Population policy and family planning communication strategies in the Arab States region. Volume II. State of the art in the Arab world

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2 Population policy and family planning communication strategies in the Arab States region Volume II State of the art in the Arab world By Saad Gadalla, Professor and Director Social Research Center The American University in Cairo and Hanna Rizk, Demographic Consultant Social Research Center The American University in Cairo Unesco

3 CONTENTS Page Preface 5 I. Overview of the Demographic situation in the Arab world 7 II. Demographic profile of selected Arab countries 25 III. Literature review, gaps in knowledge and research directions 45 Conclusion 55 Appendix: Updated demographic data for Arab states 57 SS82/WS/7 3

4 PREFACE The present manuscript represents Volume II of the report on Population Policy and Family Planning Communication Strategies in the Arab States Region. The report is based on a project conducted under contract between the United Nations Educational, Scientific and Cultural Organization (Unesco) and the Social Research Center (SRC) of the American University in Cairo (AUC). Dr Saad Gadalla, Professor and Director of SRC, served as Research Director and Principal Investigator of the project. As stated in Volume I of the report, the project aimed at: (1) compiling and highlighting research findings pertinent to the development of population policies and family planning programmes in the Arab states region; (2) interpreting these findings with a view to their utilization in planning, developing and implementing family planning communication strategies; (3) providing directions for feeding interpreted research results into ongoing and proposed family planning communication programmes; and (4) identifying major trends in population research in the region with a view to locating gaps in knowledge and recommending immediate research needs. In Volume I of the project's report, Summaries of Pertinent Literature and Research Studies, we identified, classified and summarized the 459 works selected for inclusion in the project in order to highlight research findings relevant to population policies and family planning programmes in the Arab states region. In the present manuscript, Volume II of the report, we are presenting: (1) an overview of the demographic situation in the Arab world with demographic profiles of selected Arab countries; and (2) a critical review of the findings and interpretations reported in the works summarized in Volume I, with emphasis on providing directions for their utilization, identifying gaps in knowledge, and ascertaining immediate research needs. The authors wish to acknowledge with appreciation the valuable editorial assistance of Marie Butler Schuster in the preparation of this manuscript. 5

5 CHAPTER I OVERVIEW OF THE SITUATION IN THE ARAB WORLD INTRODUCTION The end of the First World War marked the beginning of a process of political, economic and social change in several countries in the Arab world. The process gained momentum in the following two decades, infiltrated to most countries of the region and, by the midcentury, became a strong movement for modernization in basic ways of life. Common characteristics of the change included national struggle for achieving and maintaining political freedom, ambitious plans for the development of the economy, programmes for the spread of education and expansion of social and health services to a broader sector of society. One of the most dramatic concomitant changes has been with respect to the size, rate of growth, composition and distribution of population in the Arab countries. * Although the pattern and trend of change in the population events are not widely different in the Arab countries, the dimensions of change and its consequences are not of the same magnitude, due to differences in socioeconomic conditions, resources and stage of development in the various countries. A detailed analysis of the demographic situation in the Arab world is a difficult, if not an impossible, task. Basic demographic information is not available for many countries of the region, and is not reliable for the few countries which have statistical data. Most Arab countries began to conduct censuses only during the last decade or two, with the exception of Egypt which took its first complete census in 1897 and continued to conduct decennial censuses since then. However, improvement in census taking and vital statistics is essential in practically all countries of the region. Increasing numbers of Arab countries have taken advantage of the attempts made by the United Nations to cooperate in carrying out the first world census programmes around 1950, and in 1960 and Also, efforts to develop and improve vital statistics systems have been promising in a number of countries, but it must be admitted that such systems are still far from adequate in providing accurate estimates of birth and death rates. In countries lacking reliable vital statistics, estimates based on sample surveys, or derived from census data, have become available in recent years. For all these reasons, the analysis presented in this chapter depends heavily on estimates made by the United Nations. The discussion of the population situation in the Arab world in this chapter includes five aspects, namely: (1) the population size and population growth; (2) the sex and age structure; (3) the demographic variables affecting population growth; (4) the consequences of population trends; and (5) the status of population policies and family planning programmes. Further discussion will include an analysis of population growth for achieving the development goals in the Arab region as a whole. A. Population size and population growth During the last quarter of the century ( ), the Arab world has been passing through an era of rapid population growth. Before this period, during the first three decades of this century, the rate of growth was close to 1 per cent ayear. During the fourth decade, the annual growth rate grew to about 2 per cent. Since 1950, the rate of growth has continued to rise to a level ranging between 2. 5 per cent and 3. 5 per cent annually. The rate of growth, however, was not uniform in all the Arab countries during this period ( ). The population growth ranged from a minimum of 67 per cent in Mauritania, 73 per cent in Somalia and 83 per cent in Saudi Arabia, 1. The population of the Arab world in this study includes the total population of the Member States of the Arab League. These countries are Algeria, Arab Republic of Yemen, Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libyan Arab Jamahiriya, Mauritania, Morocco, Oman, Palestine (Gaza), People's Democratic Republic of Yemen, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia and United Arab Emirates. 2. United Nations. The Determinants and Consequences of Population Trends, Vol. I, New York, 1973, p United Nations World Population Prospects: As assessed in 1968, New York,

6 the Arab Republic of Yemen and the People's Democratic Republic of Yemen, to a maximum of 199 percent in Palestine (Gaza). The exceptionally high growth of 613 per cent in Kuwait was mainly due to heavy immigration. As indicated in Table I, in 1950, the population of the Arab world was estimated at million and in 1975 the population reached million. Almost one half of the countries of the Arab world attained a population growth of over 100 per cent during the last twentyfive years ( ). The total population of countries which increased during the period by less than 85 per cent was 21,575,000 in 1975, or oneseventh of the total Arab population. However, these countries are currently moving rapidly to higher rates of population growth. Since 1950, the rates of population growth in the Arab countries have been steadily rising except in a few countries where the rate of growth remained stable due to continued high mortality rates (the Arab Republic of Yemen and the People's Democratic Republic of Yemen) or to reduction andfluctuationin fertility rates (Lebanon and Egypt). The remaining Arab countries had relatively high birth rates in 1950 and continued to grow consistently during the following twentyfive years as indicated in Table II. This pattern of growth is in contrast to the observed pattern in the developed countries where the growth rates were relatively low in 1950 and continued to decline during the third quarter of the century. The population growth rates in the developed countries were close to 1. 3 per cent in 1950 and were reduced to 1. 1 in The general trend in population change in the Arab world indicates that the high rate of growth will remain at its present level till 1985 before it may level off. The estimated growth during the decade will be about 59 million people. Thus, the population of the Arab worldis expected to increase from million to million during this period. B. Sex and age structure The high rate of growth has had a considerable effect not only on the size of the population but also on its sex and age structure. Countries differ in the way their populations are distributed in the various sex and age categories due to differences in birth and death rates and the extent and pattern of migration. In addition, the sex and age structure of a population has significant demographic, economic and social implications as it affects not only fertility and mortality rates, but also dependency and labour force ratios which, in turn, affect the levels of consumption and production. Sex structure: The sex ratio (the number of males per 100 females) at birth is most commonly around 105, varying with a fairly narrow range from country to country. However, since mortality rates in the different agegroups are usually greater among males than among females, the sex ratio tends to be gradually reduced with age, eventually falling below 100. In 1975, the sex ratio in the total population of the Arab countries was and in the three broad agegroups of young dependants (under 15), producers (1564) and old dependants (65 and over), was 103.5, and 89 respectively. There is no significant difference in the sex ratio among the Arab countries, except for Kuwait, with a sex ratio of due to selectivity in immigration. The sex ratio in the three broad agegroups in four different Arab countries (Egypt, Saudi Arabia, Algeria and Iraq) are outlined in Table HI. The effect of civil war in Algeria and the excess of male emigration over female is reflected in the low sex ratio of the productive agegroup. The sex ratios in the other three countries are not different from the ratios in the remainder of the Arab states. Age structure: Census reports on age are subject to errors arising from a variety of causes. These include deliberate misstatement, a tendency to report ages ending in certain preferred digits (0 or 5), and ignorance of correct age, particularly when illiteracy rates are high, and where birthdays are not celebrated. Within these limitations an approximate picture of age structure in the Arab world will be presented. The Arab countries are characterized by a relatively higher proportion of children and a lower proportion of old people, reflecting higher fertility and higher death rates than in the developed countries. The age distribution of the Arab population classified by the three broad agegroups is shown for the individual Arab countries in Table IV. It is obvious that age structure in the Arab countries is widely different from that of the developed countries. In 1970, the agegroup under 15 constituted 26.8 per cent of the total population of the developed countries, the agegroup 1564 was 63.5 per cent and the agegroup 65 and over was 9.6 per cent of the total. The corresponding figures for the Arab countries were per cent, per cent and 3. 1 per cent, respectively. The young dependency ratio in the developed countries was and in the Arab countries the ratio ranged from 78.5 in Egypt and 75.3 in Mauritania to 103 in the Libyan Arab Jamahiriya and in the Syrian Arab Republic. The age structure of the Arab countries is shown graphically by a population pyramid showing the different frequencies of each sex at the different agegroups. The age composition of a population has demographic and economic implications and it is itself a product of the levels and trends of birth and death rates in the past. The age structure of the Arab population contains a large percentage of young adults. Therefore, high birth rates are likely to continue for the coming two decades, unless drastic measures are taken to reduce fertility rates. The most reproductive agegroup of women, 2029 years, in 1970, will be replaced in 1980 by a group which is 42 per cent larger; and in 1990 this group will be twice as large. This means that the number of children born in 1990, other things being equal, will be double the number born in 1970 and will lead to 8

7 TABLE I. Population growth in the Arab world, Country Population (in thousands) Per cent increase Algeria Arab Republic of Yemen Bahrain Egypt Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Mauritania Morocco Oman Palestine (Gaza) People's Democratic Republic of Yemen Qatar Saudi Arabia Somalia Sudan Syrian Arab Republic Tunisia United Arab Emirates Source: United Nations World Population Prospects: As assessed in 1968, New York, 1973, pp TABLE II. Trend of population growth in the Arab countries, Country Population growth rates (per cent) Algeria Arab Republic of Yemen Bahrain Egypt Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Mauritania Morocco Oman Palestine (Gaza) People's Democratic Republic of Yemen Qatar Saudi Arabia Somalia Sudan Syrian Arab Republic Tunisia United Arab Emirates Source: Recent demographic estimate for the countries and regions of the worldu.s. Department of Commerce, 1978.

8 TABLE III. Sex ratios in selected Arab countries in broad agegroups, 1970 Sex ratio Country Agegroups Total population Under Egypt Saudi Arabia Algeria Morocco Source: United Nations World Population Prospects: As assessed in 1968, New York, 1973 (medium variant). TABLE IV. Age distribution in the Arab countries, 1970 Country Per Under years cen 15 t of total population 1564 years 65 years and over Population under 15 as percentage of persons 1564 (young dependency ratio) Algeria Arab Republic of Yemen Bahrain Egypt Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Mauritania Morocco Oman People's Democratic Republic of Qatar Saudi Arabia Somalia Sudan Syrian Arab Republic Tunisia United Arab Emirates Yemen Source: United Nations World Population variant). Prospects: As assessed in 1968, New York, 1973 (medium a high rate of natural increase. The implications of this trend in age composition critically affect development. The high dependency ratio reduces the per capita income and exerts pressure on the available investment to be used for services to meet the needs of children, and, in the meantime, deprives the industry from utilizing a substantial proportion of capital in productive facilities that may raise the per capita income. C. The demographic variables As indicated earlier, the demographic history of the region indicated that before the First World War, population growth was slow until about the beginning of the century. During the first three decades of the century, growth rates continued at about 1 per cent a year then grew to about 2 per cent annually in the fourth decade and 2.4 per cent in the fifth decade. Since the end of the Second World War, growth rates continued to accelerate in almost all the Arab countries until 1975, when the rates ranged from 2. 5 per cent to 3. 5 annually with one or two exceptions. In recent years, three patterns of population growth have been noticed in the Arab countries: (1) a group of countries (including Jordan, Iraq, the United 10

9 Arab Emirates, Oman, Qatar, Syrian Arab Republic, Palestine (Gaza), Morocco, Algeria and Libyan Arab Jamahiriya) have high and sustained levels of population growth at a rate of 3 per cent or more; (2) a second group of countries (including Saudi Arabia, Bahrain, the Arab Republic of Yemen, the People's Democratic Republic of Yemen and Mauritania) have a lower rate of growth indicating an upward movement which will soon catch up with growth levels of countries in the first group; (3) a group of countries (including Egypt, Lebanon and Tunisia) have relatively high growth rates ranging between 2. 4 per cent and 2. 6 per cent, but are tending to move down slowly. The growth or decline of a population during any given period is determined by the balance of the three demographic variables: fertility, mortality and migration. Each one of these three variables is influenced by the social and economic factors prevailing in the countries concerned, and determines the trend in population movement in the region. 1. Fertility: Adequate birth registration data are still lacking for many Arab countries. In the few countries where a registration system of vital events has been established, the available statistics proved to be inaccurate. Furthermore, there are practically no adequate data to indicate the level of birth rate among tribal populations. Therefore, it has been necessary to estimate the fertility levels from censuses and sample survey data. The available data imply that the levels of fertility in the Arab countries have been high and relatively stable. The crude birth rates are generally near or over 45 per 1, 000 population. In the few cases where available birth rates extend over several decades, there is no evidence of a significant upward or downward trend, with the exception of Egypt where the birth rate declined from 42 to 34 per 1, 000 population between However, care should be taken to avoid interpreting a reduction in the birth rate over a period of a few years as an indication that the population concerned is moving permanently to a lower level of fertility. Temporary changes in social, economic and military conditions may affect fertility levels only during the period of their occurrence. The estimated average birth rates for the first five years of the second half of the century ( ) are compared with the average birth rates twenty years later ( ) for the Arab countries where data were available as shown in Table V. It is obvious that the birth rates are persistent and no significant changes (except for Egypt) occurred during the period. Twothirds of the countries included in the table had an average birth rate in over 48 per 1, 000 of the population and only one country had a rate less than 45. Three countries experienced an increase in their birth rates during the twentyyear period. Recent studies have shown that the birth rates in the Arab countries are higher than birth rates in the developed countries before the decline of their fertility began in the middle of the nineteenth century. Much attention has been devoted to the economic, social and cultural factors which may have contributed to the high levels of fertility prevailing in the Arab countries and a number of studies have been conducted in the Arab world to reveal these factors. The conclusions of these studies seem to agree that high illiteracy rates, heavy dependence on agriculture, low standard of living, and fatalistic attitudes are among the conditions which intensify the desire for large families. The motives to have large size families are generally reinforced by religious beliefs, high mor tality rates particularly among infants, early contribution of children to the family income, and parents' need for economic security and support in old age. In response to the motives for having large families, the compulsion to marry at an early age becomes strong. The unmarried female may be considered a liability for the family. Therefore, marriage of women at an early age is almost universal, allowing for a long span of reproduction. In Egypt, for example, the census of 1960 shows that 98 per cent of women were married before reaching the end of childbearing age (under 45). The same census points out that 33 per cent of females in the agegroup 1519 were already married, and 77 per cent of women in the agegroup 2024 were also married. Almost fourfifths of the females in Egypt were married before reaching age 24. Although information on marital status classified by age is not available for most Arab countries, there is no evidence that marriage patterns are significantly different in other Arab countries. Almost all the Arab countries have been concerned about the social and economic conditions in their countries and planned developement programmes to improve all related aspects. Progress has been made and is reflected on infant mortality rates, literacy percentages, life expectancy at birth, female workers in agriculture, and the per capita gross national production. Improvements actual or potential have been made on all these fronts in almost every country. The extent of development in these five aspects, which are basic for modernization and social change and might contribute to the reduction of fertility, are shown for a period of seven years from 1968 to 1975, in Table VI. It is evident from the table that infant mortality rates have markedly declined in four Arab countries, resisted decline in four others, and experienced slight declines in the remainder of the countries. However, there is much room for improvement in practically all the countries, as infant mortality rates are still over 125 per 1, 000 inhalf of the countries. With the exception of two countries, life expectancy gained 2 to 3 years in the period. A marked progress has been made in the rate of literacy which improved by 50 per 1. Since then, Egypt's birth rate has increased steadily from 34 to 39 per 1, 000 population during

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11 TABLE V. Average annual birth rates in the Arab countries, and Country Average annual birth rate Algeria Arab Republic of Yemen Egypt Iraq Jordan Kuwait Libyan Arab Jamahiriya Morocco Oman People's Democratic Republic of Yemen Qatar Saudi Arabia Sudan Syrian Arab Republic Tunisia , Source: United Nations World Population Prospects: As assessed in 1968, New York, 1973 (medium variant). cent or more in seven countries; but the greatest improvement was made in the per capita gross national production, which was doubled and tripled during the seven years in most countries of the region and accelerated higher in the oil countries. Coupled with these changes, there were improvements in the quantity and probably the quality of health, social and educational services in the Arab countries. One of the most important questions is how far did these changes influence the levels of fertility. With the exception of Egypt and Tunisia, where the fertility rates were reported to have declined during the seven years by 23 per cent in the former country and 15 per cent in the latter, a decline of 1 to 5 per cent was observed in the total fertility of women in most countries. In the meantime there was an increase in the total fertility rates in five countries. Table VII presents the total fertility rate for each country in 1968 and in 1975 as well as the percentage change during the period. Among those concerned about rapid population growth is a group who believes that the present high birth rates would decline automatically (as was the case in the developed countries), provided economic and social conditions in the Arab world change through industrialization and educational and social development. However, it must be admitted that a considerable time lag between industrialization and economic development on the one hand, and the fall of the birth rate on the other (depending on the cultural and social settings in the areas concerned), might lead to accelerated population growth, and obstruct or delay the process of social and economic development. Furthermore, the few studies conducted in the Arab world to examine factors affecting fertility, provide evidence that education below secondary school levels has had little or no effect on fertility. These studies also show that only socioeconomic Class I, which included 5 per cent of the population, had smaller family size than the average, while socioeconomic Classes II and III had the same large family size, concluding that the influence of the socioeconomic factor on fertility levels was weak. The studies clearly indicate that only a small percentage of families have adopted the small family norm, utilized methods of family planning and used them effectively. Fertility is still uniformly high among the greatest majority of the population in the Arab world. The studies show, however, that the actual number of children born is larger than the number the respondents consider ideal and that over 50 per cent unconditionally approve of family planning. The studies indicate the need for implementing planning programmes to provide contraceptive information, supplies and services and for developing family planning communication strategies to promote contraception use among the various segments of the population. 2. Mortality: Mortality data also are lacking for many countries of the Arab world and are not accurate where they are available. However, it is reasonably certain that high mortality levels and frequent peaks of high death rates were the rule well into the twentieth century. Periodical epidemics, shortages of food supply and widespread contagious diseases, caused high death rates and slowed down population growth. The desire for modernization which prevailed in the Arab world following the First World War, and 13

12 TABLE VI. Indicators of possible influential factors in fertility change, Country Infant mortality Life expectancy Per < :ent literate Females in agriculture Per capita GNP Algeria Arab Republic of Yemen Bahrain Egypt Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Mauritania Morocco Oman People's Democratic Republic of Yemen Qatar Saudi Arabia Somalia Sudan Syrian Arab Republic Tunisia United Arab Emirates $ $ Source: Population Bulletin, Populatioi n Refe: rence B ureau, Inc. Vol.33, No.4, TABLE VII. Total fertility rates and per cent change, Country Total fertility rate (per 1,000) Per cent change Algeria Arab Republic of Yemen Bahrain Egypt Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Morocco Oman People's Democratic Republic of Yemen Qatar Saudi Arabia Sudan Syrian Arab Republic Tunisia United Arab Emirates Source: Population Bulletin, Population Référer 14

13 the ensuing changes in political, economic and social conditions, motivated a concern on the part of governments for controlling disease, improving health conditions and increasing educational facilities. Departments or ministries of public health were organized and efforts were made to establish modern sanitary systems and expand health and medical services. Great efforts were made to provide facilities for primary education and to develop institutions for higher learning. These developmental measures have made possible the prevention of epidemics and the reduction of infectious diseases, and consequently reduced death rates. The discoveries of new insecticides like DDT, antibiotics like penicillin, and vaccines like BCG combined with their widespread utilization in the Arab world following the Second World War, contributed significantly the the rapid decline in the death rates. The trend in death rates during the last two decades is shown in Table VIII, which compares the average death rate during with the corresponding average in , for each Arab country. The death rates in ranged from 21 to 31 per 1,000 population (with the exception of Kuwait where the death rate was 11.2, partly due to the age structure). In , the death rates ranged between 13 and 20 per 1,000 population. (In Kuwait, the average death rate in this period was 5.6 per 1,000.) The decline in death rates, amounting to 32 to 50 per cent in two decades, surpasses the achievement of the industrialized countries when they passed through a similar stage of development. One of the significant consequences of the rapid decline in mortality rates and the persistence of the high level of fertility rates is the loss of balance between these two variables, which had regulated population growth at a moderate level until the middle of the twentieth century. In spite of the reduction in mortality rates, theyare presently much higher than those prevail inginthe developed countries. The question has been raised as to whether the decline in death rates will continue until the rates reach the levels pre vailing currently in the developed countries. The response of many experts in the field of health is that the striking decline in mortality which has occurred in the Arab countries since the end of the Second World War has been made in the absence of basic economic and social development and was possible through the application of procedures borrowed from the developed countries. They further point out that improvement through sanitary and medical facilities is effective to a certain point beyond which it is difficult to achieve further improvement without substantial economic and social de velopment. This opinion is supported by the fact that the decline in mortality in the region has slowed in the last few years. The improvement of life expectancy in the areafrom 4043 years in to 5053 in maygain8more years in the next 10 years, but a further gain that raises life expectancy to years as in the developed countries is doubtful in the absence of substantial economic and social development. In order to gain insight into the factors con, tributing to death incidences and to determine the influence of each factor on death levels, one needs to classify deaths according to cause of death as well as several characteristics of the deceased, especially age, sex, marital status, occupation, and social and economic level. Most countries of the Arab world which report total deaths make few, if any, of these classifications. In general, with respect to sex differences, TABLE VIII. Average annual death rates and per cent change, to Country Average annual death rate Per cent change Algeria 23.9 Arab Republic of Yemen 31.8 Bahrain Egypt 21.6 Iraq 22.0 Jordan 21.0 Kuwait 11.2 Lebanon Libyan Arab Jamahiriya 22.5 Morocco 25.7 Oman 28.5 People's Democratic Republic of Yemen 31.8 Qatar 28.5 Saudi Arabia 31.8 Sudan 26.3 Syrian Arab Republic 21.4 Tunisia 22.7 United Arab Emirates Source: United Nations World Population Prospects: As assessed in 1968 (medium variant), New York, 1973, p

14 review of the mortality data compiled by the United Nations reveals that in almost all countries males have a higher mortality rate than females in each agegroup (except in some cases women of childbearing age have higher mortality rates than men within the same agegroup). As to the social and economic conditions contributing to the high levels of death, the available information indicates that high mortality is associated with low per capita income; high levels of illiteracy; large proportions of males engaged in agriculture; low ratios of physicians, nurses, and hospital beds per 1, 000 population; nutritional deficiencies; inadequacy of educational and health facilities; lack of regulations and laws for improvement of working conditions and protection of the health of children and women particularly in cities; and the deprivation of areas of pure drinkingwater supply. While epidemics and famines have been controlled in most Arab countries, infectious diseases are still the cause of high rates of deaths. In rural areas, the absence of pure water supply and sewage disposal systems contributes to the high death rates. The Arab countries have advanced considerably in their efforts to improve health conditions and reduce death rates and were able to achieve striking results. However, the levels of mortality are almost double the rates in the developed countries, and the required changes to reach the death levels in these countries demand substantial improvement of the existing economic and social conditions, which is not an easy matter in the face of rapidly increasing populations. It is possible that in some cases, the increase of population which results from a reduction of the death rate may itself seriously impede the economic efforts needed to sustain the continued reduction of death rates over a long period. 3. Migration: Migration of large numbers of people is the direct result of the social, economic and demographic conditions prevailing in the areas. The term "migration" has been defined as "moves which involve a shift in residence for substantial duration". * Therefore, the movements of tourists, of nomads, and of commuters are not considered migration. Two types of population movement have been distinguished, namely, international migration which includes movements across the borders of the emigrant's country, and internal migration which refers to the movement from one area to another within the borders of the country. Both types of movements have been increasing in recent years in the Arab world. International migration: This type of movement was not of great magnitude in the area until the beginning of the century. The Lebanese outmovement to Latin America, the United States, and to other countries in the region continued all through the first half of the century. European emigration to Algeria, Tunisia, Morocco, Libya and Egypt, amounting to two million by the beginning of the twentieth century, followed the foreign occupation of these countries. The greatest majority of the European migrants in the Arab countries returned to their homeland following the termination of occupation in the fifth and sixth decade of the century. In the meantime, many of the Algerian, Moroccan and Tunisian exiles returned to their home countries after independence. In normal times the movement of people from one country to another is primarily the direct result of inadequate economic and social opportunities in the country of emigration and superior opportunities in the country of immigration. The "pull" of the high wages and salaries in the Arab oil countries has been so strong in the last few decades that considerable numbers of engineers, teachers, doctors and academic personnel, as well as skilled labourers have moved from nonoil countries of the Arab world to the oil countries where they have taken employment and remained permanently or for long periods. Among the sending countries are particularly Jordan, Egypt, Lebanon, Syrian Arab Republic and the two Yemens. The receiving countries are Libya, Kuwait, Bahrain, Qatar, Oman, Saudi Arabia, and the United Arab Emirates. It is estimated that emigrants from Egypt alone to other Arab countries amount to 1, 500, 000 persons. Kuwait has been the country most affected by international migration. The annual population growth rate of 9 to 10 per cent in the sixties and 6 per cent in the seventies is largely due to immigration. Nearly 80 per cent of the immigrants in 1970 were Arabs: 40 per cent from Jordan, 10 per cent from Iraq, 7 per cent from Syria, 6. 5 per cent from Lebanon, 7. 8 per cent from Egypt and 7. 3 per cent from other Arab countries. The bulk of the immigrants during came from Jordan (38,000) and Egypt (17,000). From the sex ratio of immigrants was 179 males per 100 females. However, during , net immigration of females surpassed that of males, thus compensating for the earlier sex differential in favour of males. One of the consequences of intensive immigration to Kuwait is the fact that, in 1970, the nonkuwaitis (391,266) outnumbered the Kuwaitis (347, 396). International migration between Arab countries had both favourable and unfavourable effects on the sending and receiving countries. The unfavourable effects could be extenuated if the movement was controlled in the interest of both types of countries. With respect to the sending countries, the outmovement of population provided some relief of population pressure in the sending countries. Furthermore, the remittances from the emigrants have helped to improve the standards of living of the emigrants' families who remained in their country, and helped the governments by making available hard currency for payment of imports. On the other hand, emigration had detrimental effects, because of the loss of scarce highlevel manpower and skilled labourers which led to rapid rise in real wages and contributed to high cost of living in the sending countries. International migration may also affect population age 1." United Nations. The Determinants and Consequences of Population Trends, 1953, p

15 TABLE IX. Growth of urban population in the Arab countries, Country Per ce nt urban Differences in urban proportion caused by net ruralurban movement (per cent) Algeria Arab Republic of Yemen Bahrain Egypt Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Mauritania Morocco Oman People's Democratic Republic of Yemen Qatar Saudi Arabia Somalia Sudan Syrian Arab Republic Tunisia United Arab Emirates Source: Population Bulletin, Population Bureau, Inc. Vol. 33, No.4, and sex structure of the sending and receiving countries and consequently their demographic position. The Arab world suffered from forced population movement. Following the ArabIsraeli war in 1948 and 1967, there were forced massive population movements from Palestine to the neighbouring Arab countries particularly Jordan, Syrian Arab Republic, Lebanon and Gaza Strip. The exact number and location of the Palestinian refugees is not known. On 30 June 1970, a total of 1,425, 000 refugees were registered with the United Nations Relief and Works Agency (UNRWA). Of these there were 506,000 in East Jordan, 273,000 in the West Bank of the Jordan River, 176, 000 in Lebanon and 196,000 in the Syrian Arab Republic. The refugees were partly living in camps and partly scattered throughout the host countries. This movement contributed to rapid population growth in the receiving areas and motivated adverse political and economic implications. Internal migration: It is evident from available data that the volume of internal migration within each Arab country is very great and it is overwhelmingly a movement from rural to urban areas and particularly to large cities. One of the problems of comparing urbanization in the various Arab countries is the differences in the definition of the term "urban". In some countries the number of the inhabitants of an area determine whether it is urban; in others the percentage of the economically active males in nonagricultural occupations and other characteristics have been used to classify the rural and urban areas in the country. In each single country the size of the ruralurban movement maybe judged from the statistics of urban population growth which are available for most of the countries under study. Assuming that the rate of natural increase is the same in rural and urban areas or somewhat higher in the rural areas, the increase in the proportion of native population living in an urban area will indicate the magnitude of the migratory movement from rural areas. The rapid growth of urban population in the Arab world in recent years has been unmatched in the history of urbanization in the developed countries. The percentage of urban population for each of the Arab countries in the year 1968 and in 1975 is shown in Table DC; and indicates large increases in the proportion of population living in urban areas during the sevenyear period, according to the national definition of "urban" in the countries concerned. The increases in the proportion of urban to total population, in the sevenyear period, range from 10 per cent to 25 per cent with a few exceptions. There was no change in the urban proportion of Bahrain and only an increase of 6. 9 per cent in the urban proportion of Kuwait. These two states had the highest urban percentage of total population in 1968, being then 78.1 per cent and per cent, respectively. The fastest urbanization was attained in countries with least urban proportion in 1968, namely the Arab Republic of Yemen, Saudi Arabia, Oman and Qatar, where the urban proportion was 6. 2 per cent in the Arab Republic of Yemen and per cent in the other three countries. Six 17

16 of the twenty countries under report had 50 per cent or more of their populations living in urban areas. These increases must have resulted, to a large extent, from heavy migratory movements from nonurban to urban areas. In the whole region, the urban population was 22.8 per cent in 1950 and had become 40 per cent in Growth of capital cities: There has been a tendency towards an increase in urban concentration. This is due to the overwhelming importance of afew cities, especially the capital cities, which are growing more rapidly than other urban localities. The concentration of administrative, commercial, and other important functions in large cities has given them "pull" power. The weak economic infrastructure of the small and mediumsize towns has also contributed to the growing concentration of urban population in a few cities. Most capital cities of the Arab countries are growing at the rate of 5 to 6 per cent a year. Although urbanization is rapid in the Arab countries, it bears no strong relationship to industrialization. In the nonoil countries only onetenth of the labour force is engaged in manufacturing; services dominate the employment scene and the impact of industrial development is not substantial. In the oilproducing countries the growing revenues from oil have led to a more rapid pace of industrialization and related activities. Factors affecting migration: Practically no Arab country has organized a register system to keep records of the change in residence and reasons of change. Therefore precise analysis of the causes, direction, and duration of internal movement of the population is not possible. How ever, conclusions may be drawn from the social, economic and demographic conditions which may motivate a desire for movement. As is the case in international migration, the movements of people from one area to another in the same country are primarily the direct result of inadequate economic and social opportunities in the sending area and superior opportunities in the receiving area. The socioeconomic factors which have generally stimulated population movement internally are inherent in the differences between rural and urban conditions of life. Almost 60 per cent of the Arab population live in rural and/or nonurban areas. The rate of growth in the urban area has continued in the last ten years at an average rate of 4. 9 per cent, while the growth rate in the rural area in the s ame period has ranged between 1 and 2 per cent. The main causes of the population mass movement from rural to urban areas may be summarized as follows: Push factors: In rural areas the per capita crop area is too small for the population. Furthermore, according to the inheritance law, the land is broken up into holdings that are too small to support a family and hence the economic pressure for emigration. Improved agricultural techniques and the introduction of farm machinery have greatly reduced the amount of labour needed on the land. The high fertility of population in rural areas provides veritable springs of manpower that can only be drained away by migration. Because of the high fertility in rural areas, the massive outmovement does not deplete the population. The weak economic infrastructure of the small andmedium size town has contributed to the growing concentration of urban population. Pull factors: The exodus of the French after the independence of Morocco, Tunisia and Algeria provided opportunities for their replacement by the local population which involved a significant transfer of population from rural to urban areas. In the oilproducing countries, industrialization and social development have expanded rapidly and created opportunities of employment which attracted job seekers from rural areas. In all countries, eventhose with a slow industrialization process, employment opportunities and higher wages in urban areas are greater than in rural areas. The relatively better educational facilities in urban areas and the concentration of secondary and higher centres of education in cities and large towns, pressures students and probably their families to move out to urban areas. D. Consequences of population trends The rate of population growth in the Arab countries is presently 3 per cent or more in 1 3 of the 21 countries and 2. 5 to 2. 9 per cent in 5 countries. In only three countries where the death rate is high, the population growth rate is around 2 per cent and is expected to rise. The current average rate of growth doubled the population in 25 years and, in most countries, neutralized or delayed the achievement of social and economic goals. The disappointing yield of resources invested in development during the first United Nations Development Decade ( ) for the developing countries provides evidence of the negative effects of rapid population growth on developmental goals. A few illustrations of obstacles to national progress as imposed by the rapid population growth are given below: 1. Heavy dependency burden: The continuing and widening gap between high birth rates and declining death rates has not only accelerated population growth, but it has also profoundly affected the age structure of the population. In 1970, children under 15 years of age constituted 45 per cent of the Arab population. This agegroup consumes and does not produce, reducing the per capita income. In the developed countries, the ratio of dependants to labour force (agegroup 1564) is 4 to 100; the dependency ratio in the Arab world ranged from in Egypt to 106 in Syria. Under such a pattern of age structure, the maintenance of existing levels of education, health, housing, and other social amenities, causes constant pressure on the economy, diverting available domestic investment to less productive uses, and detracting from efforts to improve the quality of these services. Furthermore, the high dependency ratio reduces the family's level of living, due to its relatively low per capita income. 18

17 2. Health services: All countries in the region are concerned about expanding and improving health services for their people and appreciable progress hasbeenmade. However, the level of health services available to the individuals and the community are far below the level in the developed countries. The ratio of hospital beds, qualified physicians, and trained health personnel per 1, 000 population is still deficient when compared with the services available to the individual and community in the developed countries. There is a desperate need for training more physicians and health workers, and for providing wellequipped facilities in order to improve the distribution and effectiveness of health services needed to accommodate the needs of an evergrowing population. The rapid population growth and its demographic implications of a heavy dependency ratio curtail socioeconomic improvements which are essential for health. Furthermore, the persisting high fertility constitutes a major health problem in view of the immediate and personal impact it may have upon the health of mothers and their children. It has been noticed that women in the agegroup 20 to 40 years in the developing countries are characterized by an almost continuous nutritional drain from repeated pregnancies and lactation, and are exposed to a relatively high rate of mortality. ^ 3. Food demand and supply: In recent years there has been growing concern over the problem of food shortage in the Arab world. In spite of all efforts made in the last two decades by the countries of the region to increase food production, there has been no gain in the per capita food output. Most gains achieved by expansion of arable land and the yield per unit of land, have been largely offset by the rapid population increase causing an increasing dependency on food importation from other countries. One of the major components of food supply in the Arab world is grain (wheat, corn, rice, barley and millet). The trend in per capita grain production in twenty years ( ) in four selected Arab countries (Egypt, Syria, Lebanon and Jordan) and the factors related to it (area in United Nations Report of the Ad Hoc Consultative Group of Experts on Population Policy, E/CN9/267, p. 4. United Nations Human Fertility and National Development, New York, 1971, p. 17. TABLE X. Trend in manlandfood in Egypt, Syrian Arab Republic, Lebanon, Jordan Averages of areas sown in grain, yield per hectare Total production and per capita output: and INDEXES* Country Kind Index base average Average Egypt Area in grain Yield per hectare Total grain production Population Output per person Jordan Area in grain Yield per hectare Total grain production Population Output per person Lebanon Area in grain Yield per hectare Total grain production Population Output per person Syrian Arab Republic Area in grain Yield per hectare Total grain production Population Output per person ^Source: Calculations based on FAO Production Yearbooks for the years under study. 19

18 grain, yield per hectare, and population) have been studied and the findings are included in Table X. It is obvious from the table that during the last two decades, Egypt and Syria were able to expand their areas in grain by 9 per cent and 30 per cent, respectively, through building dams and improving the irrigation system. Jordan was able to add to its grain area 3 per cent during the period, but Lebanon experienced a loss of 47 per cent of its grain area. The yield per hectare increased in Egypt only, but declined in the other three countries, largely due to insufficient rain. During the period, the population increased by 64 per cent in Egypt, 89 per cent in Syria, 117per cent in Lebanon (largely due to Palestinian refugees), and 77 per cent in Jordan. Therefore, the per capita output of grain increased only in Egypt by 0. 5 per cent a year, but decreased in Lebanon, Syria and Jordan by 78 percent, 48 per cent and 55 per cent, respectively. Under these circumstances, the food supply situation becomes a source of concern, and necessitates serious consideration and the adoption of action policies including the population element, if deprivation and malnutrition are to be avoided. 4. Urbanization: As indicated earlier, under the pressure of high density and low income in rural areas on one hand, and the relatively high wages, opportunities of work and improved services in the urban areas, there has been a rapid unplanned, and uncontrolled population movement to large cities. The large size of the ruralurban movement has intensified the problems of housing, communications and inadequate health and social services in the urban areas. Table XI shows the difference in the rate of growth in the urban and rural areas of some Arab countries and indicates the effect of migration on population growth in urban centres. In one decade ( ) the population of Cairo, Damascus and Amman increased by 48 per cent, 58 per cent and 102 per cent, respectively. The stagnant rural economy and the high rate of natural growth have made the rural areas unable to absorb its rapidly growing population. Generally the migrant streams include a high proportion of males, young persons and educated groups. The frequency distribution of rural emigrants is highest in the ages 2024, remains high at ages 2529 years, and thereafter, the numbers rapidly decline with advancing age. The selectivity in migration is bound to affect the socioeconomic structure in the sending and receiving areas. In the urban areas, the immigrants are in excess of the available opportunities of work and hence they are forced to work in nonproductive activities for low wages which results in their living in poor quarters and contributes to the expansion of slum areas and the development of delinquency and social disorganization. The unemployment ratio is particularly higher among the agegroup 1524 and among those who received 6 to 12 years of education, most of whom are immigrants. * Unesco Office in the Arab World, "Population, Education and Development in the Arab World", Beirut, Lebanon, 1977, p TABLE XI. Indices of the levels of urbanization according to the national definition of "urban" Country Census year Per cent urban Average annual rate of growth Urban Rural Egypt Iraq Libyan Arab Jamahiriya Morocco Sudan Syrian Arab Republic Tunisia Source: Urbanization and migration in some Arab and African countries. Cairo Demographic Centre, Cairo, 1973, p

19 In the rural areas the village may suffer economic deflation, since the more energetic and dynamic groups of its people move out to the city in search of a better life. Thus, the rural areas tend to become economically stagnant and socially unattractive. The rapid ruralurban migration which characterizes the Arab world, and its social and economic consequences are largely due to the accelerated population growth caused by a high and persistent fertility, and lower and declining mortality rates. Since children under 15 years of age constitute almost onehalf of the population, a very rapid increase in the cohort entering the labour force each year is inevitable during the next 15 years. The rapid increase in labour supply will require tremendous efforts in terms of expanded employment and investment requirements. Unless the number of babies born each year is moderated, the required expense to meet their minimum needs will deprive the productive activities of necessary investment for expansion and development. 5. Education: Interest in and enthusiasm for education is one of the marked characteristics of most countries in the Arab world, and much progress has been made. Primary and secondary education are made free, and the former is compulsory in areas where sufficient schools are available. In the last 10 years ( ) numbers of primary schools were doubled in Jordan, tripled in Egypt, Iraq and Saudi Arabia, and quadrupled in Syria. Education of women is progressing at a rapid rate, narrowing the educational gap between the sexes. As an illustration, the increase of students in three years ( ) among male students in Jordan was 26 per cent in elementary schools, per cent in preparatory schools, 37 per cent in secondary schools and 89 per cent in university and higher education. The percentage increase in these four levels of education among female students in the same period was 35 per cent, 56 per cent, 73 per cent and 181 per cent, respectively. In Egypt, during the same period the percentage increase in registered female students was higher than that of male students by 8 per cent in preparatory schools, 5 per cent in secondary schools and 26 per cent in universities and higher institutions of learning. The same pattern of expansion in education applies in the other Arab countries. In spite of the efforts made in increasing educational opportunities there is still a high percentage of illiteracy. The illiteracy rate in the last decade ( ) averaged among males from 60 to 70 per cent, and among females from 85 to 90 per cent. There are wide differences in the illiteracy rates among the Arab countries. They are least in Lebanon, Jordan and Kuwait where the rates are 30 per cent, 35 per cent and 45 per cent respectively, and highest in Sudan, the Arab Republic of Yemen, and Saudi Arabia with illiteracy percentages of 85, 97 and 98, respectively. Even though, the illiteracy rate has decreased among the population over 15 years of age from 81 per cent in 1960 to 73 per cent in 1970; nevertheless the absolute number of illiterates among this agegroup has increased from million in 1960 to 49.9 million in 1970, an increase of 17 per cent. 2 The expansion in formal education is obvious from the school registration rates of population inthe ages 623 years. In 1950, the registration rate of this agegroup was 10 percent, and grew to 23 per cent in 1960, 32 per cent in 1970, and 37 per cent in However, it is evident from this information, that in spite of all efforts to provide facilities for education, twothirds of the persons of school age did not have an opportunity for school education. Most efforts made by the Arab countries in recent years to improve the quality of education have been absorbed by trying to provide for the rapidly increasing numbers at all educational levels. The studentteacher ratio in 1971 was 50 in Tunisia and 40 in Algeria and Sudan. The general studentteacher ratio in the region was 34 in 1971, in spite of increasing the number of teachers from 245, 000 in 1960 to 575, 000 in In 1970, the Arab countries expressed their determination to improve the studentteacher ratio and to raise the ratio of registration in primary schools to 100 per cent by It is estimated that, at the present rate of population growth, the primary education agegroup will increase from 19.7 million in 1970 to 29.8 million in In order to provide facilities for the enrolment of this number, teachers must increase by per cent from 1970 to The improvement of studentteacher ratio to 30 will require an additional 150,000 teachers over the half million teachers needed to teach all children of primary school age. It is inconceivable that the Arab countries can achieve this goal by The accommodation of rapidly increasing numbers is only one aspect of the problem. Improving the quality of education is essential to contribute to the social and economic goals of society. Achieving these two basic goals seems to be practically impossible under conditions of rapidly increasing population. E. Status of population policies and family planning programmes The population trends in the Arab world and their associated problems have generated increased concern that national efforts to achieve economic and social development are being thwarted. Several governments reacting to this dilemma, have adopted national policies aimed at dealing with the consequences of rapid population growth and have established programmes to moderate the T. Unesco Office in the Arab World, "Population, Education and Development in the Arab World", Beirut, Lebanon, 1977, p Ibid., p Ibid., p Unesco Annual Statistical Book, Unesco Office in the Arab World, "Population, Education and Development in the Arab Countries", 1978, p

20 growth rate. Some governments have only recently recognized the link between social and economic problems and population changes, but seem hesitant to adopt an official population policy. This may be largely due to the lack of awareness of the dimensions of the problem and/or lack of understanding of the scope, goals and intent of a population policy. Few governments regard rapid population growth as a means to achieve a position of political power and economic welfare. The misunderstanding of the scope and objectives of population policy has motivated a number of scientific organizations including wellknown scholars in economics, sociology, demography, and other related fields to formulate a definition of "population policy" in order to eliminate any existing misinterpretation. The United Nations Ad Hoc Consultative Group of Experts on Population Policy formulated the following definition: "Population policy may be defined as measures and programmes designed to contribute to the achievement of economic, social, demographic, and other collective goals through affecting demographic variables, namely the size and growth of the population, its geographical distribution (national and international) and its demographic characteristics (such as sex and age distribution)". 1 It is apparent from this definition that population policies are basically concerned with achievement of economic and social development of nations, improvement of the health and welfare of the people, and conservation and improvement of the environment. However, since the conditions may vary among countries and the pressure of problems may differ, the General Assembly of the United Nations recognized that "it is the responsibility of each government to decide on its own policy and devise its own programmes of action dealing with the problems of population and economic and social progress". Therefore, any measures and programmes designed by the government to expand economic output and social amenities through affecting the size, composition, rates of growth and distribution of the population constitute population policy. á In the countries which experience rapid population growth that impedes social and economic development, two types of population policies are recommended to meet the challenge of rapid growth and to realize the welfare of the people, namely: 1. Population responsive policy: This policy includes measures aimed at ameliorating or overcoming the effects of rapid increase in population size and density, high birth rates and high population growth rates. This type of policy is concerned with such problems as economic growth, employment, food supply, education, urbanization, building of cities and towns, and development of resources. In formulating a population responsive policy for economic development, the countries concerned must integrate into their policy the factors of population trends, the industries which may find growing markets in the developed countries, the means of agricultural technology, the sources of needed investment, and the means of technical training. The population responsive policy for education must not be limited to the problem of meeting the needs of increasing numbers of schoolage children; it should also involve adapting education to the changing needs of society, devising programmes for wiping out illiteracy among adults, and increasing opportunities and facilities for female education until the educational gap between the sexes is closed. The serious social and economic consequences of the employment problem necessitate the formulation of an employment policy which may include the following: promoting labour intensive and capital saving methods of production, increasing the proportion of highly qualified specialists and skilled workers through technical training, developing the kind of mechanization that maintains the demand for labour in rural areas and eliminating the causes of low productivity of labour. 2. Population influencing policy: This policy deals with the roots of the problem of intensive population growth. It aims at moderating the rate of population growth and improving the quality of the population through direct and indirect measures that affect reduction of mortality, morbidity, and fertility rates, and consequently contribute to social and economic progress. Under this type of policy, three interrelated programmes may be distinguished. The first programme aims at improvement of general health and reduction of mortality and morbidity by dealing with the economic and cultural factors affecting health conditions and improving family nutrition standards. Special attention is directed to the health and welfare of children and to vulnerable groups in underprivileged areas within a country. To achieve this end, sufficient numbers of physicians must be trained and medical research must be encouraged. The second related programme aims at moderating rates of rapid population growth as one of the instruments available to governments to achieve their social and economic goals and improve the welfare of their people. This aim can be realized through the establishment of family planning programm.es. The nature of, and rationale for, these programmes have been stated in resolutions made by international organizations. In 1968, the United Nations Conference on Human Rights met at Tehran and resolved that "parents have a basic human right to determine freely and responsibly the number and spacing of children". The Declaration of Social Progress and Development referring to the methods of achieving the Tehran Conference resolution, called for "the formulation and establishment 1. United Nations Report of the Ad Hoc Consultative Group of Experts on Population Policy (E/CN. 9/267), 23 May 1976, p General Assembly resolution 1838 (XVII) of 18 December 1962, Population Growth and Economic Development. 3. A Study Committee of the Office of the Foreign Secretary, National Academy of Sciences: The Johns Hopkins Press, Baltimore, p

21 as needed of programmes in the field of population within the framework of national demographic policies and as art of the welfare medical services... and the provision to families of the knowledge and means necessary to enable them to exercise the right to determine freely and responsibly the number and spacing of children". Since family planning programmes aim at the general health and welfare of the family, it should be part of, or closely linked with, social and health services and/or maternity health services in order to improve the health of mothers through avoiding too many or too closely spaced pregnancies. A secondary goal of family planning programmes is to reduce the incidence of illegal abortion. The third programme under the population influencing policy includes implementing socioeconomic measures that may achieve avoluntary change in the desired number of children, such as changing the legal age at marriage, restricting polygamy, improvement of status of women, promotion of general education, and introducing population education courses into the school curriculum. While the type and emphasis of population policies may vary from one country to the other, their aim is to increase every citizen's opportunity for a fuller and more humane life, free from restraints as regards nutrition, medical care, education, employment, housing, and social security. As to the status of population policy in the Arab world, the countries of the region may be classified into four groups as follows: (1) Countries that have no population policy and favour rapid population growth. There are nofamilyplanningprogramm.es in these countries which include Libya, Syria, Saudi Arabia, Bahrain, Oman, Qatar, Kuwait and the Arab Republic of Yemen. However, contraceptives are available in Kuwait, Saudi Arabia and the Arab Republic of Yemen and family planning services may be provided by private physicians. In Syria, the French laws prohibiting family planning are still maintained. In Libya pharmacies are not allowed to sell contraceptives unless prescribed by a physician and used for medical or health purposes. (2) Another group of countries, even though they have no population policy, take a neutral position regarding human fertility. There are no government family planning programmes in these countries, but private family planning centres are allowed. Among these countries are Jordan, Iraq and Lebanon. (3) Algeria may be classified separately as it has a definite policy for reducing rate of growth, without providing family planning services. It is of the opinion that economic development would initiate new values which, in turn, would lower fertility. The late Algerian President (Boumedienne) stated "Surely there is one way for birth control and that is raising levels of living". (4) A fourth group of countries adopted an official population policy aimed at reducing rates of private family planning programmes. These countries are Egypt, Morocco and Tunisia. It is of interest to note here that Tunisia was the first Islamic country in the world to adopt a population policy with a distinct objective to restore equilibrium between socioeconomic processes and population growth. The government implemented drastic social measures to reduce fertility rates, including raising age at marriage, legalizing abortion and limiting children's allowance. The evidence from those countries reacting to the formulation of population planning policies clearly indicates the need for further understanding with regard to the magnitude and scope of the population problems faced by all countries in the Arab region. The current population growth trends exemplify the increased difficulty in meeting the demands of social and economic progress while meting out services in the areas of health, education and food production. Population policy planning prescribes the adaptation of social and economic goals to accommodate society's changing needs due to rapid increase in size and density, high birth rates, and high population growth rates. F. Compiled updated demographic data for Arab states An attempt was made to compile from various sources updated demographic data for various countries in the Arab world. The compiled data are presented in the Appendix to this manuscript to provide an easy reference to various aspects of the demographic situation in the Arab countries. 1. General Assembly resolution 2543 (XXIV),

22 CHAPTER II DEMOGRAPHIC PROFILE OF SELECTED ARAB COUNTRIES INTRODUCTION The previous chapter presented the general demographic situation in the Arab countries as a whole, The present chapter presents specific population data pertaining to the current demographic profile of selected Arab countries with emphasis on the following aspects for each country: (1) population size, distribution and structure; (2) fertility, mortality and migration (3) population growth, (4) education; (5) economic activity; (6) population policy. The information presented for the demographic profiles included in this chapter represents a summary of data compiled from bulletins published by the United Nations Economic Commission for West Asia (ECWA) in The presentation includes the following Arab countries: the Arab Republic of Yemen, Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, the People's Democratic Republic of Yemen, Qatar, Syria and the United Arab Emirates. The Arab Republic of Yemen The Arab Republic of Yemen is located at the southwestern corner of the Arabian Peninsula and is bordered by Saudi Arabia, the People's Democratic Republic of Yemen and the Red Sea. The land area covers a total of 200, 000 square kilometres, composed of fertile soil. Agricultural activities engage 90 per cent of the labour force and provide twothirds of the gross domestic product. However, the bulk of the cultivated area (93 per cent) depends on rainfall, with only 7 per cent under perennial irrigation. Projects are under way to develop the fishing and livestock industries. Employment in the industrial sector accounts for 10 per cent of the labour force, and the industrial activities produce 15 per cent of the gross domestic product (1971). Following the revolution in 1962, a modern state was established in Yemen. The government's fiveyear plan ( ) includes the development of human and natural resources and the improvement of the standard of living by providing basic services such as food, health services and education. The sources of demographic data consist of census results and sample surveys. The first population and housing census was conducted in 1975 by the Central Department of Statistics in cooperation with the United Nations. In addition, several sample surveys were conducted to provide data related to social and economic planning. Fertility and manpower surveys were also conducted. A survey on international migration is being considered for The registration of vital events is virtually nonexistent. Demographic profile 1. Population: size, distribution and structure According to the adjusted, de facto population census of 1975, the total population of Yemen was 5,036,985, with 331,649 persons residing outside of the country. The density was 23 inhabitants per square kilometre, with 11 per cent of the population living in urban centres (over 2, 000 inhabitants) and 64 per cent living in rural settlements (250 inhabitants or less). The adjusted agesex structure for the 1975 census is presented in Table I. The young dependants represent 45 per cent of the population, similar to other developing countries. The deficiency of males in the agegroup 1559 may be due to the large numbers of male emigrants working abroad, and/or census underenumeration. 2. Fertility, mortality and migration The only available data on fertility and mortality is found in the socioeconomic survey of Sana'a City in According to this survey, the crude birth rate was 46 per 1, 000 population, and the total fertility was 6. 8 live births per woman. The infant mortality rate was nearly 210 per 1, 000 live births, with an expectation of life at birth of 39 years for females and years for males. The crude death rate was estimated in 1975 at 2 5 per 1,000 population by the United Nations, and appears to be somewhat low for the conditions of life in Yemen. 25

23 TABLE I. Population of Yemenbyage, sex, Economic activity Male Female Total Agegroup (per cent) (per cent) (per cent) Source: TOTAL Yemen Central Planning Organization, A large number of Yemenis have emigrated due to the pull factor of higher income in Saudi Arabia and other oil countries in the region. An estimate of the number of temporary emigrants was placed at onethird of a million by the Swiss Technical Cooperation Team. Strong rural to urban movement is occurring in response to recent modern economic activities. The urban population in Yemen was estimated at 2. 5 per cent in 1955, 8 per cent in 1975, and is projected to be 22 per cent in the year 2000 (United Nations, 1979). 3. Population growth According to the estimate of the Central Planning Organization, the rate of natural population growth v/as placed at 1. 9 per cent per annum. The Swiss Team estimated the total population growth at 2 per cent, with the growth of Sana'a and Hodarda at 3 per cent due to the heavy influx of workers from rural areas. The United Nations estimates a total rate of growth of nearly 3 per cent in the period , due to an expected decline in mortality. In addition, the United Nations projects a total population of 7, 748, 000 in 1980 and 9,067,800 in Education A modern system of education was introduced in 1960, and includes six years of schooling for primary, three years for preparatory, and three years for secondary schooling. The enrolment ratios in these three levels are low, 24. 3, 2. 8 and 0.3 per cent, respectively. Males constitute 90 per cent of the total students at the primary and secondary levels, and 95 per cent at the university level. Illiteracy rates among adults (age 15 years and over) were 75 per cent for males and 98 per cent for females in The 1975 census indicates that per cent of the males (age 10 years and over) and 8. 6 per cent of females (same agegroup) were economically active. The occupational structure of em ployed persons include the following: per cent were engaged in agriculture, 5. 6 per cent in services and 21.5 per cent were engaged in production, transport, sales, clerical administrative jobs and professional occupations. 6. Population policy In 1978, the United Nations reported that the Government of Yemen had expressed concern about population issues, and were making plans aimed at improving mortality and morbidity rates, as well as population spacial distribution and international migration. A policy of nonintervention was adopted regarding fertility and natural increase in the immediate future. The recent development plan emphasized a policy which includes the construction of hospitals and health centres and the provision of adequate water supply systems. A policy of international migration was not formulated due to the absence of basic demographic information. This lack of information also exists with reference to the relationship between demographic factors and socioeconomic development. However, preparation for the provision of family planning services is planned and will be implemented on a demand basis. Bahrain The state of Bahrain includes over 30 islands of different sizes scattered between Saudi Arabia to the east, and Qatar to the south. The majority of the population lives on Bahrain Island which covers 570 square kilometres of the country's total of 669 square kilometres of land area, and resides in the cities of Muharraq and Sitra, where fresh water springs exist. Agricultural activities are carried out in Bahrain on about 20 per cent of the total land area, with twothirds planted with palm dates and the remainder of the cultivated area planted in vegetables and fruit. A decline in agricultural labour occurred with the discovery of oil in Bahrain in The oil industry and allied activities now contribute 80 per cent of the total public revenue, with aluminium and its allied industries providing half of the total exports of Bahrain. The source of demographic data consists of five censuses conducted in Bahrain from 1941 to Preparation is now under way for taking the sixth census in Results from the census data include the following deficiencies: (1) incomplete coverage; (2) inaccuracies in agesex reporting and nationality of immigrants; (3) inconsistencies in the basis of the definition of population (de facto and de jure), and in the classification of occupation. These deficiencies create difficulties for comparative studies. Also, Bahrain 26

24 has operated a vital registration system since 1970; however, this system suffers from incomplete coverage. Demographic profile 1. Population: size, distribution and structure According to the five censuses conducted in the years 1941, 1950, 1959, 1965andl971, the population of Bahrain has increased 218 per cent in thirty years, increasing from a total population of 89, 970 (1941), with subsequent increases of 109,650(1950), 143,135(1959), 182,203(1965), to a population of 216,078 (1971). In 1978, the total population was estimated at 342, 000 inhabitants. The average population density was 510 persons per one square kilometre of land. In the period of seven years ( ), the number of Bahrainis in the population increased by 20 per cent, while the number of nonbahrainis in the population increased by 232 per cent, resulting from increased immigration. The largest group of nonbahrainis in 1971 were Omanis (28 per cent), followed by Indians (18 per cent), Pakistanis (14 per cent) and Iranians (13 per cent). The agesex structure of the population, represented in Table II, includes a large percentage (44. 3 per cent) of young dependants in the total population. The young dependant rate (under 15 years) in the Bahrain population was 48 per cent, while that of the nonbahrainis was 25 per cent. Additionally, the nonbahrainis in the productive agegroup (1559) is nearly three males to one female, due largely to selectivity of migrants. TABLE II. Population of Bahrain by age, sex, 1971 Agegroup Male Female Total Source: Bahrain Ministry of Finance. 2. Fertility, mortality and migration Estimates of the fertility rate in Bahrain are based on indirect methods of demographic analysis. The crude birth rate is estimated at 45 per 1, 000 population, while the total fertility rate is estimated at 6. 7 live births per woman, which is relatively low compared to other countries in the region. The highest agespecific fertility rates (411 and 328 live births per 1, 000 women) are found among the agegroups 2024 and 2529, respectively. Concerning the crude death rate and the infant mortality rate for Bahrain, the estimate of the crude death rate is 8 per 1, 000 population, while the infant mortality rate is estimated at 65 per 1, 000 live births. Life expectancy at birth is 62 years for both sexes, which is high by comparison to the expectancy of life in other countries in the region. Rural to urban migration is increasing; for example in 1971, the census results indicated that 80per cent of Bahrain's population lived in urban centres, while 60 per cent lived in the two cities of Manemo and Muharraq. The rapid rural to urban migration is due largely to the pull of the oil and aluminium industries in the cities. The demographic situation of Bahrain has been increasingly affected by international migration. It is estimated that the nonbahrainis constituted 17.5 per cent of the total population in 1971, increasing to 3.4 per cent of the total population in Population growth The annual rate of population growth has been steadily increasing since Census results during the intervals of , and , indicated an annual population growth rate of 2. 6, 3. 0 and 3. 6 per cent successively, while the corresponding growth rate from 1971 to 1978 was estimated at 6 per cent. However, the future growth of population depends largely on the number of immigrants to Bahrain, which is not predictable. For example, the rate of immigrants declined slightly from 1965 to 1971, then increased tremendously during the years 1971 to 1978 by 230 per cent in the sevenyear period. 4. Education Modern education was introduced in primary schools in Bahrain in 1932, and by 1938 extended to secondary and technical schools. The first secondary school for girls was established in The general enrolment ratio was 66 per cent for males, 45 per cent for females, in the school year 1976/77. The number of female students is much lower than that of males in the primary level, and is nearly equal to that of males in the intermediate, secondary and technical levels. In 1971, illiteracy rates were 60 per cent among the population aged 15 years and over, and 25 per cent among the population aged 1014years. 5. Economic activity In 1976, the per cent of males and females over 15 years of age constituting the economically active 1. Bahrain, Ministry of State for Cabinet Affairs,

25 Bahrainis population was 83 per cent and 6 per cent, respectively. The rate of nonbahrainis constituting the economically active population was 94 and 18 per cent for males and females, respectively. Community, social and personal services constituted the largest single economic activity in 1971, and employed 29 per cent of the Bahrainis population and 33 per cent of the non Bahrainis population. Additionally, female employment in this sector represented 86 per cent of Bahrainis women in the labour force, and 82 per cent of the nonbahrainis women. The per capita income in Bahrain was $2, 350 in 1975, largely due to oil revenue. 6. Population policy Bahrain has no specific population policy, although the government representatives at international conferences have stated that a body will be established to deal with all questions related to population planning and population policies. 1 Contraceptives are available commercially; however, there is minimal government involvement in the provision of family planning services. In contrast, the government has launched programmes to improve the skill level of the Bahrainis population in order to reduce the rate of immigrants. However, the increasing market demand for labour in Bahrain may continue to restrict the policy of reducing the number of immigrants for several more years. Egypt Egypt occupiesthe northeasterncorner of Africa, and is bordered by Libya, Sudan, Israel and the Mediterranean Sea. The country's total area is composed of approximately 1 million square kilometres, with the bulk of the Egyptian population inhabiting only 3. 6 per cent of the territory and concentrated mainly in the Delta and the fertile Nile River Valley. Temperatures are high in summer, and generally mild in winter. The military revolution in 1952 ended the monarchy and marked the beginning of a number of fundamental changes including land reform, Egyptianization of assets, and the nationalization of the Suez Canal Company. The Land Reform Act called for the redistribution of land in excess of 200 feddans in order to increase peasant land ownership. Later, private land holdings were reduced to 100 feddans and reduced again in 1969 to 50 feddans. In 1971, under President Sadat, more liberal economic policies were initiated to encourage Arab and foreign investment in exportoriented industries. With the completion of the Aswan High Dam, the cultivatable land was expanded by approximately 1 million feddans, altering the methods of irrigation for 800, 000 feddans (from basin or flood irrigation to perennial irrigation), and increasing the yield per feddan to two or three crops per year. The primary agricultural crops are cotton and rice, which constitute the most important agricultural exports. In addition, sugar cane, maize and wheat are also cultivated. A number of industries have been successfully developed since the end of the Second World War, and include the following: textile spinning and weaving, cement, fertilizer and oil industries. The source of demographic data include population censuses, vital registration systems and national surveys. Egypt was the first country in the Arab world to conduct a census (1882), and additional censuses were conducted in 1897, 1907, 1917, 1927, 1937, 1947, 1960, 1966 and 1976, with the population increasing from 6. 8 million in 1882 to million in In addition to population censuses, a number of largescale national surveys have been carried out in various years including the following: (1) a housing census (1964); (2) a labour force survey (1957, with 25 rounds up to 1964 and annually from 1968 to 1975); (3) the family budget surveys ( , and ). In addition, several fertility and vital rates surveys were conducted in rural, semiurban and urban areas. A system for registering births and deaths was made compulsory in Egypt in 1912, but registration in rural areas remains incomplete. Demographic profile 1. Population: size, distribution and structure According to the results of the 1976 census, the de facto population of Egypt numbered 36, 626, 204 persons living within the country, and 1, 425, 000 persons living abroad. An additional 147, 000 persons were living in the occupied zone. The population density in the total area of Egypt was 44 inhabitants per square kilometre (1976), and 1,000 persons per habitable square kilometre. The urban population in Egypt represents 44 per cent of the total population (1976). The four urban governorates (Cairo, Alexandria, Port Said and Suez) accommodated 21.4 per cent of the total population. Concerning the age and sex composition, results from the Egyptian population censuses are more reliable than in other developing countries. In the census of 1960, the young dependants (under 15 years) represented per cent of the total population, and in the 1976 census, represented per cent. This change in the structure of the population is also reflected in the percentage of growth of the productive agegroup (age 1564), increasing from 53.8 per cent in 1960 to 56.5 per cent in Table III represents the agesex distribution of the Egyptian population in Fertility, mortality and migration Egypt has a high total fertility rate, but the rate is declining. In 1960 this rate was 7.2 live births per woman. It had dropped to 6.8 by 1966, and 1. Statement made by the Bahrain Government representative in the First Regional Population Conference for Western Asia,

26 TABLE III. Population of Egypt by age, sex, 1976 Agegroup Male Female Total Not stated TOTAL Source: Egypt, Central Agency for Public Mobilization and Statistics, 1979 TABLE IV. Age specific fertility rates in Egypt 1966 and 1969 (per 1,000) Agegroup Total fertility Source: Khalifa, was estimated at 5.4 in Also since the mid1960s, a decline in the crude birth rate has appeared. The crude birth rate was 43 per 1,000 population in 1963 and declined to 34 per 1,000 population in Beginning in 1973, however, a reversal of the downward trend in the birth rate has emerged with an increase from 34 per 1, 000 in population in 1972 to 39 per 1, 000 population in The decrease in fertility during , is thought tobe due primarily to the early success of the family planning programmes, the war conditions which postponed marriages and childbearing, increased urbanization, and higher socioeconomic development associated with rising educational levels. The upward turn after 1972 can be explained by the gradual changes in marital status of the population. The crude death rate declined from in 1960 to 11.7 in 1976, and further to 9. 9 in This decline is attributed to the continuing improvement in health services. The infant mortality rate has increased from 138 per 1, 000 live births in 1954 to 109 in 1960, and to less than 90 in The average life expectancy at birth increased from years in 1960 to an estimated 1 57 years in With respect to internal ruralurban migration, it can be gauged from the increased proportion of people living in urban areas, that the Egyptian urban population increased from per cent in 1960 to 43.8 per cent in The population movement from rural to urban centres was aided by the limited agricultural resources in rural areas and the rapid industrialization occurring in the urban areas. Cairo and Alexandria alone accommodate more than 20 per cent of the total population, with a density of 23, 688 inhabitants per square kilometre in Cairo and 7, 372 in Alexandria. The capitals of the governorates are all considered urban areas, and some of them have a greater population density than that of Cairo or Alexandria. For example, the density of Tanta and Zagazig is 32, 186 and 25, 642 inhabitants per square kilometre, respectively. In addition, there is significant movement of workers, both temporary and seasonal, from rural areas of subsistence level to areas harvesting cash crops. The movement of a number of nomadic tribes living in arid areas is also significant. Concerning external migration, the census of 1976 indicated that 1, 425, 000 Egyptians were living abroad, and that there were 115, 355 foreigners residing in Egypt. Recently, the neighbouring oilproducing countries have attracted a significant proportion of the labour force, estimated in 1980 at approximately 3, 000, 000 persons. 3. Population growth Accelerated rates of growth have resulted from the steadily declining mortality rates (since the end of the Second World War) and the fluctuating high levels of fertilityrates. In 1952, the rate of population growth was about 2. 8 per cent. By 1960, it was 2. 6 per cent. In the period , the growth rate was reduced to an average of 2. 3 per cent. This decline in the growth rate may be due to the postponement of marriage and childbearing, the distortionof living conditions following the 1967 war, and the excessive emigration to the oil countries and elsewhere. In 1976, the growth rate increased to 2.6 per cent and in 1978 it increased to 2. 8 per cent. It is estimated that the growth rate reached 3.1 per cent in If the total fertility rate remains at its presentlevel of 5. 4 live births per woman, the population living in Egypt will double in 29 years, climbing from the 36.8 million (excluding Egyptians living abroad) in 1976 to million in 2000 and million in Education The modern educational system began in the nineteenth century, and vocational and technical education programmes were introduced recently at the secondary (and higher) level. The government established eleven universities, four of which are 1. United Nations, ECWA,

27 located in Cairo, and have enrolled a total student body of nearly 600, 000. Education is offered free at all levels in all government schools, and primary education is compulsory in areas with available schools. However, the illiteracy rates remain high. For example, in 1976, illiteracy among males and females (10 years old and over) were 42 and 71 percent, respectively. The percentage of illiteracy among males and females is consistently lower among the younger agegroups. According to a Unesco projection, a reduction in the illiteracy rate among the agegroup 1519 years is expected to reach 2. 7 per cent among the males and 16.3 per cent among the females by the turn of the century Economic activity The 1976 census results indicated that the economically active population numbered 10, 954, 000 persons including 91 per cent males, and a total of 600, 000 persons residing abroad. The economically active population in Egypt comprise only 30 per cent of the total population due largely to the high dependency rate (under 15 years) and the limited participation of females. Agriculture absorbs per cent of the males (age 15 and over) in the labour force, and only 14.5 per cent of the females. Community, social and personal services employ 17. 4per cent and 52 per cent of the males and females, respectively in the labour force. Another important area of work is manufacturing which employs 14 per cent each of males and females in the labour force. According to the 1976 census, for the agegroup 614 years, participation in the labour force amounted to 20 per cent for males and 3 per cent for females. Primarily, agriculture employed the bulk of workers in this agegroup (6 14 years) with 81 per cent of the males and 67 per cent of the females employed. The estimated per capita income in 1977 was $320, one of the lowest in the region in that year. 6. Population policy Egypt is the first country in the region to recognize the importance of population in relation to development. In 1937, the Happy Family Society obtained an official FATWA, stating, in effect, that birth control under certain conditions does not conflict with the rule of Islam. Government concern about population was evidenced in 1953 with the approval of the National Population Commission by the Council of Ministers. Under the chairmanship of the Minister of Social Affairs, the Commission began the study of the demographic, economic and medical implications of population changes. The National Charter, issued in 1962, stated that'the problem of an increase in the number of the population is the most serious obstacle which confronts the Egyptian nation in its drive for raising the level of production... '. The beginnings of a population policy in Egypt was marked by the establishment of the Supreme Council for Family Planning in A major objective of the Supreme Council was the formulation of a comprehensive plan for population and family planning programmes in Egypt. The family planning programme of the Supreme Council includes plans for reducing the crude birth rate by 1 per 1, 000 population each year beginning in Services in family planning are offered in 3, 703 units sponsored by the Ministry of Health, and in 452 clinics administered by the Egyptian Family Planning Association, with support and supervision by the Ministry of Social Affairs. Also, the Supreme Council announced in 1973 a population and family planning policy in support of a reduction in birth rates. The policy specified a set of nine factors to be simultaneously promoted to transform the socioeconomic cultural system to a level conducive to low fertility. These factors included: (1) family socioeconomic level; (2) education; (3) women's employment; (4) agricultural mechanization; (5) industrialization; (6) infant mortality reduction; (7) social security; (8) population and family planning information and communication; and (9) family planning services. In 1981, the Supreme Council for Population and Family Planning adopted a new programme strategy framework in relation to fertility reduction. The strategy is directed towards the reduction of the current birth rate to 20 per 1, 000 population by the year 2000 through raising the contraceptive prevalence rate among the various segments of the population. This strategy entails three programmatic areas: (1) upgrading family planning services and integrating them into relevant health and social activities; (2) establishing communitybased socioeconomic development programmes conducive to family planning practices; and (3) strengthening population education and family planning information, education and communication programmes which aim at fertility behaviour change, adoption of small family norms and widespread contraceptive practices. Iraq The Republic of Iraq borders Turkey from the north, Iran from the east, Syria, Jordan and Saudi Arabia from the west, with the Persian Gulf to the south. The land surface encompasses 438, 446 square kilometres and consists of four different geographic areas, distinguished as follows: the alluvial plain (onefifth of the land area), the mountain region (onefifth of the land area), the steppes region (less than onefifth of the land area), and the desert plateau (onehalf of the land area). The climate varies considerably in each geographical area. Onehalf of the country is arable and onequarter is suitable for pasture, encouraging the raising of livestock and the production of agricultural products as important sources of income for rural residents. Iraq is a leading exporter of oil, and prior to the current war, the export of oil from Iraq accounted for approximately 97 per cent of its 1. Unesco, 1973, ARE. The National Charter, Government Press, May

28 total export revenue. Efforts by the government are being made to diversify the economy of Iraq, through industrial development and agricultural modernization. One source of demographic data consists of four censuses conducted in Iraq from 1947 to The results of the 1977 census have not been published fully. The census data reflect misstatements of age and an apparent underenumeration. Other sources of demographic data include records of vital registration and surveys. The Min istry of Health is charged with the registration of births and deaths, and the Ministry of the Interior is responsible for the registration of marriages, divorces and changes in personal status. In 1974, the Central Statistical Organization of Iraq conducted a fertility survey which provided information on fertility levels and differentials in the country. TABLE V. Population of Iraq by age, sex, 1977 Agegroup Not stated Male Female Total Demographic profile TOTAL Population: size, distribution and structure The 1977 census indicated that during a thirtyyear period ( ), the population increased 150 per cent, from 4, 816, 185 to 12, 000, 497 inhabitants. Additional demographic information included the following: (1) 51.5 per cent of the total population were males; (2) 140, 000 Iraqis lived abroad; and (3) per cent of the population lived in urban areas. The average density of 28 inhabitants per square kilometre included a range from 4. 5 in alanbar, Kerbela, and al Muthanna to 107 in Babylon and 630 in Baghdad (which contains 26.4 per cent of the total population). The population of young dependants (under 15 years), represented 48.9 per cent of the total, while the old dependants (65 years and older) represented 4 per cent of the total population. The sex ratio was reported at The agesex structure of Iraq's population in the latest census (1977) is shown in Table V. 2. Fertility, mortality and migration The results of the 1974 fertility survey show a crude birth rate of per 1, 000 population (39. 6 per 1, 000 in urban areas and 47 per 1, 000 in rural areas), and show the total fertility rates in the two areas at 6.6 and 7. 9 live births per woman, respectively. In addition, the gross reproduction rates were 3. 3 and 4. 0 for urban and rural areas, respectively, and the average number of children born and living per woman in the agegroup 4049 was 6. 0 and 5. 6 for urban and rural areas, respectively. The survey results revealed that the desired number of children is greater than the actual number. A marked reduction of mortality has resulted following a substantial increase in the government's investment for the provision of equipment and personnel for health services. From 1965 to 1975, the infant mortality rate declined from 137 per 1,000 live births to 89 per 1,000 live births, and life expectancy at birth rose from Source: Unpublished government figures from 1977 census. (The marked difference in size of male and female in several agegroups is largely due to misstatement of age and underenumeration.) years to 54 years. In 1975, the crude death rate in urban areas was 9. 1 per 1, 000 population, and per 1, 000 population in rural areas. Urbanization in Iraq has progressed very rapidly since independence in The urban proportion of the total population was 36 per cent in 1947 increasing to 64 per cent in * International migration increased significantly in recent years. Consequently, the Iraqis living abroad (most of whom are highly educated) increased from 0. 6 per cent of the total population in 1965 to 1.2 per cent in The total foreign population living in Iraq in 1965 numbered 78, 221 persons, and included the following representation by country: 51.1 per cent Iranians, 15.8 per cent Palestinians, 4 per cent Jordanians and 3. 8 per cent Saudi Arabians. 3. Population growth Following the census of 1947, the population of Iraq has increased annually by 2.7 per cent in the first decade, 3. 1 per cent in the second decade and 3. 3 per cent in the third decade. The average annual rate of growth in the period was 1.2 per cent in rural areas and 4.2 per cent in urban areas. 4. Education Considerable improvement has been achieved in education in Iraq in recent years. In 1965, the illiteracy rates were and per cent among males and females, respectively. Results from Unesco studies estimated the illiteracy rates in 1980 at 37.1 and 76.6 per cent for the males and the females, respectively. 1. The Vital Events Survey , Central Statistical Organization. 31

29 The enrolment rates in the schools increased at every level in the school year 1976/77 over the ratios in the school year 1967/68, as follows: (1) 1.8 per cent increase among males and 2.4 per cent among females at the primary level; (2) 2. 0 per cent increase among males and 2. 7 per cent among females at the secondary level; and (3) 2. 6 and 3. 3 per cent increase for males and females, respectively, at the higher education level. Additionally, the number of primary and secondary schools almost doubled from 1967 to In the same time period, the number of schoolteachers quadrupled. 5. Economic activity From 1965 to 1975, the number of persons in the labour force (above 15 years of age) in Iraq increased by nearly onethird. The economically active proportion of the population was 86 per cent for the males and 4 per cent for the females. In 1975, the distribution of economic activities among the labour force included the following: (1) per cent in agriculture; (2) per cent in tertiary activities; and (3) per cent in industry. The per capita income in Iraq in 1975 was estimated at $1, 550, which is lower than several of the oilexporting countries of the area. 6. Population policy The Government of Iraq favours its current population growth rate as a means of enhancing the available arable land and natural resources. However, the government is attempting to reduce mortality and morbidity levels in rural areas through the improvement of health and medical services. 1 In addition, the government is attempting to develop education and human resources training, and to reduce the outflow of professional and skilled workers. Incentives have been offered to those persons returning to reside in Iraq in order to halt the labour movement. Another area of official concern is urban migration, and reversing the outflow of current rural to urban movement. The government proposes to curtail the outflow of persons living in rural areas by diversifying services, by increasing opportunities for work and by creating a higher standard of living for all persons remaining in the rural areas. Jordan The Hashimite Kingdom of Jordan is bordered by the Syrian Arab Republic, Iraq, Saudi Arabia.and Israel. The land area covers 95, 000 square kilometres, and is separated by the Jordan River into the eastern sector (88, 595 square kilometres) and the western sector (5, 560 square kilometres) which is currently occupied by Israel. Estimates from the agricultural census of 1975 state that the cultivated land area consists of approximately 3, 904 square kilometres and the remaining cultivatable land area consists of approximately 13, 000 square kilometres. The climate of Jordan is very moderate in the valley and in Aqaba. Jordan experienced drastic changes in population movement as a result of a series of wars with Israel. The western sector was completely occupied by Israel in 1967, and consequently a significant number of its population relocated to the eastern sector, imposing serious burdens on the demographic, social and economic requirements of that part of the country. The sources of demographic data consist of a series of censuses, a civil registration system and surveys. The first 'household census' in Jordan was conducted in 1952, and provided the total number of males and females, but included no details of population characteristics. The second census was taken in 1961, and included comprehensive information about population and housing. Another census was taken in 1979, but the results have not yet been published. The lack of definitions of terms such as urban, rural, settlers and nonsettlers in these censuses pose a problem for researchers. Another source of data is available through the civil registration system, organized in However, an underregistration of deaths of approximately 60 per cent exists in this system of registration. Data is also obtained from a number of surveys, including the following: the multipurpose household survey, the agricultural and economic activity survey and the individual surveys in the areas of education, fertility, mortality and migration. Demographic profile 1. Population: size, distribution and structure Results from the 1961 census indicated that the enumerated population of Jordan was 1, 706, 232, and census results revealed the estimated population in 1975 was 2, 737, 000, indicating an increase of 60 per cent in a fourteenyear interval. The increases in the population of the eastern sectors are most notable, for example, the population was recorded at 900,776 in the 1961 census, and increased to 1, 945, 000 in the 1975 census estimate. Further illustration of the demographic changes and subsequent strain upon eastern sector development is shown by the following data for the years from 1961 to 1975: the density of population grew from 10 to 22 inhabitants in the eastern sector, and decreased in the western sector from 143 to 140 inhabitants per square kilometre; the urban population was 43 per cent in 1961 and 56 per cent in 1976; the dependency ratio in Jordan is 100, and in 1975, the young dependants constituted 47.2 per cent of the total population. Rainfall in the northwest and middle sections of the country allows for the settlement of a large percentage (approximately 80 per cent) of the population in these areas, further straining available resources. 1. The Ministry of Planning Report presented at the World Population Conference at Bucharest,

30 The agesex distribution of Jordan's population, according to the 1975 population estimate is presented in Table VI. TABLE VI. Agegroup TOTAL Population of Jordan by age, sex, 1975 (estimates) Male Female Total Source: Center of General Statistics, W.D. T Fertility, mortality and migration Fertility levels in Jordan may be derived from the findings in two surveys conducted recently in the eastern sector (the National Fertility Survey, 1972, and the World Fertility Survey, 1976). A c cording to these two surveys, the total fertility rate for married women in the agegroups 3539 years and 4549 years is 7.5 and 8. 4 live births per woman, respectively. There are no marked differences in the fertility levels between rural and urban areas, due primarily to intensive rural emigration to cities. In addition, a marked inverse relation is noticed between fertility and educational attainment levels of women; for example, in the 1976 survey, total fertility rates among illiterate women and among women at the primary and secondaryeducation attainment levels were 6. 5, 3. 7 and 2. 3 live births per woman, respectively. Indirect methods were used for estimating mortality rates, and the results indicated a crude death rate of 15 per 1,000 population; an infant mortality rate of 89 per 1, 000 live births; and expectancy of life at birth of 54 years. 1 Health services have been improving rapidly in the last fifteen years, with a rise in the physician ratio from 1. 8 (1961) to 5 (1972) physicians per 1, 000 persons. As a result of the ArabIsraeli wars in 1948, approximately 350, 000 persons moved from north and west Palestine to the eastern sector in Jordan. The number of refugees increased in 1961 to 600, 000 due to continued immigration and to the high rate of fertility among the refugees. The bulk of the refugees settled in the urban centres. International migration from Jordan is significant, with the number of emigrants 10 per cent greater than the number of immigrants. An estimation of the number of Jordanians and Palestinians living abroad amounted to 264, 717 persons in 1975, with approximately 66.1 per cent of this number residing in Saudi Arabia, 18 per cent in Kuwait, 5. 5 per cent in the Emirates and 5. 3 in Libya. 3. Population growth The annual rate of growth between 1961 and 1976 was estimated at 3. 4 per cent, resulting in an estimate of the total population in 1981 of 3,403,000 persons. 4. Education A reduction in the illiteracy rates occurred from 1961 to 1976 among the population aged 12 years and over as follows: for 50 per cent to 18 per cent among males and from 85 per cent to 41 per cent among females, respectively. School enrolment ratios have improved rapidly from 1971 to In general, male enrolment increased by 42 per cent during this period and female enrolment increased by 57 per cent for the same period Economic activity In 1960, the percentage of the population involved in economic activities totalled 23 per cent. In 1975, the distribution of the economically active population was indicated as follows: 30 per cent of the labour force was engaged in agriculture, 30 per cent was engaged in industry and 40 per cent was engaged in services. These rates for the census period were 40, 25 and 30 per cent, respectively. Census data in 1975 reported that women composed 5 per cent of the labour force, and were distributed among the following economic activities: 50 per cent engaged in social services, 25 per cent in agriculture and 15 per cent in wholesale and retail sales activities. 6. Population policy The population policy adopted by Jordan advocated conducting a decennial census of industrial and agricultural events, as well as housing and population changes. The government is in agreement that the rate of population growth in Jordan would delay the achievement of its social and economic goals. However, Jordan has not adopted a population policy with respect to the rate of growth. In the meantime, the government has taken measures for reducing mortality levels, particularly in rural areas among the Bedouin population. 1. These estimates were calculated from the findings of the National Fertility Survey in Department of General Statistics. 33

31 In addition, a number of measures have been taken to moderate internal migration and to reduce rapid urbanization. Programmes in vocational training and rehabilitation have been adopted with the aim of reducing the negative effects of the emigration of skilled labourers. Kuwait Kuwait is located at the upper end of the Persian Gulf and borders Iraq and Saudi Arabia. The territory of Kuwait is predominantly flat desert and covers a land area of 17,818 square kilometres. The winter season is moderate with the summer weather considerably hotter and more humid. The water supply consists mainly of distilled seawater. Kuwait achieved its independence in 1961, and published its constitution in 1962, providing for an elected national assembly with legislative power. Executive power is delegated to the Amir, who is both head of state and prime minister. The oil industry has been developing rapidly since Kuwait became the seventh largest oil producer in the world in 1977, realizing a per capita income of $12, 270. Kuwait possesses 20.6 per cent of the region's oil reserves and derives 90 per cent of the value of the country's exports from oil. Also, the Government of Kuwait, has made progress towards diversifying local industries, in addition to oil. A fertilizer plant has been established with a potential capacity of producing 1. 5 million tons a year (currently established), and there are 375 registered manufacturing companies (existingin 1971). The fishing and shrimp industries are also progressing rapidly. Agricultural capabilities, however, are limited to the cultivatable land area, estimated in 1977 at 17 square kilometres, with onethird of the land area devoted to vegetables. The sources of demographic data consist of censuses, a registration system and surveys. Five successive censuses have been conducted in Kuwait since 1957, 1 and provide comprehensive data on the demographic, social and economic status of the population. In addition, the registration of births and deaths (compulsory since 1 964) provides reliable information. Two largescale sample population surveys were conducted in 1972 and A manpower sample survey was implemented immediately following the 1973 survey with the aim of determining the geographical distribution of the labour force, and for classifying the sample population according to age, sex, educational status, occupation and economic activity. Demographic profile 1. Population: size, distribution and structure The population size of Kuwait in the five census years (1957, 1961, 1965, 1970 and 1975) is presented in Table VII, distinguishing Kuwaitis and nonkuwaitis, and the sex categories of each. The number of nonkuwaitis in the population is larger than the number of Kuwaitis in each census following the first census conducted in In 1975, the percentage of the nonkuwaitis was represented as follows: per cent were Jordanians and Palestinians, 6. 1 per cent were Egyptians, 4. 5 per cent were Iraqis with the non Arab population among the nonkuwaitis being primarily of Indian, Pakistani and Iranian origin. The population density in Kuwait in 1975 was 56 inhabitants per square kilometre, with approximately 90 per cent of the population living in urban areas. The agesex distribution of the population is shown in Table VIII. The excess number of males over females in the agegroups 2054 years is due to sex selectivity of immigrants. The dependency rate is 114 among the Kuwaitis and 71.4 among the nonkuwaitis. 2. Fertility, mortality and migration There has been reliable data since 1965 on fertility levels in Kuwait. The marital fertility rate among the Kuwaiti population increased from 9. 7 live births per woman in 1965 to per cent live births per woman in Comparison rates among the nonkuwaitis in 1975 was three births fewer than that among the Kuwaitis. A reduction in fertility rates is expected to occur as a result of the rapidly increasing proportion of educated women and the rising age at marriage. In 1975, the fertility of women in the agegroup 3539 averaged live births among the illiterate women and live births among those women completing the intermediate level of education. Kuwait's infant mortality rate in 1975 was 43 per 1,000 live births and the life expectancy was 70 years. In 1975, the crude death rate for females was 5. 4 per 1, 000 population among the Kuwaitis and 3. 2 per 1, 000 population among the non Kuwaitis. Comparable rates for males were 6. 8 per 1, 000 and 3. 8 per 1, 000 among the Kuwaiti and nonkuwaiti population, respectively. Kuwait is ahead of all other countries in the region in the area of health improvements. According to the 1975 census results, the non Kuwaiti population constituted per cent of the total population. However, the annual immigration rate of 14 per cent in the period , declined to 5. 8 per cent per annum in the period As expected, the male immigrants outnumbered the female immigrants, particularly in the agegroup 2544 years. The number of Kuwaitis living abroad, composed mainly of students, does not exceed 1 per cent of the total population. 3. Population growth The population of Kuwait experienced an annual growth rate of lopercent from 1957 to 1970, with a reduction to 6 per cent in the years Censuses were taken in 1957, 1961, 1965, 1970,

32 TABLE VII. Population of Kuwait by sex and 'Kuwaitis and nonkuwaitis' in the censuses of 1957, 1961, 1965, 1970 and 1975 Census year Male Kuwaiti Female Total Male NonKuwaiti Female Total Male Total Female Total * Source: Kuwait Department of Social Affairs; Ministry of Soc :ial Service; Planning Board, Ministry of Planning, * Kuwait Government: Preliminary results of 1980 census. 1972; The reduction in the growth rate is divided proportionately between Kuwaitis and nonkuwaitis, amounting to 30 per cent and 50 per cent, respectively. In the period , the growth rate of the Kuwaitis was in excess of that of the nonkuwaitis, due, in part, to the incorporation of the Bedouin population into the Kuwaiti population. Based on an expected decline in fertility and immigration levels, the United Nations projects a population of 3 million people in Kuwait by the year The net growth rate is expected to reach the level of 3. 4 per cent per annum by Education With regard to the educational situation in Kuwait, efforts are being made to reduce illiteracy rates. The illiteracy rate among the Kuwaitis was TABLE VIII. Agesex distribution of population in Kuwait, 1975 Agegroup Male Female Total TOTAL Source: Kuwai.t Ministry of Planning, per cent for the males and per cent for the females. The corresponding rates for non Kuwaitis were 27.5 and 31.4 formales and females, respectively. The facilities for providing free primary and secondary education to all children, as well as funded fellowship programmes for higher education, will contribute to a reduction in illiteracy rates and improvement in educational levels, nationwide. 5. Economic activity The discovery and development of the oil industry in Kuwait has contributed to an increasing dependence on expatriate labour. In 1975, the non Kuwaitis constituted per cent of the total labour force, with males representing 89 per cent of the total. From 1965 to 1975, the growth of the labour force was at the rate of 7. 6 per cent for Kuwaitis and 4. 1 per cent for the nonkuwaitis. During the same period, the annual growth rate of females in the labour force was and per cent for Kuwaiti and nonkuwaiti females, respectively. Concerning the distribution of Kuwaitis and nonkuwaitis in economic activities in 1975, persons engaged in community and personal services constituted per cent and per cent of the two groups, respectively, followed by whole and retailsales activities represented by 7.3 per cent and per cent of the Kuwaiti and nonkuwaiti population, respectively. The Kuwaiti women in the labour force were largely engaged in the professional and technical areas (55. 6 per cent), while the nonkuwaiti women were largely engaged as service workers (53. 3 per cent). 6. Population policy Kuwait's fouryear plan (1967/681971/72) emphasized the importance of a population policy in view of economic and social planning, and recognized the reflection of population size and structure on the economic objectives. The government recognizes that the purpose of a population policy 35

33 is to maintain a balance between the size of the population and the natural resources of the country. In recent years, Kuwait faced the problem of a shortage of skilled and managerial personnel and imported the necessary labour. However, the government is sensitive to the problems of maintaining a high proportion of alien residents. Consequently, the high level of fertility is not viewed with particular concern. The government is also active in making further improvements in the quality and range of health services. In 1976, the government launched a massive housing programme aimed at providing houses to all Kuwaitis by the early 1980s. Lebanon Located in the southwest of Asia, Lebanon is bordered on the south and east by a series of mountains which separate it from Syria, and is bordered to the south by Israel and to the west by the Mediterranean Sea. The land surface covers 10,400 square kilometres, with the terrain sloping upward from the sea to 'QuornetelSauda' reaching a height of 3,083 metres. The large Bekaa Valley in the interior of the country (about 1, 000 metres high) is lined to the east and west by mountain ranges. Due to considerable rainfall, cultivation is possible on onethird of the total land area, primarily in the narrow coastal plain and in the Bekaa Valley. Prior to 1975, rapidly growing industries in Lebanon absorbed approximately 10 per cent of the labour force, and yielded 15 per cent of the national income. Banking and tourism flourished in Lebanon due largely to the cosmopolitan environment of Beirut and the country's mild climate. The political structure of Lebanon is composed of a chamber of deputies elected by the population once every four years, proportionately representing the size of the various confessional communities. The deputies elect a president who selects a prime minister and the prime minister forms the cabinet of ministers. The source of demographic data for Lebanon consists primarily of national surveys. An official census was conducted in Lebanon in 1932 under the French mandate. A number of attempts in regular censustaking have been made from 1943 to 1970 to estimate the demographic parameters of the Lebanese population; however, due to the interference of political constraints, none have succeeded. In 1970, the Minister of Planning conducted a survey to determine the composition of the economically active population. The survey canvassed onefifteenth of the households (30,000) with reasonable accuracy, and the findings can be used to calculate national population estimates. The National Fertility and Family Planning Survey, conducted in 1971, included 2, 795 currently married women, between the ages of 15 and 49 years and provided data for population analysis. Another source of population data, conducted in 1971, is the survey on internal migration, which studied 3,671 migrants between the ages of 15 and 44 years, who had migrated prior to 1 January In addition, the registration of vital events was made compulsory in 1951, and an analysis of the figures registered indicate that the birth registration is acceptable, but the death registration was incomplete. Therefore, the following figures in the demographic profile have been derived from the national surveys. Demographic profile 1. Population: size, distribution and structure According to the 1970 survey results, the population of Lebanon was reported at 2, 136, 000, and increased to a total population (estimated) of 2, 550, 000 by The density of the population in 1975 was approximately 245 inhabitants per square kilometre, with approximately onehalf of the population living in Beirut and 30 per cent living in villages of less than 2,000 inhabitants. The 1970 agesex structure (adjustedfor underregistration) is presented in Table IX, including a young dependent proportion of 44 per cent and an old dependent proportion of 5 per cent of the total population. Consequently, the dependency ratio was 96 and not significantly different from the pattern prevailing in other countries of the region. The sex ratio was reported at , representing a somewhat higher rate in the early agegroup (under 24 years), and a lower rate in the middle agegroup (2334 years), due largely to the outmigration of males. 2. Fertility, mortality and migration On the basis of the 1970 survey, the government estimate of the crude birth rate was 34 per 1, 000 population. However, indirect methods, using 1971 fertility survey data, reveal a crude birth TABLE IX. Population of Lebanon by age and sex, adjusted, 1970 Agegroup TOTAL Male Female Source: Courbage and Tarques Total

34 rate of 32 per 1, 000 population. Calculations from these two sources indicate that the total fertility and the general fertility rates for 1970 were 4, 566 and 144 live births per 1, 000 women, respectively. The gross and net reproduction rates were 2, 318 and 2, 177 per 1, 000 women, respectively. These figures indicate that fertility levels in Lebanon are lower than corresponding levels in other countries of the region. More accurate estimates of mortality levels in Lebanon were obtained through indirect methods based on stable population models. Utilizing 1971 figures from the fertility survey, the following estimates were made: the crude death rate was 8 per 1, 000 population, the infant mortality rate was estimated at 45 per 1, 000 live births, and the life expectancy at birth for both sexes was 65 years. Thus, Lebanon is ranked second only to Kuwait, with respect to the quality of health conditions among the countries of the region. The 1970 data show a high degree of internal mobility, both rural to urban and vice versa, within Lebanon, but largely, the movement within the country has been urban bound. Beirut attracts onehalf of the rural emigrants. Emigration from Lebanon developed since the middle of the nineteenth century, and progressed towards the West and more recently towards the Arab Gulf states. The World Lebanese Union estimates that 50 per cent of the Lebanese population live abroad. Recent conflict in Lebanon has resulted in massive emigration to the Americas and Australia. 3. Population growth During the last decade, the average rate of growth in Lebanon has been approximately 2. 5 per cent. The population tripled in a thirtyeight year period from 1932 to However, in the near future a decline in the growth rate is expected due to the following factors: the recent trend of declining fertility, the additional depressing effect of hostilities on fertility and the slow decline in mortality levels (which have already reached minimum levels). 4. Education Lebanon has the lowest illiteracy rate in the Arab countries. Among the Lebanese population aged 15 years and over, the illiteracy rates in 1975 were 18 and 37 per cent for males and females, respectively. These rates are much lower among the younger agegroups. In large part, education in Lebanon is private. There are six private universities in Beirut, in addition to the governmentsponsored Lebanese University. The universities attract large numbers of students from other Arab and nonarab countries. 5. Economic activity According to the International Labour Organisation's estimates in 1970, the economically active population represents 45 per cent of the male and 15 per cent of the female population aged 15 years and over. The large number of Lebanese enrolled in institutions of higher learning accounts for the relatively low level of economically active males. The percentage of economically active females is higher in Lebanon (particularly in the younger agegroups) than in other Arab countries. Concerning the occupational distribution, the services sector comprises about 55 per cent of males and 57 per cent of females in the labour force, with agriculture engaging males and females at a rate of 18 and per cent, respectively, followed by industry at and per cent of males and females, respectively. 6. Population policy Due to the political situation in Lebanon, the government has not adopted an official population policy. However, the government has indicated an increasing awareness of the need for demographic information. A government spokesman has stated that the government recognizes the significance of a policy that improves family health and welfare, and the right of parents to choose the size of their families freely and responsively (Lebanon's representative's statement at the World Population Conference, Bucharest, 1974). The Government of Lebanon has recently approached the United Nations Fund for Population Activities for support in order to implement a survey to obtain social, economic and demographic data. This data may lead to determining reliable measurements of demographic events. Contraceptives are available on the retail level in Lebanon, although the laws in Lebanon forbid the sale and distribution of contraceptives. The Lebanese Government has abstained from making an official statement regarding family planning; however, there are indications that the government does support the activities of the Fam ily Planning Association, established in Lebanon in The People's Democratic Republic of Yemen Democratic Yemen is located north of the Gulf of Aden, and is bordered by Saudi Arabia, Oman and the Arab Republic of Yemen. The land area consists of approximately 338, 000 square kilometres, onehalf of which is desert. Climatically, the coastal strip has extremely hot and humid weather in summer, but mild temperatures in winter, while the interior has cool summers and colder winters. The rainfall averages 400 millimetres in the interior highlands, and is scanty along the coastal belt. The expansion of irrigation facilities allowed for an increase in the amount of area under cultivation by 35 per cent from 1971 to This increase in cultivated land area contributes to the importance of agriculture to the nation's economy. Agricultural products constitute 16 per cent of the gross domestic product and employ over onehalf of the country's labour force. In 1968, all farmers were organized in 37 production cooperatives. Fishing and livestock also contribute significantly to the country's economy. 37

35 The major industries include oil refining, food processing, textiles and building construction. However, a shortage in skilled manpower exists as an obstacle facing industrial expansion. Concerning the natural resources of the country, limestone is the only available mineral resource, and oil exploration is in progress. The source of demographic data consists of: (1) two censuses conducted under British rule ( ) in 1946 and in 1955, covering inhabitants only in Aden colony; and (2) a de facto census taken in 1973, covering the majority of inhabitants, with the exception of certain mountainous areas. The published preliminary results of the 1973 census, based on a subsample of the census, permit only limited demographic analysis. Another census for the country is planned for A general civil registration system was established in However, the registration of births and deaths is virtually limited to the population of Aden. Two recently conducted sample surveys serve as useful sources of information and include: (1) a threestage demographic and socioeconomic investigation in selected governorates (1973 and 1974); and (2) a survey of the socioeconomic conditions in the northern districts (1974). Demographic profile 1. Population: size, distribution and structure According to the 1973 census, the enumerated population of the People's Democratic Republic of Yemen was 1, 590, 275. In addition, the Central Statistical Office estimated the population in 1977 to be 1, 744, 000. Accordingly, the population density ranges from 1 to 45 persons per square kilometre in the six governorates. The statistical estimates in 1973 indicated that the population was distributed among urban, rural and nomadic areas, at a rate of 33, 57 and 10 per cent of the population, respectively; and also that there are 86 cities and towns in the country, with 15 per cent of the population living in Aden City and its suburbs. The agesex distribution of the population is presented in Table X and indicates that the rate of young dependants (under 15 years) in the general population is 50 per cent and the old dependants ratio (age 65 and over) is 4 per cent. The sex ratio varies in the different agegroups, with females outnumbering males in each group from age 15 and older, except in the agegroups 5559 and 65 and over. With respect to the agegroup under 15 years, the following factors may have contributed to the sex differences in numbers in each agegroup: (1) underreporting of females under 15 years; (2) outmigration of males; and (3) loss of males during the war of independence. 2. Fertility, mortality and migration According to the adjusted and unadjusted 1973 census figures, the fertility ratio (number of TABLE X. Agesex distribution of Democratic Yemen's population, 1973 Agegroup Male Female Total TOTAL Source: Democratic Yemen, Central Planning Commission, children under 5 years per 1, 000 women aged years) is 850 and 113, respectively. The crude birth rate was estimated at 48 per 1,000 population. The Social Survey conducted in revealed that the total fertility rate was 6. 1, while the United Nations estimate of the total fertility in 1979 revealed a rate of The United Nations Department of Economic and Social Affairs estimated the crude death rate for Democratic Yemen in 1975, at 21 per 1, 000 population, and the life expectancy at birth to be 45 years. Census results of 1973 indicated that the infant mortality rate was estimated at 170 per 1, 000 live births. Health services remain limited in the People' s Democratic Republic of Yemen. In 1972, for example, there were 150 doctors working in the entire country and were primarily concentrated in the city of Aden. The Government of Democratic Yemen states that rural to urban migration has been substantially reduced, due to improvements in the levels of living in rural areas, as well as the diminished employment opportunities in the urban centres. As for international migration, the number of citizens living abroad was estimated in 1973 to include 40, 000 persons; however new laws now restrict emigration. 3. Population growth In 1973, the annual population growth rate was estimated at 2. 2 per cent. This rate is expected to increase with expanded health improvement programmes. The population of Democratic Yemen is estimated to reach 2, 371, 000 by the year 1990 and 3, 093, 000 in the year 2000, if life expectancy levels rise at the rate of 2. 5 years every five years, with no changes occurring in fertility levels. 38

36 4. Education Illiteracy rates in 1973 were estimated at 70 per cent among the population 10 years old and over (51 per cent among males and 91 per cent among females). However, improvements have been achieved in the last few years. For example, enrolment rates in the first level rose from 60 per cent in 1970, to per cent in Unesco estimates indicate that the illiteracy rate in the agegroup 1519 years will be approximately 1 per cent for males and 12 per cent for females in the year The funds allocated for education in the country's budget represented 9.7 per cent in 1967/68, and increased to per cent in 1975/ Technical education and vocational education training schools in various fields (commerce, agriculture, fisheries) have been established. Female enrolment in 1975/76 was 33 per cent of the total enrolment in primary schools and 20 per cent in higher and professional schools. 5. Economic activity Results from the 1973 census indicated that the economic activity rate for males and females in the population aged 15 years and over, was 42 per cent and 9 per cent, respectively. In the same year, the percentage of males and females in the labour force engaged in each economic activity included the following: agriculture, per cent of males and 87 per cent of females; community, social and personal services, per cent of males and 8. 5 per cent of females; manufacturing, 4. 7 per cent of males and 3. 6 per cent of females. The 1973 census results also indicated an unemployment rate of 17 per cent among males and 22 per cent among females in the labour force. According to the 1977 estimate, the per capita income was $340, one of the lowest in the region. 6. Population policy In 1976, the Democratic Republic of Yemen established a National Committee on Population, with emphasis on the following goals: (1) to formulate a comprehensive national population policy; and (2) to study the effects of internal migration on economic development. The government stated that due to insufficient information, views could not be formulated with respect to the country's growth rate and fertility level. Substantial national investment has been made recently to expand health services in order to reduce mortality rates. For example, since 1975, family planning associations and family planning services have been established and supported in cooperation with the International Planned Parenthood Federation and the World Health Organization. In an effort to improve the wellbeing of the family, a set of laws was passed restricting divorce, polygamy and abortion, in addition to setting the minimum age of marriage at 16 years and 18 years for females and males, respectively. Additional measures have been pursued to minimize the effects of rapid urbanization and to curtail the outflow of educated and skilled manpower utilizing salary increases and additional incentives for those persons in the labour force. Qatar The state of Qatar is an extension from the Arabian Peninsula mainland to the Persian Gulf, and is bordered by Saudi Arabia and the United Arab Emirates. The total land area is 11, 400 square kilometres, with climate primarily hot and dry. Available water supplied from underground is unsuitable for drinking or agriculture, therefore dependence on distilled seawater is necessary. Qatar obtained its independence from Britain in 1971, and is governed by a ruler and a thirtymember advisory council, entitled to debate legislation from the Council of Ministers. The economy of Qatar relies completely on oil production and export, contributing 95 per cent of the government's revenue. Before the discovery of oil in 1937, the economy of the state relied on date palms, fishing and pearling. The government is concerned about diversifying its economy through the development of a number of industrial plants including: flour milling, fertilizer, shrimp and fishing, iron and steel and aluminium smelting. Efforts are also being made to develop agriculture. The source of demographic data consists of census estimates. Qatar conducted a census in 1970 and this census provides the only available demographic information. The agesex structure and sex ratios from the census results indicate considerable underenumeration and misstatement of age. Therefore, the figures provided here are estimates derived by comparison with countries of similar socioeconomic levels. Demographic profile 1. Population: size, distribution and structure The population estimate for Qatar in 1949 was 25, 00030, 000; in 1970, the estimate was 111, 133 (40. 5 per cent were Qataris), and the population estimate in 1980 was 260,000. The number of Qataris constituted per cent of the total population in In 1970, the percentage of the population living in and around Doha (the present capital) represented 80 per cent of the Qatari and 85 per cent of the nonqatari population. The nonqataris are primarily nonarab Asians, and the representation by country includes the following: 31.5 from Iran, from Pakistan, 5. 5 per cent from India and 6. 2 per cent from Indonesia. The Arab nonqatari population has the following representation by country: 8. 3 per cent Palestinian and 1. Democratic Yemen, Central Statistical Organization,

37 4. 9 per cent Omanis. The number of males among the nonqataris is three times as large as that of females (1970). The agesex structure in 1970 is shown in Table XI. The young dependent population (under 15 years) is 52 per cent of the total Qatari population and 26 per cent of the nonqatari population. The old dependent proportion is 5 per cent among the Qatari population, and is negligible among the nonqatari population. 2. Fertility, mortality and migration In the absence of information on fertility in Qatar, an estimate was made in 1975, and resulted in a crude birth rate of 50 per 1, 000 population, and a total fertility rate of 7. 2 live births per woman. High fertility among the Qataris is partly due to early age at marriage and a greater proportion of marriages than in other Arab countries. The percentage of ever married males and females in the population (age 20 and over) in 1970, was and per cent, respectively. In the absence of reliable information on vital events, the mortality rates have been estimated on the basis of the recent improvement of health services, due largely to the oil revenue. In 1975, life expectancy at birth was estimated at 5 5 years, with the projection to 70 years by the end of the century (a goal which was achieved by Kuwaitis). Concerning international migration, there has been considerable international activity in Qatar since the discovery of oil. In 1970, the immigrant population represented per cent of the total, with 63 per cent of the immigrants as nonarab Asians. Internal migration in Qatar is negligible, and the majority of emigrants are students. 3. Population growth The annual rate of population growth ranged from 6. 2 to 7. 1 per cent in the years from 1949 to From 1960 to 1970, the annual rate of growth increased to 10.7 per cent; and from 1970 to 1980, TABLE XI. Population of Qatar by age, sex, 1970 Agegroup Male Female Total TOTAL Source: Qatar, in collaboration with the British Middle East Development Division, n. d. the average annual rate was 8. 5 per cent. Estimates project a decline in the rate of growth, possibly to 3 per cent in the year At this rate, the total population of Qatar will reach 437,000 by 1990, and 738,700 by the year Education Modern formal education started as late as 1951 for males and 1955 for females. In 1970, the illiteracy rate was 63.3 per cent among the population aged 15 years and over. Serious efforts have been made to eradicate illiteracy and is evidenced by the percentage of illiteracy in each of the agegroups, as follows: 81 per cent among the agegroup 3039, per cent among the 2029 agegroup and 21.8 per cent among the agegroup 1519 years (1970). The Government of Qatar provides education, books and school supplies free of charge in order to encourage school enrolment. In 1970, the school enrolment rates were 83.5 per cent among males and among females in the agegroup 1014 years. Also, comparison rates for illiteracy among Qataris and nonqataris indicated that for the agegroup 3036 years, illiteracy rates are lower among the nonqataris. However, in the agegroup 1529, the illiteracy rates for non Qataris are higher than the rates for Qataris. In addition, Qatar has a university, and provides a number of vocationaltraining schools where stipends are paid. Increased priority is being placed on training teachers in order to meet the increased demand for teachers and to reduce the dependence on foreign teachers. Foreign teachers constitute 70 per cent of males and 52 per cent of females of the total number of teachers in the primary schools and 97 and 94 per cent, respectively, of the teachers in the secondary schools Economic activity In 1970, the percentage distribution of the non Qatari force in industry represented the following: 43 per cent in oil, per cent in areas of government activities and per cent in construction. With respect to the distribution among the economic activities, the percentages for non Qataris were: 28.9 per cent in teaching, handling goods, clerical and general services; 18 per cent in construction; per cent in wholesaleretail trade; and 11.9 per cent in government. Birks and Sinclair^ estimated the total labour force in 1975 at approximately 62, 00071, 000 persons with approximately 12, 500 represented by Qataris. 6. Population policy According to a statement made by a Qatari representative, 'the purpose of all efforts in the population field is to improve the society's quality of 1. Birks and Sinclair (1980a) based on data obtained from the Ministry of Education. 2. Birks and Sinclair (1978a). 40

38 life through the provision of social and economic security to the individual and family' (PostWorld Population Conference consultation for the ECWA region in 1975). To achieve the improvement of the quality of life, the government emphasized the educational and training services which are provided free to both sexes. Stipends are paid to students in technical and professional schools; in addition, students are sent abroad at the government 1 s expense for purposes of study. Medical and surgical services are provided free to all residents of the country. One of the apparent concerns is achieving less dependence on foreign workers, and consequently, the attitude towards current levels of fertility appear to be favoured. However, no official statement has been issued. Syria Located on the eastern coast of the Mediterranean Sea, the Syrian Arab Republic is bordered by Turkey from the north, Iraq from the east, Israel and Jordan from the south and Lebanon from the west. Syria covers a land area of approximately 185, 180 square kilometres, and includes 45 per cent arable land, with desert and mountains composing the remaining land area. The climate is relatively hot, with the rainfall somewhat irregular, which affects the production of agricultural commodities. The completed Euphrate dam is expected to double the irrigated area. Agriculture has an important role in the country's economy, employing onehalf of the labour force and contributing onefifth of the gross domestic product. Other important industries in Syria include textile production, mining and manufacturing (contributing 23 per cent to the gross national product in 1975), and phosphate and cement production. Oil has become one of the country's most important exports and its reserve was estimated at 11, 900 million barrels in The sources of demographic data consist of census data, surveys and a system of civil registration. The 1960 census is considered the first reliable demographic census with complete coverage. The census conducted for 1970 is more accurate than the 1960 census, but also reflected an estimated underenumeration of 2 per cent in urban and 11 per cent in rural areas. In addition to census data, Syria has a system of civil registration, with regularly published statistical reports. These reports reflect underregistration. Another important source of demographic data includes several sample surveys, providing demographic and socioeconomic information in the following areas: infant and child mortality, the status of working women and the socioeconomic conditions of rural women. In 1976, a sample population census was conducted to provide information on fertility, mortality and internal migration patterns. The Central Bureau of Statistics has undertaken an annual labour survey to obtain information on the size and geographical distribution of the labour force, by age, occupation and economic activity, since Demographic profile 1. Population: size, distribution and structure In 1977, the population of Syria was estimated at 7, 845, 000 inhabitants, with 45 per cent residing in Damascus City, Damascus and Aleppo. Urban population growth has increased from 37 per cent in 1960 to 45 per cent of the population in The density varies greatly from rural to urban areas, and was recorded at 45 inhabitants per square kilometre in In Damascus, the density was 10,000 inhabitants per square kilometre in The sex distribution of the population is presented in Table XII and the agesex distribution is presented in Table XIII. The age structure in 1977 indicates that 49 per cent of the population was under 15 years of age and approximately 4. 4 per cent was 65 years and over. The sex ratio in 1977 was 105. An TABLE XII. Year * 1977* Male The sex distribution of the population in the Syrian Arab Republic Female T Total Source: Syrian Arab Republic, Office of the Prime Minister, Central Bureau of Statistics, * Midyear estimate. TABLE XIII. Population of the Syrian Arab Republic by age, sex (estimate 1977) Agegroup TOTAL Male Female Source: Syrian Arab Republic, Office of the Prime Minister, Central Bureau of Statistics, T o tal

39 apparent deficit of males in the agegroups 20 to 24, and 35 to 39, is largely due to outmigration. The marked difference in the number of males and females in the early agegroups is due to misstatement. 2. Fertility, mortality and migration Findings of the FollowUp Sample Survey of Vital Statistics (first round, ) indicate that the total fertility rate was 7. 5 live births per woman (8.5 in rural areas and 6.4 in urban areas). The crude birth rate was per 1, 000 population. According to the same survey, the crude death rate was 8.5 per 1,000 population, with significant differences in rural and urban areas (at 9. 5 and 7. 5 per 1, 000 population, respectively). Due to improvements in public health services and facilities, the crude death rate has decreased by 50 per cent, with the life expectancy at birth increasing from 56.8 years to 64.2 years during the period from 1970 to In recent years, Syria has been experiencing significant migratory movement. The 1977 Follow Up Sample Survey indicated that in 1977 the number of emigrants was 145, 900, and the number of immigrants was 56,500, with the direction of emigration towards Kuwait, Saudi Arabia and Libya. In addition, the 1970 census showed that the volume of internal migration was approximately 18 per cent of the total population. Internal population movement is primarily towards urban areas, particularly to Damascus City, Damascus and Rakka. Onefourth of the total population of Damascus City are immigrants. 3. Population growth Due to the gap between a high birth rate and a low death rate, population growth is occurring rapidly in Syria (approximately 3. 7 per cent annually). The Central Bureau of Statistics estimates that the size of the population will be 10, 156, 000, increasing to 11, 936,000 by Education In recent years, significant progress has been made in the field of education. The number of primaryschool students increased by 55.4 per cent from 1970 to 1977, while the number of students in secondary and vocational schools was doubled. In addition, students in the teachers 1 training colleges increased annually by per cent. The annual increase in the number of students (from 1970 to 1977) for males and females was per cent and 22 per cent, respectively. Concerning illiteracy, the rates declined sharply from 1960 to 1977, particularly in rural areas, where the illiteracy rate declined from to per cent among males, and from to per cent among females. 5. Economic activity In 1975, census results indicated that 74 per cent of the males (aged 15 years and older) and 15 per cent of the females were economically active. At that time (1975), the economically active population in the labour force was composed of approximately onethird wageearners, onethird selfemployed, and nearly a quarter occupied as unpaid family workers. The distribution of the labour force by branch of economic activity include the following: agriculture engaged 80 per cent of womenin the labour force and 41 per cent of the men; community, social and personal services engaged 14 per cent of the males and 10 per cent of the females; manufacturing and commerce engaged 26 per cent of the males and 7.2 per cent of the females in the labour force. 6. Population policy In 1972, a Syrian family planning association was established and through the Ministry of Health proceeded to provide family planning services at health centres in order to improve the general health standards of the family. In 1974, a nongovernment family planning association was established to provide family planning guidance and services to parents. The opinion expressed by the government in 1976, regarding the population issue, endorsed the acceptance of the level of fertility at that time. There was no interest expressed in utilizing direct methods to regulate fertility; however, indirect methods suchas improvements in the educational levels and the status of women through increased work opportunities were not disregarded, In the fiveyear plan ( ), the Syrian Government emphasized expansion of health and medical services in rural and urban areas. The United Arab Emirates The United Arab Emirates (U.A. E. ) are constitutedby seven small states (emirates), including Abu Dhabi, Dubai, Sharjah, RasalRhaimah, Fujeira, Ajman and Umn alqiwain, and covers a total land area of 77,700 square kilometres. Bordered by Qatar, Saudi Arabia, Oman and the Persian Gulf, the territory is primarilyflat desert, with the exception of the alhajar mountains which rise to a height of 3,000 metres. The union of the six emirates was formed in 1971 following independence from the United Kingdom, and the seventh emirate, Rasal Khaimah joined the union in A constitution was set up in 1971 and was extended in 1976 for another five years. Before the discovery of oil in 1958, the economyof the area was limited to oasis agriculture, fishing, pearling and trade with neighbouring countries. In 1976, the United Arab Emirates produced 719 million barrels of oil, generating a revenue of 27, 069 million dinars. Oil contributes 95 per cent of the total exports and 70 per cent of the gross domestic production. Abu Dhabi produces 81 per cent of the total oil and Dubai produces 16 per cent. The agriculture and fishing industries continue to play an important role in the economy of the remaining emirates. The union is considering the development of additional 42

40 industries including cement, gas processing and power production. The sources of demographic data consist of census information and estimates made from comparison data. The first census in the country was conducted in 1968 and provided a classification of the population by age, sex, religion, occupation, and educational level. The Central Statistical Department, established in 1972, has conducted and published the results of the 1975 population census, and also the establishment censuses. The 1975 census was the second census, and included more detailed information. However, the census results did not include the population composition by nationality, which is necessary for completion of an analysis of the socioeconomic and demographic variables. Estimates show that approximately 70 per cent of the total population are immigrants, and therefore the characteristics of the total population may be different from those of the nationals. The only available demographic data for the United Arab Emirates include the 1975 census results (vital registration is virtually nonexistent as well as the absence of socioeconomic surveys) and, therefore, the figures that are included in the demographic profile are estimates derived from comparisons with countries at similar levels of socioeconomic development. Demographic profile 1. Population: size, distribution and structure The censuses conducted in 1968 and 1975 report the total population of the United Arab Emirates at 180,226 and 557,887 persons, respectively. 1 The nationals constituted 63.5 per cent of the population in the former census (1968) and 30.5 per cent of the population in the latter (1975) census. 2 The results of the 1975 census reported that the population density was 6.7 inhabitants per square kilometre, and the population living in urban areas was 84 per cent of the total population. The agesex composition of the population in the 1975 census is presented in Table XrV. The figures reveal that there are large numbers of males in excess of females in all agegroups, particularly in the productive ages. Census results indicated the following: (1) females represent nearly 30 per cent of the total population; (2) the young dependants (under 15 years) represent per cent of the population; and (3) the old dependants (65 years and older) represent 2 per cent of the population. Both groups are smaller than the percentages in these agegroups in the other Arab countries. 2. Fertility, mortality and migration The 1975 census results indicated that the total fertility rate was 5. 9 live births per woman and the gross reproduction rate was 2.9. These rates are low relative to the fertility rates in the other Arab countries in the region, probably due to underestimates. The fertility level of the nationals, TABLE XIV. Population of the United Arab Emirates by age, sex, 1975 Agegroup TOTAL Male Female Total Source: United Arab Emirates, Ministry of Planning, as separate from that of the immigrants, could not be measured, due to lack of data. However, the fertility level of the nationals is estimated to be higher than that of the nonnationals, based on the rates found in other countries of the region. Improvements and continued expansion in health services, along with socioeconomic improvements, have affected a drop in mortality levels in the United Arab Emirates following the discovery of oil. In 1975, life expectancy was estimated at 60 years and infant mortality was estimated at 65 per 1,000 live births. International migration continues to have an important role in determining the demographic characteristics of the population. In 1975, the nonunited Arab Emirate population constituted 70 per cent of the total population indicating an annual rate of growth of 23 per cent during the period from 1968 to The rapidly increasing number of immigrants is reflected in the increase in the number of work visas issued to nonunited Arab Emirates citizens for the years 1975 and 1976; for example: in 1975, a total of 127,938 work visas were issued, and in 1976, 239,555 work visas were issued. The percentage distribution for those countries receiving work visas is represented as follows: 40 per cent were issued to Indians, 25 per cent to Pakistanis, and 20 per cent to Arabs. However, new legislation has been passed to limit the number of expatriate workers. In the meantime, emigration from the United Arab Emirates is very limited. In 1975, census data indicated that the total number of emigrants was estimated at 2,370, many of whom were students. 1. British Embassy, 1968; Ministry of Planning, Birks and Sinclair (1978a). 43

41 3. Population growth The population of the United Arab Emirates has grown at an annual rate of per cent during the period from 1968 to 1975, with the growth rate for Abu Dhabi and Ajman being and 17. 7, respectively. The growth rate among the nationals and nonnationals was 5.1 and 22.9 per cent, respectively. The total population numbered 180, 226 in 1968, and increased to 551,887 in 1975, with estimates at slightly more than one million in Estimates of future population include the following: 1.7 million for 1985, and 2.7 million for 1990, assuming a decline occurs in the rate of immigration. 4. Education Following the building of the first school for boys in 1953, education developed rapidly. The number of boys and girls enrolled in schools in the school year 1958/1959 was 1,954 and 381, respectively the number grew to 37, 305 and 30, 136 for boys and girls, respectively in 1976/1977. Primary and secondary education has been made free and compulsory. In 1975, the illiteracy rates for boys and girls (10 years of age and over) were and per cent, respectively. 5. Economic activity In 1975, research findings indicated that the economically active nonnationals of the labour force constituted 85 per cent of the total labour force. The annual growth rate of the labour force, during the period from 1968 to 1975, was 3.8 per cent for the nationals and 25 per cent for the nonnationals. Findings showed that in 1975, 93 per cent of males and 10 per cent of the females (aged 15 years and over) were economically active. 1 The occupational distribution of males in the labour force in 1975 is indicated as follows: per cent were engaged in production and related activities, per cent in service, 10 per cent in clerical, and 6. 3 per cent each in professional, technical and sales fields. The occupational distribution for females in the labour force during the same period is as follows: 43.4 per cent engaged in professional and technical activities, 29, 1 per cent in service, and 19.8 per cent in clerical fields. The World Bank estimates for the per capita income in 1977 placed the United Arab Emirates at $14,420, one of the highest in the world. 6. Population policy The United Arab Emirates Government has been concerned with the socioeconomic development of the country with particular emphasis on the effect of international migration on development and the uneven geographical distribution of the population. The government is of the opinion that the present level of fertility is too low and that there is a need for rapid population growth of the nationals in order to attain future stability for the country and for the achievement of socioeconomic development. Manpower shortages among professional and skilled occupational categories have been identified. Efforts are being made to close this gap utilizing family subsidies to encourage children to attend schools and continue their education. In 1980, nearly 24 per cent of the budget was spent on education in the United Arab Emirates. During the past two decades, facilities have been provided for the expansion and improvement of health services, with emphasis in rural and more remote areas. The concentration of the population in the limited urban areas is also of concern to the government. 1. United Arab Emirates, Ministry of Planning,

42 CHAPTER in LITERATURE REVIEW, GAPS IN KNOWLEDGE AND RESEARCH DIRECTIONS INTRODUCTION As indicated earlier, the Social Research Center of the American University in Cairo has compiled available works dealing with population and family planning in the Arab States, placing particular emphasis on works of direct or close relevance to the development of communication strategies for population policies and family planning programmes. A total of 459 research works, written during the period , were summarized and presented in Volume I, Summaries of Pertinent Literature and Research Studies. These works were obtained from three main sources including: (1) works published in reviews, bulletins and journals (55 per cent); (2) papers presented to national and international conferences and seminars (29 per cent); and (3) documents from ongoing research (16percent). Table I presents the distribution of works by country, including the percentage share for each country and the percentage share of the respective countryto the total population of the Arab States. A majority of the research work was related to Egypt (96 works), Tunisia (74 works), Morocco (31 works) and Syrian Arab Republic (30 works); these four countries are known to be the region's leaders in the field of population and family planning re search. A significant number of works pertained to Iraq (17 works), Sudan (17 works), Algeria (14 works), Jordan(14 works), Lebanon(12 works) and Kuwait (10 works); a considerable interest in population issues is developing rapidly in these countries. Only a few studies have been compiled for other countries in the region, evidencing the scarcity of relevant works completed in these countries. TABLE I. Distribution of papers by countries dealt with Country Number of papers Per cent of total papers Per cent of total population I. Specific countries Algeria Arab Republic of Yemen Bahrain Egypt Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Mauritania Morocco People's Democratic Republic of Yemen Qatar Saudi Arabia Sudan Syrian Arab Republic Tunisia II. Combination of countries III. General studies

43 The classification of works by subjectmatter is presented in Table II, which points out that 43 per cent of the papers analyse the demographic situation, 28 per cent discuss the issue of fertility and family planning behaviour in specific countries, 18 per cent report on the implementation and outcome of population policies and family planning programmes, and 12 per cent present Islam's view on the status of the family and the practice of family planning. The contents of the present chapter include a review of the compiled literature and an analysis of the gaps in knowledge revealed by the review of this literature. The literature review attempts to synchronize the findings and viewpoints related to various population and family planning issues in the Arab countries. The identification of gaps in knowledge attempted to highlight current contributions to research, to delineate work remaining to be accomplished, and to recommend future research directions. I. REVIEW OF LITERATURE The literature review will be presented in this chapter under four major topics: (A) population and demography; (B) fertility and family planning behaviour; (C) population policies and family planning programmes; and (D) Islam's views on family planning issues. A. Population and demography (125 works) The works classified under this topic represent 42 per cent of the total works compiled in Volume I, and reviewed in this chapter. They are descriptive of the general demographic activities in the Arab region, and may be divided into the following four categories: (1) the demographic situation (65 works); (2) migrationand urbanization (41 works); (3) population and development (56 works); and (4) methodological and theoretical population issues (33 works). 1. Demographic situation (65 works): The majority of works in this category described the impact of rapidly growing populations on the social and economic conditions in the Arab world as a whole; and with specific emphasis on particular countries, namely Egypt and Tunisia, where more demographic information is available. All of the works are based largely on available census information; however, a few works are based on statistics from sample surveys. Several studies pointed out that the lack of demographic information, the scarcity of reliable statistics, and the inadequacies of birth and death registration contribute to incomplete demographic research results. Several studies discussed the demographic trends which characterized the population situation in several Arab countries including an increased dependency ratio, high and constant birth rates, and high, but declining death rates. The implications of an accelerated population growth rate was discussed in view of providing public services and in meeting the requirements for education, health and social welfare. The consequences for social and economic development resulting from the effects of population growth on certain demographic variables were discussed in a number of works, including: (1) the potential change in the composition of the economically active population and of the general labour force; (2) a variation in population size and age composition, between urban and rural areas; TABLE II. Classification of papers by subject Subiect Number Papers collected Per cent of total I. Demographic position (195) (42.6) Demographic trends Migration and urbanization Population and development Methodology and theoretical issues II. Fertility and family planning behaviour (127) (27.7) Fertility determinants Family planning behaviour Medical aspects of family planning Abortion III. Population policies and family planning programmes (83) (18.1) IV. Islam's views on population and family planning issues (53) (11.6) Islam and family planning Islam, the family and social change Islam, abortion and sterilization

44 and (3) the inadequate system of health services contributing to the high level of infant and adult mortality. As a result, a majority of papers projecting population trends recommended the implementation of family planning programmes as a necessary measure for extenuating the consequences of a rapidly growing population. A minority of papers favoured the current high rate of population growth based on the assumption that countries in which natural resourcrs are not completely exploited, cannot have a population problem. 2. Migration and urbanization (41 works): The majority of these studies discussed the demographic, socioeconomic and cultural aspects of urban migration. Twentyfive works are based on census information, 13 works are based on sample surveys and the remaining works are supported by estimates. Ten of the studies are concerned with migration in Egypt and Tunisia, six of the studies examine the subject in the Syrian Arab Republic and several works discuss population movement in each of the following countries: Morocco, Kuwait, Iraq, Lebanon, Sudan, Algeria, Jordan, Libyan Arab Jamahiriya and the Arab Republic of Yemen. All the studies cited the occurrence of rapid urbanization in recent years in the Arab countries, and the accelerated movement from rural areas to cities. The discussion of the factors contributing to this internal migration indicated that the most important factors are: (1) the deteriorating conditions of the rural areas; and (2) the greater employment opportunities and improved educational and cultural facilities in the urbanized centres. Additional factors were found to determine the volume and direction of migratory movement including the distance and size of the cities, the level of education and the discovery of oil. In addition, the results from several studies reported the following causes of increased rural migration: (1) a resistance of couples to control their fertility; and (2) the improvement in health services and consequent reduction of mortality; both of these factors have contributed to an increase in population density in rural areas and, consequently, to a reduction in social and economic opportunities. Several studies described the selectivity of migration by age and sex structure, and found the migrant population to consist predominately of male, young and productive persons. Also, study findings revealed that the fertility patterns of rural migrants were not significantly altered, indicating that urbanization has not affected fertility levels. Consequently, family planning programmes are strongly recommended for both urban and rural areas. In addition to the discussion of the causes of migration and the factors contributing towards increased migration, several studies pointed out that major problems are facing the urban areas. As a result of the large population movement from rural to urban areas, heavy burdens are being imposed on the various public facilities and limited accomplishments have been made regarding social and economic development. 3. Population and development (56 works): Onehalf of the works in this category discussed the interrelationship between population and development in three of the countries, namely Syrian Arab Republic (12), Algeria (6) and Sudan (6). Six works discussed this topic in the Arab world in general and reference to individual Arab countries was made in several works as follows: Egypt (6), Tunisia (5), Morocco (4), Jordan (2), Qatar (2), Kuwait (2) and one each for Bahrain, Lebanon, Arab Republic of Yemen and Iraq. Nearly all the works emphasized the unmatched race between population growth and economic and social development. Several studies referred to a summary of the goals set in the fiveyear plan in certain countries and indicated that factors having an unfavourable effect on the attainment of development goals include: (1) ruralurban migration; (2) ill health; (3) low proportions of economically active population; (4) limited female participation in economically productive activities; and (5) high illiteracy rates. Several works provided estimates to 1985 of the prospects for economic development in relation to the expected population growth. Topics receiving particular attention from the authors included the changes in age and sex structure, high dependency ratio, the relation between childbearing and unemployment of women, rates of unemployment for men and women, and labour and unemployment in general. Several works elaborated on the role of education as a factor in socioeconomic development, and as an influence on the demographic variables. Some studies mentioned the problems of training the required number of teachers to meet the demands imposed by the increasing population of school aged children. For example, one study pointed out that in spite of all efforts and expense, Egypt has enrolled in school only 68 per cent of the primary school aged population. Also, remarks from another study stated that enrolment of females in schools remains below that of males at all levels, and that in order to meet the educational goals in the next 20 years, the number of schools must be doubled. The problems of meeting the goals of full educational enrolment have serious implications for the development of the Arab society as a whole. In addition, several studies examined the health situation and found that health conditions and the effects of high mortality and morbidity rates delay or prevent social and economic development. Findings indicate that although health services and medical care remain inadequate in the Arab world, recent population growth continues to threaten the capability for any future savings or investment capital to provide even modest improvement to social and health services. A majority of the works concluded their studies with recommendations to implement family planning and to increase the participation of women in developmental programmes. Further recommendations from the studies included the following measures: improving the status of women, reducing infant mortality, providing safe, inexpensive and acceptable contraceptives and training 47

45 family planning administrative and service personnel. The importance of these measures in contributing to the progress in social and economic development was emphasized. 4. Methodological and theoretical population issues (33 works): Studies in this category were limited to nine Arab countries: Sudan, Syrian Arab Republic and Tunisia each were the focus of three of the works. Two works were related to research methodologies in Egypt and one each referred to Libyan Arab Jamahiriya, Kuwait, Jordan, Arab Republic of Yemen and Algeria. Five studies discussed principles of demographic methods in general. Onefourth of the works reported on the methods and problems of collecting demographic information, suggesting demographic models and explaining methods used for studies of family life and human fertility. Another onefourth of the research works investigated various aspects of demographic techniques and the status of demographic research in the Arab countries, as a whole. Reference was made to the most critical problems affecting the curtailment of demographic research in the Arab world and are reported as follows: (1) the lack of basic statistics; (2) the shortage of qualified demographers; (3) the absence of professional demographic research organizations; (4) the lack of communication between research scholars; (5) the inadequacy of facilities for training demographers; and (6) the marked variation in the quality and quantity of demographic information about the region. The remaining works in this category referred to methodological and theoretical issues in specific Arab countries and included descriptions of techniques and methods used in censustaking, vital statistics, the labour force surveys and in KAP studies. Most of the works emphasized the need for improving and sophisticating current research practices, census operations, and vital registration techniques. B. Fertility and family planning behaviour (127 works) About 28 per cent of all the collected papers dealt with fertility and family planning behaviour in the Arab world and may be classified under the following four categories: (1) fertility determinants (58 works); (2) family planning behaviour (43 works); (3) medical aspects of family planning (11 works); and (4) abortion (15 works). 1. Fertility determinants (58 works): Nearly all of the papers in this group examined factors affecting fertility in specific countries, namely Egypt (25), Tunisia (7), Morocco (4), Jordan (4), Syrian Arab Republic (3), Lebanon(2), Algeria(2) and one each for Sudan, Kuwait andmauritania. Eight papers referred to fertility factors in the Arab world, in general. Fertility levels in countries with available information were compared. Birth rates showed an increase after 1965 in Kuwait and Algeria, a decrease in Egypt and Tunisia, and no change in Jordan and Morocco. In general, fertility is recognized as high in the Arab countries, and also slightly lower in urban than in rural areas. According to some studies, the recent increase in birth rates in many countries is mainly due to an improvement in registration and to better health care. A review of the findings obtained from fertility and KAP studies conducted in the Arab countries points out contradictions with respect to the socioeconomic factors affecting fertility. However, there is considerable agreement on the inverse relation between fertility levels and the educational level of women, the occupational level of husbands and the cultural level for the couple. Similarly, the marked effects on fertility of paid employment of women, and the woman's age at first marriage were pointed out. The findings about knowledge and practice of contraception are also contradictory. Several studies conclude that contraceptives are almost unknown to parents, while other studies indicate that all respondents know one or more methods of contraception. Further findings conclude that divorce reduces fertility, but polygamous and multimarriages have no definite effect on fertility. Investigation of other factors indicated that a positive correlation exists between birth rates and infant mortality rates, that differences in religious affiliation do not affect fertility, and that differential fertility between urban and rural areas is due mainly to differences in the economic and cultural variables influencing modes of behaviour.,in a few papers, the sociopsychological factors influencing fertility were examined concluding that men tend to have a passive and unfavourable attitude towards small families, and that they are generally opposed to the employment ofwomen; inaddition, parents of couples interfere in the decision of determining the number of desired children, considering children as a gift from God, and as a source of family prestige. The attitudinal studies indicate that disapproval of family planning was highest among illiterates, and the desire for additional children was due mainly to sex preference and fear of infant mortality. However, findings clearly pointed out that the ideal number of children was less than the actual family size for all socioeconomic classes. Further conclusions made in some papers on the consequences of high fertility pointed out that large size families create unfavourable conditions and possible repercussions on the physical and psychological development of the child. Furthermore, successive pregnancies tend to undermine the mother's health, place burdens and stress upon the fathers, and generally affect the mother's ability to care for existing children. 2. Family planning behaviour (43 works): Nearly all of the studies in this group were conducted in countries having established population policies and family planning programmes, namely: Egypt (18), Tunisia (12), and Morocco (5). The remaining eight papers examine family planning behaviour in Lebanon (3), Iraq (3) and Algeria and the People's Republic of Yemen (oneeach). Topics discussed in these works include the following: (1) the extent of family planning practices among 48

46 different agegroups of mothers in rural and urban areas; (2) the socioeconomic characteristics of family planning acceptors; (3) factors influencing family planning acceptance; (4) contraceptive methods and their use effectiveness; and (5) the most preferred contraceptives. The basis for the information obtained in a majority of these studies is KAP surveys conducted on small samples of the population. The studies indicate significant differences in the extent of and the desire for family planning whether among different countries or within the same country among various socioeconomic groups. These results may be partly due to generalizations made on the basis of findings from studying a small sample of cases, and therefore cannot be considered as an accurate reflection of the pattern of family planning behaviour in the Arab world. However, considering this limitation, some important findings are revealed: (a) among the factors influencing the acceptance of family planning practices are the educational level of women, the improved socioeconomic conditions and the existence of mutual communication between husband and wife; (b) the factors hindering the spread of family planning include a belief among a high percentage of wives that contraceptive methods are harmful to health, and that these methods are not approved by religion. However, some studies indicate that the majority of the respondents and most of the religious leaders, asserted that religion approved family planning; (c) several studies revealed that knowledge of contraceptives is not widespread. One study in Tunisia points out that 40 per cent of men and 25 per cent of women of childbearing age had no knowledge of contraceptives. However, in areas where family planning programmes are established, several important changes have occurred rapidly. For example, in a fiveyear period, the knowledge of family planning grew from 44 per cent to 90 per cent, the proportion of individuals desiring fewer children increased from 23 per cent to 56 per cent, and the number desiring a larger family decreased from 68 per cent to 42 per cent; (d) a number of studies investigated the ideal versus the actual number of children desired by both men and women. Results from one study in Tunisia, for example, stated that for women the average ideal number of children was 2. 5, for men 3.5; in comparison, the average number of living children was 4.5 per family. Between rural and urban areas, a marked difference in the desired number of children was found. For example, in Morocco, 70 per cent of the rural families as compared to 42 per cent of the urban families wanted to have more children. The ideal number of children desired was higher in rural than in urban areas, and in both areas the ideal number was less among men than among women; (e) studies of preference in the use of contraceptives indicate that the oral pill and the IUD are more popular than other contraceptive methods. In Egypt, about 70 per cent of the contracepting women use the oral pill. In Tunisia, an estimated 7 to 10 per cent of the married women of reproductive age are fitted with an IUD; (f) sources of contraceptive information were examined in different surveys and the responses from the respondents indicate that friends, relatives and neighbours as well as family planning centres, hospitals and private physicians were the main sources of informationoncontraceptives. The mass media was usually cited as a source of information by fewer respondents. More information about contraceptive methods was requested by men and womenin rural areas; (g) studies dealing with the opinions of health personnel regarding the implementation of family planning programmes show the following: (1) most physicians recommend that family planning education be given routinely to all patients; and (2) most traditional midwives disapprove of the use of contraceptives; (h) finally, several studies showed that the majority of women expressed the desire to limit family size but were not actively controlling the number of births. 3. Medical aspects of family planning ( works): Three papers in this group discussed the medical implications in general, and eight papers investigated the problems and relative advantages of contraceptive use as experienced by the following specific countries: Egypt (3), Tunisia (2), Morocco (1), Iraq (1) and a combination of Arab countries (1). Types of contraceptives were discussed including their medical implications and relative advantages. A comparison is made between the traditional, chemical, and more modern contraceptive methods, concluding that the prescription of any method should depend on each individual case. Methods of female sterilization for birth control were also discussed. Periodic abstinence was recommended in one study as a safer method than mechanical or chemical contraceptive methods. Another study emphasized the need for perfecting some of the contraceptive methods; a result of survey findings revealed that 50 per cent of IUD users and 75 per cent of pill users had discontinued these methods by the end of the survey period due to side effects, or unsuccessful use of these methods. Emphasis was placed on the need for and importance of physicians rather than the mass media to deal with the psychological and physiological problems of family planning. 4. Abortion (15 works): The prevalence and medical consequences of induced abortion were described in specific Arab countries. Six papers discussed induced abortion in Egypt, two papers each discuss the issue in Tunisia, Lebanon and Jordan. One paper each examined the abortion situation in Morocco, Iraq and Kuwait. In general, the studies under this topic dealt with the impact of socioeconomic conditions, level of female education, unwanted pregnancies, and the age of mothers on the frequency of abortion. An investigation of the methods used in induced abortion and the complications encountered were also reported in some studies. The decrease in the incidence of abortion as a result of the change of the penal code in Tunisia has been estimated, as well as the impact of the introduction of the pill and IUD in several other countries. 49

47 C. Population policies and family planning programmes (84 works) Several studies in this group described the establishment, development, objectives and achievements of family planning programmes in countries with existing programmes. Seven papers discussed the philosophy, scope and methods of population policy in general; five papers presented a descriptive analysis of the status of population policies and family planning programmes in the Arab world, as a whole. The remaining papers discussed family planning programmes and objectives and achievements of family planning in specific countries, namely: Tunisia (25), Egypt (23), Morocco (11), Sudan (3), Iraq, Syrian Arab Republic and Algeria (2 each), the Arab Republic of Yemen, Kuwait and Lebanon (1 each). A number of papers described the current and future prospects of population characteristics for those countries having no officially organized family planning programmes and emphasized the necessity of adopting population policies. Some studies described the respective roles of the pediatricians, traditional birth attendants, and female volunteers in family planning programmes. Other studies elaborated on providing family planning services through workers' organizations, maternal and child health (MCH) centres, educational schemes and health programmes. Several studies discussed problems related to family planning programmes such as the belief system in peasant societies, difficulties of producing a simple, cheap and acceptable contraceptive for the developing countries and the prevailing legal systems. Some studies emphasized the need for efficient administration, leaders' training programmes and the systematic evaluation of the success or failure of family planning programmes. Several studies explained the rationale for family planning programmes with emphasis on the improvement of health status of mothers and children; the achievement of nutritional, educational, and social needs; and the reduction of the high rates of population growth. Some studies explained the reasons for encouraging population growth in certain countries on grounds that the country is underpopulated (Sudan), or for purposes of maximizing the growth of the indigenous population to check the increasing rate of foreign employment (Kuwait). In addition, some writers express the opinion that the Arab world has no overpopulation problem, maintaining that a maldistribution of population may exist as a result of the creation of artificial boundaries among the Arab countries. Several studies focused on measures for effective implementation of family planning programmes, both current and proposed. Implementation strategies include the following: introducing outreach contraceptive distribution projects; integrating family planning activities into public health and social welfare programmes; involving the traditional birth attendants and the pediatricians in providing family planning information; concentrating family planning campaigns in rural areas; producing multidimensional mass media to reach all cultural levels; changing the socioeconomic conditions of the peasant society to create a favourable atmosphere for accepting family planning; introducing population education in schools, literacy classes and adult education programmes; introducing new laws to effect a change in the status of women and the age at marriage; and expanding educational facilities and employment opportunities for women. A few studies outlined the constraints to the successful implementation of family planning programmes as follows: (1) a lack of knowledge of contraceptive methods, particularly in rural areas; (2) gaps in research regarding the factors affecting motivation and change in the traditional norms and values; (3) inadequate government funding; (4) absence of continuity in leadership; (5) confusion of intergovernmental relationships; (6) inadequate services at family planning clinics; and (7) high rates of infant mortality. D. Islam's views on family planning issues (53 works) The majority of the studies in this group were contributed to the conference held at Rabat, Morocco, in 1971, by the International Planned Parenthood Federation(IPPF). Twentysix papers discussed the topic of Islam and family planning; 19 papers described Islam's concept of the status of the family, and reviewed changes in kinship systems in Muslim societies, and eight papers focused on the question of abortion and sterilization in Islam. 1. Islam and family planning: Discussion in the studies dealing with this topic encompassed the Muslim precepts and teachings with reference to family planning. In all the studies, the method of approach was descriptive and based on references from the Koran, the prophetic traditions, and the interpretations of theologians. Most writers on this topic recognized that family planning is permitted by Islam, by analogy with what was known and approved of in the time of the Prophet, 'AlAzl'. The basis for the support of this argument can be found in the following precepts: (1) Islam does not approve of a weak, spineless community; (2) traditional culture can be adapted to the consequences of modern living; (3) Islam calls on parents to be concerned about begetting and bringing up healthy children who will be able to face the problems of life; and (4) Islam awards individuals ample scope to exercise judgement in solving problems and framing laws according to the circumstances of time and place. In addition, some studies indicated that Islam has provided two natality models, including: (1) a traditional model which encourages high fertility to compensate for high mortality; and (2) a fertility control model which encourage s fertility limitation, once mortality is lowered. In both models, Islam advocates family planning as enhancing to family health and wellbeing. It is true that Islam encouraged reproduction during the founding of Muslim civilization and empires; yet new conditions have emerged, and many M us lim countries now face the crisis of overpopulation. Two papers advanced the opinion that family planning is tolerated by Islam if the objective is 50

48 to regulate births, and not to limit the number of offspring. Two other papers were explicitly against family planning on grounds that birth control by any method tends to impoverish life and that abortion and sterilization are repudiated by Islam. These two studies also maintained that birth control as a means of averting hunger and hardship would imply a lack of faith in God and God's omnipotence. 2. Islam, the family and social change: The papers dealing with this topic review the status of the family, recognizing that Islamic society has passed through basic social and economic changes which have reflected on the family. The development of industrialization, the processes of modernization, and the rapidly emerging urban centres are recent phenomena affecting changes in basic ways of life in the Islamic society. Admitting overwhelming changes in the Islamic society, studies emphasize that Islam is opposed toa static socialorder; and in recognition that development is inevitable, Islam being a flexible and adaptable religion, is capable of meeting the challenge of modernization and adapting itself to every aspect of development. Islam has provided fixed principles, but in order to meet developing needs, is leaving details and methods of application to the individual's interpretation. In addition, Islam allows a change in rules to conform with public interest if no contradiction with the faith or divine decree exists; and further, a great body of jurists allow modification of the law where there are no explicit texts or true consensus. Regarding the status of the family and the role of women in Islam, many papers pointed out that Islam emphasized the family as the foundation of society. Women have the basic right to choose their own husband and to have the marriage annulled, also to share the inheritance of her parents and to handle property. Thus, Islam placed women on an equal footing with men in all legal matters and functions. Historically, women had an equal role with men in propagating the Islamic faith; for example, sanctioning four wives for a man is nearly prohibited and the power of divorce by husbands is restrained. Social and economic change in the Islamic society has led to the emergence of the nuclear family, female education and employment, all are incompatible with excessive numbers of children. Since Islam emphasized the proper upbringing of children and numerous children interfere with this goal, consequently a small number of children and the spacing of births are encouraged. As a result, methods of family planning are allowed by Islam if utilized to achieve this end. The consensus of most papers is that family planning is consistent with the teachings of Islam and the achievement of happiness for the man and his family, 3. Islam, abortion and sterilization: The question of abortion and sterilization in Islam was the focus of eight papers in this group. Many papers touched on this question in their discussion of Islam and family planning. A majority of the studies support the permissibility of abortion if practised before animation (before the completion of four months of pregnancy), while a minority limited approval to the duration of pregnancy of 40 days only. Several writers postulate that abortion is conditional even in the early stage of pregnancy, and is allowed in cases where the mother's life is in danger, or the probability is strong that the child will be born deformed or diseased. Arguments on the subject affirm the prohibition of abortion either before or after the fetus becomes viable, on grounds that all phases of fetal growth possess a life tobe respected and that abortion poses a danger to the life and health of the woman. Another argument states that there is no justification for abortion on grounds of fear of poverty or overpopulation, or of a high rate of population increase. Basic differences in the opinions of the writers regarding the view of Islam on sterilization also are pointed out. Several studies admit to the validity of sterilization in Islam in cases of danger to the mother's health from excessive pregnancies or, from compelling demographic or health reasons. Other studies reason that since there is no clear text either in the Koran or in the traditions that forbids it, sterilization is unconditionally permissible. Others assume that temporary sterilization is allowed, but permanent sterilization is prohibited. In the former case, sterilization becomes one of the many methods of family planning permitted by Islam and approved by Muslim jurists. Other opinions state that sterilization is generally not prohibited if medically performed with consent of both partners, and provided there is no resulting impairment of virility or harmful effects. II. GAPS IN KNOWLEDGE AND RECOMMENDED RESEARCH DIRECTIONS Generally, population research in the Arab countries is in an initial stage of development and fundamental handicaps must be overcome before basic progress can be achieved. The analysis of the studies reviewed in this chapter indicates that only four of the Arab countries were the focus of 70 per cent of the compiled works. There are gaps in the knowledge related to various areas of population and family planning literature and related data collection techniques are in need of improvement. As mentioned earlier, few countries have undertaken population censuses regularly, and vital statistics remain far from adequate, both contributing to limited research information. More than onehalf of the Arab countries only recently began census taking (in the 1950s and early 1960s), and therefore analysis of population trends and changes is not possible. Many censuses have not yet been published due to incomplete results. Other handicaps in the field of population research include the scarcity of trained demographers, nonexistence of financial resources to support research efforts and the lack of knowledge by policymaker s of the social and economic consequences of population trends. The extent of these problems in the various Arab countries reflects the quantity of population research undertaken in each country. 51

49 Since reliable demographic data is a prerequisite for population research, improvement in census taking and in establishing effective systems for obtaining vital statistics are critical needs in many of the Arab countries. Questionnaires and methods of data collection should be modified according to the conditions prevailing in the Arab countries. For the purposes of comparative studies, standardization of demographic concepts and definitions is needed on a regional level. The reliability of demographic research data will be improved through the use of relevant designs for improving the quality of estimation methods and survey errors. Current research techniques hamper many countries in the Arab region in the completion of a full and comprehensive appraisal of their particular demographic situation. A. Gaps in knowledge related to the demographic variables The majority of the studies dealing with the demographic situation are concerned with rapid population growth, due to an accelerated imbalance between birth and death levels andinclude fertility, mortality and migration studies. 1. Fertility: The gaps in knowledge and recommended research directions related to fertility are dealt with under item 4 of this section, entitled 'Gaps in knowledge related to fertility and family planning behaviour'. 2. Mortality: While fertility levels were the focus of the majority of the studies of population growth, mortality levels stimulated much less interest. At present there are gaps in the knowledge of mortality implications in the Arab world, and further research is needed. Trends in declining death rates have been pointed out in some studies and comparative descriptions were made between Arab countries and within types of areas among specific countries. Attempts were made in a few papers to construct models for infant mortality and to evaluate rural health services. But further study is necessary of mortality patterns after childhood in order to contribute to the accuracy of estimating age and sex structure, as this contributes to the accuracy of population projection. Furthermore, knowledge of the effects of malnutrition on mortality is indispensable in recommending measures necessary for reducing mortality. 3. Migration and urbanization: The discussion in works dealing with these topics referred primarily to the situation in Egypt and Tunisia. The majority of studies discussed the demographic, socioeconomic and cultural characteristics of migrants to cities, and the increasing pressures of rapid population grow thin urban centres. There are gaps in the present knowledge of the factors, and consequences of immigration within different types of areas, maintaining the distinction between urbanization and industrialization as these affect fertility and mortality. In this respect, research is needed in the following areas of study: (1) the fertility and mortality levels of rural migrants, compared with the levels of nonmigrants remaining in the rural areas; (2) the effect of shortterm male migration on fertility; (3) the process of migrants' integration at their place of destination; (4) the effect of migration on age structure and birth rate in sending and receiving areas; (5) the motivation, timing and direction of seasonal migration, particularly nomadic movement; and (6) the extent, nature and causes of international migration. Few papers have observed the migration of highly qualified personnel to the oilproducing Arab countries and to the West, and complete observation and documentation of this activity is needed. Also, the shortage of various skills and its effects on the development of the sending countries is not known. B. Gaps in knowledge related to population and development The knowledge implicating population as one of the variables affecting development indicates a difference in opinion as to the extent and importance of this variable. An incomplete understanding of this relationship is due to the lack of adequate data and information, as well as the limitations of an analytical framework. In most studies concentrating on population and economic development, the expected changes in mortality and fertility levels (and consequently in the rates of population growth) in the studied countries were not considered. Determinants and consequences are not known for the effect of high fertility, declining mortality and rapid population growth as factors affecting the development of social and economic institutions and conditions, i.e. education, housing, unemployment, health, agricultural productivity, industrialization and the levels of living in general. Further research should include the effects of development on the demographic variables (fertility, mortality and migration) and the geographic distribution of inhabitants, with a clear understanding of the social and economic factors associated with fertility differentials. The effects of the relative deficiency of adult populations in the Arab countries on the per capita output needs to be investigated, in view of the implications and economic consequences of a rapidly growing proportion of dependants. Adequate analysis must be completed for the extent of participation of women in the labour force, with particular attention to standardization of definitions and interpretations of 'women engaged in economic activities', in order to validate comparisons among Arab countries. Other issues concerning worker productivity as this contributes to economic development require further research in the following areas: (1) poor health as a major cause of low productivity, to include a realistic estimation of losses in output in view of the investment in health improvement programmes; (2) low agricultural productivity, with particular emphasis on results of efforts at extensive cultivation; (3) insufficient quantity of land, to include the effects of agricultural overpopulation on wastage of manpower and an estimate of the gains in agriculturalproductivityassociated with land reclamation and improved irrigation 52

50 methods; (4) introduction of machinery and changes in the efficiency of production; and (5) reform in economic and social structure. Additionally, industrialization has not been adequately studied. The areas where more knowledge and analysis is particularly needed include the demographic implications of industrialization (birth and death rates, and rates of population growth), and their reflection on per capita income and standards of living in the Arab countries; the obstacles to industrialization, including qualified manpower, sufficiency of raw materials and power resources, marketing distribution of manufactured goods; and also the effects of different rates of population growth on basic factors of production. Further research should also include the issue of needed investment for social developmental purposes to provide for additional schools, sanitary facilities, health institutions, etc. A distinction must be made between 'demographic' investments (necessary for a growing population to maintain a constant living standard) and 'economic' investments (which tend to raise the living standard), estimating the effect of rapid population growth on decreasingly available capital and on retarding economic development. Such studies will require cooperative efforts by demographers, statisticians, psychologists, economists, biologists, physicians and geographers. C. Gaps in knowledge related to methodological and theoretical population issues Many of the papers in this subject area suggest an improvement of the methodological and theoretical approaches to data collection. As mentioned previously, the value of any demographic study depends basically on the accuracy of data, which in turn are affected by the clarity and relativity of the schedules used and the suitability of methods followed in data collection. Since the conditions and problems in the Arab countries are different from those of the developed countries, and indeed are different among the Arab countries themselves, there is need for development of questionnaires, schedules and methods of data collection suited to conditions prevailing in the Arab countries. Concepts and definitions of such terms as 'urban', 'participation of women in labour force', 'levels of education' must be standardized to allow for meaningful comparisons. The majority of works in this section have emphasized the similarity of certain overall demographic characteristics in the Arab world, such as levels of fertility and mortality, and trends in population growth. However, the great diversity of economic and social conditions reflected in the social structures and in the size and resources of individual countries has often been overlooked in the analysis. Since all developmental and population policies depend basically on the reliable estimation of demographic events in the future, research designed to improve the quality of projections would seem to warranta high priority. Also, further studies are needed on sampling methods, survey designs and survey errors to accommodate the wide range of conditions in the Arab world. D. Gaps in knowledge related to fertility and family planning behaviour As indicated earlier, most of the works in this section were limited to factors affecting fertility and fertility differentials in urban areas, and pointed out the limited amount of information available. A considerable proportion of the studies are based on findings of KAP surveys and the conclusions were made from too small a sample to be reliable. In general, information on the socioeconomic determinants of fertility is relatively scanty and descriptive. The approach of most studies was to examine the associative relationship between a number of variables and fertility, without determining a causal relationship. The evidence for the effect of income on fertility is not strong when other associated factors are held constant. Since income is correlated positively with education, infant survival and urbanization, the observed negative effect of income on fertility may be influenced by the former variables; therefore the effect of each variable should be determined separately. Education appears tobe one of the most powerful and pervasive variables which contribute to the reduction in fertility levels. However, research is needed to test the degree of effect of this variable in the area of compulsory education and male and female education. The necessity to determine the fertility differential effect of male education and female education emerges from the fact that male education may represent more of a 'pure income' effect, positively affecting fertility levels, while women's education is expected to represent a 'price effect' and negatively affects fertility levels, as more women are encouraged into the labour force and away from the home, at the expense of an increased number of children. Again, the negative impact of women's education on fertility represents several causal relationships in need of separate documentation, particularly lower fertility levels resulting through such channels as: (1) improved efficiency of contraceptive acquisition and use; (2) exposure to modern ideas; (3) increased opportunities for nontraditional activities; and (4) new opportunities for labour force activity. The effect of each channel of information input should be measured separately. Research is also needed to measure the influence of education in changing fatalistic attitudes, enhancing the belief in one's ability to control events and in increasing the wife's role infamily decisionmaking. Similarly, further research may determine the extent of fertility differential between females working at home and away from home, other factors being equal, as well as to assess the effect of the level of women's contribution to family income and her role in decisionmaking. In the experience of several countries, the studies show that the pattern of fertility for families changing occupational status is intermediate between the original and the new occupational group. This pattern of fertility change needs to be examined 53

51 with respect to the change in overall occupational status in the Arab world. There is evidence that where children are economically productive, parents choose higher fertility and the validity of this assumption needs to be tested through an analysis of information obtained from different Arab countries. The literature on family planning behaviour is largely descriptive of existing programmes. Evidence from these studies indicate that the desired family size inmost areas of the Arab world remains high. Family planning activities have helped people to avoid excess fertility and meet demands for small families, but have little or no independent effect in creating the demand for a small family size. The lack of family planning information was found to be one factor limiting the use of contraceptives. Also findings indicated there was widespread ignorance about overpopulation and its consequences. There is a need for research regarding how to create a small family norm and hence a demand for family planning. In general, the attitudes towards family planning are favourable but practice of family planning is very limited. Also, research is needed on how to improve the use of contraceptive methods. Many surveys indicated high rates of discontinued use by IUD and pill acceptors. The medical side effects of family planning methods, as these affect family planning behaviour, need further examination. Additionally, the practice and duration of breast feeding, the effects of reduced lactation on increased fertility and poorer health of infants is not clear and needs further investigation. Additional recommendations for research in family planning behaviour include studies on the differences in the biological capacity to conceive and reproduce, both among different populations and among different strata of the same population. Additionally, the relation between the different types of family structure and family planning behaviour also needs clarification. Clearly, the necessary prerequisites for modifying family planning behaviour include several important measures, and studies are required in all of these, namely sex preference among different strata of society, the female's role in family decisionmaking, the role of women in society and the role of inheritance and social security systems on fertility E. Gaps in knowledge related to population policy and family planning programmes The studies in this area discussed a wide range of aspects related to population policies and the implementation of family planning programmes, and were clearly limited to descriptive comments on the population policy of individual Arab countries and the problems encounteredinpolicyimplementation. Research is needed in the area of population policy formation and its influence on the rate of population growth, the administrative problems involved in execution of population policies and the impact that such measures are likely to have on economic and social development. There is also a need to achieve a clearer understanding of the social and economic variables conducive to fertility decline such as different levels of education, indices of economic development, changing roles of women and different types of kinship and family structure. The literature review shows that all these variables need to be researched at their different stages of development. Also, the effect on fertility of longterm economic and social plans must be studied and considered in formulation of the population policy. In addition, the formulation of population policy must be preceded by investigation and recognition of cultural values and traits in the concerned countries, in order to avoid any value conflicts and to ensure the achievement of the desired pattern of development and demographic changes following the adoption of the population policy. A population policy concerning the migration aspect should be based on an understanding of the motivations for, and conditions of migration. Therefore, the integration of migrants at their place of destination, and the consequent effect for the place of origin must be studied. Additionally, the choice of the time of migration and the place of destination, as well as the factors of seasonal migration, must be clarified. As indicated, the adoption of a population policy is not a guarantee for achieving its objectives. Various types of research are basic for the successful implementation of population policy. Causal relationships involved in population changes in a country need tobe determined in order to predict and influence its future path. Research results should be used to set the exact points at which successful intervention is possible for population policy to influence fertility decisions. Similarly, the effects of social and economic development on fertility should be examined before determining the most appropriate mode of industrial development. For example, each type of industry (heavy, light or cottage) would have different important effects on other social and economic variables. It is hypothesized that light industries would tend to draw women out of the home and give them incentives to reduce fertility. Heavy industry relies primarily on male labour and would not have the same effect. But cottage industries, by enabling women to combine work at home with family responsibilities may serve only to endorse existing high fertility patterns. More studies are recommended in this area. In addition to research in public policy formation, the elements of population policy should be examined to stress its effect on the improvement of the welfare of the individual. Studies are needed to assess the efficiency of different types of contraceptive measures in averting births which would have occurred in the absence of these devices. As mentioned before, research is needed in the biomedical field to include the improvement of contraceptive methods. Concerning the dissemination of contraceptive information, there is a need to investigate the most effective methods of disseminating information and for motivating couples as contraception acceptors, among the various segments of the population. 54

52 In addition, there is a need for sociological research regarding the roles played by different family members in the decisionmaking process and for correlation with programmes which aim at creating the desire for a small family norm. It is also important to study the attitude and motivation of men, as important determiners regarding family planning decisions. Research related to population policy for any country must not be limited to fertility implications but must also include the interrelationship between fertility and mortality, morbidity and migration. The results of this research should be utilized to provide necessary background information for educating policymakers. Finally, research is needed, following the adoption of population policies, to determine the effect of such a policy on population events, comparing the achievements with the stated objectives of the policies. Of particular importance is the monitoring of the recently reduced growth rates in some Arab countries and the study of the possible circumstances leading to this decline in the growth rates. F. Gaps in knowledge related to Islam's views on family planning issues 1. Islam and family planning: Most studies reviewed conclude that family planning is permitted by Islam; however, there is some disagreement about the conditions under which family planning can be accepted and practised. Several studies indicated a need for research to clarify the social and economic circumstances, necessitating family planning in accordance with the teachings of Islam about the welfare of the individual, and the prosperity and strength of society. Society's changing characteristics, as well as the necessary behavioural changes associated with these changes, are recommended for further study. Religious opposition to family planning also needs further analysis. 2. Islam, the family and social change: Most of the papers reviewed recognize the social and economic change undergone by Islamic societies and the impact of the change on the family and the development of society. More research is recommended to define the Islamic principles guaranteeing protection to women in view of the present complex nature of society. Specifically, further study is recommended to determine the measures necessary for translating these principles into guidelines for practice in daily life. Another area requiring further research encompasses the wide disparity in national laws governing marriage, divorce and separation in developing countries, with emphasis on determining the relationship to the variation in fertility levels. 3. Islam, abortion and sterilization: The studies indicated that there is a distinct difference of opinion among the scholars regarding Islam's view about abortion and sterilization. Research recommendations include the need for a clarification of abortion and sterilization as methods for fertilityregulation, from the religious point of view. Additional investigation is needed to determine the volume of legal and illegal abortions performed, where dependable information is available. There is also a need for medical research to determine the immediate effect of induced abortion on secondary sterility and miscarriage, as well as the effect of induced abortion on sterility with other accompanying complications. Studies indicate a variance in response to the liberation of abortion laws and the adoption of contraceptive use; therefore, research is needed on the possibility of legalizing abortion, in view of the culture and values in the Arab countries. Conclusion The present manuscript attempted to ascertain the state of the art with respect to population policies and family planning communication strategies in the Arab states region through a critical review of pertinent literature and research studies, with emphasis on identifying gaps in knowledge and recommending research needs. The 459 research works selected for review, written during the period , were summarized and presented in Volume I. Since that period, new research on the subject was conducted, changes occurred in the conceptualization, formulation and implementation of population policies and family planning programmes and numerous works were published in this rapidly growing field. Accordingly, amanuscript of this kind can never be definitive or complete. Nevertheless, we feel that the attempt made in this manuscript to analyse the demographic situation in the Arab countries, to review the empirical findings of relevant research, to identify gaps in knowledge and to recommend needed research will be pertinent to the concrete situations with which policymakers in the Arab states region must deal to solve, or to ameliorate, their countries' population problems. 55