Demography | Hasnat Hussain (Reus-11)

Demography
Q.1) Define population growth rate and contraceptive prevalence rate. What
are the three components of IMCI?
ANS:
Population growth rate:
“Difference b/w crude birth rate and crude death rate. In other words it is the rate at which
a population is growing.”
PGR = CBR – CDR x 100

Contraceptive prevalence rate:

“Contraceptive prevalence rate is the proportion of women of reproductive age who are
using (or whose partner is using) a contraceptive method at a given point in time.”
CPR = number of women (15-49 years old) using a contraceptive method / total number of
women (15-49 years old) x 100

Three components IMCI:

1. Improving case management skills of health-care staff.
2. Improving overall health systems.
3. Improving family and community health practices.

Q.2) Give differences b/w demographic trap and demographic transition.

Briefly classify occupational hazards.
ANS:
Differences b/w demographic trap and demographic transition:

Demographic transition
“Demographic transition (DT) refers to the transition from high birth and death rates to low
birth and death rates as a country develops from a pre-industrial to an industrialized state.”

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 DT is typically demonstrated through a demographic transition model (DTM).

 Most developed countries are in stage 3 or 4 of the model; the majority of
developing countries have reached stage 2 or stage 3. The major exceptions are some
poor countries, mainly in sub-Saharan Africa and some Middle Eastern countries,
which are poor or affected by government policy, notably Pakistan, Palestinian
Territories, Yemen, and Afghanistan.
 The transition involves 4 stages as follows;
1. Stage one
 Pre-industrial state.
 Death rates and birth rates are high and roughly in balance.
 Because birth and death rates are approximately in balance, population
growth is typically very slow in stage one.
2. Stage two
 Developing country.
 The death rates drop rapidly due to improvements in food supply and
sanitation, which increase life spans and reduce disease.
3. Stage three
 Birth rates fall due to access to contraception, increases in wages,
urbanization, reduction in agriculture, an increase in the status and
education of women.
4. Stage four
 There are both low birth rates and low death rates.

Demographic trap
“Combination of high fertility (birth rates) and declining mortality (death rates) in
developing countries, resulting in a period of high population growth rate (PGR)."
 High fertility combined with declining mortality happens when a developing country
moves through the demographic transition of becoming developed.
 During "stage 2" of the demographic transition, quality of health care improves and
death rates fall, but birth rates still remain high, resulting in a period of high
population growth.
 The term "demographic trap" is used to describe a situation where stage 2 persists
because "poor living standards leads to high fertility, which in turn leads to more
poor living standards (vicious cycle)."
 One of the significant outcomes of the "demographic trap" is explosive population
growth.
 Africa and Latin America are facing a demographic trap.

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Classification of occupational hazards:

1. Physical hazards
 Heat, cold, light, pressure, noise, radiation, electricity.
2. Chemical hazards
 Gases, dusts, metals, acids, alkalis.
3. Biological hazards
 Virus, bacteria, fungus, parasites.
4. Mechanical hazards
 Due to heavy machinery.
5. Psychological hazards
 Anxiety, depression, stress ulcers, hypertension.

Q.3) What are the causes of demographic imbalance in Pakistan? Give basic
mortality measures.
ANS:
Causes of demographic imbalance in Pakistan:
Demographic imbalance is mismatch of resources and population. It is the disequilibrium
between the population and the present resources. Also called “overpopulation”.
1. Mass migration (Afghan refugees)
2. Decreased mortality rate
3. High fertility of Pakistani women
4. Early marriage
5. Lack of family planning
6. Illiteracy
7. Poverty  more children, more working hands

Basic mortality measures:

1. Crude death rate
2. Specific death rate
3. Case fatality rate
4. Proportional mortality rate
5. Infant mortality rate
6. Neonatal mortality rate
7. Perinatal mortality rate
8. Maternal mortality ratio

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9. Standardized mortality rate

Q.4) Define and give rates and significance of the following;

(a) dependency ratio
(b) life expectancy at birth
(c) growth rate (Pakistan)
ANS:
Dependency ratio:
“Ratio of those not in the labour force (the dependent part) and those in the labour force
(the productive part).”

 Dependency ratio of Pakistan  66 % (2014)

 Significance  It shows the ratio of economically inactive compared to
economically active.

Life expectancy at birth:

“Average number of years which a baby is expected to live according to the mortality
pattern in that country.”
 Life expectancy at birth of Pakistan  66.4 years (2012)
 Significance  It is one of the best indicators of a country’s level of development and
health status.

Growth rate:
 Defined previously.
 Growth rate of Pakistan  1.6 % (2013)
 Significance  It gives the rate at which a population is growing. A positive
growth rate indicates that the population is increasing, while a negative
growth rate indicates that the population is decreasing. A growth rate of zero

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indicates that there were the same number of individuals at the beginning and
end of the period.

Q.5) Give causes of high fertility.

ANS:
Causes of high fertility:
1. Early age of marriage
2. Illiteracy
3. Family pressure
4. Natural urge
5. Children are considered source of income and support in old age
6. No spacing of births
7. Muslims have a higher fertility than Christians
8. No family planning

Q.6) Short note on any three of the following;

(a) population pyramid
(b) population doubling time
(c) dependency ratio
(d) difference b/w fertility and fecundity
ANS:
Population pyramid:
“Population pyramid is a graphic representation of population of an area or a country in
terms of its composition by age and sex at a point in time.”
 It provides the age and sex distribution of the population.
 Males are on left side of the pyramid and females are on the right.
 Children are at the base while old people are at the tip of the pyramid.
 It consists of horizontal bars.
 Uses  (i) male to female ratio can be determined (ii) shows population changes (iii)
dependency ratio can be calculated (iv) economic stability of the country can be
determined.

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 Demography | Hasnat Hussain (Reus-11)

Population doubling time:

“Approximate time during which a population will be doubled.”
 If a population is growing at 1% per year, it will double in about 70 years.
 So we can calculate the PDT of any population by; dividing 70 by the population
growth rate.
PDT = 70/growth rate
 PDT of Pakistan is 70/1.6  43.75 years.
It means that after 43.75 years, the population of Pakistan will be doubled.

Difference b/w fertility and fecundity:

 Demographers say that fecundity is the ability to have babies and fertility is the rate
at which women actually have babies.
 Fertility is confined to women during their reproductive ages (15-49 years). It refers
to the number of live births a woman has had (actual reproductive behaviour).
 Fecundity means the physiological ability of women to conceive (to bear children). It
is dependent upon many factors such as fertilization of eggs by sperms and the ability
to carry the pregnancy.
 In simple words, fecundity means “how many children can a woman reproduce” and
fertility means “how many children the woman have reproduced”.

Q.7) Define population.

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ANS:
Population:
“A population is the summation of all the organisms of the same group or species, which
live in a particular geographical area, and have the capability of interbreeding.”

Q.8) Briefly describe proximate determinants of fertility in fertility control.

ANS:
Proximate determinants of fertility:
The 7 proximate determinants are:
1. Proportion of married women among all women of reproductive age
2. Contraceptive use and effectiveness
3. Prevalence of induced abortion
4. Duration of postpartum infecundability
5. Fecundability (including frequency and timing of intercourse)
6. Prevalence of permanent sterility
7. Spontaneous intrauterine mortality

These proximate determinants directly influence fertility. Any change of these

determinants will cause a change in fertility. Thus, these factors determine the level of
fertility.
The first four are the most important determinants of fertility.

Q.9) In Pakistan mortality rate has decreased in recent years but quality of life
is still poor due to high morbidity and low socioeconomic status of the masses
which can be assessed indirectly by means of health indicators.
(a) Briefly describe the morbidity and socio-economic indicators.
(b) What is meant by integrated and multi-sectoral approach in PHC?
ANS:
Morbidity and socio-economic indicators:
 Described previously in the 1st chapter.

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 Demography | Hasnat Hussain (Reus-11)

Integrated and multi-sectoral approach in PHC:

Integrated Approach
Coordination of various health care components into a single program.
Advantages;
 Make sure that all resources are being used and no resource is being wasted
 Makes the health care program more stable

Multi-sectoral Approach
Coordination of the health sector with other sectors e.g. education department, finance,
agriculture, information etc. to promote and provide PHC.
Advantages;
 PHC becomes more efficient and stabilized

Q.10) A small district has a population of 60000 of which 45% are females. Out
of the total population 5% is above 65 years of age and 20% is below 15 years
of age. The birth rate of district is 12/1000 and annual population growth is
2%.
(a) Calculate the sex ratio and interpret your result.
(b) What is the dependency ratio of the district?
(c) What will be the population of the district after 5 years?
(d) If the district has an IMR of 50/1000, how many infants will die in one
year?
ANS:
Sex ratio:
Sex ratio = number of males/number of females x 100
Number of females  45 % of total population (60000) which is 27000.
Number of males  33000
By putting in the values, we get;
Sex ratio = 33000/27000 x 100 = 122

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It means that there are 122 males per 100 females in this district.

Dependency ratio:

People aged 0-14  20% of total population  12000

People aged 65 and over  5% of total population  3000
People aged 15-64  60000-12000-3000  45000
By putting in the values, we get;
Dependency ratio = (12000+3000)/45000 x 100 = 33.33%

Population after 5 years:

Future population = present population (1+r)t
r = growth rate/100
t = number of years
By putting in the values, we get;
Population after 5 years = 60000 (1 + 2/100)5 = approx. 66244

Number of infant deaths in one year if IMR is 50/1000:

Total number of births during the particular year = birth rate x total population
Which will be  12/1000 x 60000 = 720 births
Total number of infant deaths during the particular year = IMR x total births
Which will be  50/1000 x 720 = 36 deaths

Q.11) The population of a city was 80000 on 1st July 2013. Birth rate was
25/1000 and death rate was 8/1000. There was no case of out and in

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migration during the year. Population of age 15-64 was 50000.

(a) Calculate the annual growth rate.
(b) If annual growth rate remain persistent, how many years will it take for the
population to become doubled?
(c) If IMR was 60/1000 live births, what number of infants would die in that
particular year?
(d) What is the dependency ratio? Interpret it?
ANS:
Annual growth rate:
Growth rate = CBR-CDR x 100
CBR  25/1000
CDR  8/1000
By putting in the values, we get;
Growth rate = 25-8/1000 x 100= 17/1000 x 100 = 1.7%

Years required for the population to be doubled:

Population doubling time = 70/growth rate
Growth rate  1.7%
By putting in the values, we get;
PDT = 70/1.7 = 41 years

Number of infant deaths if IMR is 60/1000:

Total number of births during the particular year = birth rate x total population
Which will be  25/1000 x 80000 = 2000 births
Total number of infant deaths during the particular year = IMR x total births
Which will be  60/1000 x 2000 = 120 deaths

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Dependency ratio:

People aged 15-64  50000

People aged 0-14 + People aged 65 and over  30000
By putting in the values, we get;
Dependency ratio = 30000/50000 x 100 = 60 %
Interpretation;
 60% dependency ratio means that for every 100 working persons, there are 60
dependants.

Q.12) The world population has risen to 7 billion in December 2011, which is
not only alarming to human but also for entire ecosystem. Since 1960, a billion
population is added after every 12 years, which is a concern in developing
countries as 82% are residing in under developed and developing countries.
They have only 20% of the world resources to utilize. A low income society will
not have money for quality of life, which will thus be compromised.
(a) Why the world population has been growing so rapidly over the past 100
years?
(b) What are the three threats of population bomb on ecosystem?
(c) What are the effects of population growth on quality of life in developing
countries?
ANS:
Reasons of rapid population growth:
1. High fertility
2. Lack of family planning
3. Decreased mortality
4. Improved health care facilities
5. Increased agriculture productivity  no famines and droughts

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6. Immunization
7. Lack of epidemics
8. Mass migration
9. Illiteracy
10.Poverty in developing countries  more children, more working hands

Threats of population bomb on the ecosystem:

1. Demographic threats
2. Economic threats
3. Social threats

Effects of population growth on the quality of life in developing countries:

1. Inadequate food, shelter and clothing
2. Poverty
3. Unemployment
4. Elevated crime rate
5. Lack of health facilities
6. Lack of education
7. Insufficient water supply
8. Lack of natural resources e.g. fossil fuels
9. Overcrowding  spread of communicable diseases
10.Pollution
11.Global warming
12.Deforestation

Q.13) Short note on zero population growth.

ANS:
Zero population growth:
“Zero population growth means a population that is unchanging – it is neither growing, nor
declining; the growth rate is zero.”
 This demographic balance occurs when the birth rate and death rate are equal.
 ZPG is also determined by immigration (when a person migrates to a country) and
emigration (when a person leaves their country to settle somewhere new).

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 Therefore, a country that has reached zero population growth has a population
where births plus immigration is equal to deaths plus emigration over the course of a
year.
 Zero population growth is often a goal of demographic planners and
environmentalists who believe that reducing population growth is essential for the
health of the ecosystem.
 There are several countries around the world that are at or near ZPG, including
Iceland, Germany, Portugal, and Poland.

Prepared By: Hasnat Hussain (Reus-11) 

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