Introduction Introduction Chapter 5 Chapter 5
Chapter 1 Chapter 1 Chapter 6 Chapter 6
Chapter 2 Chapter 2 Notes for Indicators Notes
Chapter 3 Chapter 3 Notes for boxes Notes for boxes
Chapter 4 Chapter 4 Indicators Indicators
CHAPTER 6 Printer Friendly printer friendly version
Chapter 1 A Vision for a Sustainable Urban Future: Policy, Information and Governance

What Can We Do?

A Vision for the Urban Future

A Win/Win Approach: Social Development and Urban Growth

A Better Information Base for Decision-making

Preparing the Urban Transition: A Last Word

A Win/Win Approach: Social Development and Urban Growth

This Report has repeatedly described massive urban growth in developing regions as “inevitable”. The confluence and inertia of at least two dominant processes—globalization with its many economic and social ramifications, and population growth in rural and urban areas—make urban growth ineluctable during coming decades. This is particularly the case in Africa and Asia.

However, the speed and size of this inevitable urban growth is not fixed. If policymakers could reduce the intensity of population growth, they would have more time to address existing needs while preparing to deal with future increases in urban population.

Until now, attempts to slow urban growth have focused almost exclusively on reducing rural-urban migration, but they have rarely succeeded. Migrants keep on coming to the cities because they perceive, correctly, that, despite all the drawbacks, urban habitats offer more choices.

Attempts to slow migration fail to address the principal demographic component of urban growth, which is natural increase in urban areas (and, indirectly, in rural areas). As urbanization levels rise, natural increase accounts for a growing proportion of all urban growth. This pattern presents policymakers with an untapped win-win opportunity: reducing the rate of natural increase by improving the social conditions of the poor and advancing women’s rights.

Reducing natural increase means improving the social and economic status of the poor, ensuring that quality reproductive health services are affordable and available, and empowering women. Together, these interventions influence individuals’ fertility preferences and ability to meet them. Development empowers the exercise of human rights and gives people greater control over their lives.

There is also a clear positive linkage between development, women’s empowerment and the ability to plan one’s family effectively. Women who can decide for themselves the number and spacing of their children have more freedom to pursue work, education and community activities and to earn an income outside the home.(6)

Reducing the gender gap in education and health, and widening women’s opportunities for more varied and better-paid work, would encourage economic growth. Rising incomes, in turn, reduce gender inequality, but they do not break down all barriers to women’s participation and development.

24

REPRODUCTIVE HEALTH, UNMET NEEDS AND NATURAL INCREASE

Almost one fifth of married women in developing countries have an unmet need for family planning services. This need is more than twice as high among adolescents as it is in the general population. It remains very high in most low-prevalence regions. High levels of unmet need for effective contraception have led to 70 to 80 million uninten­ded pregnancies each year in developing countries. Addressing these preferences could reduce exposure to reproductive health risks and open possibilities for young women in education, employment and social participation.(1)

Such findings are of considerable relevance for urban growth. What would happen, for instance, if the urban poor were able to achieve their desired fer­tility levels? An illustrative exercise suggests that it would make a significant difference in the rate of growth of urban populations in developing countries.(2)Demographic and Health Survey data from two countries (Bangladesh, 2004, and Colombia, 2005) were used to estimate what it would mean for fertility if women had perfect access to reproductive health services and achieved their desired fertility size.

Under these conditions, Colombia’s projected urban population growth during the 2005-2025 period would be reduced from an average of 1.66 per cent  per year to 1.21 per cent  per year and its rural population growth would be reduced from -0.20 per cent  to -0.83 per cent.

In Bangladesh, the projected urban growth rate would be reduced from 3.38 per cent  to 3.05 per cent and its rural growth rate would be lowered even more, from 0.80 per cent  to 0.39 per cent, during that period. A lower rate of rural natural increase would evidently contribute to reducing rural-urban migration. This simulation is by no means a perfect representation of reality, but it is nevertheless suggestive.

A rise in age at marriage would also have an impact on natural increase. In most developing countries, childbearing takes place within marriage, making age at marriage a primary indicator of exposure to risk of pregnancy. Overall, among 20-24 year olds, 90 per cent of young women have their first births after marriage. In developing countries, between half and three quarters of all first births to married women are within the first two years of marriage.(3)An increase in the average age at marriage could be expected to have an important effect on fertility decline.


Advances in this domain have often been disappointing. Women continue to be disproportionately represented among the poor.  Overall, economic liberalization may have had a negative effect on poverty reduction in general and on women in particular.(7)The evolution of the health sector is particularly disappointing.(8)Moreover, a World Bank study found that services related to reproductive health are more inequitable than any other cluster of services.(9)The public health sectors designed to protect poor women are failing them in many parts of the developing world.(10)Not surprisingly then, poor urban women’s fertility is significantly higher than among non-poor urban women. Moreover, in the household, poverty inhibits the bargaining power of women who may not have the ability to implement their preferences as opposed to their spouses’. This also plays into access to reproductive health information and services.(11)

Policymakers have recognized the advantages of slowing down urban growth, but have not understood the costs and the limitations of efforts to prevent rural-urban migration. Successful urban growth reduction depends not on restricting people’s right to migrate, but on empowering people and facilitating the exercise of their basic human rights, including the right to reproductive health.


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