Economic Benefits of Intervention
Contraception or family planning can yield long-term economic benefits through three main routes. One is reasonably direct and easy to quantify; the others are more complex. First, contraception can produce economic benefits by reducing maternal mortality and morbidity and improving child health—benefits that can be captured through estimates of savings to the health system.
Second, contraception can have economic payoffs if it occurs in a setting where high fertility is constraining economic growth. Longstanding arguments in development economics have centered on whether rapid population growth acts as a drag on economic growth. Some camps argued that high fertility, in particular, would condemn a country to slow (or even negative) per capita income growth. Others argued that the negative effects would be mild and short lived, as households adapt to existing resource constraints by reducing childbearing and as technological changes, such as those that result in higher agricultural yields, alter the productivity equation. By the late 1990s, however, a consensus emerged from examination of more than 40 years of experience and data: rapid population growth, in general, and high fertility, in particular, typically lead to slower economic growth and higher levels of poverty than would otherwise be realized (Birdsall and Sinding 2003).
Third, when contraception reduces the rate of population growth, it can have multiple effects (economic and other) on the environment. High fertility, coupled with rural-to-urban migration, has led to rapid urban growth, often outpacing the provision of clean water and sanitation. In an analysis of 42 cities in Latin America, Asia, and Africa, Brockerhoff and Brennan (1998) found that urban growth rates were positively correlated with infant mortality rates, likely owing to crowding, a weakening of the public infrastructure, and increased air pollution. Ambient air pollution is now emerging as a serious threat to human health in virtually all the large cities in the world, responsible for 1 percent of global deaths and DALYs (WHO 2002b).4
Population growth is also responsible for much of the increase in carbon emissions that contribute to global climate change. Although developing countries account for only 20 percent of carbon emissions today, some researchers have estimated that these countries will account for 50 percent by 2050, given current rates of development (Bongaarts 1992). Bongaarts estimated that population growth would account for 48 percent of the growth in carbon emissions in developing countries between 1985 and 2100. Birdsall (1994) estimated that realistic reductions in fertility could reduce emissions in 2050 by as much as 15 percent in developing countries; more important, however, she estimated that by reducing fertility, family-planning programs could reduce emissions more cost-effectively than taxes on carbon emissions could. Similarly, Brinkley, Potts, and Walsh (2003) found that family-planning programs are likely more cost-effective than any emissions policy. (At the same time, it is important to note that the largest per capita consumption of nonrenewable natural resources occurs in the low-fertility settings of wealthy countries, where policies promoting conservation are overdue.)
