The world population is estimated to have reached seven billion on 31st October 2011. The UN Population Division foresees a global population of 9.3 billion people in 2050 and more than 10 billion by the end of this century. Much of this increase is projected to come from 58 high-fertility countries: 39 in Africa, nine in Asia, six in Oceania and four in Latin America. Afghanistan is one of the nine Asian that will contribute to this global population increase.
In 1979, for the first in its history, Afghanistan attempted to conduct a national population and housing census. Notwithstanding the fact that security conditions at that time made it impossible to conduct the census in all of Afghanistan’s provinces the data gathered during that partial census still form the basis for present day population estimates as no other national census has ever been conducted during the past 30 years. Given the long time that has passed since then, these population estimates started to vary widely between 23 and 31.4 million. The population of Afghanistan is estimated to increase by 1 million per year for the next 40 years. By 2025 the medium variant of the United Nations population projections indicates that the population is estimated to have increased to 47 million and by 2050 to approximately 76 million. Figure 1 shows the high, medium and low variants of population growth for Afghanistan from 2010-2100. The main components of population growth in any country are fertility, mortality and migration. Afghanistan has a high rate of population growth, high fertility and mortality rates as well as a high migration rate.
2. Components of Population Growth
2.1 High fertility
The Total Fertility Rate (TFR) in Afghanistan was 6.3 children per women in 2008. Fertility is lower in urban areas (5.3) compared to rural areas 6.49). Similarly, TFR is 4.1 among women with secondary education compared to 6.5 among women with no formal education. The high fertility observed in Afghanistan is related to a number of factors.
Early marriage: The mean age at marriage is close to 17.9 years.
Low contraceptive use: Only 15 percent of women use a modern method of contraception (Figure 2). There are socioeconomic differences in the use of modern contraception among women: it was 28 percent among women in the highest wealth quintile but 7 percent among those in the poorest quintile (Figure 3). Similarly, just 14 percent of women with no education use modern contraception as compared to 31 percent of women with at least primary education, and 13 percent for rural women versus 28 percent for urban women. Overall, the two most common methods of modern family planning among all currently married women of reproductive age were contraceptive injections (6 percent) and oral contraceptive pills (5 percent). Female sterilization was low at 1 percent. Use of long-term methods such as intrauterine device and implants are negligible.
Source: MICS (2003), NRVA(2005), AHS (2006), NRVA(2008)
Afghanistan Health Survey (2006)
Five other underlying factors contribute towards high fertility; they are rooted in the sociocultural value-system.
1. Value of children as a source of domestic and agricultural labour and old-age economic and social security for parents
2. Low social and educational status of women in society, which prevents them from taking decisions on their fertility and use of family planning services
3. Son preference
4. Large age differentials between spouses which constrain communication on issues related to reproductive health
5. Socio-economic and gender roles
Population momentum due to a young age structure
Figure 4: Population by age groups and sex (percentage of total population)
Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm,Sunday, July 10, 2011; 10:45:24 AM
The phenomenon population momentum occurs when a large proportion of a country’s population is of childbearing age. Even if the fertility of people in Afghanistan reaches replacement level, that is if couples have only enough children to replace themselves when they die, for several decades the absolute numbers of people being born still will exceed the numbers of people dying.
Life expectancy at birth is 47.5 years for women and 47.2 years for men. Afghanistan’s health care indicators are among the lowest in the region, i.e. infant mortality rate 103 per 1000 live births, under five mortality rate 149 per 1000 live births and neonatal mortality rate 45 per 1000 live births. The maternal mortality ratio is estimated to be 1,400 maternal deaths per 100,000 live births, one.
A high mortality rate means that individuals, especially infants, young children and mothers do not have the fundamental right to a long and healthy life. Since high mortality is especially prevalent among the poor, rural groups, and those with fewer opportunities for education, it undermines the fundamental right for an equitable and just society for all Afghans. High mortality is directly related to high morbidity, or the high prevalence of illness and disease. High levels of morbidity increases health costs for families and means that people are less productive or are unable to work due to frequent illnesses.
Access to health services: Access to any public health facility within one hour walking is possible for only 57 percent of the population. The corresponding figure for the rural population is 54 percent, for urban dwellers 79 percent and for the nomads (Kuchi people) it is only 37 percent. In remote areas, where motorized transport is used to reach health centers, transport costs play an additional role as barrier to health care access.
Expenditure on health: While the Total Health Expenditure (THE) per capita expenditure is $42 it is actually higher than the $ 34 that the WHO recommends for the cost of an essential basic package of health care services. The reality is that the source of this financing disproportionately falls on the shoulders of households. Private expenditures on health constitute roughly 76 % of THE expenditures, of which household out of pocket expenditure (OOP) is approximately 99.7 %. Such high household OOP highlight the need to develop mechanisms to reduce the financial burden on the households, such as increased government allocations to the health sector and the introduction of financial risk protection mechanisms. Afghanistan will increase public spending on health from $10.92 to at least $15 per capita by 2020. The share of domestic revenue allocated to health was only 4%. It is significantly lower than the 15 % recommended by the Abuja Declaration of 15%.Donor contributions represent 75 % of total public expenditures on health. 
So important is the need to address maternal and newborn health that the Integrated Strategic Framework (ISF) has identified maternal and newborn health as one of its five priority programme areas. Family planning could prevent as many as one in every three maternal deaths by allowing women to delay motherhood, space births, avoid unintended pregnancies and abortions, and stop childbearing when they have reached their desired family size. Furthermore, after giving birth, family planning can help women wait at least two years before trying to become pregnant again, thereby reducing newborn, infant, and child deaths significantly. Teen pregnancies pose health risks not only for the babies but also for the young mothers, particularly those under age 18. Family planning can help young women avoid having children during this high-risk time and also avoid the social and economic consequences of early childbearing.
Investments in family planning are cost effective because of the strong synergistic effects of longer inter-birth intervals and lower fertility with other development goals. For every dollar spent in family planning, between two and six dollars can be saved in interventions aimed at achieving other development goals.
For decades Afghans have used voluntary and forced migration for coping with conflict natural disasters and the uncertainties of eking out a living in rural areas. As the result of years of war and conflict, almost one in three Afghans became a refugee, with many others displaced from their homes. According to UNHCR figures, over 5 million refugees returned since 2002 increasing Afghanistan’s overall population by approximately 20 percent. Between 1 January and 08 October 2011 a total of 55,710 Afghans voluntarily repatriated with UNHCR assistance. Among these 4,421 individuals returned during the reporting period (25 Sept – 08 Oct), 3,260 of them from Pakistan, 1,153 from Iran and 8 from other countries. The average number of returns, per day, in 2011 stands at 198 and shows a decrease of 49% compared to the daily average of 386 individuals per day during the same period in 2010.
UNHCR IDP data for March 2011 indicates a total of 416,593 persons comprising 68,151 IDP families which is 41% higher than it was at the end of December 2010. 
Due to years of conflict the destruction of physical infrastructure which sustains a rural economy such as irrigation channels, roads, markets and commercial networks has put a strain on receiving communities struggling to cope with already limited resources. This has resulted in migration from rural areas to urban centers such as Kabul, Herat and Mazar-e-Sharif for economic reasons. The unprecedented migration of people from rural to urban areas increases the burden on already over-burdened public services and social infrastructure.
3. Population and Development Inter-relationships
3.1 Socio-economic setting:
Afghanistan’s GDP has been growing steadily over the past years, with a real growth rate of 22.5% in 2009/10. Nevertheless, over 36% of the population lives below the poverty line. Poverty in Afghanistan highlight patterns of exclusion and vulnerability, which have a strong provincial and gender dimension, and puts in evidence the rural-urban divide. Afghanistan’s economy is heavily agrarian based and hence subject to fluctuations in global agricultural prices and environmental factors. Only 27% of the population has access to clean drinking water and 41% to electricity (NRVA 2007/8). Furthermore, some 7.3 million people (31 percent of the population) are food insecure and another 5.4 million people (23 percent) are vulnerable to food insecurity (NRVA 2007/2008).
Rapid population growth in situations of low economic growth tends to increase outlays on consumption, drawing resources away from saving for productive investment and, therefore, tends to retard growth in national output through slow capital formation. The strains caused by rapid population growth are felt most acutely and visibly in the public budgets for health, education and other human resource development sectors.
Population and development influence one another. The influence may be positive or negative depending on other factors and conditions. In the case of Afghanistan, the fore-mentioned demographic factors interact and create the following problems, at least, in the short run.
1) The rapidly growing young population demands an increase in expenditure directed at social services such as education, health, water and housing.
2) The rapidly growing labour force demands heavy investments in human resource development as well as development strategies which ensure future job creation opportunities.
3) Lack of employment opportunities for young males leads to increased risk of their induction Into the narcotics industry, illegal armed groups and terrorist organizations, while girls are vulnerable to increased levels of gender--‐based violence (GBV), including early/child marriage.
4) Rapid population growth in the context of poverty eradication reduces the possibility of attaining sustainable economic growth.
Most of the eight Millennium Development Goals are directly or indirectly related to population issues in development, as they address poverty reduction (MDG1); improvement in the health of the people, including reduction in maternal, infant and childhood mortality and the prevention communicable diseases such as HIV/AIDS, tuberculosis, malaria etc (MDGs 4,5,6); universal primary education (MDG2); gender and development (MDG3); access to safe water and basic sanitation (MDG7 target 10&11); provision of employment opportunities (MDG8 target 16); rural and urban development (MDG7 target 11); rural and urban development (MDG7 target 11); and the overall sustainable utilization of available resources for development (MDG7 target 9).
The specific aspects of population that affect development are: i) the current and projected population size; ii) population growth rates and associated demographic factors – fertility, mortality and migration; iii) the observed characteristics of population (including age and sex composition, rural and urban composition, population distribution and density). Population dynamics affect labour force supply and unemployment rates, the supply of school age population and the ability to achieve universal education at different levels, and related social and economic indicators that critical to the MDGs. In essence, population dynamics and associated characteristics have significant implications for the achievement of overall plan of social and economic development of a country, particularly its programme of poverty alleviation, reduction in the level of unemployment, improved health/nutrition, and accessibility of the people to social services and infrastructure facilities, such as education, health, potable water, sanitation, housing and environmental security. Putting the population at the centre of development allows for the formulation of a human development agenda in economic and social development planning. It is therefore important to understand the demographic factors in population dynamics and their relationship with social and economic factors in order to design appropriate development strategies that address the needs of the people. This is why the achievement of MDGs and overall development goals of the country require the explicit consideration of population factors as cross-cutting. Population is relevant to every sector of the economy and society.
Youth: With approximately half the population between the ages of 10-24 years this provides a window of opportunity to exploit the demographic dividend for high growth and poverty reduction. For this opportunity to result in accelerated growth, the government needs to invest more in the human capital formation of its youth. Although much progress has been made in access to education, in particular for women and girls, literacy rates continue to be low. It is important to note that the gender gap in literacy rates is currently at a historical low. Afghanistan is amongst the three poorest performers in literacy in the world. It is estimated that only 29% of the population over 15 is literate, with overall youth (15-24) literacy being 39%. Primary school enrolment has increased, yet approximately half of school-aged children are not in school. Significantly, the net enrolment ratio for secondary education is only a third of that for primary education, with the numbers of girls decreasing in particular. This is due to children having to work, as well as a number of cultural and societal barriers.
Lack of employment opportunities for young males leads to increased risk of their induction Into the narcotics industry, illegal armed groups and terrorist organizations, while girls are vulnerable to increased levels of gender--‐based violence (GBV), including early/child marriage. The situation of Afghan girls is of particular concern – under traditional pressures many enter early marriage and experience early motherhood. However, very early marriage appears to be on the decline, as the percentage of women who were married before age 15 reduced from 11 percent among women who are now 30-34 years old to 3 percent for the currently 15-20 year olds. Births among 15–19 year olds are associated with the highest risk of infant and child mortality as well as a higher risk of morbidity and mortality for the young mother. The adolescent birth rate of 155 is very high.
Youth is not currently a priority area for the government although they have been addressed to a limited extent in the Afghanistan National Development Strategy (ANDS), a national youth policy still does not exist. Moreover, research focussing on youth in particular has never been conducted in Afghanistan. The concept of youth is therefore not clearly understood by government, donors and UN entities.
Urbanization: With a city dwellers’ population of around 7.2 million representing almost one-quarter of the total and increasing at an estimated annual rate of four percent, Afghanistan might well be the fastest urbanising country in Asia. Rapid urbanization brings with it many challenges. Among those challenges is the soaring demand for urban housing. Supplying water, sanitation and health services are other major challenges.
Population and the environment: The overall population density in Afghanistan is not high by regional standards, but population pressure is contributing to environmental degradation and undermining the local population's means of livelihoods in certain areas. Up to 80% of Afghans are directly dependent on natural resources for income and sustenance. Agriculture provides livelihoods for more than 60% of the population. Afghanistan is naturally arid, dominated by desert or semi-desert. Approximately 75% of Afghanistan is vulnerable to desertification. More than 80% of Afghanistan’s water resources originate in the Hindu Kush mountains at altitudes above 2,000 metres. In the past 50 years, drought and rising air temperatures have shrunk the larger glaciers in the Pamir and Hindu Kush by 30%, while some smaller ones have vanished altogether. Some 85-90% of the country’s water is taken from surface sources, and 10-15% from below the ground. It is estimated that current groundwater resources feeding the Kabul water supply can only cope with increased demand until 2012. Only some 31% of households currently have access to safe drinking water. Forests now occupy less than 1.0-1.3 million hectares, or just two percent of the county’s area, adding to the burden on the large portion of the Afghan population that depends on timber for construction and fuel for cooking. With farmers competing for the use of the most productive areas, vast expanses of Afghanistan’s once highly productive grasslands have been converted into grazing-resistant cushion shrublands. Soil erosion has increased.
4. Priority areas for action
4.1 Data gathering on population dynamics
Objective: Integrate population variables into social and economic policies, plans and programmes at all levels
At present it is difficult to assess Afghanistan’s demographic features comprehensively and accurately because of lack of data. With only the 1979 incomplete General population Census in Afghanistan, an accurate basis for population and development planning in Afghanistan is missing. However, with repeated pre-census activities undertaken during the past eight years with the support of UNFPA, in addition to various National Risk and Vulnerability Assessments (NRVA) conducted, the potential for evidence based policy development and results based development planning is steadily improving.
Given the current security situation and the low capacity of the state to plan, collect, analyze and disseminate census data, the most viable option to realize a more effective information gathering strategy is through a staggered or ‘rolling” census. This approach was approved in principle by international census experts at a meeting held in August 2010 in Istanbul. A project proposal was concurrently prepared, submitted and approved by the Government of Japan for financing the census in Bamyan province. On 10 July 2011, the government decided that the provincial census would not be authorized and that the country should await security to return to normal in order to conduct a full census, rather than a rolling one.
What can the UN do?
· Enhance awareness of policy makers and communities about the linkages between population, resource, the environment, poverty eradication and sustainable development.
· Promote the collection, analysis and dissemination of gender disaggregated data and information on population issues
· Enhance the technical capacity of staff relevant in government institutions regarding methods and approaches for integrated population development and gender sensitive planning and programming
· Advocate for and plan services bearing in mind the population variables including the increased need for services targeting in and out of school youth, the increase in reproductive health services, the need for employment, land, food and infrastructure.
4.2 Gender equity and human capital development
Objective: Promote gender equity and human capital development
What can the UN do?
· Promote gender awareness and the importance of women's empowerment among men and women
· Encourage positive gender attitudes within the household, schools, work place and in the society
In line with the United Nations National Education Support Strategy
· Support the strengthening of the governance and administration of the education system
· Support improving equitable access and enhance the quality of general and Islamic Education
· Increase access to Higher Education and improving its quality in line with the priorities of National Higher Education Sector Plan
· Promote Technical & Vocational Education and Training program in terms of access and quality
· Promote Literacy and Non- formal Programs
· Advocate for increased resources for the education sector
4.3 Mortality and morbidity
Objective: Reduce infant, child and maternal morbidity and mortality rates
What can the UN do?
· Advocate for improve the quality and accessibility, and availability of primary health care services, especially reproductive health to the population, especially targeting underserved areas and vulnerable groups
· Increase the capacity for trained supervised deliveries and health practices related to child bearing and mother and child nutrition
· Promote appropriate health seeking behavior
· Promotion of equitable access to priority services, especially by the poor
· Support the implementation of the National Reproductive Health Strategy and the Child and Adolescent Health Strategy
· Support the development of the Reproductive Health Commodity Security Strategy and mobilize resources for Reproductive Health Commodity
Objective: Reduce the potential negative impact of rural-rural and rural-urban migration
What can the UN do?
· Improve the availability of data on migration, including magnitude and composition of migrants
· Support the economic and social development in the rural areas, including education and health services and infrastructure
· Reduce the obstacles in urban infrastructure and strengthen the infrastructure and services
4.5 Population pressure on natural resources and environment
Objective: Alleviate the impact from population pressure on natural resources and environment
5. What can the UN do?
· Improve the availability of data on the impact of population pressure on the environment and natural resources
· Advocate for compatibility between population size and growth with access to clean water and sanitation waste disposal systems
· Encourage reforestation
· Enforce legislation pertaining to common community property and right to use open access resource
Some stakeholders and what they can do in relation to population issues
A wide range of Stakeholders are both responsible for and are impacted by population policy. These involve Government bodies, civil society and private sector. The following bodies and ministries inside the government have a prime role in addressing population issues in Afghanistan: Office of the President, Ministry of Economy, Ministry of Finance, Ministry of Public Health, Ministry of Education, Ministry of women’s Affairs, Ministry of Labour and Social Affairs, ministry of Information and Culture (and DMoYA), Ministry of Urban Development, Ministry of Rural Rehabilitation and Development, Ministry of Justice, Ministry of Hajj and Religious Affairs. NGOs also have a very important role in the process of policy dialogue, development and implementation of population programmes.
Ministry of Finance:
· To mobilise resources locally and internationally in order to support population programmes and activities
· To allocate financial resources to population activities and programmes
Ministry of Economy:
· To co-ordinate, monitor and evaluate all population activities and programmes
· To prepare and issue guidelines for the integration of population concerns into development plans at national, regional and local government levels
· To collaborate with other stakeholders in matters related to population and sustainable development
· To collect, disseminate and promote population data utilisation
· To coordinate NGOs dealing with population issues
· To collaborate with other stakeholders in the mobilisation of resources for the implementation of national priority programmes (NPP)
· To develop programmes that promote social justice and alleviate poverty through sustained economic growth
· To carry out research on strategies for eradicating poverty
Ministry of Public Health
· To co-ordinate the implementation of reproductive health programmes
· To collaborate with other public and private institutions in the provision of reproductive health services
· To set standards and guidelines for service delivery and health providers
· To train health personnel at all levels, as well as to ensure that health education is integrated into curricula of health training institutions
· To carry out research on reproductive health issues, in liaison with other institutions or agents
· To coordinate and implement health aspects of STIs, HIV and AIDS
· Through the Health Information System, to collect and use gender disaggregated data and information
· To provide monitoring and supportive supervision of reproductive health programmes
Ministry of Education:
· To support participation of the community, institutions and the private sector in the provision of equitable and quality education
· To strengthen advocacy and social mobilisation for gender equity, equality and the empowerment of women
· To ensure the provision of basic education to all children
· To strengthen literacy programmes
Ministry of Agriculture:
· To ensure that population variables are integrated into training programmes for extension workers so as to equip them with relevant skills that will enable them to relate population growth to levels of food production, consumption and other development activities at local levels
· To promote the use of better farm implements, techniques and practices of modern farming and improved food processing and storage facilities
· To ensure food security for the nation
Ministry of Work, Social Affairs, Martyred, and Disabled:
· To promote, in liaison with other institutions, employment opportunities especially for the youth and people with disabilities
· To introduce comprehensive labour legislation that will encourage participatory labour relations in to public and private sectors
· To promote the welfare of the elderly and disadvantaged groups
Ministry of Information and Culture (Deputy Ministry of Youth)
· To develop a policy on youth and development
· To promote youth programmes for responsible parenthood
· To establish and strengthen youth councils and development committees
Ministry of Women's Affairs:
· To advocate for gender equity, equality, women’s empowerment and children rights
· To educate women on the importance of breast-feeding, safe motherhood and family planning
· To ensure that special attention is paid to programmes that are directed at the elimination of socio-cultural and discriminatory practices against the girl-child
· To collaborate with other stakeholders in educating women, men and children on their rights
· To ensure that gender is mainstreamed in policies, programmes and plans
· To identify discriminatory laws
· To sensitise women, men and children on the elimination of harmful socio-cultural practices e.g. early marriage
Ministry of Energy and Water:
- To promote the use of, and research on, renewable energy resources
- To create awareness in the community on the dangers of environmental degradation in matters relating to the supply of energy - like electricity and fuel wood
- To ensure the availability of clean and safe water for all people
Ministry of Refugees and Repatriation:
· To coordinate migration matters
· To manage and coordinate refugee matters
Ministry of Haj and Religious Affairs
· To support birth spacing programmes
· To support girls education
 23.8 million in 2005 (CSO and UNFPA, Afghanistan Household Listing Project (HHL), 2003-2005); 28.4 million in 2009 (US Census Bureau, 2009); 29.2 million in 2009 (Government of the United Kingdom, Department for International Development (DfID), 2009) and 31.4 million in 2010 (United Nations Department of Economic and Social Affairs, Population Division, 2010 World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm medium variant)
 National Risk and Vulnerability Assessment 2007/2008
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 Integrated Strategic Framework. United Nations in Afghanistan. July 2011-December 2012.
 Family Planning Saves Lives. Population Reference Bureau. 2009. http://www.prb.org/pdf09/familyplanningsaveslives.pdf (Accessed 09.11.2011)
 Moreland, Scott and Sandra Talbird (2006). Achieving the Millennium Development Goals: The contribution of fulfilling the unmet need for family planning. Washington D. C.: USAID, 2006.
 UNHCR Global Appeal 2010-2011
 Research Study on IDPs in urban settings Afghanistan. World Bank UNHCR 2011.
 UNHCR Afghanistan Update 10 October 2011.
 Integrated Strategic Framework. United Nations in Afghanistan. July 2011-December 2012.
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