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Population and Development in Egypt

The Arab Republic of Egypt is considered a middle-income country, relying on remittances from Egyptians working abroad, revenues from the Suez Canal and oil, as its main sources of income. Economic growth was robust in the late 1990s, but suffered considerably from the results of 11 September 2001, regional imbalances and hesitant steps in the field of economic policies. Following a normalization after the Iraq war, economic growth picked up and reached 4.4 percent in 2004.

Egypt covers an area of 1,001,449 km2 that is mostly desert (Sahara). Only 6 percent of Egypt’s area is inhabited. Recently, the Egyptian government adopted a policy of land reclamation and fostering of new settlements in the desert, but despite this effort most people are living in the Nile Delta and the narrow Nile Valley. With a population of 75.4 million inhabitants in 2008, Egypt has the largest and most densely settled population among the Arab countries at 869 persons/km2.

Administratively, Egypt is divided into 28 governorates and Luxor City. The seven Urban Governorates (Cairo, 6th of October, Giza, Helwan, Alexandria, Port Said, and Suez) have no rural population. Each of the other 22 governorates is subdivided into urban and rural areas. Nine of these governorates are located in the Nile Delta (Lower Egypt), eight are located in the Nile Valley (Upper Egypt), and the remaining five Frontier Governorates are located on the eastern and western boundaries of Egypt.



The majority of Egyptians (43.3 percent) live in Lower Egypt (north of the country), whereas 37.1 percent live in Upper Egypt (south). Less than 2 percent occupy the Frontier Governorates and 18.1 percent inhabit the Urban Governorates such as Cairo or Alexandria located in the northern part of the country.



Egypt's population has witnessed a remarkable increase over the previous decades. In the second part of the second century, the population rose sharply from 35.3 million in 1970 to about 75 million today, i.e. doubled in less than 40 years.

Globally, the population growth rate has decreased from the 1960s to our present time, from 2.6 percent in 1960 to 2 percent in 2005. But Egypt is a country that is still growing fast, with an average of 3 children per woman. The population is extremely young, as more than a half (57.2 percent) of the nationals are under 25 years old and 37.3 percent are under 15. That is to say that 33.5 percent of the whole population is between 10 and 25.



In 1991, almost a quarter of the Egyptian population (24.3 percent) was considered to live below the national poverty line. The proportion below the poverty line now represents only a fifth of the population. Around the year 2000, the number was considerably reduced (16.7 percent) but slightly rose afterwards to reach 20 percent in 2008.



The country has made significant improvements in overall economic development. According to the UNDP statistical update of HDI, Egypt ranked 116 out of 179 on the human development index (HDI) in 2008. The HDI is calculated on the basis of life expectancy, literacy levels and per capita income. Notice in this chart that the development index has been continually increasing since the 1970s.

The steady improvement has pulled Egypt from the low to the medium category of human development. At the Millennium Summit held at the UN in 2000, the Egyptian Government agreed to achieve further progress in key development areas by 2015. Halving extreme poverty, achieving universal primary education for girls and boys, reducing under-five mortality by two-thirds, reducing maternal mortality by three-quarters, and ensuring environmental sustainability are just four of the eight so-called Millennium Goals (MDGs) that were agreed upon in New York.
Indeed, the underlying contextual determinants of several evolving development issues in Egypt are population related. The perpetuation of poverty, increasing unemployment rates among youth and women, food shortfalls, the fragmentation of cultivable land, but also the high rates of illiteracy (especially among women), the gender gaps in educational enrolment and dropouts, the persistence of unmet needs in reproductive health and family planning services, the shortages in housing and water resources and environmental degradation are all predisposed and compounded by the nature of Egypt's population growth and composition. Those explicit facts have greatly shaped the political commitment to invest increasing efforts to address population issues within the ICPD/MDGs operational framework.
Reproductive Health

The critical importance of reproductive health in achieving international development goals was affirmed at the highest level at the 2005 World Summit. Reproductive health is defined as a state of physical, mental and social well-being in all matters relating to the reproductive system at all stages of life. It implies that people have a satisfying sex-life with the freedom to decide if and when they want to procreate.
Everyone has the right to enjoy reproductive health, which is a basis for having healthy children, intimate relationships and happy families. Reproductive health encompasses key areas of the UNFPA vision: that every child is wanted, every birth is safe, every young person is free of HIV and every girl and woman is treated with dignity and respect.
Family Planning

Egypt has achieved remarkable progress with respect to its national health indicators over the past decades. Availability of basic health services is almost universal. Ninety-five percent of the population is now living within 5 km of primary health centers. Utilization of services is, however, lagging behind due to inadequate quality of care and other factors.
The country has also a strong government-led national family planning programme. The Contraceptive Prevalence Rate (CPR) is up from 47.6 percent in 1991 to 60.3 percent in 2008. The Total Fertility Rate (TFR) has been slowly declining from 4.4 live born children per woman in 1988 to 3 in 2008, while the gap between the urban governorates and the rural ones has been reduced. The TFR has decreased because the 'average age at first marriage', the 'average age at first birth' and the 'contraceptive prevalence rate' have all increased.
Nevertheless, there remains an unmet need for limiting the number of children per women. Although the TFR and CPR are not part of the globally agreed MDG indicators, Egypt considers progress in those indicators as a prerequisite for achieving its national policy goal of reducing population growth. By 2017, the government hopes to have stabilized the size of the Egyptian population by reducing the TFR to replacement level (2 children/woman).
Maternal Health
Proper care during pregnancy and childbirth is important to the health of both mother and her baby. Maternal and child health is expected to benefit from the reduction of the TFR and the use of contraceptives to space births. Government, international donors, and NGOs have invested heavily in increasing the quality, availability and accessibility of maternal and child health services.
Antenatal care from a trained provider is important in order to monitor the pregnancy and reduce the risks for the mother and child during pregnancy and delivery. The percentage of women receiving antenatal care rose constantly over a period of about ten years from 39.1 percent in 1995 to 73.8 percent in 2008.
A woman is considered to have had 'regular' antenatal care if she had four or more visits during her pregnancy. If 'any' antenatal care is mentioned, it means that the woman had between one and four visits to the doctor.
In 2008, antenatal care was received by 74 percent of the births during the five-year period before the survey. Women reported having 'regular' antenatal care for 65 percent of births during that period. 74.5 percent of women between 20 and 34 years old had 'any' antenatal care as against 68.8 percent of those 35 years old and more. Younger future mothers are more aware of the benefits of the antenatal care. The same phenomena can be observed through the discrepancy between the urban and rural governorates. Indeed, 84.8 percent of urban women have received 'any' antenatal care as against 67.3 percent of rural women.


The rise of antenatal care over the years has encouraged a substantial decrease of the Maternal Mortality Rate (MMR). Indeed, the MMR was 55/100,000 live births in 2008 as compared to 84/100,000 in 2000 and 174/100,000 in 1990. Regional differences are stark though, with the MMR being lowest in urban governorates and highest in frontier governorates.


Infant Health
According to the Ministry of Family and Population (MoFP), the Neonatal Mortality Rate stood at 16/1,000 live births while the Infant Mortality Rate was 25/1,000 live births. The Total Child mortality under five years old was 28/1,000 for the period 0–4 years before the survey. Again, regional differences were marked, with IMR being lowest in urban governorates (25.4/1,000 in 2008) and highest in rural governorates, especially in rural Upper Egypt (38.6/1,000 in 2008). 
Overall, 92 percent of Egyptian children are considered as immunized against all major preventable diseases, with main vaccinations such as BCG (Tuberculosis), MMR (Rubella), and the three DPT-Polio injections. Only 0.2 percent have not received any vaccinations.
Female Genital Mutilation (FGM) is the partial or total removal of the female external genitalia. Adherence to the practice of female circumcision — also referred to as Female Genital Cutting (FGC) — remains extremely widespread in Egypt. According to the Demographic and Health Survery (DHS) 2008, the percentage of ever-married women (15–49 years) that are circumcised is 95.2 percent. However, in the younger age bracket of 15–17 the percentage drops significantly to 74.4 percent, suggesting that recent efforts have had a positive impact.
Studies show that more than 70 percent of ever-married women approve of FGM/C. Moreover, more than 65 percent of FGM/C is performed by doctors in spite of a Ministerial decree outlawing doctors from performing it.
The practice of FGM/C is conducted by both Muslims and Christians, although the ratio is higher among Muslims. Both religious officials condemn the practice, yet there is a tougher anti-FGM/C stand by Christian Orthodox officials at all levels.
In 2007, the Azhar Supreme Council for Islamic Research, the highest religious authority in Egypt, issued a statement explaining that FGM/C has no basis in the core Islamic Sharia or any of its partial provisions. The Dar el Ifta also issued in the same year a Fatwa (legal opinion or ruling issued by esteemed Islamic scholars such as the Mufti) condemning FGM/C. However, there is still no consensus among Muslim religious leaders, and the practice is most often pursued for religious reasons.
In 2008, new legislation was passed criminalizing FGM/C practice nationwide. The law provides for a sentence ranging from three months to a maximum of two years, with a 1,000 to 1,500 Egyptian pounds penalty. UNFPA supported the introduction of the legislation through advocacy efforts. 
Another Reproductive Health issue of concern is the prevention of HIV and AIDS. Egypt is considered a low prevalence country with regard to HIV and AIDS, with less than 0.1 percent of the 15–49 population being infected in 2007. There is, however, no adequate surveillance system in place. Hence, the true extent of infection in the general population is not known. It is generally agreed upon that HIV-prevalence has been rising in Egypt since it was first recognized officially in 1986.
One of the biggest challenges is the low level of knowledge among Egyptians on HIV and AIDS, which also contributes towards stigmatizing views with respect to people living with HIV and AIDS and groups vulnerable to infection. The National AIDS Programme (NAP) was established in 1987 but to date Egypt has not yet endorsed a multi-sectoral strategy to combat HIV and AIDS.
HCV Hepatitis C
Egypt has the highest Hepatitis C prevalence of the world. 12.2 percent of women have been detected positive in HCV antibody tests, whereas 17.4 percent of men have tested positive, which makes a total of 14.7 percent of the 15–49 years old population. HCV infection is higher among rural (12 percent) than urban residents (7 percent). The level is also higher in Lower Egypt than in the other geographic areas. Chronic HCV is one of the main causes of liver cirrhosis and liver cancers and is indeed one of the top five causes of death.
Egypt is making overall progress in the field of reproductive health. However, greater efforts are required to address both the constraints and gaps in provision of comprehensive reproductive health care in Egypt, including stronger coordination mechanisms among various stakeholders and the need for more effective partnerships with civil society and the private sector. Health sector reform is paving the way for an integrated family practice approach and aims to provide easy access to affordable basic health services to all Egyptians, rich and poor, urban and rural, young and old.
Gender Equality
Gender equality is one of the eight Millennium Development Goals as well as a human right. Investments in gender equality can improve the lives of both men and women, with lasting benefits for the next generations. It is, first and foremost, a human right. Women are entitled to live in dignity and in freedom from war and from fear.
Empowering women is also an indispensable tool for advancing development and reducing poverty. For more than 30 years, the Fund has been in the forefront of advocating for women, promoting legal and policy reforms and gender-sensitive data collection, and supporting projects that improve women's health and expand their choices in life.
Yet discrimination against women and girls — including gender-based violence, economic discrimination, reproductive health inequities, and harmful traditional practices — remains the most pervasive and persistent form of inequality.
In spite of substantial improvements in female literacy rates, enrolment rates, labour force participation, and unemployment, there remains a gender gap in favour of males.
Despite some relative successes, Egypt's rank on gender empowerment in the UNDP Human Development Report 2004, was at a very low 75 out of 78 countries at a GEM value as low as 0.266. In the Gender-Related Development Index (GDI), for 144 countries, Egypt was 99th with a GDI value of 0.634, and in an international study that measured the global gender gap of 58 countries (World Economic Forum 2005), Egypt came last, with a rank of 58th out of 58.
According to official indicators, women’s participation in the labour force increased from 18 percent in 1996 to 31.4 percent in 2004. Females represent 23.9 percent of the labour force (15+) and the female unemployment rate was 24 percent in 2004.
Generally speaking, gender disparities in Egypt are pronounced. Illiteracy among women is almost twice as high as among men. Fifty percent of ever-married women have been subjected to violence, 20 percent during the last year, and half of them find it justified. A combination of attitudinal barriers and traditions continue to deny women equal access to education, employment and health care. Many women lack awareness of their rights and have poor status and authority in areas of decision-making.
Egypt’s outward commitment to equal rights for men and women is exemplary. Domestic law guarantees women’s equality, enshrined in article 40 of the Constitution, which states that citizens 'are equal in front of the law and equal in rights and duties. There shall be no discrimination between them based on gender, origin, language or belief.'
Reflecting this egalitarian spirit, the country has ratified the seven main Human Rights instruments, including the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) on 18 September 1981. Upon ratification, Egypt made reservations to articles 9 (2), 16 and 29 pledging compliance provided that it does not run counter to the Islamic Sharia law. Article 16 concerns women's rights within marriage and family and Article 9 (2) concerns the equal right of men and women to pass their nationality to their children. In 2004 the government amended the Nationality Law, allowing gender equality regarding the right to pass on the mother's nationality to her children in cases where the father is a non-Egyptian.
In Egypt, young people are not only the most important capital, but also constitute the largest segment of the population. According to the 2006 census, approximately 40 percent of Egyptians are between the ages 10 and 29. With the rights investments this youth bilge will represents a demographic opportunity that will positively shape the country's future.
Once Egypt's young people reach working age, given a relatively low proportion of older and younger non-working populations to support, they present a 'demographic gift' of low economic dependency. However, the large size of this cohort places enormous pressures on social services and the labor market and creates a major challenge for development planning. Failures in these institutions could result in the social and economic marginalization of a large proportion of youth that will be unable to compete in an increasingly globalized economy, hence turning the 'gift' to demographic 'burden'.

Egypt has made great progress in achieving the Millennium Development Goal of universal basic education enrolment. However, despite the decades of investment and massive efforts in the area of education, it still remains that there are approximately 2 million young people in Egypt that have never attended school. It has been concluded that 13 percent of females and 3 percent males aged from 10–29 years have never attended school. Detailed figures can be shown in the graph below (2006 national census).
Civic Participation
Civic participation includes group socialization, views about country priority issues, voting, volunteering activities and group membership. Based on information in the Survey of Young People in Egypt (SYPE) from 2010, it was concluded that young people in Egypt are socially disengaged and barely touch upon these issues. It was concluded that in total only 2.2 percent of all young people participate in voluntary activities. Moreover, it was concluded that only 1 percent of all young females participate in voluntary activities, in comparison to 3.3 percent of males.
Further to this data, it was also concluded that young people in Egypt are politically disengaged. Male young people are twice as likely to exercise their right to vote as female young people. Moreover, the incidence of voting was found to be highest amongst youths from middle income households at 19 percent, compared to 13 percent among the poorest quintile and 17 percent among the richest.