Population Situation Analysis
Egypt 2016
December 2016
Team Leader:
Dr. Magued Osman
Authors (In Alphabetical order):
Ahmed Ragaa Ragab, MD, Ph.D.
Hanan Girgis, Ph.D.
Hassan Zaki, Ph.D.
Magued Osman, Ph.D.
Noha Al-Khorazaty
Ramadan Hamed, Ph.D.
Saeed Al-Masry, Ph.D.
Sherine Shawky, M.D., DrPH.
Zeinab Khedr, Ph.D.
Researchers:
Karim Shalaby
Amr Diab
Fady Ismail
Contents
Executive Summary 8
Introduction 13
Chapter 1: Population Status in Egypt 17
1-1- Introduction 17
1-2- Population Size and growth rate 17
1-3- Population dynamics 21
1-4- Population Characteristics 35
1-5- Demographic dividend in Egypt 40
1-6- Awareness of the population growth challenges 44
Chapter 2: Population and development strategy 47
2-1- Introduction 47
2-2- The national strategy for population and development 2015-2030 47
2-3- Other supporting strategies 50
2-4- The Sustainable Development Goals (SDGs) 52
2-5- Social protection programs 54
2-6- What else to do 56
Chapter 3: Sexual and Reproductive health 58
3-1- Introduction 58
3-2- SRH services 58
3-3- SRH, Health Systems and Service Delivery 60
3-4- Health Sector Reform Programme (HSRP) 61
3-5- Reproductive Health Services for Young People 64
3-6- How Reproductive Health and Reducing Unwanted Births Contribute to Poverty Reduction 65
3-7- Situation and trend in HIV/AIDS and STIs 66
Chapter 4: Inequalities and the exercise of rights 82
4-1- Introduction 82
4-2- Population Inequality by Poverty 83
4-3- Slum Areas 93
4-4 Street Children 99
4-5 Fishermen 103
Chapter 5: Women Status in Egypt 105
5-1 Introduction 105
5-2 Overview of the Gender Gap 106
5-3 Gender Gap in Educational Attainment 109
5-4 The gender gap in the labor market 119
5-5 Empowering women 126
5-6 Violence against women 130
5-7 Cultural constraints on women empowerment 133
Chapter 6: Youth and adolescents’ emerging issues 136
6-1 Introduction 136
6-2 Gender based violence among female adolescents 136
6-3 Youth access to Sexual and Reproductive Health 140
6-4 Youth political and civic participation 145
Chapter 7: Public policies and Management of the population program 149
7-1 Introduction 149
7-2 The interdependence between demographic changes and economic,social, and environmental developments 149
7-3 Sustainable Development Strategy: Egypt Vision 2030 153
7-4 Toward a more efficient and effective management of the population program 161
Chapter 8: Challenges and recommendations 167
8-1- Introduction 167
8-2- Challenges 168
8-3- The way forward 176
Annex 1: Demographic Dividend 181
References 184
Executive Summary
The report presents a new analysis for the current population situation in Egypt. The new analysis is needed given the changes in the political, economic, and social eco-system in the last few years.
Thus, the report will serve as:
A baseline for monitoring the implementation of the National Population Strategy,
A source for technical input and recommendations to UNFPA’s 10th Country Program, and,
The main UNFPA resource for technical input and recommendations to the for thcoming UNDAF.
An overview of the population status in Egypt indicate that political instability between 2011 and 2014 had its impact on health services delivery including reproductive health and family planning and had a significant impact on economic growth, job creation and poverty. The lack of advocacy activities supporting the two-child policy and spacing between births coupled with a conservative mindset contributed to turning the stalled fertility levels between
1995 and 2005 to an increase in total fertility from 3 to 3.5 child per women in 2014. The reproductive role of women was competing with their productive role in a society that witnessed a setback in women empowerment and gender equality.
The recent population projections of the UN Population Division suggest that the population of Egypt might reach, based on the medium scenario, 151 million by 2050. Such increase will have its significant impact on natural resources, especially water and energy, and might have serious implications on food security, poverty and social stability. It also implies that the country is not likely to benefit from a demographic dividend if fertility levels does not come down in the coming few years.
For such challenges, policy matters and Egypt has adopted a set of policies and strategies including the population and development strategy 2015-2030 and Egypt vision 2030. The review shows that targets adopted in the planning phases were not achieved due to lack of resources, weak coordination, lack of continuity in institutional framework, centralization, and absence of monitoring and evaluation.
Issues related to inequality are pertinent when addressing population dynamics. In Egypt, significant disparities in population and health outcomes can be explained by poverty level and place of residence (urban vs. rural and upper Egypt vs lower Egypt). This can be illustrated in Figures 1, 2 and 3, it is evident that poverty and living in rural upper Egypt are highly associated with large families and/or low contraceptive prevalence and fertility level.
The implications is not only reflected in a higher fertility level, but also manifested in internal and illegal migration, in increasing unemployment and in risk of political unrest. This is mainly hurting the youth and is creating a vicious circle that will become harder to break.
Securing reproductive health and family planning services especially in deprived areas and among marginalized sub-populations should get the highest priority. Programs need to be specific to the local context and different approaches need to be considered especially in rural upper Egypt.
Political commitment and legislative framework offer a unique opportunity to reduce population growth and to improve population characteristics which will improve overtime quality of life and opportunities. The 2014 Egyptian Constitution, the new Vision for 2030, the population strategy and the Sustainable Development Goals provide a comprehensive approach to integrate population and development. However, the institutional framework needs to be enhanced to address challenges that go beyond high fertility level. The root causes need to be addressed in a participatory and harmonized approach and should not be limited to governmental organizations.
A comprehensive approach to population issues should take into consideration the benefits that can result from having a demographic dividend through a significant and continuing decline in fertility. Demographic dividend is the economic growth potential that can result from shifts in a population’s age structure when fertility levels decrease due to a larger share of the working-age population than the non-working-age share of the population.
Egypt can harness its demographic dividend through investments that would improve health, education, economic policy, and governance, and ultimately slow population growth. Economic growth can occur if younger population have access to high quality education, adequate nutrition and health including sexual and reproductive health.
These efforts are needed to break the vicious cycle of poverty, low education, early childbearing, and high fertility that has trapped a large segment of the Egyptian society. Demographic dividend can be addressed within the context of the sustainable development goals. The triple E's, namely, Educate, Empower and Employ can serve as a framework for not missing the demographic dividend.
Empowerment can be achieved through the access of all people to essential health care services especially women and girls who must have the rights and freedom to define their lives which require protecting them from harmful practices, child marriage and from all forms of violence. Women in Egypt continue to endure multiple forms of social, cultural, economic and political exclusion caused mainly by two important factors: First, the failure of public policies to bridge the gender gap which is ever-expanding on several levels. Second, the persistence and severity of social norms hindering economic and legal empowerment. No demographic dividend can take place without youth empowerment. In addition to accessibility to quality education, youth political and civic participation is an essential part of building a sustainable future. Comprehensive sexuality education needs to be more accessible. In addition, sexual and reproductive health for youths should be integrated in the health system to prevent them from risks.
In addition to adopting the demographic dividend as a framework, the report outline a set of suggestions including:
Provision of adequate and sustainable funding to ensure complete coverage of contraceptives especially in deprived areas,
Building capacity to provide better quality reproductive health services to reduce unmet needs and dropouts,
Advocating for adopting lower fertility norms, spacing between births, and avoiding early pregnancy,
Empowering women through financial inclusion, legal support and skills development to decrease unemployment and to create opportunities,
Empowering youths through knowledge, entrepreneurship, information and access to credit to create jobs and improve quality of life,
Encouraging NGOs to play a larger role in providing services in remote areas and to marginalized sub-populations and in providing advocacy activities,
Emphasizing population targets in conditional cash transfer programs as a vehicle to enhance social transformation and improve quality of life,
Collaborating with the private sector in population activities through their corporate social responsibility programs,
Using social media and innovative ideas to communicate with youths
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