications prove well founded mortality rates will continue to rise both amongst 1-5 year olds infected by their parents, and amongst the most at risk groups - 15-40 year old adults. The latter is particularly critical since it is this population that is the most economically active and it is from this population that the majority of teachers in most countries are drawn. Significant increases in mortality in this group will increase the school age dependence ratio, making it much more difficult to finance educational services, will deplete the often inadequate teaching force available, and reduce the working lifetime of teachers trained at considerable cost. The Economist Intelligence Unit speculates in a Zambian study that AIDS will cause a steady increase in the incidence of breakdowns, accidents, delays and misjudgements, and output will suffer. The danger is that skilled workers, supervisors and managers will die of AIDS faster than replacements can be trained (Southern African Economist 1992:19). One Bank has already lost 55 skilled personnel since 1989 and has been forced to close some branches as a result. Some employers are now screening workers and reconsidering their education and training programmes. In Zimbabwe, where the average length of service of skilled workers with a particular company is thought to be about three years, attempts are being made to resist employment discrimination against workers carrying the virus. Many of those infected will have a productive working life that extends beyond the length of time in any particular job.
The full implications of the spread of HIV have yet to be established and there continues to be much uncertainty as to how the disease will develop and what effects it will have on population growth and health status. If mortality rates do reach the levels of the most pessimistic predictions the working age population may be decimated and the social fabric of societies severely damaged. A recent prognosis suggests that population growth rates could decline by between 1 % and 2 % as a result of increased adult and child mortality and a consequent decline in life expectancy (Anderson et al 1991). Seroprevalence rates vary widely from country to country and reliable data which might provide a comprehensive picture is largely absent. Reported rates of seroprevalence amongst pregnant urban women who have been tested range from 5% to 20% or more in Sub-Saharan Africa, amongst sex workers figures as high as 70% to 80% have been found in some populations (de Bruyn 1992:249). In some central African capitals 50% of the admissions to hospitals are now aids related (World Bank 1991).
African HIV infection occurs heterosexually. Patterns of infection vary but it appears to be most common for seroprevalence rates to be greater amongst 15-29 year old females than males, with the opposite trend amongst 30-50 year olds. In Tanzania the majority of known cases of HIV are amongst women and about a quarter of those who were pregnant and infected gave birth to infected children. About 30% of women attending ante-natal clinics in Lusaka carry the virus. In Angola child mortality is estimated to increase by 17% by the year 2000 as a result of AIDS. Women are responsible for about 70% of the agricultural production in rural areas and the burden of caring for sick children may result in declining food production. Estimates from Zambia suggest that there may be as many as 600,000 orphans by the year 2000. In Sub Saharan Africa as a whole the figure may be as high as 5 to 10 million orphans, with a further 10 million children infected with AIDS by their parents (Southern African Economist 1992). The direct costs of treatment have been estimated to range from 36% to 200% of GNP per capita (Southern African Economist 1992:4). These are substantial, especially in countries which have seen spending on health decline, and place an unsustainable burden on public health systems as the numbers infected grow.
Many countries are now introducing sex education into schools. Extensive efforts are being made to provide information on safe practices both through sex education in schools, through the primary health care system and through the efforts of NGO's in circulating free educational materials. In Zimbabwe, Zambia and Botswana Action magazine is widely available and carries health and environmental stories in comic strip form to wide audiences (see for example Action Magazine No 8). This magazine is supported by grants from ODA, SIDA, the Zimbabwe Trust and the Gabarone Round Table. Redd Barna amongst others sponsors a schools HIV/AIDS education programme which has produced over 400,000 booklets for students and teachers, a range of posters and other learning materials, has sponsored over 60 in-service training workshops, and has assisted in the incorporation of information on HIV into the school curriculum. An evaluation report (Marangwanda 1991) indicates that most of these programme objectives have been achieved. In an extensive survey of educational administrators, parents and adolescents Dzvimbo and Schatz (1992) have traced knowledge about and attitudes towards sex education directed partly towards HIV awareness and intended to lead to behavioural changes. Their data illustrates how complex and varied reactions are to the introduction of these matters into the school curriculum. Views of educational administrators, parents and students were at variance with each other and within the groups there were differences associated with different types of school mission, district authority etc. Wilson, Greenspan and Wilson (1989) illustrate that despite campaigns to provide information misconceptions remain prevalent amongst secondary school students in Zimbabwe. More than 40% of their sample believed that most people with AIDS in Africa were homosexual that HIV seropositive individuals look unhealthy and that HIV can be contracted from toilet seats and mosquitoes.
In other regions, many countries are introducing HIV related content into school curricula. To give only one example amongst many, the Community School Board in Papua New Guinea has now agreed that sex education should now be part of upper primary curriculum with the support of the Council of Churches who were previously unenthusiastic. This is a result of growing concern both with population growth and with sexually transmitted diseases (Education Now 1991:6).
A pervasive problem for educational programmes designed to promote low risk sexual behaviour is that whilst it is relatively easy to show that informational messages are being received, there is little firm evidence on the extent to which this alters risk behaviours. The analytical problems are formidable, and, in such a sensitive area, data is often inaccessible and unreliable. The analytical problems are similar to those involved in studying other risk behaviour. Recent modelling of risk assessments related to cigarette smoking identifies three sources of information that influence perception of risk. First there are prior risk assessments that individuals have derived from general attitudes and prejudices, second there are risk assessments based on direct experience and that of significant others around them, and third there are risk assessments that are influenced by information deliberately provided by educational and health organisations. It is the last element that educational campaigns may influence.
As far as smoking is concerned there is some evidence that government campaigns can influence the perception of risk in voluntary health related behaviours. Studies of smoking seem to indicate that young people are more influenced by campaigns and more likely to over estimate risks than are comparable older individuals. This is thought to be because direct and indirect experience indicates to older individuals levels of true risk, whilst information on the, adverse effects of smoking is usually unquantified but implied to be very risky (Viscusi 1991). The analytic problem becomes most acute when attempts are made to link perception of risk to actual decisions on whether to smoke. In these there often appears not to be a direct or high correlation between perceived level of risk and actual behaviour. This has part of its explanation in different dispositions to risk avoidance. Some individuals are highly risk averse, with low levels of risk influencing behaviour. Others, whose perception of risk is the same, are more inclined to accept the risk. Few studies in developing countries appear to have tried to apply risk analysis to safe sexual behaviour perhaps unsurprisingly given the difficulties in collecting data on private behaviour in areas which are often culturally very sensitive.
Whilst there appears no effective antidote, and treatment is relatively costly, educational programmes targeted at reducing behaviour thought to increase risk are an obvious option. Much is already being done in providing information packages, developing curriculum materials, and training teachers in how to introduce the topic. Evidence on the effectiveness of these efforts is beginning to emerge which indicates that messages on safe sexual practice do get across, though not necessarily to all members of target groups. It is argued in the literature that HIV prevention is a gender issue since seroprevalence rates tend to be much higher amongst certain groups of young women, the responsibilities of care for AIDS patients often fall on women, and the role of women in child care means that their health is especially important in continued reductions in child mortality and reducing the number of orphaned children (Bassett and Mhloyi 1991, de Bruyn 1992). There is therefore a case to place special emphasis on the education of girls and women about risk patterns and safe practices, alongside efforts to encourage men to be more well informed and adopt patterns of behaviour which reduce the spread of HIV.
The role donors can play in these efforts must be approached very carefully. In many societies human sexual behaviour is not regarded as a legitimate field with which governments or donors should concern themselves. Assistance for AIDS/HIV educational programmes depends on it being possible to agree on appropriate relationships which are mutually beneficial.
Urbanisation in the developing world is changing the nature of the educational challenge that confronts developing countries. In 1991 a majority (48%) of the populations of medium human development countries lived in urban areas (excluding China). Only in the lowest human development countries were rural populations predominant (71% excluding India) (UNDP 1992:136). Poverty is endemic in many of these urban areas and is often comparable to that in rural areas. Table 4 shows how urban populations are likely to grow.
It is striking that cities often produce high proportions of countries GDP. Estimates made in the early 1980's suggested that Lima in Peru, with 27% of total population was responsible for 43 % of GDP Manila with 13 % of the population accounted for 33%, Lagos with 5% of the population produced 57% of the value added by manufacturing, and Port Au Prince in Haiti with 14% of the population generated 40% of national income (UNDP 1990:86). These figures may have overstated the importance of cities to national economies since much rural production may not be traded. However since these estimates were made urbanisation has continued rapidly and the economic polarisation implied by these estimates has probably increased. In 1960 there were only three cities with a population of more than 10 million in the developing world, by 2000 there are likely to be at least 18. There were only 9 cities with a population of more than 4 million in 1960 in the developing world, by 2000 there are likely to be 50 (UNDP 1990:86).
Table 4 Rate of Increase in Urban Population 1985-2000
|
|
Urban Population |
|||
|
1985 |
2000 |
Increase |
%Increase |
|
|
Africa |
174 |
361 |
187 |
108 |
|
Asia |
700 |
1187 |
487 |
70 |
|
Latin America |
279 |
417 |
138 |
49 |
|
Oceania |
1.3 |
2.3 |
1 |
77 |
|
Developing Countries |
1154 |
1967 |
813 |
70 |
|
Industrial Countries |
844 |
950 |
106 |
13 |
|
World |
1998 |
2917 |
919 |
46 |
Source: UNDP 1990:87 Table 5.1
Both because urbanisation means that increasing proportions of the population are urban and because many of these urban dwellers are poor, shifts are implied by urbanisation in patterns educational assistance targeted on poverty alleviation. These shifts are not only of a quantitative kind. Urban environments are different to rural environments; employment opportunities have a different quality, and different types of educational provision may be thought relevant.
Displaced populations have been growing. In the Sudan, in Southern Africa, and in parts of South East Asia there are substantial flows of people driven by war, drought and famine to seek safer and more tolerable living conditions. For example more than 400,000 refugees are estimated to be in makeshift camps in Kenya coming from the surrounding countries at rates of anything up to 1000 an hour (Sunday Times 7.6.92:22), and there are almost certainly more than ten million displaced persons throughout Africa. These populations, and others like them, represent some of the most marginalised and educationally underprivileged groups whose prospects are the most bleak. The states in which they reside may or may not recognise their citizenship and are unlikely to place a high value on educational provision for either adults or children. As the numbers of refugees have grown so their social and economic characteristics have been changing. Most are now from rural, poorly educated and economically deprived backgrounds moving from one developing country to another through force of circumstance (Preston 1991). The need for emergency assistance to these groups is widely recognised. The politics of educational assistance are much more complex. The needs exist at several levels. Basic health and nutritional information is a priority to keep such populations as healthy as is feasible under difficult conditions. In some cases language and communication problems can only be solved if members of the displaced community acquire the language of their hosts.
Longer term resettlement programmes are likely to benefit from inputs that raise the educational status of these displaced populations and improve their employment prospects. It may be that because of the special characteristics of these groups, and because their status is often difficult to define, NGO's may be best placed to provide educational assistance.
