1

U.S. Census Bureau

IB/99-1

International Brief

U.S. Department of Commerce

Economics and Statistics Administration

BUREAU OF THE CENSUS

IB/99-1

Issued March 1999

• Peru, one of Latin America’s

largest nations, is home to over

26 million people.

• Peru’s demographic profile

reflects dramatic declines in

fertility and mortality since the

mid-1970s. The country’s crude

birth rate has been reduced by

over one-fourth of its 1975 level;

its crude death rate, by half.

• As a result, Peru’s population is

increasingly concentrated in the

labor force age range (ages 15 to

64). During the coming 20 years,

the ratio of dependent-age

population1 to working age

population will decrease by over

one-fifth of its 1998 level.

• Within the country, regional and

urban-rural variations in fertility

and mortality are pronounced.

For instance, infant mortality is

three times higher in rural areas

than in Lima, the capital2; the

total fertility rate (TFR), twice as

high.

• Demographic variations reflect

disparities in wealth, resources,

and availability of government

services. Access to maternal

health care and family planning

services, like other health care

services, continues to be significantly better for urban than for

rural couples. Current government policy seeks to correct this

situation.

Peruvian Demography

Reflects Subnational Social

and Economic Disparities

Latin America’s fifth largest nation

has historically been, and continues

to be, divided along linguistic and

class lines. Lima, the national capital, is the apex of the hierarchy and

smaller settlements and rural areas

are at its base.

The 70 percent of the Peruvian

population living in urban areas have

higher incomes, on average, and

more access to resources,

government services, and other

amenities than do rural residents.

For example, according to the 1996

Demographic and Health Survey

(DHS) report (ENDES 1996), over

90 percent of urban households

have electricity; less than one-fifth of

rural households do (Table 2.9).

Similarly, only 6 percent of females

ages 6 and above living in urban

places have no education, but 24

percent of rural females have no formal schooling (ENDES 1996: Table

2.6). The percentage of females

with at least a secondary education

is 57 percent in urban areas and 16

percent in rural areas.

Lima differs markedly from the rest

of the country not only in terms of its

industry and labor market, its educational offerings and the availability of

services, but also in terms of a series of demographic and health indicators. For example, infant and child

mortality rates are much lower in

Lima than in the rest of the country.

Child mortality in Lima is about onefourth the level in other urban areas

and one-eighth the level prevailing in

rural areas (box).

One-fourth of Peruvian children

were malnourished in 1996, and

again the problem varied with

residence. In Lima, 10 percent of

children under age 5 were classified as malnourished. That figure

was 20 percent in other urban

areas and 40 percent in rural areas

(ENDES 1996: Table 9.8).

Urban residents also tend to enjoy

better health care coverage than

rural residents. In 1996, over 80

percent of urban women in need of

prenatal care received such care

by Thomas McDevitt

Demographic Differentials in Peru:

Infant Mortality, Child Mortality, and Fertility

Infant Child Total

Percent of mortality mortality fertility

population rate rate1 rate

Area 1993 1986-96 1986-96 1993-96

Rural.......................................... 30 71 31 5.6

Urban2 ....................................... 70 35 12 2.8

Lima .......................................... 29 23 4 2.5

1Child mortality (ages 1 to 4) is the probability of dying between exact ages 1 and 5.

22,000 or more inhabitants. Forty-one percent of Peru’s population lives in urban areas other than Lima.

Sources: INEI 1993 and ENDES 1996.

1

Dependent age groups are defined to include youth

(ages 0 to 14) and the elderly (ages 65 and over). 2

Throughout this report, Lima refers to the Lima metropolitan area.
2

U.S. Census Bureau

IB/99-1

from a trained health professional,

but fewer than half of rural mothers

did (ENDES 1996: Table 8.2).

Similarly, 4 out of 5 urban births

but only 1 out of 5 rural births were

attended by a doctor or nurse

(Endes 1996: Table 8.8).

Peru’s Demographic Transition

Peru has been quite successful in

lowering mortality. Since 1975, life

expectancy at birth has increased

from 57 years to nearly 70 years,

fueled in part by a rapid fall in infant

and child mortality. Infant mortality

has declined from an estimated 105

infant deaths per 1,000 live births in

1975 to 41 today (Table 1).

Over the same period, the number

of births women have on average

(the total fertility rate (TFR)) has

fallen from 5 to 3. Fertility is declining throughout Peru, albeit faster in

urban areas than in rural areas. Between the 1977/78 World Fertility

Survey and the 1996 DHS, urban

fertility fell by nearly 40 percent, to a

TFR of 2.8 children per woman.

During the same time period, rural

fertility fell by about 25 percent, to

5.6 children per woman (ENDES

1991/92: Table 3.3; ENDES 1996:

Table 3.1).

Peru’s rate of natural increase has

also declined from around 2.6 percent per year in 1975 to about 2.1

percent in 1998. If present trends

continue, Peru’s population will grow

by over one-third of its present

size—from 26 million persons today

to nearly 37 million persons—by the

year 2020.

During the same time frame, Peru’s

age structure will become increasingly older and increasingly concentrated in the prime economically

productive age range (Table 1). By

2020, the working age population

(persons ages 15-64) will be over

half again as large as today, and the

number of elderly will have doubled,

while the under-15 age group will

have increased only slightly (Figure

1). Largely as a result of the growth

of the working age population

relative to the under-15 population,

Peru’s dependency ratio will fall from

67 percent to just 52 percent over

the coming 2 decades (Table 1).

Contraceptive Use

The fertility decline central to

Peru’s demographic transition has

been made possible by an increase in the use of family planning

and a shift to more effective methods of contraception. Contraceptive

prevalence has risen from about 41

percent of married women in the

late 1970s to 46 percent in 1986

and to 64 percent in 1996 (Table

2). Adoption of more efficient,

modern methods of contraception

since 1986 accounts for nearly all

of this increase (Figure 2).

However, data from the 1996 DHS

show distinct differences in usage

patterns. Rural and less educated

women have lower contraceptive

prevalence rates than other

women, and they rely more heavily

on less effective, traditional methods (Figure 3).

High Risk Pregnancies,

Unwanted Fertility and Unmet

Need for Contraception

Although the practice of family planning is growing, the unmet need for

contraception is still high. Indeed,

over half of all pregnancies that went

to term in 1996 were considered

“high risk” (ENDES: Table 7.5).

Some of these pregnancies could

have been avoided with family planning. Apart from the matter of health

risk, there is evidence that women

were bearing an average of about

Figure 1.

Population of Peru by Age and Sex: 1998 and 2020

2,000 1,500 1,000 500 0

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80+

0 500 1,000 1,500 2,000

Source: U.S. Bureau of the Census, International Data Base.

1998

2020

Thousands

Male Female

Figure 2.

Changes in Contraceptive Use and 

Method Mix Over Past 20 Years

Source: U.S. Bureau of the Census, International Data Base; and ENDES 1996.

Traditional

21.4%

Modern

19.9%

Nonusers

58.7%

Traditional

22.8%

Modern

23.0%

Nonusers

54.2%

Traditional

22.9%

Modern

41.3%

Nonusers

35.8%

1977/78 1986 1996

(Percent of married women ages 15 to 49)
3

U.S. Census Bureau

IB/99-1

one child more than the number they

desired in 1996 (ENDES 1996:

Tables 3.1, 6.9, 7.5).

One in 8 married women said she

wanted to limit or space future

births, but was not using a method

of family planning in 1996. The percentage of married women in this

situation, deemed to have unmet

need for family planning, was higher

in rural areas (20 percent) than in urban areas (9 percent). The percentage was also higher for less educated women than for women with a

secondary education (Figure 4).

Part of the problem stems from

limited access to family planning

services. In 1991, median travel

time to the nearest source of a

modern method of contraception

was 16 minutes for urban residents compared with about an

hour for rural residents (ENDES

1991/92: Table 4.12).

Information on the use of induced

abortion provides additional evidence of unmet need. Peruvian

health officials have been cited as indicating that as many as 1 in every 3

pregnancies in the country is terminated through induced abortion (The

Washington Post, 11/10/95:A24).

And abortion is considered one of

the leading causes of maternal mortality in Peru. The government and

proponents of its population policy

say that greater access to contraceptive services is required to reduce both unwanted pregnancies

and abortions.

The Government Responds

One of the challenges facing Peru

during the coming years will be

that of expanding access to family

planning and other reproductive

health services for poor, less educated, and rural underserved populations. The government recently

reversed a policy, in place since

1996, of setting targets for sterilizations. Its stated commitment

now is to a goal of ensuring that

women have information and counseling to achieve their individual

desires with respect to spacing and

number of children.

References

Instituto Nacional de Estadística e

Informática (INEI). 1993. Peru:

Crecimiento y Distribución de la

Población (Análisis de Cifras

Preliminares). Censos Nacionales

1993 series. Lima.

Instituto Nacional de Estadística e

Informática and Macro International,

Inc. 1997. Encuesta Demográfica y

de Salud Familiar 1996. (ENDES

1996). Columbia, MD.

Instituto Nacional de Estadística e

Informática, Associacion Benefica

PRISMA, and Macro International,

Inc. 1992. Encuesta Demográfica y

de Salud Familiar 1991/1992.

(ENDES 1991/1992). Columbia, MD.

The International Programs Center

(IPC) collects, assesses, and analyzes population and related statistics from all countries. Based on

these data, IPC produces the demographic estimates and projections

used in this series of reports. This

report was prepared with the support of the U.S. Agency for International Development. More detailed

information is available from the International Programs Center, Population Division, Bureau of the Census, Washington, D.C. 20233-8860.

Figure 3.

Contraceptive Method Mix by 

User Characteristics: 1996

Source: ENDES 1996.

Sterilization

Other modern

Traditional

Percent of married women ages 15-49

0 10 20 30 40 50 60 70 80

Higher

Secondary

Primary

None

Rural

Other urban

Other large urban

Lima

Residence

Female educational attainment

Figure 4.

Unmet Need for Family Planning: 1996

Source: ENDES 1996.

Spacing

Limiting

Percent of married women ages 15-49

0 5 10 15 20 25

Higher

Secondary

Primary

None

Rural

Other urban

Lima

Residence

Female educational attainment
Table 1.

Population Indicators for Peru:

1990 to 2020

(Population in thousands, figures may not add to totals because

of rounding)

Indicator 1990 1998 2000 2010 2020

POPULATION

Total country ....... 21,989 26,111 27,136 32,122 36,904

Urban ............. 15,150 18,802 19,747 24,503 29,276

Rural.............. 6,839 7,308 7,389 7,619 7,628

Male, Total Country

All ages ........... 11,068 13,132 13,645 16,133 18,508

0 to 14 . . . . . . . . . . . . 4,319 4,741 4,834 4,999 5,038

15 to 44 . . . . . . . . . . . 5,074 6,207 6,469 7,795 8,828

15 to 49 . . . . . . . . . . . 5,493 6,757 7,063 8,635 9,899

15 to 64 . . . . . . . . . . . 6,366 7,857 8,230 10,288 12,236

65+ . . . . . . . . . . . . . . . 383 534 581 846 1,234

75+ . . . . . . . . . . . . . . . 111 161 176 285 429

Female, Total Country

All ages ........... 10,921 12,979 13,491 15,989 18,396

0 to 14 . . . . . . . . . . . . 4,186 4,595 4,682 4,827 4,849

15 to 44 . . . . . . . . . . . 4,960 6,083 6,343 7,651 8,650

15 to 49 . . . . . . . . . . . 5,377 6,630 6,935 8,491 9,721

15 to 64 . . . . . . . . . . . 6,278 7,752 8,123 10,172 12,105

65+ . . . . . . . . . . . . . . 457 632 686 990 1,443

75+ . . . . . . . . . . . . . . . 147 217 238 379 568

Married Females

Ages 15 to 49...... 3,099 3,902 4,112 5,144 6,051

15 to 19 . . . . . . . . . . . 138 160 163 187 189

20 to 24 . . . . . . . . . . . 493 579 602 686 752

25 to 29 . . . . . . . . . . . 630 757 789 936 1,081

30 to 34 . . . . . . . . . . . 603 773 808 996 1,142

35 to 39 . . . . . . . . . . . 501 656 702 888 1,061

40 to 44 . . . . . . . . . . . 401 538 574 778 966

45 to 49 . . . . . . . . . . . 334 439 475 673 859

DEPENDENCY RATIO

Both sexes ........ 73.9 67.3 65.9 57.0 51.6

LIFE EXPECTANCY AT BIRTH (years)

Both sexes ........ 65.7 70.0 70.8 74.4 77.1

Male .............. 63.6 67.7 68.5 72.0 74.6

Female ............ 68.0 72.3 73.2 76.9 79.7

INFANT MORTALITY RATE (per 1,000 births)

Both sexes ........ 57.8 40.8 37.1 23.6 15.2

Male .............. 64.3 45.9 41.7 26.3 17.0

Female............ 51.0 35.5 32.4 20.6 13.4

UNDER-FIVE MORTALITY RATE (per 1,000 births)

Both sexes ........ 81.0 54.7 49.1 29.7 18.5

Male .............. 87.1 59.6 53.6 32.8 20.5

Female............ 74.6 49.6 44.4 26.5 16.4

MATERNAL MORTALITY RATIO 1989-1996

(per 100,000 births)

Total . . . . . . . . . . . . . . 265

TOTAL FERTILITY RATE

Per woman . . . . . . . . 4.1 3.3 3.1 2.6 2.3

Note: Dependency ratio is the number of persons under age 15

and ages 65 and above per 100 persons ages 15 to 64 years.

Sources: U.S. Bureau of the Census, International Programs

Center, International Data Base; and ENDES 1996, Table 7.12.

Table 2.

Contraceptive Prevalence Among Currently

Married Women 15 to 49 Years of Age by

Method

Method

Percentage of married

women currently

using specific

methods for

selected years

Percentage of

married woman

currently using

specific methods

by residence:

1996

1977/78 1986 1996 Lima

Other

urban Rural

All . . . . . . . . . . . . . 41.3 45.8 64.2 71.6 69.2 51.2

Pill . . . . . . . . . . . . . 5.5 6.5 6.2 7.9 6.5 4.3

Condom . . . . . . . . 1.4 0.7 4.4 8.0 4.1 1.4

IUD . . . . . . . . . . . . 1.8 7.4 12.0 17.1 13.0 6.1

Female

sterilization. . . . . 3.6 6.1 9.5 9.6 12.6 5.4

Other modern . . . 7.6 2.3 9.2 8.2 9.3 10.3

Traditional ...... 21.4 22.8 22.9 20.7 23.7 23.7

Sources: ENDES 1996, Tables 4.4 and 4.6; and U.S. Bureau of

the Census, International Programs Center, International Data

Base.

Table 3.

Other Proximate Determinants of Fertility

CHILDLESS WOMEN: 1996

Percent of currently married women ages

45 to 49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.6

DURATION OF POSTPARTUM

INFECUNDABILITY: 1996

Median Months By Residence

Country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.6

Lima . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2

Other larger centers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.9

Remaining urban . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.0

Rural ............................................... 12.1

Median Months By Educational Attainment

None ............................................... 15.3

Primary ............................................. 11.5

Secondary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.9

Higher. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.3

Source: ENDES, 1996, Table 5.12.

Table 4.

Age-Specific Fertility Rates

(Per 1,000 women)

Age 1975 1986 1993 1998 2000

15 to 19. . . . . . . . . . . . . . 93 83 79 67 62

20 to 24. . . . . . . . . . . . . . 238 191 184 167 160

25 to 29. . . . . . . . . . . . . . 265 204 175 165 162

30 to 34. . . . . . . . . . . . . . 220 165 147 129 122

35 to 39. . . . . . . . . . . . . . 174 126 110 90 81

40 to 44. . . . . . . . . . . . . . 70 66 51 39 34

45 to 49. . . . . . . . . . . . . . 16 13 8 7 6

Total fertility rate . . . . . 5.4 4.2 3.8 3.3 3.1

Source: U.S. Bureau of the Census, International Programs

Center, International Data Base.

4 IB/99-1

U.S. Census Bureau