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21st May 2000

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Growing challenges

Asia faces the key issues of HIV/AIDS, family planning, adolescent sexual needs, ageing and migration in the coming century
By Tharuka Dissanaike

India's billionth citizen was born last week. Despite the media and political spotlight and celebration for the parents, it was decidedly a sobering moment for India and the rest of the world. India and China top the world's most populated countries with billion populations–a good moment to ponder on Sri Lanka's own situation and future trends in population composition.

Dr. Nibhon Debavalya, Director, Population and Rural and Urban Development, United Nations Economic and Social Commission for Asia and the Pacific outlined the population and reproductive issues for the Asian region in the coming century. Speaking at the annual session of the Population Association of Sri Lanka, Dr. Debavalya said that HIV/AIDS, family planning, adolescent sexual needs, ageing and migration will be key issues in the world's most populated region.

Enjoying better health care and physical quality of life than our South Asian neighbours and many other developing countries, Sri Lanka has certainly made great strides in controlling fertility and thereby population growth.

Due to better education and high school attendance, Sri Lankan women marry much later in life. The average age of 25.5 years is high even by western standards. Family size is largely by choice. Knowledge of contraceptive use is widespread, due to high literacy and a good health service.

Fertility, and due to it population growth, have slowed down considerably since the mid- sixties, following an explosion of numbers in the two decades preceding. "However, between 1971 and 2000, nearly 6.5 million people have been added, despite the continued reduction in the growth rate," said Dr. A.T.P.L. Abeykoon, Director, Population Division of the Ministry of Health.

The country's population density is high. The countrywide average of 289 per square kilometre is high enough, but in urban centres this ratio rockets to 3,153 in the Colombo district, 1,154 in Gampaha, 687 in Kandy and 631 in Galle.

Population pressures on the environment and natural resources are best expressed in the deforestation rate during the past century. At the turn of the century forests covered over 70 per cent of the land area but in 1989 the cover was estimated at 24 per cent. If the rate of deforestation continues it is estimated that in 2020 the country will not have more than17 per cent.

"While the forests were declining, the population increased from 3.5 million in 1900 to 16.8 million in 1989. Thus deforestation in Sri Lanka is closely linked to population growth resulting in increased human activities like shifting cultivation, timber exploitation and fuel wood," said Dr. Abeykoon.

"Population and environment are interlinked. During the first half of the century traditional practices in agriculture, forestry, fishing and mining were carried out to a degree that was well within the absorptive capacities of the eco-systems."

The demand for increased food production with dwindling land resources will force farmers to use more and more chemical fertilisers and pesticides, which would, in turn create serious environmental problems.

The link between poverty and population increase is apparent. A vicious circle spells out that statistically people with lower incomes have bigger families and in turn suffer consequences of nutritional deficiency, sanitation and health problems, lack of housing and education opportunities.

In the districts of Matara, Hambantota, Batticaloa, Amparai and Moneragala family size is generally larger than elsewhere in the country. Close to 50 % of the population of these districts has families with three or more children.

While the total percentage countrywide is at 30% from a high of 50% two decades ago, the larger family sizes of these districts (not counting the entire Northern Province) reflect the possible lack of contraceptive availability or awareness.

With increased education, family sizes decline. A mother with no education is likely to have more than four children, while a mother with more than secondary education is likely to reduce the family size to two children.

The number of sterilisations performed on both males and females is on the decline. Sterilisation is becoming less popular as a contraceptive method.

"With income levels rising, people are less likely to want to queue up at clinics to get sterilised and receive their monetary incentive," Dr. Abeykoon said.

Meanwhile, injectables are fast becoming the most popular form of modern contraceptives. But there has not been a sufficient increase in sales and distribution of modern contraceptives-the pill, IUD, injection and condom, to bridge the drop in sterilisation and represent the needs of the growing young adult population.

Indices like maternal mortality (number of deaths due to pregnancy and childbirth complications in 100,000 live births) have declined considerably due to better health care.

But in certain specific pockets of the country, the rates are still very high. The overall rate of 23 per cent is not reflected in districts like Amparai 97, Kilinochchi 143, Mannar 96.6 and Nuwara Eliya 47.

With the population increase, the spectre of malnutrition too has raised its head. "In 1993 about 25 % of children under five were suffering from chronic malnutrition (height for age) and 16% were acutely undernourished (weight for height)," said Dr. Abeykoon.

Sri Lanka's biggest future concern is its ageing population. In 30 years over 20 per- cent of our population will be aged. This is due to the baby boom of the '40s and '50s coupled with the high standard of living and better health facilities as well as the slowing down of the population growth rate.

The increasing numbers of aged people are generally regarded as a burden on the country's resources and welfare.

But Dr. Abeykoon differs. "The issue of population ageing has to be looked at in a positive light. Given the high-life expectancy, a large majority of the 60 to 70-year-olds are relatively healthy and physically fit to contribute to economic activity. Health and social care support for the elderly need to be focused on those over 70 years, whose number would double in the next 25 years."

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