Egypt's "Two-child policy"

EGY170913003CAIRO – The economy is forcing Egyptian authorities to become increasingly explicit about family planning, one the most private of matters in this traditional, majority Muslim country.

As Egypt’s population hits the milestone mark of 100 million, President Abel Fatah el-Sissi is rolling out a campaign called “Two is Enough.”
Supported by the United States and United Nations as essential for Egypt’s economic development, the campaign is not like China’s harsh rule limiting children. Instead, authorities are doing their best to persuade young couples to stop at two kids.

“The two biggest dangers that Egypt faces are terrorism and population growth and this challenge decreases Egypt’s chances of moving forward,” el -Sissi said recently.

Egypt’s unemployment rate fell from 11.3 percent in the first quarter of last year to 10.6 per cent in the same period this year, according to the most recent government statistics. But the country still needs to create jobs for almost a million people entering the workforce annually.

Even more worrisome, Egypt is already at the “water poverty” line, or what the United Nations defines as acute water scarcity. The country’s water shortage is likely to worsen when Ethiopia starts filling the reservoir behind the Grand Renaissance Dam expected later this year, a move guaranteed to reduce the volume of water in the Nile River as it flows northward toward Egypt.

In addition to a media campaign encouraging fewer births, the “Two is Enough” campaign is giving maternal and child healthcare services and cash support to 1.15 million women in the country’s poorest families.

“I heard about the campaign on Facebook,” said Rosie Bakhoum a 25-year-old mother of one in Sohag, one of the 10 governorates in Egypt where the birth rate is more than 3 children per woman. “The ideal number of kids in rural Upper Egypt is still four (to work the land) but I think this program will succeed because honestly, economic conditions are forcing us to have smaller families.”

The government is calling for fewer babies amid sharp increases in the price of food and transportation in the wake of a three-year, $12 billion bailout program inked by el-Sissi's government and the International Monetary Fund in 2016 that proscribed cuts to state subsidies for gasoline, electricity, and water and devalued the Egyptian pound.

To help cash-strapped officials in Cairo, the United States Agency for International Development (USAID) is providing the Egyptian government with $19 million over the next five years to help state-run clinics and public health non-profits increase contraceptive use and improve women’s health. The United Nations Population Fund has also allocated about $6 million dollars for reproductive health services in Egypt this year.

“We know that USAID family planning programs have made tremendous impact in the past,” said USAID Mission Director Sherry F. Carlin, referring to how fertility rates fell from 5.8 children per mother to three under former President Hosni Mubarak. “We stand poised again to be a part of the solution to the rapid growth in Egypt’s fertility rate.”

The push is a reversal from recent Egyptian policies.

In the six years between Mubarak’s forced departure during the Arab Spring and el-Sissi's current initiative, family planning projects were not well funded, and the birth rate started rising.

Support for birth control was pulled during the one-year presidency of the Muslim Brotherhood’s Mohamed Morsi, whom el-Sissi overthrew in July 2013. Since then, state funding for healthcare has been slow to bounce back during Egypt’s six year-long economic crisis.

Women’s rights advocates also argued that legalized abortion must be an option for the government to slow population growth to its target of 2.4 children per woman.

“The campaign needs to reach beyond 10 governorates – young men need to be included in education efforts – and abortion needs to be a legitimate and legal option for women in addition to contraception,” said Nada Nashat, an attorney at the Cairo-based Centre for Egyptian Women’s Legal Assistance.

But Egyptian law bans abortion. Women who undergo abortions and doctors who perform them can face three or more years in prison.
Already under fire by Islamic fundamentalists for promoting more equality for Coptic Christians and battling Islamic State jihadists in the Sinai, el-Sissi is unlikely to move to legalize abortion any time soon.

But officials acknowledge that gaps in medical service must be bridged for the “Two is Enough” program to succeed.

“The role of nurses is particularly important given that up to 30 percent of women may stop using birth control because they cannot access advice when it is needed,” said Randa Fares, a coordinator for population programs at the Ministry of Social Solidarity, the government's central welfare agency.

Other key economic and cultural barriers to reducing family size remain.

“Many believe more children offers more economic support in old age,” said Fares, referring to how millions of Egyptians enter retirement without a pension in Egypt. “Also driving up birth rates is competition between sisters-in-law over who has the most children and concerns that if they do not give birth to a son, husbands may take another wife.”

Nader reported from Sohag.

Photo: September 19, 2017 - Luxor, Egypt - A local boy rides the Nile ferry. With Egypt’s population set to double over the next 50 years scientists and policymakers are increasingly worried about water security for the country's youth.
Credit: Mina Nader/ ARA Network Inc. (09/19/17)

Story/photo published date: 07/05/18)

A version of this story was published in USA Today.
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