and Williamson (2003:474) estimate that for every two refugees, one local is pushed out of the home labor market.

These pressures generate much migration in the region (Hatton and Williamson 2003). Most of this migration is within the region, within-country and between-country. People migrate to other rural areas where sometimes competition for land generates conflict, and to cities where slow growth in infrastructure and jobs make urban poverty a serious issue. And the pressures for international outmigration are projected to continue to mount (Hatton and Williamson 2003).

Yet things could really change. As the case of Botswana shows, with good management the region‘s enormous mineral wealth and other natural resources can be tapped to create social and physical infrastructure and generate employment for the large cohorts of young people. Some of the wealth could be invested in expanding the manufacturing sector, which can absorb large amounts of labor. Such measures could offset demographic pressures and enhance living standards. In many settings though, this wealth has been viewed as having been turned into a ―resource curse‖, facilitating elite capture and reducing the need for the political leadership to maintain their legitimacy by building institutions for a developmental state (Collier and Goderis 2007, Unsworth and Moore 2010).

Despite many successes, most countries in this region face challenges to growth arising from institutional constraints of various kinds. Tackling these constraints to growth is urgently required. In addition, most countries would benefit from strengthening family planning programs, to ease the currently high momentum of population growth that further constrains the prospects for improving standards of living.

# **5.   Do Family Planning Programs Help Lower Fertility?**

Family planning programs seek to expand the availability of contraceptives and reduce barriers to their use.<sup>15</sup> They are especially important for the poor, who typically have higher numbers of unwanted children than the rich except in settings with very effective programs, such as Indonesia (Figure 5). Family planning programs also typically disseminate information on contraception, and on how lower fertility can help parents invest in their children and avail new opportunities for raising living standards.<sup>16</sup> Parents – especially poorer parents – have imperfect information on these issues. Households also appear to face difficulties in making optimal choices that involve long-term planning horizons (see for example Cronqvist and Thaler 2004 on pension decisions). Offering simple information on contraception ― or more complex messages through media such as soap operas that portray the lives of people with small families and how they access new opportunities ― helps reduce imperfect information. Many studies using cross-sectional survey data have found access to media significantly associated with increased contraceptive use and reduced fertility.<sup>17</sup> The few quasi-randomized evaluations of media effect have found it effective at altering fertility and contraceptive use in Tanzania (Rogers et al 1999) and reducing fertility in Brazil and India (La Ferrara et al 2008; Jensen and Oster 2009).<sup>18</sup> In a highly influential paper, Pritchett (1994a) argued that family planning programs have little impact on fertility: ―Ninety percent of the differences across countries in total fertility rates are accounted for solely by differences in women's reported desired fertility.... The results contradict theories that assert a large causal role for expansion of contraceptive use in the reductions of fertility.‖ Pritchett (1994: abstract) Many have taken Pritchett‘s study as indicating that effort on family planning programs is ill-spent, but he later concludes that his estimates imply that strengthening a family planning program substantially (by 50 points out of a scale of 0-100) would reduce fertility by one birth (Pritchett 1994b: 626). Bongaarts 13