Implications and costs of UN fertility scenarios and of meeting unmet need

Scott Moreland, Futures Group International
Ellen Smith, Futures Group International

The United Nations regularly prepares three population projections that are widely used by demographers and non-demographers alike. These are based on three fertility scenarios. However, there is a relative dearth of analyses of what would be required to realize these fertility scenarios in terms of the proximate determinants of fertility, especially family planning. This study uses the Bongaarts proximate determinants model to estimate what changes in contraceptive use are implied by each UN scenario. It also analyzes a fourth scenario in which current unmet need for family planning is met in a regionally-defined time period. This fourth scenario is based on projections of the contraceptive prevalence rate (CPR), and calculates the implied changes in TFR. Thus the future paths of CPRs and TFRs can be compared across the three UN scenarios and the fourth Unmet Need scenario. Four national population projections were prepared for each of 99 developing countries and aggregated at the regional level. Furthermore, total costs of the national family planning programs in each scenario were estimated by using regional, method-specific costs. Such analysis provides a starting point for thinking about what types and size of family planning programs might be required to reach the three UN fertility scenarios, and how much these programs might cost. The Unmet Need scenario provides a valuable comparison point, since its approach is based on current contraceptive use and desired fertility, rather than on historical fertility trends (as is the case with the UN scenarios). The results from the four scenarios can be compared to assess each scenario’s feasibility and implications for population growth. Finally, results can be used as inputs in studies looking at family planning as a cost-effective strategy in other sectors, such as to reduce future carbon emissions or educational costs.

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Presented in Session 64: Sexual and reproductive health: infertility and assisted reproductive technologies