Egypt pushes population control: 'Two is Enough'

Jacob Wirtschafter and Mina Nader | Special to USA TODAY

CAIRO – Egypt's faltering economy pushed authorities to become explicit about family planning, one of the most private of matters in this traditional, Muslim country.

As Egypt’s population hits the milestone of 100 million, President Abdel-Fattah el-Sissi is rolling out a campaign called “Two is Enough.”

The campaign, supported by the United States and the United Nations, is not like China’s harsh rule limiting children. Instead, authorities want 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 last year at a youth conference.

Egypt’s unemployment rate fell to 10.6 percent for the first quarter this year, down from 11.3 percent in the same period last year, according to the most recent government figures. The country needs to create jobs for nearly 1 million people annually entering the workforce.

Egypt is at the “water poverty” line, what the United Nations defines as an acute scarcity of water. The water shortage is likely to worsen. Ethiopia will probably start filling the reservoir behind the Grand Renaissance Dam this year, a move that will 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 provides maternal and child health care, plus cash support to 1.15 million women in the country’s poorest families.

“I heard about the campaign on Facebook,” said Rosie Bakhoum, 25, who has one child and lives in Sohag, one of the 10 states in Egypt where the birthrate is more than three 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's call for fewer babies comes amid sharp increases in the price of food and transportation after a three-year, $12 billion bailout program inked in 2016 by el-Sissi's government and the International Monetary Fund that required cuts to state subsidies for gasoline, electricity and water, in addition to devaluing the Egyptian pound.

To help the cash-strapped government in Cairo, the U.S. Agency for International Development will provide Egypt with $19 million over the next five years to help state-run clinics and nonprofit groups increase the use of contraceptives and improve women’s health. The U.N. Population Fund allocated about $6 million this year for reproductive health services in Egypt.

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

The new 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 initiative, family planning projects were not well funded, and the birthrate started rising.

Support for birth control was pulled during the one year that President Mohammed Morsi was president until he was overthrown by el-Sissi in July 2013. Since then, state funding for health care has been slow to bounce back during Egypt’s 6-year-old economic crisis.

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

"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 Center for Egyptian Women’s Legal Assistance.

Egyptian law bans abortion. Women and doctors who perform them could face three or more years in prison.

El-Sissi is unlikely to move to legalize abortion, since he's under fire by Islamic fundamentalists for promoting equality for Coptic Christians and is battling Islamic State terrorists in the Sinai.

Officials acknowledged 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.

“Many believe more children offer more economic support in old age,” since millions of Egyptians enter retirement without a pension, Fares said. “Also driving up birthrates 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, Egypt.