POPULATION TRENDS AND CHALLENGES IN THE MIDDLE EAST AND NORTH AFRICA

P O P U L AT I O N

REFERENCE

BUREAU

POPULATION TRENDS AND CHALLENGES IN THE MIDDLE EAST AND NORTH AFRICA

The people of the Middle East and North Africa (MENA)* have long played an integral, if sometimes volatile, role in the history of human civilization. MENA is one of the cradles of civilization and of urban culture. Three of the world's major religions originated in the region--Judaism, Christianity, and Islam. Universities existed in MENA long before they did in Europe. In modern times, MENA's politics, religion, and economics have been inextricably tied in ways that affect the globe. The region's vast petroleum supply--two-thirds of the world's known oil reserves--is a major reason for the world's interest. But the influence of MENA extends beyond its rich oil fields. It occupies a strategically important geographic position between Asia, Africa, and Europe. It has often been caught in a tug-of-war of land and influence that affects the entire world.

Today, MENA's rapid population growth exacerbates the challenges that this region faces as it enters the third millennium. For hundreds of years, the population of MENA fluctuated around 30 million, reaching 60 million early in the 20th century. Only in the second half of 20th century did population growth in the region gain momentum. The total population increased from around 100 million in 1950 to around 380 million in 2000--an addition of 280 million people in 50 years. During this period the population of the MENA region increased 3.7 times, more than any other major world region (see Figure 1).

Population Change MENA experienced the highest rate of population growth of any region in the world over the past century. MENA's annual population growth reached a peak of 3 percent around 1980, while the growth rate for world as a whole reached its peak of 2 percent annually more than a decade earlier.1 Improvements in human survival, particularly during the second half of the 20th century, led to rapid population growth in MENA and other less

Figure 1

Ratio of Population Size in 2000 to Population Size in 1950, by Major World Regions

3.7

3.6

3.2

2.6

1.8 1.3

MENA Sub-Saharan Latin

Asia

North Europe

Africa America

America

S O U R C E : United Nations, World Population Prospects: The 2000 Revision (New York: United Nations, 2001).

developed regions. The introduction of modern medical services and public health interventions, such as antibiotics, immunization, and sanitation, caused death rates to drop rapidly in the developing world after 1950, while the decline in birth rates lagged behind, resulting in high rates of natural increase (the surplus of births over deaths).

The declines in mortality that occurred in the past 50 years in the developing world mostly benefited infants and young children. In MENA, infant mortality (infants dying before their first

This overview of population trends and challenges in the MENA region is the first in a series of policy briefs from the Population Reference Bureau that analyze population, environment, reproductive health, and development linkages within the framework of the Cairo Programme of Action and the cultural contexts of population groups in the region. Future briefs on MENA will cover specific populationrelated topics or country case studies.

* Countries and territories included in the Middle East and North Africa region as defined here are listed in the table on page 4.

birthdays) dropped from close to 200 deaths per 1,000 live births in the early 1950s to fewer than 50 deaths per 1,000 live births at the turn of the 21st century. Despite this sharp decline and the fact that infant mortality rates in some oil-rich Persian Gulf states are quite low (Kuwait's infant mortality is as low as the average for Europe), the regional infant mortality rate in MENA remains

Figure 2 Decline in Infant Mortality Number of deaths under age 1 per 1,000 live births 250

Yemen

200

Morocco

150 Saudi Arabia

100 Venezuela

Malaysia 50

0 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995

S O U R C E : United Nations, World Population Prospects: The 2000 Revision (New York: United Nations, 2001).

Figure 3 Total Fertility Rates

Average number of births per woman

8

Yemen

7 6

Turkey 5 4

Saudi Arabia Morocco

Egypt

3

2 1950-55 1960-65 1970-75 1980-85 1990-95 2000-05

S O U R C E : United Nations, World Population Prospects: The 2000 Revision (New York: United Nations, 2001).

higher than that of Latin America and East Asia (see Figure 2).

While the "demographic transition," the shift from high to low mortality and from high to low fertility, is well under way throughout the region, individual countries are at different stages (see Figure 3). On average, fertility in MENA declined from 7 children per woman around 1960 to 3.6 children in 2001. The total fertility rate (average number of births per woman) is less than 3 in Bahrain, Iran, Lebanon, Tunisia, and Turkey, and is more than 5 in Iraq, Oman, Palestinian Territory, Saudi Arabia, and Yemen (see Table 1 on pages 4 and 5).

Even though the decline in fertility rates is expected to continue in the MENA region, the population will continue to grow rapidly for several decades. In a number of countries, each generation of young people enters childbearing years in greater numbers than the previous generation, so as a whole they will produce a larger number of births. This phenomenon is referred to as "population momentum." The population of the region is increasing at 2 percent per year, the second highest rate in the world after sub-Saharan Africa. Nearly 7 million people are added each year, and MENA's population is expected to nearly double in the next 50 years (see Figure 4).

Demographic Consequences and Challenges Regardless of the level of economic development or national income, MENA governments are increasingly challenged to provide the basic needs for a growing numbers of citizens--adequate housing, sanitation, health care, education, and jobs--and to combat poverty, narrow the gap between rich and poor, and generally improve the standard of living. In addition, the region's scarce water resources need to be managed in the face of growing demand.

Its young population gives unprecedented momentum to MENA's population growth. Onethird of MENA's population is under age 15. Over the next 15 years these children and adolescents will reach their childbearing years and enter the job market. In most MENA countries, the number of women of childbearing age (15 to 49 years) will at least double in the next 30 years. Providing quality reproductive health services to a

2 PRB MENA Policy Brief 2001

growing number of women is a challenge and is key to slowing population growth.

As MENA's total population increases, so does its elderly population and with it a health burden that has important implications for the cost and configuration of health systems. For example, the elderly population of Egypt (60 years and older) is expected to grow from 4.3 million in 2000 to 23.7 million in 2050. Saudi Arabia's elderly population is expected to grow from 1 million in 2000 to 7.7 million in 2050.

MENA's working-age population is growing very rapidly as huge cohorts of children reach adulthood. In 1996, for example, there were five Jordanians under 15 years of age poised to enter the labor market for every Jordanian age 45 to 60 nearing retirement age. For Saudi nationals, this ratio was 8-to-1 in 1996 (see Figure 5).

The region's economic dependency--the ratio of the economically inactive to economically active population--is the highest in the world. Because of its young age structure and low level of female labor force participation, the proportion of the population that is economically active is lower in MENA than in all other regions. According to the International Labour Organization (ILO), the only countries with a dependency ratio of two or higher (an average of two or more persons not economically active per one economically active person) are found in the MENA region.2

Commitment to political stability, investment in health and human resources, and sound economic policies can turn the population challenges of MENA to "demographic bonuses." A demographic bonus may occur, for example, when a large young population is healthy, educated, trained, and ready to be absorbed in a market economy and to contribute to the national economy. Unfortunately, MENA countries are currently more likely to experience "brain drain," as large flows of educated peo-

Figure 5

Age and Sex Profiles of Jordan and Saudi Arabia in Mid-1990s

80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14

5-9 0-4

20 16

Jordan, Nationals 1996

Males

Females

12 8

4 04 Percent

8 12 16 20

Figure 4 Ratio of Projected Population Size in 2050 to Population Size in 2001

4.0

3.4 2.9

2.3

1.9

1.7

1.6

1.5

* Palestine includes the Arab populations of the West Bank and Gaza. S O U R C E : Carl Haub and Diana Cornelius, 2001 World Population Data Sheet (Washington, DC: Population Reference Bureau, May 2001).

Saudi Arabia, Nationals 1996

80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14

5-9 0-4

20 16 12

Males

Females

8 4 0 4 8 12 16 20 Percent

S O U R C E : United Nations Economic & Social Commission for Western Asia (ESCWA), Demographic and Related Socio-Economic Data Sheets for Countries of Social Commission for Western Asia as Assessed in 1996 (Beirut: ESCWA, 1997).

MENA Algeria

Egypt Jordan Palestine* AraSbiaaudi Turkey Yemen

PRB MENA Policy Brief 2001 3

Ta b l e 1 Selected Demographic and Reproductive Health Indicators

MIDDLE EAST AND NORTH AFRICA Algeria Bahrain Egypt Iran Iraq Israel Jordan Kuwait Lebanon Libya Morocco Oman Palestine 4 Qatar Saudi Arabia Syria Tunisia Turkey United Arab Emirates Yemen

Population Mid-2001 (millions)

385.6

31.0 .7

69.8 66.1 23.6

6.4 5.2 2.3 4.3 5.2 29.2 2.4 3.3

.6 21.1 17.1 9.7 66.3

3.3 18.0

Births per 1,000

Pop.

Deaths per 1,000

Pop.

26

7

25

6

21

3

28

7

18

6

37

10

22

6

27

5

20

2

23

7

28

4

26

6

39

4

42

5

31

4

35

6

31

6

19

6

22

7

18

4

44

11

Rate of Natural Increase

(%)

2.0

1.9 1.9 2.1 1.2 2.7 1.6 2.2 1.8 1.7 2.4 2.0 3.5 3.7 2.7 2.9 2.6 1.3 1.5 1.4 3.3

Projected Population

(millions)

2025

2050

568.7

719.4

43.2

51.5

1.7

2.9

96.2

114.7

88.4

100.2

40.3

53.6

8.9

10.6

8.7

11.8

4.2

6.4

5.4

5.8

8.3

10.8

40.5

48.4

4.9

7.6

7.4

11.2

0.8

0.9

40.9

60.3

27.1

35.2

12.5

14.2

85.2

97.2

4.5

5.1

39.6

71.1

Projected Pop. Change

2001-2050 (%)

87

66 300 64 52 127 64 128 181 35 106 66 218 239 45 185 106 46 47

54 295

Percent Urban

59

49 88 43 64 68 91 79 100 88 86 55 72 -- 91 83 50 62 66 84 26

1 Average number of children that would be born to a woman by the time she ended childbearing if she were to pass through all her childbearing years conforming to the age-specific fertility rates of a given year.

2 Deaths of infants under age 1 per 1,000 live births.

ple leave the region for Europe, North America, and other parts of the world.

Many governments struggle to provide for the basic needs of their growing populations. MENA's unemployment rate is the highest in the world. According to one analysis, between 1996 and 2010, MENA economies will need to create half again as many additional jobs as those that existed in 1996 in order to prevent the region's unemployment rate from increasing above its mid-1990s' rate of about 14 percent--assuming the proportion of working-age population who enter the labor market remains unchanged.3 The Egyptian economy, for example, needs to create an additional 500,000 new jobs each year to absorb new entrants into its job market. Even some of the oilrich countries in the Gulf, such as Saudi Arabia, which have traditionally had no unemployment, are faced with youth unemployment.

Unemployment is highest among young people and women. In Jordan in 1997, three-quarters

of the unemployed were 15 to 29 years of age, and the female unemployment rate was twice as high as that of men.4 Women in MENA face the highest rate of unemployment in the world. According to the ILO, the largest gender gaps in unemployment are found in MENA. Unemployment rates in Egypt were reported to be 24 percent for women in 1995, compared to 7 percent for men.5

To prepare its growing working-age population for the era of economic globalization, MENA requires a much greater investment in human resources. Despite governments' efforts in the area of education, the number of illiterate adults continues to increase in some countries. In Egypt, between 1980 and 1995, the literacy rate among the population age 15 years and older increased from 40 percent to 50 percent, but the total number of illiterate Egyptians still grew from 16 million to 19 million. Morocco's illiterate population grew from 8 million in 1980 to 9.5 million in 1995, despite the increase in its literacy rate from

4 PRB MENA Policy Brief 2001

Percent of Pop.

Age

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