Exploring the Link between Structural Adjustment Programs, - PDF document

Exploring the Link between Structural Adjustment Programs, Educational Discontinuities and Stalled Fertility in Sub-Saharan Africa Endale Kebede a , Anne Goujon a , Wolfgang Lutz a Affiliation: a Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/OeAW, WU) This paper is under review. Please don’t cite it. Abstract Recently, most population projections for Sub-Saharan Africa have been corrected upwards because in a number of countries the earlier declining trends in fertility rates had stalled in the years around 2000. While most studies so far have focused on economic, political or other factors prevalent around 2000, here we show that the phenomenon is likely caused by the cohorts of girls who should have entered school in the 1980s but could not do so due to cuts in social expenditures following the Structural Adjustment Programs (SAP) imposed on several African countries. These programs affected expenditures on education by governments and households and had an impact on school intake, particularly for girls. Because of the well- established strong link between female education and fertility in Africa, the fertility decline stalled when these relatively less educated young cohorts entered their prime childbearing ages around 2000. To study this hypothesis in more detail we combine individual level data from series of DHS (Demographic and Health Surveys) for 18 African countries – with and without fertility stalls – thus creating a pooled dataset of 1,831,022 births to 573,091 women for cohorts born from 1950 to 1990 by level of education. Visual and multivariate statistical analyses clearly confirm the hypothesis that the fertility stalls in the affected countries were largely caused by the cohorts of women that experienced education stalls in the context of SAP. Conversely, most countries that did not undergo such education stalls in the 1980s also did not face fertility stalls around 2000. Significance Statement Whether Sub-Saharan Africa’ s population will “only” double from 1 billion today or increase to 3 or 4 billion by 2100 will crucially depend on the future course of fertility. This will have massive implications for Africa and for the rest of the world, not least through international migration pressure and difficulties in meeting the sustainable development goals. Hence it is of highest priority to better understand the drivers of fertility decline and the reasons for its recent stall in some countries. Our finding that stalls are the late consequences of cuts in the education system in the 1980s helps to resolve the puzzle. It clearly points at the necessity to prioritize universal female education on the African continent. Keywords Fertility, Sub-Saharan Africa, education, structural adjustment programs, population projections

Introduction All human populations have entered the process of demographic transition in which first death rates start to fall due to socio-economic development and improved public health and after a lag of several decades, birth rates start to decline. During the period when death rates are already low and birth rates are still high, the populations grow rapidly. This was the case in Europe and North America around 1900 and the process subsequently spread to Latin America, East Asia and then Southern and Western Asia. In most of these regions fertility rates have already fallen to low levels, even when the population still continues to grow due to the age-structural momentum in which larger cohorts of young women still enter the reproductive ages and death rates continue to fall. Sub-Saharan Africa has been the last region to enter this demographic transition. It was only in the 1980s that birth rates started to fall in most countries, but these declines have been uneven and stalling at times. Particularly in the late 1990s and early 2000s, some sub-Saharan African countries have experienced a levelling off of their fertility decline and in some cases even saw a reversal leading to an increase( as shown in figure 1). Much has been written and speculated about this so-called stalled African fertility transition (1). The reasons for this interruption of the fertility decline in many Sub-Saharan African countries have remained a demographic mystery as little consensus exists on the causes of the stalls (2). Most of the existing studies try to link the fertility stalls to some specific period factors such as the slower trends in socio-economic development prevalent in the stalling countries (3), the low priority assigned to family planning programs in the beginning of the 21st Century (4, 5), the impact of HIV/AIDS mainly through its effect on child mortality (2, 6) and other factors related to public and reproductive health. In contrast to Figure 1: Period birth rates (births per 1000 of population) for selected African countries with stalled and non-stalled period TFR declines. these explanations , recently, Goujon et al. (7) proposed another plausible explanation focusing on cohort rather than period effects. They linked the fertility stalls around 2000 to the fact that some cohorts of women were subject to an education stall, due most likely to the adverse effects on education of the structural adjustment programs launched by the Bretton wood’s institutions in the 1980s. While Goujon et al (7) gave

only a tentative descriptive analysis based on cross-sectional period data, here we test the hypothesis systematically on cohort data constructed from a pooled individual level data of 1.831,022 births to 573,091 women based on series of Demographic and Health Surveys (DHS) in 18 countries. IMF policies, education and fertility The International Monetary Fund (IMF) and the World Bank provide low-cost financing to governments in economic turmoil, notably via lending programs, usually attached with conditionalities with which recipient countries have to comply. In the 1980s, these institutions launched the Structural Adjustment Programs (SAP), which made it possible for governments of many African countries with fiscal problems to get loans. It was a response to the post-independence African economic crises in many countries for which the World Bank mostly blamed excessive state interventions in the economy (8). Consequently, most of the conditionalities attached to the structural adjustment loans and facilities aimed at achieving balance of payments and usually included austerity measures through cutting government expenditures predominantly in the social sector or introducing user fees for those services. These budget cuts affected in particular the education and health systems, which had never been very strong in these poverty stricken countries (9, 10). The social impacts of these SAPs recommended and often imposed by IMF and World Bank have been highly controversial. While few studies have shown that adjustment lending had a positive effect on economic growth (11), there is a larger body of literature discussing the adverse consequence of SAPs on social and economic developments of the recipient countries starting soon after their implementation (12 – 15). It has also been demonstrated that the progress of improving the quantity and quality of education that had started immediately after the independence of many countries has been seriously hampered through these budget cuts (12, 16, 17). At household level it affected c hildren’s education negatively and girls suffered more as a result of discrimination in with-in household resource allocation in time of economic stress (13). These effects are also clearly visible in the cohort data presented in this study. Recently, the possible negative impact of IMF sponsored SAPs on child mortality has given rise to a controversial discussion in the pages of PNAS. Daoud et al (18) argue on the basis of a large pooled dataset from DHSs that SAPs reduce the protective effect of parental education on child health, especially in rural areas. Their models show that without SAPs living in a household with educated parents reduces the odds of child malnourishment by 38 percent, whereas in the presence of these programs the protective effect is reduced to 21 percent. Similar adverse effects are found in sanitation, shelter and health care access. In a reaction to this paper Subramanian and De Neve (19) point at the shortcomings of a purely cross-sectional approach and defend IMF policies. In particular, they point at the fact that after 2000 IMF policies and lending mechanisms have considerably changed and that under the Millennium Development Goals child health has become a priority. Interestingly, these two papers only address the changes of the protective effects of educated parents and do not discuss the first order effect that SAPs had on hampering education in the 1980s and thus reducing the proportion of educated parents, which by itself would have a sizable negative effect on child health. In addition, the papers do not address the lasting cohort effects of the SAPs on education structure nor do they mention their effects on fertility. They cover issues of the 1980s and 1990s and discuss how blame should be assigned regarding a phenomenon that is supposedly over and history.