Demography and

Family Planning

Community Health Nursing

Unit II

Rija Acharya
M.Sc. nursing
Batch 2013
 2

Demography
 CONTENTS 3
Definition of the terms

Demographic cycle
Demographic measurement tools
Growth rate and measurement of population
change

Determinant of population change

World population growth through history and

current status.
 INTRODUCTION 4

A population is a summation of all the organisms of

the same group or species, who live in the
same geographical area, and have the capability of
interbreeding.

Demography is the study of the size, structure, and

distribution of these populations, and temporal changes
in them in response
to birth, migration, aging and death.
 5
Population dynamics

It is the branch of life sciences that studies short-term

and long-term changes in the size and age
composition of populations, and
the biological and environmental processes
influencing those changes.
Population size 6
It is the number of individuals in a population.
It has an important effect on the ability of the
population to survive.

Population Density
It is the number of individuals in a given area.
If they are too far apart they may only rarely
encounter one another resulting in little reproduction.
 7
Population Dispersion

It is the pattern of distribution in which a population

exists.

It may be:
i. Clumped Dispersion Pattern
ii. Random Dispersion
iii. Uniform Dispersion
 Clumped Dispersion Pattern 8

A pattern in which individuals in a population are more

concentrated in certain parts of the habitat.
It occurs in these 3 situations:
When suitable living conditions are distributed in
patches
Mates are easier to locate in groups
Limited seed dispersal or asexual reproduction.
 Random Dispersion 9

Random dispersion occurs when environmental

conditions do not vary greatly within a habitat and
when individuals are neither attracted to nor repelled
by others of their species.
Organisms are distributed unpredictably.
 10

Uniform Dispersion

Equally spaced throughout a habitat.

 11

Uniform Random Clumped

 12

DEMOGRAPHIC
CYCLE
 13
Demography Cycle

Demographic cycle describe changes in

population size and composition due to increase
or decrease in number of births and deaths.

The history of world population since 1650

suggests that there is a demographic cycle of 5
stages through which a nation passes.
 14
Demographic Cycle

1. First Stage
2. Second Stage
3. Third Stage
4. Fourth Stage
5. Fifth Stage
 First stage (High Stationary)
15
It is characterized by high birth rate and high death
rate which cancel each other. So the population
remains stationary.

Example: Britain in the 17th and 18th century.

In 2011, there are no countries in stage 1, however

it is believed that some Brazilian tribes (within the
numerous rainforests) are in this stage.
Second stage (Early Expanding) 16

There is a decline in death rate while the birth rate

remains unchanged. So the population expands.

Many developing countries of Asia and Africa are in

this stage.
 Third stage (Late Expanding) 17

Death rate declines further and birth rate begins to fall.

Yet there is an increase in population since birth
exceeds deaths.

E.g. Egypt, Brazil, Nepal, India

Fourth stage (Low Stationary) 18

Low birth rate and low death rate. So the population

becomes stationary.
E.g. USA, UK, France, Denmark are in this stage.

Fifth stage (Declining)

Population begins to decline as birth rate is lower than death

rate.
East European countries like Germany and Hungary are now in
this stage
 Demographic Measurement Tools 19

In demography there are two aspects which are usually

studied and measured.

These include:

Population static

Population dynamics
 Demographic Measurement Tools 20

Population Static- It refers to the study and

measurement of population characteristics (size,
composition, distribution) at any given point in time.

Population dynamic- It refers to the study and

measurement of population change and components of
change overtime.
 Measurement tools for Population
static 21

1. Population Composition
Median age
Age dependency Ratio
Sex ratio
Population pyramid
Marital status
Socio-economic status
Family size
 Measurement tools for Population
22
static

2. Population Distribution
Urban and Rural Settlements
Density

3. Population size
4. Life Expectancy
 Measurement tools for population
23
dynamic

1. Birth and Fertility rate

Crude Birth rate
General Fertility Rate
General Marital Fertility Rate
Age Specific Fertility Rate
Age Specific Marital Fertility Rate
Total Fertility Rate
 Measurement tools for population
24
dynamic

2. Death rates and ratios

Crude Death Rate
Age Specific Death Rates
Sex Specific Mortality Rates
Age Sex Specific Mortality Rates
Cause Specific Death Rates
Maternal Mortality Rates
 Measurement tools for population
dynamic 25

3. Migration
Immigration rate
Emigration rate
Net Migration rate
Measurement of population change

26

The population change over time can be expressed based on the

relationship among the three component of population change i.e.

births, deaths and migration.

P2 = P1 (B-D) (I-E)

Where:
P2 = Population at the later date
P1 =Population at the earlier date
B= Birth between two dates
D = Death between two dates
I = Immigration or in- migration
E = Emigration between the two dates.
 27

Natural Increase of Population

The difference between the birth and death is the natural

increase in population.
The rate of natural increase The rate of natural increase
is one at which the population is increasing or
decreasing in a given year whether or not birth are
surplus over death and expressed as a percentage of the
base population.
Rate of Increase = *100
 28

Growth Rate

It is the rate at which a population increase or

decreases in a given year because of natural
increase and net migration. It is expressed as the
percentage of the base population
Growth Rate = *100 or
Growth Rate = Rate of Natural increase Net
Migration rate
Determinant of Population Change 29
(Population Triad)

1. Fertility

2. Mortality

3. Migration
 Fertility 30

One major indicator and determinant of demographic change

is fertility, which is expressed as the total fertility rate(TFR).

TFR refers to the number of children that would be born alive

to a women if she experiences through all her child bearing
years conforming to the age specific fertility rates currently
prevalent in community.

Fertilityis a function of a woman's fecundity and of social,

cultural, economic, and health factors that influence
reproductive choices in the country in question.
 Fertility contd 31
The most important non-physical factors influencing a
country's total fertility rate include:
- relationship status
- use of contraception
- the fraction of women who are infecund for example,
because they are breastfeeding a child.
- and the prevalence of induced abortion.
Fertility levels are lower in developed countries than in
developing nations because more women in developed
countries work outside of the home and tend to marry later
and use contraception to prevent childbearing.
 Mortality
32
Mortality is the second major variable that shapes population
trends.

A population's age structure is an important factor influencing

its death rate.

Death rates are highest among infants, young children, and the
elderly.

So, societies with many elderly people are likely to have more
deaths per 1,000 people than those where most citizens are
young adults.
 33
Mortality contd

Developed countries with good medical services have

more people in older age brackets than developing
countries, so the developed societies can have higher death
rates even though they are healthier places to live overall.

Life expectancy serves as a measure of the general health

of the population, which depends on the satisfaction of
many basic human needs such as adequate nutrition, clean
water and sanitation, as well as access to medical services
like vaccinations.
 Migration 34

The third major factor that drives population trends is

migration.
Migration is less predictable over long periods than
fertility or mortality, since it can happen in sudden
wavesfor example, when refugees flee a waror
slowly over many years.
Immigration often changes host nations ' or regions'
ethnic mixes and strains social services.
On the positive side, it can provide needed labor (both
skilled and unskilled).
 35
Population Doubling Time

Theamount of time for a given population to double,

based on the annual growth rate.
To determine doubling time, divide 70 by the growth
rate as a percentage. i.e., a growth rate of 3.5 represents
a doubling time of 20 years.
The world's current (overall as well as natural) growth
rate is about 1.14%, representing a doubling time of 61
years.
 World Population Growth through History 36

Human population has grown very slowly for most of its

existence on earth.

Scientists currently estimate that modern human beings (Homo

sapiens) evolved roughly 130,000 to 160,000 years ago.

Many threats, from diseases to climate fluctuations kept life

expectancy short and death rates high in pre-industrial society,
so it took until 1804 for the human population to reach one
billion.
 37
World Year Time to add 1
population billion
reached
1 billion 1804
2 billion 1927 123 years
3 billion 1960 33 years
4 billion 1974 14 years
5 billion 1987 13 years
6 billion 1999 12 years
 38
Population growth history

Through the early decades of the Industrial Revolution, life

expectancies were low in Western Europe and the United States.

Thousands of people died from infectious diseases such as typhoid

and cholera, which spread rapidly in the crowded, filthy conditions
that were common in early factory towns and major cities.

But from about 1850 through 1950, a cascade of health and safety
advances radically improved living conditions in industrialized
nations.
 39
Contd

Growth rate- 1.8% in 1950s.

Growth rate peaked at 2.2% in 1963.
Declined to below 1.1% by 2012.
Total annual births- 138 billion in 1980s
Total annual births- 134 million in 2011.
Total deaths- 56 million per year in 2011 (Are
expected to increase to 80 million per year by 2040).
POPULATION GROWTH WORLDWIDE 40
 41
Current rate of population growth (2012)

Developed countries - 0.42%,

Less developed countries - 1.3%
Least developed countries is 2.2% (UNFPA).
 Population change in Nepal
42
(Census 2011)
Population of Nepal is 26,494,504.

The increment of population is 3,343,081 during the

last decade.

Per annual growth rate is 1.35%.

Population growth rate (%) Nepal 43

1961 1971 1981 1991 2001 2011

1.64% 2.05% 2.62% 2.08% 2.25% 1.35%

 Impact of population change
44

Agriculture, economy and urbanization

Food and nutrition
Literacy and education
Labor force and employment
Clothing and housing
Health care services
Water supply and environment
 Implication of Population studies
45
in CHN
Help nurses to plan and manage need based health care
services for the community at large.

Help to analyze health needs, morbidity and mortality

pattern, utilization of health care services and accordingly
plan and manage health care services.
Help to know about the ratio of young and elderly
population. It helps nurses to determine economic
burden.
 Implication of Population studies
in CHN 46

Distribution and concentration of population in the

community will help to identify areas where services are
needed most.

Specific death rates helps to identify population groups at

risk, specific causes of death etc. and to plan and
implement preventive and control measures.
 REFERENCES 47
1. Park K. Preventive and social medicine. 19th edition. Jabalpur:
Prem Nagar; 2007.p.36-37, 115-117
2. Linking population, poverty and development[online]. [cited
2013 oct 16]; Available from:
http://www.unfpa.org/pds/trends.htm
3. Global Health Observatory. [online]. [cited on 2013 oct 16];
Available from:
http://www.who.int/gho/publications/en/index.html
4. World Population growth. [cited 2013 16 oct 16]; Available
form:
http://www.worldbank.org/depweb/beyond/beyondco/beg_03.p
df
5. The World Factbook. [online]. [cited 2013 oct 16]; Available
from: https://www.cia.gov/library/publications/the-world
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