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Famine and family planning in Africa

31 August 2012


From Dr John Moor

Sir, - The Sahel region of Africa is again in the news (17 August). Directors of different charities make suggestions about the "root causes" of famine in these parts. Factors mentioned include "high food prices and inequality" and "a food system hijacked by agribusiness corporations". Save the Children says: "we will continue to lurch from crisis to crisis unless we address the underlying drivers of hunger that children in the Sahel face every single year."

One such driver is the rapid growth of human population. In Niger, the population has risen from four million in 1970 to 16 million now. The fertility rate (average number of children per woman) is seven, the highest in the world. In Ethiopia (also experiencing food shortage), the population has doubled between 1984 and 2012 from 40 million to 80 million. Is it surprising that, with a finite area of land and many more mouths to feed, people go hungry?

Helping African women to reduce their fertility is difficult, and requires social as well as health measures, but it can be done. Throughout the 1960s, there were food shortages in Botswana. The fertility rate was six. In 1968, the newly independent government invited the International Planned Parenthood Federation (IPPF) to advise and help in this matter. IPPF recommended a three-pronged programme: that family-planning clinics should be a core part of primary health care; that special "under-five clinics" to protect and treat young children should be established; and that girls and boys should have equal educational opportunities.

The government accepted this programme, and the help from IPPF to train local men and women to execute the plan. Now, in 2012, the fertility rate is 2.8, and food shortages are a thing of the past.

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