“Foundations” is an occasional series of informal question-and-answer sessions with employees of The William and Flora Hewlett Foundation to give them an opportunity to explain their work. Tamara C. Fox is a program officer in the Foundation’s Population Program. She makes grants to support research, training and advocacy related to reproductive health and family planning worldwide. She currently is leading a major initiative examining how population and reproductive health issues affect economic development.
In previous work, at the World Bank and the Urban Institute, she examined policymaking on immigration, health care financing and reproductive health. She has a Ph.D. in agricultural and resource economics from the University of California, Berkeley; an M.Sc. in health planning and financing from the London School of Economics; and a B.S. in genetics and biomedical policy from Cornell University.
What attempts have been made to understand the relationship between population dynamics in poor countries and the impact of those dynamics on economic well-being?
Conventional thinking about the relationship between the two has been debated since the eighteenth century, when Thomas Malthus predicted that the world’s population would outrun food supply. But there has not been much investment in research on this topic in the past few decades. In the mid-1980s the National Academy of Sciences reviewed the science in this area and was unable to draw strong conclusions. That was because they had neither the good data nor the more sophisticated econometric tools that we now have. They didn’t conclude there wasn’t a relationship between population and poverty, just that they couldn’t quantify it. It was a hard time for the field.
Most recently, in the past several years, there has been a realization that research that discounted links between population and poverty didn’t fully consider the ways that household dynamics on one hand and national economic policy on the other might complicate the relationship. For example, it might make sense for a family to have a fifth child because it needs help to harvest a crop, but it might still adversely affect the larger community for the population to grow. So we haven’t always understood how micro- and macroeconomic incentives might be misaligned. The microeconomic researchers and the macroeconomic researchers often didn’t talk to each other about how their models fit together. Some of the research we’re supporting is designed to better relate the two.
How have developing countries been affected by researchers’ uncertainty about the relationship between population and poverty?
Investments in reproductive health and family planning have varied geographically. In East Asia, which invested in family planning in the 1950s and 1960s, the investment has paid off. Today there are estimates that about a third of the economic rise in East Asia was due to changes in fertility rates. By contrast, Africa didn’t invest in family planning programs in the same way. Fertility has not fallen as quickly in Africa as in most other parts of the world in the past half-century, and there’s been little or no economic growth in three decades in Africa. And it isn’t clear if many African countries have the economic infrastructure to capitalize upon the benefits of lower fertility if there were major shifts in fertility in the coming years.
Before the Foundation’s current efforts began, what did some of the more recent research show about the relationship between population and poverty?
One important insight is that a drop in fertility rates creates a window of opportunity when it becomes easier for a country to make economic gains. If a family is supporting two or three children instead of five or six, it may be able to save money that can be invested in the economy, fueling economic growth. But often there is only a window of perhaps a couple decades during which this type of investment is possible, because if the fertility rate stays low, eventually the population will age, and there will be a larger population of older people being supported by a smaller workforce.
It’s important for a country to have good economic policies to make use of that window while it has relatively small numbers of dependent children and dependent elderly. So it’s not only population size and growth that matter, but also the composition of that population. This is a major shift in the sophistication of the research that occurred from the ’50s and ’60s to the ’80s and ’90s.
Tell us about the nature of the research that Hewlett is funding in this field.
We’ve invested about $13 million in twenty-two grants so far. We funded the Center for Global Development to help frame Hewlett’s overall research effort. It convened experts, policymakers and donors to review and critique our plans over the next five years. The African Economics Research Consortium-one of the best economics research groups in Africa-currently is doing its first-ever research relating population and poverty , including case studies in about a dozen countries.
We’re also funding research on the topic at Harvard, which is home to some of the top macro- and microeconomists who work on these issues, and at the World Bank. And we’ve partnered with the governments of the United Kingdom, the Netherlands, and (we hope soon) France to co-fund research with their national research councils, involving researchers in Europe as well as in Africa.
Who do you hope pays attention to this new research?
We’re trying to speak to new audiences-development economists and economically minded policymakers-and explain to them in their own terms why reproductive health and population dynamics matter to them. We want to bring this research to finance ministers, the World Bank, the International Monetary Fund-people who shape the debates about development and where resources should go. The focus is on the economic outcomes of reducing poverty and improving economic growth, not directly on reproductive health and fertility outcomes, which we focus on in the rest of the Foundation’s Population Program.
How long do you expect it to take to have research results that can influence policy?
Perhaps two years. By the end of this year, we’ll have launched most of the major research initiatives in which we plan to invest. After that we’ll begin a communications piece to get the research findings out into the world: publishing them in peer-reviewed journals and the lay press, development debates and conferences.
What does this mean for the Population Program’s other work in family planning?
It’s still crucially important to look at the individual level. Societies don’t have children, people have children, and the Program invests to ensure that women and families have access to family planning services so they can have the number of children they want to have, when they want to have them. Unintended or mistimed pregnancies can be difficult for women, and it can be difficult for families living in poverty to care for additional members. In Africa, where one in sixteen women dies of a pregnancy-related cause, an unplanned pregnancy can present an even larger risk. And that’s why investing in family planning and reproductive health services is so important.