World Population Situation

Menoufiya University Faculty of Nursing Psychiatric Department Woman and Reproductive Health Fourth Year

Supervised by Assistant Prof. Inas Kassem

Prepared by: 1Sally Said AboEl-Yazid Shaldam. 2Tahany Fawzy Keshk. 3- Aml Shawky El-Morshedy. 4Samar Hamdy Gobashy. 5Ingy Nabil Fayez.

6Samar Abd El-Aziz Anbr. 7Asmaa Mosad EL-Bably. 8Hanan El-Sayed Nada. 9- Hanan Gamal El-Breedy. 10- Doaa Tarek Dawood. 11- Eman Salem Omara. 12- Ayat Esawy Abd El-Aal. 13- Samar Abd El-Fatah Ragab. 14- Elham Ramzy El-feki. 15- Asmaa El-Mohammdy ElEtewy. 16- Inas Salah Metwaly. 17- Basma Fawzy El-Zanaty. 18- Doaa Mohammed El-Shehaly. 19- Hosn Mahroos Abd El-Salam. 20Amira Rabea Saleh. 21- Basma El-Sayed El-Daly. 22- El-Shimaa Mahmoud Shams El-Deen. 23- Asmaa Arabi Saad. 24- Samar Shawky Askar. 25- Eman Mohammed Shaban. 26- Amal Abd El-Razek Sadah. 27- Asmaa Ahmed Serag El-Deen. 28- Zhraa Mohammed Badr. 29- Samah Sebak Salem.

:Outlines .Introduction-1 2-Measuring Fertility, Mortality, and Population growth Fertility* *Fertility rate *General fertility rate *Total fertility rate *Why is fertility rate important? *Crude Birth Rate, Crude Death Rate, Total Fertility Rate *Crude birth rate *Other methods of measuring birth rate *Factors affecting birth rate Mortality rate* Factors affecting a given death* rate

*Infant mortality *Infant mortality rate *Infant mortality rate in countries Egypt Infant mortality rate* *Perinatal mortality *Fetal mortality *Neonatal mortality *Perinatal Mortality Rate *Maternal mortality *Maternal Mortality Ratio (MMR) *Maternal death rates in the 20th century 3-Migration *Types of migration :The growth rate-4 Population Growth: NATURAL *INCREASE Fertility control-5

*References

1-Introduction: Earth's population is increasing by over 140 people every minute ... equivalent to another Los Angeles plus another Chicago every month. •

Right now, with "only" 6.4 billion of us: (1) We are driving over 50 species of plants and animals to extinction per day! (2) We are destroying rain forests many times faster than they can regenerate. (3) We are consuming stored solar energy (fossil fuels) at rates thousands of times faster than it is regenerating. (4) There are regions in the U.S. where we are consuming fresh water at least 10 times faster than it is being replenished. (5) We are causing soil salinization and erosion several-fold faster than rates of restoration. (6) We are over-fishing our oceans, radically changing the species balance in many places. •

For several years population has been increasing faster than many vital non-renewable and renewable resources. •

This means the amount of these resources per person is declining, in spite of modern technology. •

Other massive social and environmental problems ... political instability, loss of freedoms, vanishing species, rain forest destruction, desertification, garbage, urban sprawl, water shortages, traffic jams, toxic waste, oil spills, air and water pollution, increasing violence and crime ... continue to worsen as our numbers increase by more than 70 million more people every year. Solving these problems will be much less difficult when we stop increasing the number of people affected by them. •

Two billion people live in poverty, more than the population of the entire planet less than 100 years ago. •

Today there are more people suffering in misery and starvation in the world than ever before in history. •

•

In many developing countries, couples are still averaging 4 to

6 children. Nearly half of them would like to have fewer children, but they lack access to family planning (not including abortion). Providing the education and supplies they need would cost only a few dollars per year. While populations of some industrialized countries have stabilized, over three billion people live or struggle to exist in countries where population is still growing rapidly with doubling times of less than thirty years. •

2- Measuring Fertility, Mortality, and Population growth -The population of a country can change in only three ways births,deaths,or migration

-Fertility refers to the actual reproductive performance of the population.

Fertility Rate Definition: The number of live births per 1000 women of the childbearing

age group (15-44).

Also Known As: general fertility rate Examples: As a country's fertility rate decreases, the birth rate will also decrease because fewer babies will be born.

General fertility rate A refined measure of fertility in a population; the numerator is the number of live births in a year, the denominator is the number of females of childbearing age, usually defined as ages 15-44 (but increasingly recognised as extending to age 49).

Total fertility rate (TFR) The mean number of children a woman is expected to bear during her child-bearing years. It is also independent of the age-sex structure of the population.

Why is fertility rate important? Fertility rate is, basically, the number of children that the average woman will have in her lifetime. If the average woman has exactly two children in her lifetime, this is just enough to replace herself and one man, and thus maintain the population. Ultimately, this is the only thing that matters in determining long-term population growth. If the average woman has two children, then the number of people in the next generation will be the same as the number of people in this generation. You often hear people say that improved diet or medicene or other things that cause people to live longer cause population to grow, or that wars or other disasters cause population to shrink. But this is only true indirectly: only if it changes the number of children that the average woman has in her lifetime. That is, if many women die while still young, they may not live long enough to have all the children that they otherwise might have had. But beyond that, how long people live doesn't matter. Everybody still dies sooner or later. If a war wipes out a large number of people, this causes an immediate drop in the population, of course. For the time that the war lasts population growth becomes negative. But once the war is over, if the number of children per woman is the same, the old population growth rate will immediately resume. There is a temporary change in the total numbers, but the rate of growth does not change.

Crude Birth Rate, Crude Death Rate, Total Fertility Rate The Crude Birth Rate (CBR) and Crude Death Rate (CBR) are statistical values that can be utilized to measure the growth or decline of a population. The Crude Birth Rate and Crude Death Rate are both measured by the rate of births or deaths respectively among a population of 1000. The CBR and CDR are determined by taking the total number of births or deaths in a population and dividing both values by a number to obtain the rate per 10000. For example, if a country has a population of one million and 15,000 babies were born last year in that country, we divide both the 15,000 and 1,000,000 by 1000 to obtain the rate per 1000. Thus the Crude Birth Rate is 15 per 1000.

The Crude Birth Rate is called "crude" because it does not take into account age or sex differences among the population. In our hypothetical country, the rate is 15 births for every 1000 people but the likelihood is that around 500 of those 1000 people are men and of the 500 who are women, only a certain percentage are capable of giving birth in a given year. Crude Birth Rates of more than 30 per 1000 are considered high and rates of less than 18 per 1000 are considered low. The global Crude Birth Rate in 2005 is 20.15 per 1000. The Crude Death Rate measures the rate of deaths for every one thousand people in a given population, such as a country. Crude Death Rates of below ten are considered low while Crude Death Rates above twenty per 1000 are considered high. Many African countries have very high Crude Death Rates. The global Crude Death Rate in 2005 was 8.78 and in the United States the rate was 8.25 per 1000. The term total fertility rate is used to describe the total number of children the average women in a population is likely to have based on current birth rates throughout her life. The number, which ranges from more than 7 children per woman in developing countries in Africa to around 1 child per woman in Eastern European and highly-developed Asian countries. Associated with total fertility rate is the concept of replacement rate. The replacement rate is the number of children each woman needs to have to maintain current population levels or what is known as zero population growth for her and her partner. In developed countries, the necessary replacement rate is about 2.1. Since replacement can not occur if a child does not grow to maturity and have their own offspring, the need for the extra .1 child (a 5% buffer) per woman is due to the potential for death and those who choose or are unable to have children. In less developed countries, the replacement rate is around 2.3 due to higher childhood and adult death rates.

Crude birth rate -Is the natality or childbirths per 1,000 people per year. -It can be represented by number of childbirths in that year, and p is the current population. As of 2007, the average birth rate for the whole world is 20.3 per year per 1000 total population, which for a world population of 6.5 billion comes to 134 million babies per year. -Another indicator of fertility is frequently used: the total fertility rate average number of children born to each woman over the course of her life. In general, the total fertility rate is a better indicator of (current) fertility rates because unlike the crude birth rate it is not affected by the age distribution of the population. -Fertility rates tend to be higher in less economically developed countries and lower in more economically developed countries. -The birth rate is an item of concern and policy for a number of national governments. Some, including those of Italy and Malaysia, seek to increase the national birth rate using measures such as financial incentives or provision of support services to new mothers. Conversely, others aim to reduce the birth rate. For example, China's One child policy; measures such as improved information about and availability of birth control have achieved similar results in countries such as Iran.

*Other methods of measuring birth rate Total number of births in the United States, 1934 to present General fertility rate (GFR) – This measures the number of births per 1,000 women aged 15 to 44 or 15 to 49. •

Standardised birth rate (SBR) – This compares the age-sex structure to a hypothetical standard population. •

Total fertility rate (TFR) – The mean number of children a woman is expected to bear during her child-bearing years. It is also independent of the age-sex structure of the population. •

Child to woman ratio – This measures the number of children below five to the number of women of child-bearing years •

(age 15 to 44). In the past, when there is no universal registration of births, this ratio is a relatively good indicator of fertility since it can be measure using data from the Census. However, high infant mortality rate would cause huge difference between child to woman ratio and general fertility rate (GFR).

Factors affecting birth rate Pro-natalist policies and Antinatalist policies from government • Existing age-sex structure • Availability of family planning services • Social and religious beliefs - especially in relation to contraception and abortion • Female literacy levels • Economic prosperity (although in theory when the economy is doing well families can afford to have more children in practice the higher the economic prosperity the lower the birth rate). • Poverty levels – Children can be seen as an economic resource in developing countries as they can earn money. • Infant Mortality Rate – A family may have more children if a country's IMR is high as it is likely some of those children will die. • Urbanization • Typical age of marriage • Pension availability • Conflict •

Mortality rate Mortality rate is a measure of the number of deaths (in general, or due to a specific cause) in some population, scaled to the size of that population, per unit time. Mortality rate is typically expressed in units of deaths per 1000 individuals per year; thus, a mortality rate of 9.5 in a population of 100,000 would mean 950 deaths per year in that entire population. It is distinct from morbidity rate, which refers to the number of individuals in poor health during a given time period (the incidence rate) or the number who currently have that disease (the prevalence rate), scaled to the size of the population. One distinguishes:

The crude death rate, the total number of deaths per 1000 people. The crude death rate for the whole world is currently about 9.6 per 1000 per year (based on 62 million deaths in 2006, for a population of 6470 million[1]). 2. The perinatal mortality rate, the sum of neonatal deaths and fetal deaths (stillbirths) per 1,000 births. 3. The maternal mortality rate, the number of maternal deaths due to childbearing per 100,000 live births. 4. The infant mortality rate, the number of deaths of children less than 1 year old per thousand live births. 5. The child mortality rate, the number of deaths of children less than 5 year old per thousand live births. 6. The standardised mortality rate (SMR)- This represents a proportional comparison to the deaths that would have been expected if the population had been of a standard composition in terms of age, gender, etc..[2] 7. The age-specific mortality rate (ASMR) - This refers to the total number of deaths per 1000 people of a given age (e.g. 16-65 or 65+). 1.

In regard to the success or failure of medical treatment or procedures, one would also distinguish: The early mortality rate, the total number of deaths in the early stages of an ongoing treatment, or in the period immediately following an acute treatment. 2. The late mortality rate, the total number of deaths in the late stages of an ongoing treatment, or a significant length of time after an acute treatment. 1.

Note that the crude death rate as defined above and applied to a whole population of people can give a misleading impression. The crude death rate is affected by birth rate and life expectancy. For example, the number of deaths per 1000 people can be higher for developed nations than in less-developed countries, despite life expectancy being higher in developed countries due to standards of health being better for example. This happens because developed countries have a relatively lower birth rate. A more complete picture of mortality is given by a life table which summarises mortality separately at each age. A life table is necessary to give a good estimate of life expectancy.

Factors affecting a given death rate • • • • • • • •

Age of country's population Nutrition levels Standards of diet and housing Access to clean drinking water Hygiene levels Levels of infectious diseases Social factors such as conflicts and levels of violent crime Amount and quality of health care available

Infant mortality Infant mortality is defined as the number of deaths of infants (one year of age or younger) per 1000 live births. The most common cause of infant mortality worldwide has traditionally been dehydration from diarrhea. Because of the success of spreading information about Oral Rehydration Solution (a mixture of salts, sugar, and water) to mothers around the world, the rate of children dying from dehydration has been decreasing and has become the second most common cause in the late 1990s. Currently the most common cause is pneumonia. Major causes of infant mortality in more developed countries include congenital malformation, infection and SIDS. Infanticide, abuse, abandonment, and neglect may also contribute to infant mortality Related statistical categories: Perinatal mortality only includes deaths between the foetal viability (22 weeks gestation) and the end of the 7th day after delivery. • Neonatal mortality only includes deaths in the first 28 days of life. • Post-neonatal death only includes deaths after 28 days of life but before one year. • Child mortality includes deaths within the first five years after birth •

Infant mortality rate Infant mortality rate (IMR) is the number of newborns dying under a year of age divided by the number of live births during the year. The infant

mortality rate is also called the infant death rate. It is the number of deaths that occur in the first year of life for 1000 live births. In past times, infant mortality claimed a considerable percentage of children born, but the rates have significantly declined in the West in modern times, mainly due to improvements in basic health care, though high technology medical advances have also helped. Infant mortality rate is commonly included as a part of standard of living evaluations in economics. [1] The infant mortality rate is reported as number of live newborns dying under a year of age per 1,000 live births, so that IMRs from different countries can be compared.

Infant mortality rate in countries Nearly two orders of magnitude separate countries with the highest and lowest reported infant mortality rates. The top and bottom five countries by this measure (taken from the The World Factbook's 2008 estimates) are shown below.

Rank

Country

Infant mortality rate (deaths/1,000 live births)

1

Angola

182.31

2

Sierra Leone

156.48

3

Afghanistan

154.67

4

Liberia

143.89

5

Niger

115.42

218 Iceland

3.25

219 Hong Kong

2.93

220 Japan

2.80

221 Sweden

2.75

222 Singapore

2.30

*Egypt Infant mortality rate Year Infant mortality rate Rank Percent Change Date of Information

200 3

35.26

86

200 4

32.59

79

-7.57 %

2004 est.

200 5

32.59

78

0.00 %

2005 est.

200 6

31.33

78

-3.87 %

2006 est.

200 7

29.5

79

-5.84 %

2007 est.

200 8

28.36

80

-3.86 %

2008 est.

2003 est.

Definition: This entry gives the number of deaths of infants under one

year old in a given year per 1,000 live births in the same year; included is the total death rate, and deaths by sex, male and female. This rate is often used as an indicator of the level of health in a country.

Perinatal mortality Perinatal mortality (PNM), also perinatal death, refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Variations in the precise definition of the perinatal mortality exist specifically concerning the issue of inclusion or exclusion of early fetal and late neonatal fatalities. Thus the WHO ‘s definition "Deaths occurring during late pregnancy (at 22 completed weeks gestation and over), during childbirth and up to seven completed days of life" is not universally accepted. The perinatal mortality is the sum of the fetal mortality and the neonatal mortality.

Fetal mortality Fetal mortality refers to stillbirths or fetal death. It encompasses any death of a fetus after 20 weeks of gestation or 500 gm. In some definitions of the PNM early fetal mortality (week 20-27 gestation) is not included, and the PNM may only include late fetal death and neonatal death. Fetal death can also be divided into death prior to labor, antenatal (antepartum) death, and death during labor, intranatal (intrapartum) death. Fetal mortality can be decreased by good preconception health among women before they get pregnant.

Neonatal mortality Early neonatal mortality refers to a death of a live-born baby within the first seven days of life, while late neonatal mortality covers the time after 7 days until before 29 days. The sum of these two represents the neonatal mortality. Some definitions of the PNM include only the early neonatal mortality. Neonatal mortality is affected by the quality of in-hospital care for the neonate. Neonatal mortality and postneonatal mortality (covering the remaining 11 months of the first year of life) are reflected in the Infant Mortality Rate.

Perinatal Mortality Rate The PNMR refers to the number of perinatal deaths per 1,000 total births. It is usually reported on an annual basis. It is a major marker to assess the

quality of health care delivery. Comparisons between different rates may be hampered by varying definitions, registration bias, and differences in the underlying risks of the populations. PNMRs vary widely and may be below 10 for certain developed countries and more than 10 times higher in developing countries. The WHO has not published contemporary data.

Maternal mortality Maternal death, or maternal mortality, also "obstetrical death" is the death of a woman during or shortly after a pregnancy. In 2000, the United Nations estimated global maternal mortality at 529,000, of which less than 1% occurred in the developed world. However, most of these deaths have been medically preventable for decades, because treatments to avoid such deaths have been well known since the 1950s.

Maternal Mortality Ratio (MMR) Maternal Mortality Ratio is the ratio of the number of maternal deaths per 100,000 live births. The MMR is used as a measure of the quality of a health care system. "Lifetime risk of maternal death" accounts for number of pregnancies and risk. In sub-Saharan Africa the lifetime risk of maternal death is 1 in 16, for developed nations only 1 in 2,800.

Maternal death rates in the 20th century The death rate for women giving birth plummeted in the 20th century. The historical level of maternal deaths is probably around 1 in 100 births. Mortality rates reached horrible proportions in maternity institutions in the 1800s, sometimes climbing to 40 percent of birthgiving women. At the beginning of the 1900s, maternal death rates were around 1 in 100 for live births. The number today in the United States is 11 in 100,000, a decline by orders of magnitude.[11]

The decline in maternal deaths has been due largely to improved asepsis, use of caesarean section, fluid management and blood transfusion, and better prenatal care. Recommendations for reducing maternal mortality include access to health care and emergency obstetric care, funding and intrapartum care.[12] Moreover, political will and support play a major role and without it reforms to reduce maternal mortality cannot be made.

Migration-3 Is the movement of people across a specified boundary for the purpose.of residing

Types of migration* a-Involuntary: slavery, ethnic persecution, wars, natural disasters, famines b-Voluntary: to seek jobs (skilled or unskilled), to get an education, because of marriage, upon retirement -----------------------------a-Internal migration: within a country e.g. rural to urban b-International migration: skilled professionals to other countries Migrants (workers, prostitutes, truck drivers) may spread infectiousdiseases e.g. HIV/AIDS, TB, diphtheria Jet travel speeds up disease transmissionMigrants often live in urban slums and experience adjustment(problems (these can affect their physical or mental health

:The growth rate-4 Is the rate at which population is increasing or decreasing in a given areadue to natural increase at net migration expressed as a percentage of base .population

Population Growth: NATURAL INCREASE* Natural increase is a simple measure of population growth which examines the differences between births (fertility) and deaths (mortality) in a given group. It is usually determined by subtracting the crude death rate from the crude birth rate. Natural increase is generally expressed as a percentage figure. e.g. an annual natural increase of 0.8 means that a country is increasing its population by 0.8 .per cent each year If the death rate is greater than the birth rate, then a population may be experiencing natural decrease

Fertility control-5 Fertility control is the regulation over the reproductive system as awhole, not just as it applies to child bearing, whereas birth control is the regulation of the number of children via management or prevention of contraception through a variety of methods. These methods include, but are not limited to, the use of oral contraceptives and the condom. Population control, as its name implies, is the direct control of a .country's, or community's, or segment of society's population Reproduction may be controlled by late marriage or by decline in the.population of married to un married individuals in the population :A couple may control their fertility in three ways .First: delay the birth of their first child by using contraception .Second: practicing birth spacing Third: finally having completed their family size to stop childbearing to adopt the previous strategies.Couples must have the ability to make a conscious choice about their reproductive behavior, or control of reproduction must be socially acceptable.There must be perceived social .or economic advantages to reduce fertility

References 1.Http://mdgs.un.org/unsd/mdg/Metadata.aspx? IndicatorId=0&SeriesId=562. 2. Presumably, they are registered as stillbirths rather than infant deaths if the infant dies shortly after birth. 3. Barbara A. Anderson; Brian D. Silver (December 1986). "Infant Mortality in the Soviet Union: regional differences and measurement issues". Population and Development Review 12 (4): 705–737. doi:10.2307/1973432. http://links.jstor.org/sici?sici=00987921%28198612%2912%3A4%3C705%3AIMITSU%3E2.0.CO %3B2-E. 4. Maternal Mortality in Central Asia, Central Asia Health Review (CAHR), 2 June, 2008 5. Koonin, Lisa M.; Hani K. Atrash, Roger W. Rochat, Jack C. Smith (12/1/1988). "Maternal Mortality Surveillance, United States, 1980– 1985". MMWR 37 (SS-5): 19–29. 6. Deneux-Tharaux, D; Berg C, Bouvier-Colle MH, Gissler M, Harper M, Nannini A, Alexander S, Wildman K, Breart G, Buekens P. (2005). "Underreporting of Pregnancy-Related Mortality in the United States and Europe". Obstet Gynecol 106: 684–692. 7. Nour NM (2008). "An Introduction to Maternal Mortality". Reviews in Ob Gyn 1: 77–81.

8. Maternal Mortality in Central Asia, Central Asia Health Review (CAHR), 2 June, 2008. 9. Http://www.who.int/whosis/mme_2005.pdf Maternal Mortality in 2005], access date=08-230-2008 10. Thaddeus, S; Maine D (1994). "Too far to walk: Maternal mortality in context". Social Science & Medicine 38 (8): 1091–1110. doi:10.1016/0277-9536(94)90226-7. 11. See for instance mortality rates at the Dublin Maternity Hospital 1784–1849 12.Http://www.who.int/whosis/mme_2005.pdf Maternal Mortality in 2005], access date=08-230-2008 13.Richardus JH, Graafmans WC, Verloove-Vanhorick SP, Mackenbach JP. The perinatal mortality rate as an indicator of quality of care in international comparisons. Med Care. 1998 Jan;36(1):54-66 PMID 9431331 14. Everitt, B.S. The Cambridge Dictionary of Statistics, CUP. ISBN 0-521-81099-x 15. See "Fertility rates"; Economic Geography Glossary at University of Washington 16.Espenshade TJ, Guzman JC, and Westoff CF (2003). "The surprising global variation in replacement fertility". Population Research and Policy Review 22: 575. doi:10.1023/B:POPU.0000020882.29684.8e. 17."How Fertility Changes Across Immigrant Generations." Research Brief #58, Public Policy Institute of California, 2002. -Http://www.health.state.pa.us/hpa/stats/techassist/fertility.htm -From Wikipedia, the free encyclopedia

-More than half of the global population lives where fertility is below replacement level (Chris Wilson and Gilles Pison, Population & societies, no. 405, October, 2004) -Fertility Below Replacement Level (Chris Wilson, 2001, Science 304 (no. 5668), pp. 207-209) -United Nations Population Division, World Population Prospects: the 2002 Revision -United States Census Bureau, International Data Base