LECTURE NOTES

For Health Science Students

Population and Development

Melake Demena

HaramayaUniversity

In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center,
the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education

July 2005
 Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00.

Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter
Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education.

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Limited permission is granted free of charge to print or photocopy all pages of this
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©2005 by Melake Demena

All rights reserved. Except as expressly provided above, no part of this publication may
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This material is intended for educational use only by practicing health care workers or
students and faculty in a health care field.
 PREFACE

Studies within particular countries, suggest that

population growth above 2% a year inhibits efforts to
raise income in poor countries with high birth rates and
young age structure. In countries that are already poor,
then, rapid population growth only makes matters worth
leading to economic insecurity. Economic insecurity,
intern, encourages people to have large families.
Poverty and lack of economic opportunities increase
incentives to exploit marginal resources, such as
overgrazed land, over harvested forests, and thereby
further environmental degradation. Rapid population
growth although not a direct cause, appears to
exacerbate all these trends and makes solutions harder
to implement. Governments need to provide basic social
services (such as health care and education),
infrastructure and investments that will lead to job
opportunities.

The lecture notes on population and Development

Provide information on demographic concepts, current
trends of population growth, patterns and

i
interpretations; and the Impact of rapid population
growth on health and other socio-economic
development.

In the absence of relevant text and reference books that

are specifically prepared for undergraduate students of
health sciences, the lecture notes help to maintain
standard of course contents among the different health
sciences training institutions and alleviate the scarcity of
text books.

The lecture notes are primarily prepared for health

officer students; however, they could also be used by
other categories of medical and health sciences
students of diploma or degree level.

ii
 ACKNOWLEDGMENT

The development and publishing this lecture note was

made possible through the administrative and financial
support of The Carter Center (EPHTI) for which I extend
my deepest gratitude. Special acknowledgement goes
to Ato Gizachew Ashagire, Gondar University, for his
contribution and professional input in developing this
document. I would also like to express my heart-felt
appreciation to Ato Aklilu Mulugeta for his commitment
and moral support for the successful accomplishment of
the lecture note. I thank the Alemaya University, the
Faculty of Health Sciences and to all colleagues and
partners who participated in reviewing the manuscript;
and to my students that directly or indirectly contributed
to the development of the lecture note.

Last, but not least, I am very grateful to W/t Tinebeb

Retta for typing the whole manuscript.

iii
 TABLE OF CONTENT

Title Page
Preface................................................................................ i
Acknowledgement ............................................................. iii
Table of Content ...............................................................iv
List of Tables ................................................................... viii
List of Figures .................................................................. ix

CHAPTER ONE: Introduction to Population Studies ... 1

Demography ...................................................................... 1
Sources of Demographic Data .......................................... 2
Census .................................................................. 3
Registration of Vital Events .................................... 7
Sample Surveys .................................................... 7

CHAPTER TWO: Demographic Measurement Tools

and Techniques ............................................................... 9
Tools of Measurement ....................................................... 9
Ratios ................................................................. 10
Proportions .......................................................... 10
Rates ................................................................... 11
Techniques of Demographic Measurement .................... 12

iv
 Measures of Fertility ........................................... 12
Measures of Mortality .......................................... 20

CHAPTER THREE: Growth of Populations ................. 31

Reasons for Population Growth ....................................... 33
Population Growth Forms .............................................. 35
Population Dynamics ...................................................... 37
Population Structure ....................................................... 38
Population Pyramids ....................................................... 39
The Ecological Ages ....................................................... 41
Types of Populations ...................................................... 44
Theory of Demographic Transition .................................. 45

CHAPTER FOUR: World Population Growth, Current

Trends, Patterns and Interpretation ...... 53
World Population Distribution and Regional Growth
Rates................................................................................ 55
Trends in Fertility ........................................................... 67
Ranges in Birth Rates ......................................... 68
Low Fertility in Developed Countries .................... 68
Fertility Decline in Developing World .................. 69
Marital Fertility Decline ....................................... 71
Age of Marriage ................................................... 72
Infant Mortality ..................................................... 72

v
 Contraception ...................................................... 73
Family size Preference ....................................... 74
Education ............................................................ 74

Trends in Mortality .......................................................... 74

Mechanisms of Mortality Decline ......................... 77
Mortality Differentials ........................................... 78
Infant Mortality ..................................................... 79
Female Education ................................................ 81

Migration .......................................................................... 81
International Migration .......................................... 82
Internal Migration ................................................. 85

CHAPTER FIVE: Women and Development ................ 88

Introduction ...................................................................... 88
Understanding Gender ..................................................... 90
Violence Against Women ................................................. 92
Gender – based Violence ............................................... 93
Empowering Women ........................................................ 93
Education ............................................................. 93
Employment Opportunity ..................................... 94
Legislating Equality ............................................ 95
Emphasizing the Girl Child .................................. 95

vi
 Male Responsibility ............................................. 96
Program of Action of the ICPD ............................ 97
The status of Women in Ethiopia ................................... 98
Working conditions .............................................. 98
Social services .................................................. 101

CHAPTER SIX: Impact of Rapid Population Growth

on Socio-Economic Development . 107
Social Implications of Population Growth ....................... 107
Population Growth and Environment ............................. 108
Health and Development .............................................. 110
Effects of health on Development ..................... 111
Measures / Indicators of Development ............. 115
GNP and Social Indicators and ......................... 116
Health Indicators and GNP ............................... 120

CHAPTER SEVEN: Population Policies .................... 126

The Population Policy of Ethiopia ................................. 128
Background ....................................................... 128
Rational of the National Population Policy ........ 137
Objectives of the National Population Policy ..... 138
Reference ................................................................... 141

vii
 LIST OF TABLES

Table 2.1: Calculation of Total Fertility Rate. ............ 17

Table 3.1: Population Structure of Town “A” by Age
and Sex, September 2003. ...................... 51
Table 4.1: Distribution of World Population by
Regions, 1950, 1990 and 2025. .............. 61
Table 4.2: World Population Number, Vital Rates
and GNP in 1992. .................................... 62
Table 4.3: Comparison of Gross National Income,
and Gross National Income in PPP,
(1999). ..................................................... 63
Table 4.4: The 25 Most Populous Countries Ranked
by Size, Medium Variant, 1990 and 2025.
................................................................. 65
Table 4.5: Crude Death Rate and Life Expectancy in
World and Regions. ................................ 77
Table 6.1: Life Expectancy at Birth by Income
Group, 19983. ....................................... 121

viii
 LIST OF FIGURES

Fig. 3.1: Exponential Growth Curve (J. shaped). ............ 36

Fig. 3.2: Sigmoid Growth Curve (S-Shaped). .................. 37
Fig. 3.3: Age – sex Structure in Transition ...................... 43
Fig. 3.4: The Demographic Transition Model. ................. 48
Fig. 3.5: Population Growth through Natural Increase. ... 52
Fig. 4.1: World Population Growth 7000–6000 B.C. ....... 59
Fig. 4.2: World Population Growth 1750 – 2150. ............ 60
Fig. 6.1: Links between Health and Income ................. 122

ix
 CHAPTER ONE
INTRODUCTION TO POPULATION
STUDIES

Instructional Objectives
After Completing this chapter the learner is able to:
¾ Define Demography
¾ Identify the different sources of demographic data
¾ Explain the differences between the major sources of
data
¾ List and state steps needed in conducting population
census.

1. Demography
Definition
Demography can be defined as the study of human
populations including their composition, distributions,
densities, growth and other characteristics as well as the
causes and consequences of changes in these factors.

1
Demography, as understood today, is the scientific study of
human population and its dynamics. It is derived from two
Greek Words:
• Demos means population
• Graphics means to draw

Demography focuses its attention on three readily available

human phenomena:

• Changes in population size (growth or decline)

• The composition of the population and
• The distribution of population in space.

Demography deals with major “demographic processes”

namely fertility, mortality and migration. These processes are
continually at work within a population determining its size,
composition and distribution.

2. Sources of Demographic Data

Demographic data are important in providing factual basis for
decisions on matters of public policy and action concerning
social and economic affairs. These data can be processed to
indicate present and future requirements of the population in
terms of the types and extent of social needs of the society
such as health, education and employment.

2
The major sources of demographic data include:

2.1. Census
2.2. Registration of vital events (Records)
2.3. Sample surveys
2.4. Ad-hoc Demographic studies

2.1. Census
Census is defined as an enumeration or complete population
count at a point in time within a specified geographical area. A
census provides more reliable and accurate data if properly
enumerated.

The conducting of censuses has a long history, but modern

censuses were first held in the 17th century. By the end of
eighteenth and beginning of the nineteenth century many
countries had held their first censuses. Some countries
including Ethiopia have only recently held their first censuses.

Old Censuses Modern Censuses

- Babilonia in about 3800 B.C. - Quebec (Canada) in 1666
A.D.
- China in about 3000 B.C. - USA in 1790 A.D
- Egypt in about 2500 B.C - England and France in
1801 A.D.
- Zaire in 1984 A.D
- Ethiopia in 1984 A.D.

3
2.1.1. Techniques of Census Taking
There are two techniques of conducting census, dejure and
defacto.

A. DEJURE
This technique is the counting of people according to the
permanent place of location or residence.

¾ Advantages

• It gives permanent picture of a community.

• It provides more realistic and useful statistics.

¾ Disadvantages

• Some persons may be omitted from the count. A

household member who is temporarily away from
home may be missed from being counted unless
the enumerator makes sure that nobody is missing.
• Some may be counted twice.
• Information collected regarding persons away from
home is often incomplete or incorrect.

4
B. DEFACTO
This technique of conducting census refers to counting
persons where they are present at the time of the census
period.

¾ Advantages

• There is less chance for the omission of persons

from the count.

¾ Disadvantages

• Difficult to obtain information regarding persons in

transit. These are persons who are, for example
travelling and have left their area of permanent
residence but haven’t reached the area of
destination during the census day.
• It provides incorrect picture of the population in a
community.
• Vital statistics are usually distorted (in areas with
high migration).

5
2.1.2. Use of Census
A census is useful for:

• Planning
• Calculating health indicators and vital indices.

2.1.3. Steps in Conducting Census

The major steps to be followed in a census include.
• Planning and preparation
• Collecting information
• Compilation and analysis
• Evaluation

2.1.4. Qualities of a Census

A census must have the following qualities
• It should include every individual in the area (no
omission or duplication).
• Information should relate to a well – defined point
in time.
• It should be taken at regular intervals (preferably
every 10 years).
• It should refer to people inhabiting a well defined
territory.
• Information be obtained from personal contact.

6
2.2. Registration of Vital Events (Statistics)
It is a regular and continuous registration of vital events. Civil
registration system, which records births, deaths, marriages
etc. (vital statistics), enables rates of population growth to be
calculated; but are much less adequate than national
censuses. In developing countries where illiteracy rates are
high and communications are poor, the problems of recording
births and deaths are immense not only in rural populations
but also in urban areas. However, efforts are being made to
improve the collection of these data in many countries.

2.3. Sample Surveys

A sample survey is another source of demographic data
carried out in a scientifically selected area which covers only a
section or portion (sample) of the population under
consideration.

As countries have began increasingly to formulate population

policies as part of their development programs, especially
since 1970; so they have required more data about their
populations. Demographic surveys have become increasingly
important as a comparatively rapid method of obtaining such
information. It was recognized that the quality of demographic
data available for the developing world was poor and the need

7
for better data both for scientific study and for policy
application is also recognized.

For example, the first ever nation wide population census

taken in 1984 in Ethiopia revealed a total population of
42,184,952. However, the population projection based on the
two National sample surveys of 1964-71 put the population
figure at around 34.6 million for 1984. Thus the census
produced an excess population of about 7.4 million (21 %
above the projected figure).

Study Questions

1. What is Demography?
2. Name and explain the different sources of
demographic data?
3. State the steps that should be fallowed to undertake a
population census.
4. Explain the advantages and limitations of sample
surveys.

8
 CHAPTER TWO
DEMOGRAPHIC MEASURMENT TOOLS
AND TECHNIQUES

Instructional Objectives

After completing this chapter the learner is able

to:
¾ Stat the measurements used in demographic data
¾ Calculate ratios, proportions and rates and
discuss their importance
¾ List and calculate the different measures of fertility
and mortality

The major demographic processes of fertility, mortality and

migration constitute the basic components to determine the
size, composition and distribution of a population which
require basic tools and techniques of measurement.

1. Tools of Measurement
The tools of measurement include:
• Ratios
• Proportions and
• Rates

9
 1.1. Ratios: Ratio is a quecient of any two demographic
quantities. It is the result of dividing one quantity by
another. Ratio quantifies the magnitude of one
occurrence or condition in relation to another. It is
expressed in the form of:
a , or a ; b
b
Examples:
• Sex Ratio (male – female) = Males
Females
• Doctor to Population Ratio = Number of Doctors
Number of Population
• Dependency Ratio = No. of People < 15 years +65 years and above
No. of Population 15-64 years of age

Qualification:

• The numerator and denominator (a and b) are defined

for a specific geographic area and period of time.
• The numerator may or may not be a sub – group of the
denominator.

1.2. Proportion: A proportion is a ratio which

indicates the relation in magnitude of a part of the
whole. The numerator is always included in the

10
 denominator. A proportion is usually expressed as
a percentage.

Example: Males to total population ratio

Males x 100
Males + females

• Illegitimate Birth Ratio = No. of illegitimate live births x 100

Total No. of live births
1.3. Rates: A rate measures the occurrence of some
particular event (example death) in a population
during a given time period. It is a statement of
the risk of developing a condition. It indicates the
change in some event that takes place in a
population over a period of time. It is defined per
unit of time.

Rate = Vital event X (K)

Population at risk
Example: Death Rate = No. of deaths in one year X 1000
Mid year population

A rate comprises the following elements:

• Numerator
• Denominator

11
 • Time specification and
• Multiplier or constant (100, 1000, 10000, 100,000 etc)

A Rate is a ratio or a proportion in which the numerator is part

of the denominator. All rates are ratios, but all ratios are not
rates.

2. Techniques of Demographic Measurement

A change in the overall size of a population is the result of
three cumulative changes in the number of births, deaths and
migrants. Since births and deaths occur continuously, and
since people frequently change their place of residence, they
are the bases of demographic analysis. Depending on their
direction and magnitude these processes are important for
social and economic planning, in assessing the present needs
and the needs of the future expansion of socio-economic
infrastructure. The techniques for measuring fertility, mortality
and migration are described further.

2.1. Measure of Fertility

Fertility is the reproductive performance of an individual, a
couple, a group or a population. It is meant the actual bearing
of children. Some demographers prefer to use natality in place
of fertility.

12
Fertility leads to increase of population. It differs from
fecundity – which refers to the physiological capability of a
woman to reproduce. A woman’s reproductive period is
roughly 15 – 49 years of age.

The most important measures of fertility include:

2.1.1. Crude Birth Rate (CBR)

The crude birth rate indicates the number of live births
(children born alive) per 1000 mid – year population in a given
year.

CBR = Number of live births in a year X 1000

Total mid – year population

In the world CBR varies widely from population to population.

It is high for population of the developing countries and low for
those of the developed ones.

Example: According to world population data sheet of the

Population Reference Bureau the Crude Birth Rate for 2003
was:

• World = 22/1000 population

• More developed counties = 11/1000 population

13
 • Less developed countries = 24/1000 Population
• Less developed (except China) = 28/1000 population
• Africa = 38/1000 population
• Sub-Saharan Africa = 40/1000 population
• Eastern Africa = 41/1000 population
• Ethiopia = 40/1000 population
• Ethiopia = 45/1000 (1984 population census)
• Ethiopia = 44/1000 (1994 population census)

Fertility may be grossly determined as high, medium or

low based on CBR values.
High fertility Rate = > 30/1000
Medium fertility rate = 20-30/1000
Low fertility rate = < 20/1000

2.1.2 General Fertility Rate (GFR)

The General Fertility Rate is the number of live births per 1000
females aged 15-49 years (fertile age group) in a given year.
The GFR in more sensitive measure of fertility than the CBR,
since it refers to the age and sex group capable of giving birth
(females 15-49 years of age). It eliminates distortions that
might arise due to different age and sex distributions among
the total population. The major limitation of GFR is that not
all women in the denominator are exposed to the risk of child
birth.
GFR = Number of live births in a year X 1000

14
 Number of females 15-49 years of age

The GFR is approximately four times the CBR.

2.1.3 Age specific fertility rates (ASFR)

The Age specific fertility rate is defined as the number of
children born alive to females in a specific age group per 1000
females in that specific age group, example (15-19),
(20-24),….. (45-49) years of age.

ASFR = No. of live births to females in a specific age group in a year X 1000
Mid-year population of females of the same age group

For example, ASFR for women 20 – 24 years of age is

expressed as:

ASFR (20-24) = Live births to women 20- 24 years of age X 1000

Total No. of females 20 – 24 years of age

For instance if there were 4,000,000 women (females) in the

age group 20-24 years and if the there were 200,000 live
births to women in the same age group, the Age specific
fertility rate for these women (20-24 years of age) will be;

ASFR (20-24) years of age = 200,000 X 1000 = 50

15
 4,000,000

That is, there are 50 live births for every 1000 women 20-24
years of age.

2.1.4. Total Fertility Rate (TFR)

The total Fertility Rate is the average number of children that
would be born to a woman throughout her life time or her child
bearing age (15-49 years), if she were to pass through all her
child bearing years at the same rates as the women now in
each age group.

The TFR sums up in a single number the Age Specific Fertility

Rates of all women at a given point in time. If 5 – year age
groups are used, the sum of the rates is multiplied by 5. This
measure gives the approximate magnitude of “completed
family size”.

The TFR is one of most useful indicators of fertility, because it

gives the best picture of how many children women are having
currently.

TFR = Sum of all Age specific fertility rates multiplied by age

interval

16
 (Usually 5).

Example:
Table 2.1: Calculation of Total Fertility Rate

Age group Number of Number of live Age specific

of mothers Women births to the age birth rates
group
15-19 years 1,237,721 117,583 0.095
20-24 978,136 268,987 0.275
25-29 979,623 283,111 0.289
30-34 989,693 254,351 0.257
35-39 814,243 162,034 0.199
40-44 548,882 57,633 0.105
45-49 406,540 22,766 0.056
Total 5,954,838 1,166,465 1.276
TFR = 5 x 1.276 = 6.38

i.e. 6.38 children per woman in her reproductive life.

Total fertility rate also varies widely between populations in the
world. It is higher for developing countries than developed
ones. According to World Population Data Sheet of the
population Bureau the TFR for 2003 was:
• World = 2.8 children per woman
• More Developed Countries = 1.5 children per woman

17
 • Less developed countries = 3.1 Children per woman
• Less Developed countries = 3.5 Children per woman
(Excluding china)
• Africa = 5.2. Children per woman
• Sub – Sahara Africa = 5.6 Children per woman
• Eastern Africa = 5.6 Children per woman
• Ethiopia = 5.9 Children per woman
• Ethiopia 1994 = 6.5 Children per woman
• Ethiopia 1984 = 7.2 Children per woman

2.1.5. Gross Reproduction Rate (GRR)

The Gross Reproduction Rate is the average number of
daughters that would be born to a woman throughout her
lifetime or child bearing age (15-49 years), if she were to pass
through all her child bearing age.

This rate is like the TFR except that it counts only daughters
and literally measures “reproduction”; a woman reproducing
herself by having a daughter.

The GRR is calculated by multiplying the TFR by the

proportion of female births (Sex Ratio at birth).

GRR = TFR X Male births

Male + Female births

18
Example: - The sex ratio at birth of Ethiopia (2001) = 100.6
(i.e 100.6 males for every 100 females)

- and the TFR (2001) = 5.9 (5.9 children per women)

GRR = TFR X proportion of female births

GRR = 5.9 X 100 = 2.94
200.6
= 2.9 daughters /woman

2.1.6. Child – Woman Ratio (CWR)

Child woman ratio is defined as the number of children 0 – 4

years of age per 1000 women of child bearing age, (15 -49
years). This ratio is used where birth registration statistics do
not exist or are inadequate. It is estimated through data
derived from censuses.

CWR = No of children 0 – 4 years of age X 1000

Total No of women 15 – 49 years age

Example:

19
If the number of children under 5 years of age in an area is
2,000,000 and the number of women 15 – 49 years of age is
8,000,000.

The CWR = 2,000,000 X 1000 = 250

8,000,000 1000
That is 250 children 0 – 4 years of age (under five) per 1000
women of the reproductive age.

2.2. Measures of Mortality (Death)

Mortality refers to deaths that occur within a population
(reduction of population). The incidence of death can reveal
much about the living standard, the health status of a
population and the availability of health services.

Mortality (Death) rates have three essential elements:

• A population group exposed to the risk of death

(denominator)
• The number of deaths occurring in that
population group (numerator)
• A time period.

Measures of mortality include:

20
2.2.1. Crude Death (Mortality) Rate (CDR)
The crude death rate is the number of deaths per 1000
population in a given year.

CDR = Total number of deaths in a year X 1000

Mid-year population

As its name implies the CDR is not a sensitive measure

(indicator) of health status of a population. It is affected by
particularly the age structure of the population.

Crude Death Rate also varies between populations of the

world. According to the “World Population Data Sheet of the
population Reference Bureau the crude Death Rate during
2003 was.

• World = 9 deaths per 1000 population

• More developed countries =10 deaths per 1000 population
• Less Developed countries = 8 deaths per 1000 population
• Less Developed countries (Excluding China) = 9 deaths per 1000
population
• Africa =14 deaths per 1000 population
• Sub – Saharan Africa =16 deaths per 1000 population
• Eastern Africa = 17 deaths per 1000 population

21
 • Ethiopia = 13 deaths per 1000 population
• Ethiopia 1994 = 15 deaths per 1000 population
• Ethiopia 1984 = 19 deaths per 1000 population

2.2.2. Age specific Death (Mortality) Rates

Death Rates can be calculated for specific age groups, in
order to compare mortality at different ages. E.g. for infants (<
one year of age), children 1-4 yeas of age, children under five
years, etc.

ASMR = Number of deaths in a specific age group X 1000

Mid-year population of the same age group

¾ Infant Mortality Rate (IMR)

Infant Mortality Rate is the number of deaths of infants under

one year of age (0-11 months of age) per 1000 live births in a
given year.

Infant (children under one year of age) are at highest risk of

death than any other age group.

IMR = Number of death of children < 1 year of age in a year X 1000

Total live births during that year

22
The infant mortality rate is considered to be a sensitive
indicator of the health status of a community, because it
reflects the socio-economic condition of the population; i.e. the
level of education, environmental sanitation, adequate and
safe water supply, communicable diseases, provision of health
services etc. These factors mostly affect infants and children
under five years of age. Hence, IMR widely varies between
countries in the world.

According to the “world population Data sheet of the

population reference Bureau for 2003”, the infant mortality rate
of:

• World = 55 infant deaths per 1000 live births

• More developed countries = 7 infant deaths per 1000 live births
• Less developed countries = 61 infant deaths per 1000 live births
• Africa = 88 infant deaths per 1000 live births
• Sub Saharan Africa = 93 infant deaths per 1000 live births
• Easter Africa = 102 infant deaths per 1000 live births
• Ethiopia = 97 infant deaths per 1000 live birth
• Ethiopia (1994) = 110 infant deaths per 1000 live births

23
¾ Child Mortality Rate (CMR)
It is the number of deaths of children 1-4 years of age per
1000 children 1-4 years of age. It is a sensitive indicators of
the health status of a community.

CMR = Number of deaths of children 1-4 year of age in a year X 000

Total number of children 1-4 years of age

¾ Under Five Mortality Rate (<5MR)

It is the number of deaths of children under five years of age in
a year (0-4 years of age) per 1000 children under five years of
age (0-4 year). It is also a very good indicator of the health
states of a community

It can also be calculated as the number of deaths of children

under five years of age in a year per 1000 live births.

<5MR = Number of deaths of children <5 yrs in a year X 1000

Total number of children < 5 years of age

OR

< 5MR = Number of deaths of children <5years in a year X 1000

Total live births in the same year

24
 • According to Health and Health Related Indicators
(MOH), the under five mortality Rate of Ethiopia is
estimated to be:
- 140/1000 live births, currently
- 161/1000 live births, (1994)

¾ Neonatal Mortality Rate (NNMR)

Neonatal period is the first month of age of an infant.

Neonatal mortality (death) is the death of infants under one
month (<4 weeks). Per 1000 live births.

Neonatal Mortality Rate (NNMR) = Number of deaths of infants < 1 mouth in a year X 1000
Total number of live births in the same year

Neonatal mortality rate reflects mortality due to:

. Maternal factors during pregnancy
. Birth injuries
. Neonatal infection, etc.

It is an indicator of the level of prenatal and obstetric

components of maternal and child health care (MCH).

25
¾ Post-Neonatal Mortality Rate (PNNMR)

The past neonatal age is the period of time between one

month up to one year.
Post – Neonatal mortality (death) is deaths of infants one
month (four weeks) of age up to one year (1 – 11 months age
of) per 1000 live births.

PNNMR = Number of deaths of infants 1 month to 1 year of age in a year X1000

Total Number of live births during the same year

The post-neonatal mortality rate reflects deaths due to factors

related to;

• Environmental sanitation
• Infections (communicable diseases)
• Nutritional problems
• Child care etc.

It can be used as an indicator to evaluate Maternal and Child

Health Care services and socio-economic development of a
community or country.

26
2.2.3. Maternal Mortaly (Death) Rate (MMR)

Maternal mortality rate is the number of maternal deaths

related to pregnancy, child birth and post natal (peurperium)
complications per 1000 live births (usually per 100,000 L.B).

MMR = Number of deaths of women related to pregnancy child birth and peurperium in a year X 100,000
Total number of live births in the same year

It is a sensitive indicator of health status of a population. It

reflects the socio- economic status of a community.

The Maternal Mortality Rate of Ethiopia is estimated to be

more than 850 deaths per 100,000 live births annually. This is
among the highest in the world.

2.2.4. Sex Specific Death Rates (SSDR)

Sex Specific Death Rate is the number of deaths among a

specific sex group (males or females) per 1000 population of
the same sex group.

Sex specific Death (Mortality) Rate for males = Number of deaths among males X 100
Total number of males

Sex specific mortality rate is used to determine which sex

group is at higher risk of death than the other.

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Study Questions

1. What are ratios, proportions and rates? Explain their

differences.
2. Distinguish the difference between natality, fertility and
fecundity
3. List and define the important demographic measures of
fertility and mortality.

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4. Exercise on Fertility & Mortality
A survey was conducted in town “X” in September 2003. It
revealed a total population of 389,000 (196,500 males and
192,500 females). Total number of children born a live during
the previous year was 16,400. The survey has also recorded
a total of 5835 deaths (3200 meals and 2635 females) during
the same year. The survey has also identified the following
deaths among the population.

¾ Children < 1 month = 370

¾ Children 1 month - 11 months =1100
¾ Children 1 year – 4 years = 1865
¾ Children 5 – 4 years = 800
¾ Persons 15 – 49 years = 700
¾ Previous 50 years and above = 1000
¾ Death of mothers during pregnancy and child birth =130

Questions
Based on the above data provided and tables 1and2,
calculate the following measures of fertility and mortality. If
there no date available to calculate any one of the following
measures of fertility or mortality your answer has to be “Data
Not Available”.

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1. Crude Birth Rate
2. Crude Death Rate
3. General Fertility Rate
4. Infant Mortality Rate
5. Neonatal Morality Rate
6. Post Neonatal Rate
7. Sex Ratio at Birth
8. Under five morality Rate
9. Sex Specific Mortality Rate for Females
10. Sex specific Mortality Rate for Males
11. Maternal Mortality Rate
12. Total Fertility Rate
13. Gross Reproductive Rate

30
 CHAPTER THREE
GROWTH OF POPUALTIONS

Instructional Objectives
After completing this chapter the learner is able to:
¾ Define demography
¾ Identify the different sources of demographic data
¾ Explain the differences between the major sources of
data
¾ List and state steps needed in conducting population
census

If we assume that the number of individuals entering a

population (immigration), equals the number of leaving
(emigration), population growth is the result of the increase of
births over deaths. This relationship is summarized by a
formula known as the balancing equation. It is expressed as:

P2 = P1 + ( B – D) + ( I + E)
Where:-
P2 = Size of population for the year under
consideration
P1 = Size of population in the preceding year
B = Number of births between the two dates

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 D= Number of deaths between the two date.
I = Number of immigrants in the time under
consideration (between P2 and P1)
E = Number of emigrants in the time under
consideration (between P2 and P1)
The differences between births and deaths in a population
produces the Natural Increase (or Decrease) of a population.
The rate of Natural Population increase is the rate at which a
population is increasing (or decreasing) in a given year due to
excess (or deficit) of births over deaths expressed as a
percentage of the base population.

RNI = Births - Deaths X 100

Total Population
OR
Birth Rate - Death Rats
10
Net Migration: is the difference between the numbers of
persons entering a geographic area (Immigrants) and those
leaving the area (emigrants).

Total Population Growth Rate

It is the rate at which a population is increasing (or
decreasing) in a given year due to natural increase and net
migration expressed as a percentage of the base population.

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Total Growth Rate = Natural increase + Net Migration X 100
Total Population

1. Reasons For Population Growth

Thomas Malthus, (1766-1834), English clergyman and
economist in his “essay, “The Principles of Population”,
hypothesised that there is relationship between economic
development and population growth. He claimed that
population was increasing faster than food production, and he
feared eventual global starvation.

Malthus was criticized that he could not foresee how modern

technology would increase food production, and that he
considered people only as consumers, but they are also
producers, since “with every mouth God sends a pair of
hands”. However, his observations how populations increase
and his arguments are important when there are fixed
resources such as land, energy resources, etc.
He suggested that populations tend to grow in geometric
progression (Exponential), doubling in size every 'n' years
depending on the population growth rate; while food supplies
can at best grow in arithmetic progression.

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Geometric Progression:- A series of ordered numbers is
said to be in geometric progression if the proportion of any
two adjacent numbers is the same.

e.g. 3, 9, 27, 81 ……………..; or 1, 2, 4, 8, ……….. etc.

Population size over a period of years is said to follow a

geometrical pattern of growth, if the change within a particular
year is proportional to the population size at the beginning of
that year.

Arithmetic progression:- a series of figures is said to be in

arithmetic progression, when the difference between any two
adjacent figures is the same.

e.g. 3, 5, 7, 9, 11,…………………; or 1. 2, 3, 4, …….. etc.

Population size over a period of years is said to be in
arithmetic progression, if the size changes by a constant
amount each year.

The doubling time of a population is the number of years it

would take for a population to double in size if the present rate
of growth remained unchanged. Its purpose has been to
emphasize how quickly populations can grow, doubling their
numbers geometrically. Doubling time cannot be used to

34
project future population size because it assumes a constant
growth rate over decades, where as growth rates do change
over time. To calculate doubling time, divide the number 70
(actually 69.3 for better accuracy) by the population growth
rate expressed in percent. For example a country with a
population growth rate of one percent would double its
population in about 70 years; at 2% in 35 years; at 3% in 23
years.

Doubling Time = _______70_________

Population Growth Rate

Malthus said that if the growth of population exceeds that of

food, preventive checks such as continence (self resistance in
refraining from sexual intercourse) and delayed marriage must
be introduced; or Positive Checks, such as starvation or
famine, disease and war will plague the society. He grouped
these checks under the heading of "Misery and Vices".

2. Population Growth Forms

Populations have characteristic patterns of increase which are
called Population Growth Forms.

There are two patterns of population growth forms.

35
A. Exponential Growth Form (J - Shaped Growth Curve)
In this growth form density increases rapidly in exponential or
compound interest fashion, when there is no environmental
restrictions; and then stops abruptly as environmental
resistance or other limits of resources become effective more
or less suddenly. This resistance is the carrying capacity, the
upper level beyond which no major increase can occur (K).

Population Carrying Capacity

Growth K

Time

Time
Fig. 3.1.: Exponential Grow Curve (J – shaped)

B. Sigmoid Growth Form (S - Shaped)

In this growth form the population increases slowly at first
(establishment or positive acceleration), then increases more
rapidly (perhaps approaching a logarithmic phase), but soon it
slows down gradually as the environmental resistance

36
increases percentage wise (the negative acceleration phase),
until a more or less equilibrium level is reached and
maintained that is the carrying capacity, showing more or
less an S – shaped curve.

Carrying Capacity
K
Population
Growth

Time
Fig. 3.2: Sigmoid Growth Curve (S- shaped)

3. Population Dynamics

¾ Definition

Population dynamics is the study of the changes in population

size and structure over time

37
¾ Major Factors in Population Dynamics
Three major factors or variables determine the population
of a defined area and its growth over time. There are:

♦ Births (Fertility)
♦ Deaths (Mortality)
♦ Migration
a) immigration (in migration)
b) emigration (out migration)

The balance among these three factors determines whether a

population increases, remains stationary, or decreases in
number. The relation between births and deaths is referred to
as Natural Population Increase (Natural Population Growth).
When the net effect of migration is added to natural increase,
this is referred to as Total Increase (Total Growth).

4. Population structure (composition)

Aside from the total size, the most important demographic
characteristic of a population is its population structure.
Population structure refers to the composition of the
population in terms of Age, sex, occupation, religion,
educational status, geographical distribution, socio– economic
status etc. The structure of a population is influenced or

38
affected by births, deaths and migration and their predisposing
factors.

The age – sex structure determines potential for future growth

of specific age groups, as well as the total population. For
these reasons the age structure has significant government
policy implications. A population of young people needs a
sufficient number of schools and later, enough jobs to
accommodate them. Countries with a large proportion of older
people must develop retirement systems and medical facilities
to serve them. Therefore, as a population ages needs change
from child care schools and jobs tol to jobs, housing, and
medical care.

5. Population pyramid
The age–sex structure of a country can be studied through
population pyramids. Population pyramids show pictorially
(graphically) the effects of the three factors that influence
population. The overall shape of the pyramid indicates the
potential for future growth. Population pyramids present the
population of an area or country interms of its composition by
age and sex at a point in time. The series of horizontal bars in
a pyramid represent the percentage contribution of each age
and sex groups (often of five years age group interval) in the
population. A glance at a population pyramid can tell a great

39