16 accommodate the rapidly swelling<sup>work force. While apocalyptic predictions such as those in The Population</sup> Bomb and The Limits to Growth<sup>have not materialized and are unlikely to do so, populations which are</sup> growing at between 2 and 4<sup>percent per year -- doubling every 17 to 35 years -- are in many instances</sup> overwhelming governments' abilities<sup>to maintain current living standards, much less make progress.</sup> _45._ The devolution of program strategy<sup>development to Country Departments, with support from</sup> Technical Departments and PRE,<sup>provides an opportunity for the Bank, as never before, to deal with</sup> population as an integral component<sup>of country operations. In the large number of countries where it is an</sup> important development issue, population<sup>should be trea.ed as a key component of country economic work,</sup> and not left entirely to sector staff, whose<sup>expertise and responsibilities generally relate to health and family</sup> planning services. In addition, PRE<sup>should give high priority to cross-national research, particularly on such</sup> still poorly understood questions<sup>as the consequences of rapid population growth for environmental</sup> sustainability.

46. High fertility is not only a macroeconomic<sup>issue, as pointed out earlier. It I e.s tremely important</sup> implications at the family level<sup>as well and, therefore, for efforts to reduce poverty.</sup> _.s_ not sufficient to focus tbe policy dialogue exclusively<sup>at the macro level. A strong case can be made about the benefits of</sup> reduced fertility for the family,<sup>in terms of the health of the mother and the children already born, their</sup> nutritional status, access to education,<sup>family income, alternative opportunities for women (such as</sup> employment outside the home),<sup>and other reasons.</sup> 47. Because population-development<sup>relationships are multi-faceted and complex, they must be handled</sup> in a country-specific way. Operations,<sup>indeed, the Country Departments, have primary responsibility for</sup> defining population issues and<sup>for designing appropriate population strategies. Africa, for example, has</sup> undertaken a whole series of initiatives,<sup>including the Long-TLrm Perspectives Study, the Capacity-Building</sup> Initiative, the McNamara speech to<sup>the African Leadership Forum, the "agriculture, environment, population</sup> nexus" work, the establishment<sup>of its regional popuiation task force, and the recent decision to add several</sup> population staff positions in the<sup>Technical Department. In addition, it has prepared a regional population</sup> strategy and a series of very specific<sup>country action plans. Its analytic work and policy dialogue have</sup> contributed importantly to policy<sup>change in Nigeria, for example. Asia has produced a discussion note on</sup> future population lending and has<sup>embarked on an ambitious regional sectoral review. It has produced an</sup> excellent population sector study<sup>on the Philippines.</sup> EMENA has within the past year<sup>produced a</sup> comprehensive population strategy<sup>for the Maghreb countries and an analytical piece on Islam and family</sup> planning.

48. LAC's approach advocates that<sup>where population is a politically sensitive subject, or where fertility</sup> rates are not excessive, the Bank<sup>should not insist upon demographic objectives but rather should promote</sup> family planning as an important<sup>health measure, as a basic right of couples, and as a measure to help alleviate</sup> poverty. Sector work in Brazil<sup>has linkeA family planning and women's health in a powerful and imaginative</sup> analysis.

49. Whether or not general fertility<sup>reduction is a politically acceptable or developmentally essential</sup> objective, discussing family planning<sup>as an aid to individual families in realizing their family size objectives</sup> is important and fully justified.<sup>In addition, wherever possible, and where the Bank's own analysis clearly</sup> indicates that population growth<sup>is seriously undermining a country's ability to achieve other development</sup> objectives, the Bank should not<sup>hesitate to share these views with policymakers in the borrowing countries.</sup> High fertility is both a macro<sup>and a micro issue.</sup>