June 2018

GUATEMALA POPULATION DYNAMICS: 2015–2055 JUNE 2018

This publication was prepared by Ellen Smith, Juan Dent, Kaja Jurczynska, Marisela de la Cruz, and Claudia Roca of Palladium and the Health and Education Policy Plus project.

Suggested citation: Smith, E., J. Dent, K. Jurczynska, M. de la Cruz, and C. Roca. 2018. Guatemala Population Dynamics 2015–2055. Washington, DC: Palladium, Health and Education Policy Plus.

ISBN-13: 978-1-59560-172-8

Health Policy Plus operates as Health & Education Policy Plus (HEP+) in Guatemala.

Health Policy Plus (HP+) is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-15-00051, beginning August 28, 2015. HP+ is implemented by Palladium, in collaboration with Avenir Health, Futures Group Global Outreach, Plan International USA, Population Reference Bureau, RTI International, ThinkWell, and the White Ribbon Alliance for Safe Motherhood.

This report was produced for review by the U.S. Agency for International Development. It was prepared by HEP+. The information provided in this report is not official U.S. Government information and does not necessarily reflect the views or positions of the U.S. Agency for International Development or the U.S. Government. Guatemala Population Dynamics: 2015–2055

Contents

Abbreviations ...... v Executive Summary ...... vi Background ...... 1 Guatemala Today ...... 2 Guatemala Tomorrow: Plan K’atun ...... 9 What is the Demographic Dividend? ...... 10 What is the Link between Demography and Violence? ...... 11 Overview of Methodology ...... 13 Scenarios ...... 14 Limitations ...... 21 Results ...... 23 Projections ...... 23 Interpersonal Violence ...... 30 Conclusion ...... 36 References ...... 37

ii Guatemala Population Dynamics: 2015–2055

List of Figures

Figure 1: Guatemalan Population According to Censuses 1893–2002 ...... 2 Figure 2: Doubling Time, Guatemalan Population 1950–2015 ...... 3 Figure 3: Population Pyramid of Guatemala, 2015 ...... 3 Figure 4: Gross Enrollment Ratio for Primary and Secondary School by Sex, 2007–2015 ...... 5 Figure 5: Net Enrollment Ratio for Primary and Secondary School by Sex, 2007–2015 ...... 5 Figure 6: Age of Students by Primary Grade, 2014 ...... 6 Figure 7: Distribution of Women’s (15–49) Educational Attainment, 1995–2014 ...... 6 Figure 8: TFR and Women’s Education, 1987–2014 ...... 7 Figure 9: Contraceptive Prevalence Rate, 1987–2015 ...... 8 Figure 10: Unmet Need, 1995–2015 ...... 8 Figure 11: GDP Per Capita, 1995–2015 ...... 9 Figure 12: Total, Child, and Old Age Dependency Ratios, 1990–2100 ...... 11 Figure 13: Conceptual Framework...... 13 Figure 14: Contraceptive Prevalence Rate, 2015–2055 ...... 15 Figure 15: Mean Years of Schooling by Age, 2014 ...... 16 Figure 16: Percentage of Adults Reporting Highest Level of Education Achieved as Diversificado or Tertiary, by Age and Sex, 2014 ...... 17 Figure 17: Mean Years of Schooling, Women, 2015–2055 ...... 18 Figure 18: Economic Submodule of DemDiv Model ...... 18 Figure 19: Expected Years of Schooling, Men, 2015–2055 ...... 19 Figure 20: Scenarios for Gross Enrollment Ratio for Diversificado by (a) 2055 and (b) 2032 ..... 20 Figure 21: Total Fertility Rate, 2015–2055 ...... 23 Figure 22: Percent of Dependents in the Total Population (National), by Scenario ...... 25 Figure 23: Gross Domestic Product per Capita by Scenario, 2015–2055 ...... 26 Figure 24: Number of Health Workers Required by Scenario, 2015 and 2055 ...... 27 Figure 25: Number of Students per Year by Level of Schooling and Scenario, 2015–2055 ...... 28 Figure 26: Cumulative Education Expenditures by Scenario and Level of Schooling, 2015– 2055 ...... 29 Figure 27: Urban Population by Age Group in 2015 and 2055 ...... 30 Figure 28: Homicides in Guatemala ...... 31 Figure 29: Youth Perceptions of the Most Important Problems Facing Guatemala ...... 32 Figure 30: Youth Perceptions of the Economic Situation in Guatemala ...... 33 Figure 31: Guatemala's Future Projected Age Structure, 2055 ...... 34 List of Tables

Table 1: Sociodemographic Characteristics of Departments Included in Study...... 2 Table 2: Scenario Assumptions ...... 15 Table 3: Number of Health Centers and Hospitals in 2015 by Department ...... 20 Table 4: Urban Population by Department and their Largest City, 2015–2055 ...... 21 Table 5: Mean Years of Schooling in the Population (25+) Estimates (National) ...... 21 Table 6: Impact of Educational Attainment on TFR by Ethnicity ...... 24 Table 7: Number and Percent of Additional Maternal Deaths Averted by 2055 Compared to Base Scenario ...... 25 Table 8: Employment Gap by 2055 Compared to Base Scenario (millions) ...... 26

iii Guatemala Population Dynamics: 2015–2055

Acknowledgments

We would like to acknowledge Health and Education Policy Plus (HEP+) staff Jay Gribble, Herminia Reyes, and Polly Mott who contributed to the analysis and finalization of this report. We would also like to extend a special thanks to Claudia Quinto with HEP+ for her invaluable efforts to collect data and prepare the subnational model files. Likewise, Antoinette Sullivan, Yma Alfaro, and Mario Von Ahn from the U.S. Agency for International Development/Guatemala’s Office of Health and Education provided valuable input and support throughout the development of the study and report.

HEP+ met with a series of stakeholders to discuss the analytical framework and possible use of results. HEP+ thanks representatives from the following organizations for their valuable input: Ministry of Education, Ministry of Health and Social Assistance, National Institute of Statistics, Organization for Women’s Health and Development, United Nations Population Fund, APROFAM, Ministry of Public Finances, National Alliance of Indigenous Women’s Organizations for Reproductive Health, Nutrition and Education, Project Miriam, Presidential Secretariat for Women, and Wings Guatemala.

More information on the tools used in this analysis are available at:  DemDiv: http://www.healthpolicyproject.com/index.cfm?id=software&get=DemDiv  Spectrum (DemProj and RAPID): http://www.avenirhealth.org/software- spectrummodels.php

iv Guatemala Population Dynamics: 2015–2055

Abbreviations

CPR contraceptive prevalence rate

ENCOVI Encuesta Nacional de Condiciones de Vida

ENSMI Encuesta Nacional de Salud Materna-Infantil

EYS expected years of schooling

FP family planning

FAO Food and Agriculture Organization

GCI Global Competitiveness Index

GDP gross domestic product

HDI Human Development Index

HEP+ Health and Education Policy Plus

ICT information and communications technology

MMR maternal mortality ratio

MYS mean years of schooling

TFR total fertility rate

UNDP United Nations Development Programme

UNESCO United Nations Educational, Scientific and Cultural Organisation

USAID U.S. Agency for International Development

v Guatemala Population Dynamics: 2015–2055

Executive Summary

Population dynamics lay at the heart of some of the most salient development topics in Guatemala, including health, education, economic growth, and security. This study— conducted by Health and Education Policy Plus, a project funded by the U.S. Agency for International Development—aims to elucidate the interconnections between these topics and identify the population trends common among them. Guatemala is a youthful and diverse country, with a detailed vision for addressing its challenges outlined in its Plan K’atun. This study examined whether and how achieving certain goals within Plan K’atun could affect various sectors and outcomes, specifically those related to health, education, economic growth, and security.

The study examined eight population groups: the national population, five departments (Huehuetenango, Quetzaltenango, Quiche, San Marcos, and Totonicapán), and two ethnicities (indigenous and non-indigenous). Health and Education Policy Plus analyzed four scenarios: base (i.e., business-as-usual); meeting only family planning goals; meeting only educational goals; and meeting both family planning and educational goals. Analyses were carried out using a variety of data sources and tools—including DemProj, DemDiv, and RAPID—which are summarized in the report. The accompanying Annex contains extensive tabulations of all results.

Results show that achieving Plan K’atun’s family planning and educational goals can have significant long-term socioeconomic and security benefits for Guatemala. Achieving the family planning goals have far-reaching demographic impacts, beginning with decreasing the total fertility rate, slowing population growth, and transitioning the age structure. These impacts, in turn, put less stress on future public resources in sectors such as health, education, and urbanization—stressors that traditionally challenge both economic growth and security. Achieving the educational goals gradually increases the educational level of the working-age population, which in turn has both demographic and economic implications by increasing the age at marriage and productivity, respectively.

The effects of both the family planning and educational achievements can be seen in the demographic dividend: a one-time economic opportunity to capitalize on advantageous demographics with a relatively large and well-educated working population. Declines in fertility produce this opportunity and amplify it, as per capita gross domestic product is higher when the total population size is smaller. A more educated adult population is better able to take advantage of this demographic opportunity because it is more productive. Taken together, the economic impacts of achieving family planning and educational goals can be seen in the projections of gross domestic product per capita.

$10,000 Family Planning + Education, $8,667 $8,000 Family Planning $6,000 Only, $8,230 USD) $4,000 Education Only, $7,858 $2,000 GDP per GDP per Capita (2015, Base, $7,378 $0 2015 2020 2025 2030 2035 2040 2045 2050 2055 Source: HEP+ Projections

vi Guatemala Population Dynamics: 2015–2055

Background

Guatemala’s population dynamics and diversity shape virtually every aspect of life, society, and human development. It is possible to understand the country’s population structure and dynamics by examining current trends in fertility, mortality, and migration; projecting how these trends will change over time; and estimating the socioeconomic impacts of future demographic changes. Exploring underlying population dynamics is a critical first step to identifying strategies that will advance a range of development priorities.

While changes in population dynamics affect many aspects of development, implementing effective social-sector policies can help Guatemala capitalize on a demographic dividend and increase its per capita gross domestic product (GDP). This report summarizes an extensive analysis—conducted by Health and Education Policy Plus (HEP+), a project funded by the U.S. Agency for International Development—on the effects of education and family planning investments on Guatemala’s population and economy through 2055, and their implications for security and resource demands. With an understanding of the interaction between population dynamics and human capital investments, USAID Guatemala—together with the Government of Guatemala and other key stakeholders—can better understand how to prioritize resources for development.

The analyses cover eight population groups: 1. National 2. Huehuetenango 3. Quetzaltenango 4. Quiche 5. San Marcos 6. Totonicapán 7. Indigenous 8. Non-indigenous

Table 1 shows the geographic and ethnic makeup nationally and for the five departmental analyses (i.e., population groups one through six in the list above); representing a variety of these characteristics, to capture the diversity of the Northwest and Southwest regions of Guatemala, was key to their selection. In addition, these five departments have been the targets of USAID-funded health assistance in recent years. However, the two regions in which these five departments reside are not nationally representative. Compared national figures, a higher portion of their populations are indigenous, fertility rates are higher, and health, education, and socioeconomic indicators are lower.

HEP+ recognizes the large degree of variation—often systemic—that can be hidden beneath national figures. Heterogeneity and inequality are critically important when thinking about both subnational populations and national averages. Recognizing this, we still primarily focus on our analysis of the national situation for the purposes of this report and only refer to the subnational results when these variations account for strikingly different results. Full results of the seven sub-national populations can be found in the Annex document but are not discussed in depth here. The authors hope that the baseline, national-level information provided here can serve as template for similar subnational reports.

1 Guatemala Population Dynamics: 2015–2055

Table 1: Sociodemographic Characteristics of Departments Included in Study

Urbanization Ethnicity1 Total Departments Percent Percent Non- Population Indigenous Urban Rural indigenous National 16,176,132 49.5 50.5 38.8 61.2 Huehuetenango 1,260,152 31.1 68.9 56.0 44.0 Quetzaltenango 884,140 59.6 40.4 47.1 52.9 Quiche 966,889 32.6 67.4 83.9 16.1 San Marcos 1,148,096 29.7 70.3 33.0 67.0 Totonicapán 503,258 48.0 52.0 93.6 6.4

Source: HEP+ projections (total population) and ENCOVI, 2014 (urbanization and ethnicity) Guatemala Today Population Guatemala’s population has grown quickly in the last century, from 1.4 million in 1893 to 11.2 million by 2002 (see Figure 1). While Guatemala’s rate of population growth has decreased over the last 50 years, the population continues to increase rapidly with a relatively short population doubling time of around 34 years (see Figure 2). With a current, total population that exceeds 16 million (HEP+ projection), Guatemala now has the largest and fastest growing population in Central America, driven primarily by fertility. Figure 1: Guatemalan Population According to Censuses 1893–2002

12 11.2

10 8.3 8 6.1 6 4.2 4 2.8 2 2 1.4 Number of People Number of People (millions) 0 1893 1921 1950 1964 1981 1994 2002

Source: Census Reports from the corresponding years

1 Defined by self-identification.

2 Guatemala Population Dynamics: 2015–2055

Figure 2: Doubling Time, Guatemalan Population 1950–2015

40 35 30 25 20

Years 15 10 5 0

Source: HEP+ estimation based on average annual rate of population change, United Nations Population Division, 2017

With a median age of 19.7, Guatemala has a youthful age structure (see Figure 3). Currently, 67% of the population is under age 30; 38% are under age 15; and 21% are between ages 15 and 24. Figure 3: Population Pyramid of Guatemala, 2015

Male Female 80+ 70-74 60-64 50-54 40-44 Median age: 19.7 30-34 Age Age Group 20-24 10-14 0-4 8 6 4 2 0 2 4 6 8 % of population

Source: HEP+ estimation based on United Nations Population Division, 2017

More than half of Guatemala’s population now resides in urban areas, the largest being Guatemala City, Mixco, Villa Nueva, Quetzaltenango, and Petapa. Even though Guatemala’s urban growth rate2 has decreased since the 1950’s, today’s comparatively high rate of 3.3% (see Box 1) is higher than any other country in Central America and the country’s urban population has grown rapidly over the past 68 years (United Nations, 2017). Youth make up a large share of those residing in urban centers, many of whom left their villages in search of

2 Growth of the urban population resulting from 1) rural to urban migration; 2) urban natural increase; 3) reclassification of rural areas as urban.

3 Guatemala Population Dynamics: 2015–2055 work or education. However, the rapid nature of Box 1. Urban Growth Rate this growth challenges the state’s capacity to accommodate the growing number of young According the United Nations, the people. As a result, 34% of Guatemala’s urban 2010–2015 urban growth rate was: population resides in slums, informal settlements, or inadequate housing (United Nations Statistics  Least developed countries: 3.97% Division, 2017).  Less developed countries: 2.41% Since the time of the civil war (1960–1996),  Developed regions: 0.3% international migration—including to the United States and Mexico—has been seen by many people Source: United Nations Population as a survival strategy. Today, the net migration Division, 2017 rate is the lowest in decades, at -0.6 per 1,000 (2015) compared to a peak of -7.5 in the 1990s (United Nations Population Division, 2017). This dip in migration corresponds to the more restrictive immigration policies enforced internationally. Over 60,000 people were forcibly returned from the United States and Mexico in 2011, creating significant re-integration challenges (International Organization for Migration, n.d.). Nonetheless, many individuals are still hoping to migrate, predominantly for economic reasons (55%), family reunification (18.6 %) or because of security concerns (3.4 %) (International Organization for Migration, 2017). Guatemala is also still among the top countries of origin for unaccompanied child migrants to the United States, many of whom are seeking asylum from coerced recruitment by gangs (Jonas, 2013). Education Figure 4 and Figure 5 show recent trends of two types of school enrollment ratios in Guatemala. Figure 4 shows the gross enrollment rate, i.e., the total number of students in each level, divided by the number of children in the corresponding age group. Guatemala’s gross enrollment ratio shows an education system where there are many “catch-up students”—those who are older than the typical age of their level in school. For example, elementary students older than age 12 pushes the primary gross enrollment ratio above 100%. Gross enrollment ratios above 100% typically mean that children in the past were not enrolled in school or that there is a lot of grade repetition, which often adds stress to an educational system struggling to keep up with a large volume of students. As seen in Figure 4, Guatemala’s gross enrollment ratio for primary school has been decreasing towards 100% recently, while it has been increasing for secondary school. There are only small gender differences at both levels.

The net enrollment ratio, shown in Figure 5, is the number of enrolled students of the corresponding age, divided by the total population of children of the corresponding age. In other words, it does not account for older students. Thus, it reflects how on-track today’s children are, in terms of moving through the educational system at appropriate ages. Net enrollment in primary school has been declining in recent years, which may be a cause for concern, though gender disparity has nearly disappeared. Net enrollment for secondary school has been increasing, demonstrating an increase in youth enrolled in an age- appropriate school level.

4 Guatemala Population Dynamics: 2015–2055

Figure 4: Gross Enrollment Ratio for Primary and Secondary School by Sex, 2007–2015

140%

120%

100% Primary - Female 80% Primary - Male 60% Secondary - Female

40% Secondary - Male

Gross Enrollment Gross Enrollment Ratio (%) 20%

0% 2007 2008 2009 2010 2011 2012 2013 2014 2015

Source: UNESCO, 2018

Figure 5: Net Enrollment Ratio for Primary and Secondary School by Sex, 2007–2015

100%

80%

60% Primary - Female Secondary - Male 40% Secondary - Female Secondary - Male

Net Enrollment Net Enrollment Ratio (%) 20%

0% 2007 2008 2009 2010 2011 2012 2013 2014 2015

Source: UNESCO, 2018

Figure 6 shows the age distribution of students in each grade of primary school. This illustrates the challenge of older students catching up in primary school and the reason for the differences in the gross and net enrollment rates. While the single largest age group represented in each grade is the corresponding age (e.g., 7 years old in first grade, 8 years old in second grade, and so on), there are also many older students in each grade, several years older than the intended grade-level age.

5 Guatemala Population Dynamics: 2015–2055

Figure 6: Age of Students by Primary Grade, 2014

100%

80%

60%

40%

20%

Percentage Percentage of Studentsin Each Grade 0% First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade (age 7) (age 8) (age 9) (age 10) (age 11) (age 12)

6 7 8 9 10 11 12 13 14 15 >15

Source: HEP+ analysis of Instituto Nacional de Estadistica, 2016

As Figure 7 shows, women of reproductive age have steadily increased their highest educational level in recent decades. Between 1987 and 2014, the percent of women of reproductive age with no education was nearly cut in third, while the percent with secondary or higher education nearly doubled. This has implications for fertility, as the next section discusses. Figure 7: Distribution of Women’s (15–49) Educational Attainment, 1995–2014

100% 21.2% 24.5% 25.4% 30.1% 80% 32.9% 39.7%

60% 40.4% 47.2% 49.3% 44.4% 45.9% 40% 46.1%

20% 38.4% 28.3% 25.3% 25.5% 20.2% 14.2% 0% 1987 1995 1998-99 2002 2008-09 2014-15

No Education Primary Secondary

Source: HEP+ analyses of ENSMIs: Ministerio de Salud Pública, 1989; Instituto Nacional de Estadística, 1996; Instituto Nacional de Estadística, 1999; Ministerio de Salud Pública y Asistencia, 2003; Ministerio de Salud Pública y Asistencia, 2011; Ministerio de Salud Pública y Asistencia, 2017. Fertility The total fertility rate (TFR) in Guatemala has decreased from 4.4 in 2002 to 3.1 in 2014. Figure 8 shows both the decrease in TFR since 2000, as well as the inverse relationship

6 Guatemala Population Dynamics: 2015–2055 between fertility and women’s education. Although TFR decreases are seen across the entire population, the decreases for less educated women have been far steeper. From this pattern we can surmise that increasing female education has been an important driver of decreasing the national TFR, as new cohorts of young women moving into the childbearing years are increasingly better educated. This study estimates—in a systemic and methodologically rigorous way—how increases in female education contribute to decreases in fertility and population growth, as explained in the methodology section. Figure 8: TFR and Women’s Education, 1987–2014

8 7 7.1 6.8 7 6.4 6 5.2 5.1 5.2 5.2 4.7 5 4.6 3.8 4 3.2 2.7 2.6 2.9 3 2.3 2.2

per per Woman 2.1 2 1

Average Average Number of Children 0 1987 1995 1998-99 2002 2008-09 2014-15

No education Primary Secondary or more

Source: HEP+ analyses of ENSMI (Encuesta Nacional de Salud Materna-Infantil) databases

To understand the decline in national TFR in Guatemala, Figure 7 and Figure 8 must be read together. As the proportion of women of reproductive age with no education decreased, the proportion of women with the highest TFRs (shown in Figure 8) also decreased. Furthermore, the TFR of those women in the categories of no education or primary education also decreased with time. Taken together, we can see that the decrease in TFR in Guatemala is both a product of increasing women’s education, as shown in Figure 7, as well as declining fertility within each educational group, as shown in Figure 8. Finally, decreases in TFR are often associated with other societal changes, such as increases in the age of marriage and access to family planning methods. Family Planning Another principal driver of fertility rates is use of family planning. The most widespread metric of family planning use is the contraceptive prevalence rate, or CPR, which measures the percentage of women, ages 15 to 49, that are currently using some form of contraception. This study uses the CPR for women in union. CPR is divided between modern contraceptive methods with higher effectiveness and traditional methods with lower effectiveness at averting unintended pregnancy. The use of family planning is one of the main inputs into this study because of its impact on fertility. Figure 9 shows the upward trend of CPR in Guatemala over the past nearly 30 years, reaching 60.6% of women in union in 2014–15. Although the use of family planning has increased, the proportion using traditional methods has not changed very much—making up 14–20% of family planning use in each survey. It is worth noting that Figure 9 only illustrates a national snapshot, but important subnational variations, such as differences between the indigenous and non-indigenous populations, underlie these national figures.

7 Guatemala Population Dynamics: 2015–2055

Figure 9: Contraceptive Prevalence Rate, 1987–2015

80%

60% 11.7% 10.0% 40% 8.8% traditional 7.3% 4.5% modern 48.9% 4.2% 44.0% 20% 34.4% 27.0% 31.0%

CPR CPR Womenfor in Union 19.0% 0% 1987 1995 1998-99 2002 2008-09 2014-15

Source: HEP+ analyses of ENSMIs: Ministerio de Salud Pública, 1989; Instituto Nacional de Estadística, 1996; Instituto Nacional de Estadística, 1999; Ministerio de Salud Pública y Asistencia, 2003; Ministerio de Salud Pública y Asistencia, 2011; Ministerio de Salud Pública y Asistencia, 2017.

Another key metric in family planning policy is unmet need, which is the percentage of (in this case, in-union) women who do not wish to become pregnant in the next two or more years, but are not using contraception (Bradley, 2012). This metric identifies women who may benefit from using a contraceptive method, which could allow them to fulfill their own desire to avoid or delay a pregnancy. At the population level, unmet need tells us how widespread lack of access to family planning is. Figure 10 shows that unmet need halved between 2002 and 2014–15, after years of stagnation. Figure 10: Unmet Need, 1995–20153

30% 28.1% 26.8% 27.6% 25% 20.8% 20% 13.9% 15% 10% 49 in union 5%

Percentage Percentage of women 15- 0% 1995 1998-99 2002 2008 2014-15

Source: ENSMIs: Ministerio de Salud Pública, 1989; Instituto Nacional de Estadística, 1996; Instituto Nacional de Estadística, 1999; Ministerio de Salud Pública y Asistencia, 2003; Ministerio de Salud Pública y Asistencia, 2011; Ministerio de Salud Pública y Asistencia, 2017. Economy Guatemala is a lower middle-income country with a GDP of 63.4 billion USD and a GDP per capita of 3,924 USD (World Bank, 2018). The country’s strong economic growth over the past five years has not benefited the population equally, and the poverty rate has risen from 56.0% in 2000 to 59.3% in 2014 (World Bank, 2018). As Figure 11 shows, Guatemala’s per capita GDP has—for 15 years, apart from the 2008 financial crisis–been steadily marching

3 A new definition of unmet need (Bradley, 2012) was used after 2012, in this case impacting only the 2014-15 survey.

8 Guatemala Population Dynamics: 2015–2055 upwards. Unlike GDP, the GDP per capita is result of both national demographics and economic conditions. Figure 11: GDP Per Capita, 1995–2015

$4,500 $4,000 $3,500 $3,000 $2,500 $2,000 $1,500 $1,000

GDP per GDP per Capita (Current USD) $500 $0

Source: World Bank, 2018 Violence Beyond the demographic, educational, and economic realities, Guatemala has experienced high rates of interpersonal violence since the end of its 36-year civil war in 1996. While homicides have declined since they peaked in 2009, nearly 4,500 homicide-related deaths occurred in Guatemala in 2017 alone (Instituto Igarapé, 2017). This level of violence is higher than the number of battle-related deaths in some armed conflict settings, including Yemen, Libya, and South Sudan (Uppsala Conflict Data Program, 2017).

Young people are both the victims and perpetrators of violent crime in Guatemala, with urban youth gangs—or maras—and drug trafficking receiving much of the blame. Most young Guatemalans do not engage in violence. For those who do, the causes are diverse and complex, with ties to the civil war and its consequences. These causes include the destruction of social networks and the economic, social, and governance deficits associated with a weak state. Gang-driven violence, however, is also linked to Guatemala’s demographic trends, particularly migration, urbanization, and the rapid expansion of the youthful population— the cohort most vulnerable to voluntary or forced gang recruitment. Beyond this simple direct effect, these population dynamics also exacerbate some of the proximate economic and social drivers of violent behavior. Guatemala Tomorrow: Plan K’atun Guatemala’s vision for its future is outlined in the National Development Plan K’atun Our Guatemala 2032. Timed to a change in the Mayan calendar, Guatemala’s development plan outlines the country’s vision for the next K’atun, or 20-year period. The plan is organized around five axes, each of which has priority areas. The five axes and the priorities relevant to this study are: 1. Urban and rural Guatemala  Sustainable urban development 2. Wellbeing of the people  Reduce maternal, infant, and child mortality  Develop integrated sexual and reproductive health

9 Guatemala Population Dynamics: 2015–2055

 Guarantee coverage and quality of education 3. Wealth for all  Acceleration of economic growth with productive transformation  Macroeconomic stability within a broad framework of development  Generation of decent and quality employment 4. Natural resources today and for the future 5. The State as the guarantor of human rights and the driver of development  Strengthening the State’s abilities to respond to development challenges  Security and justice with equity, and social, cultural, and age relevance

Within these five axes, Plan K’atun lays out a vision for the future of this study’s main topics: Reproductive Health  Priority: Achieve universal sexual and reproductive health for the population in childbearing ages, emphasizing sexual education for adolescents and young people. o Goal 1.b.: Reach, in 2025, a TFR of two children per woman, to contribute the woman’s and family’s health. . Line E: Universal access to contraceptives through an increase in the coverage of health service, guaranteeing the availability of each service. Education  Priority: Guarantee the population between zero and 18 years access to all levels of the education system. o Result 1.1.: In the year 2032, the school-age population (zero to 18 years) has completed with success each of the age-appropriate educational levels. Economy  Priority: Acceleration of economic growth with a productive transformation o Goal 1.: In 2032, the GDP growth has been gradual and sustained, reaching a rate of no less than 5.4%: a) between 2.4 and 4.4% during 2015–2020; b) between 4.4 and 5.4% during 2021–2025; c) no less than 5.4% in the following years, up to 2032. Demographic Dividend  The demographic dividend is a challenge, insofar as it becomes a variable of development, from the perspective of intergenerational transfers. Plan K’atun, in this sense, lays the foundations to guarantee employment for the working-age population, and thus generate enough resources for universal social protection.

As seen in the methodology section, HEP+ based the scenario analyses on Plan K’atun’s vision of the future. What is the Demographic Dividend? The demographic dividend is a temporary opportunity for faster economic growth that begins when fertility rates fall, leading to a larger proportion of working-age adults and fewer young dependents. A balanced population age structure, combined with investments in education, can stimulate a boost in economic development.

10 Guatemala Population Dynamics: 2015–2055

High fertility rates give way to young populations, composed of many children and relatively fewer working adults. Young populations require high familial and governmental investments in social sectors that are used heavily by children, such as health and education. After fertility rates fall, populations begin ageing, meaning that children account for a decreasing percentage of the national population, and working-age adults account for a greater percentage of the population. This change in the national age structure, visually summarized by population pyramids, allows for both families and governments to shift resources away from certain social sectors and toward savings and investment.

Family planning and education are central to the concept of a demographic dividend. Investments in family planning can allow couples to control their fertility, often leading to decreases in national fertility rates and spurring a transformation in a country’s age structure. Education plays two roles in the demographic dividend. First, increases in female education are associated with decreases in fertility. Second, increases in education improve the productivity of the workforce, meaning educating today’s children leads to greater economic growth in the future. Investments in education allow a country to take advantage of the demographic opportunity presented by falling fertility rates.

As seen in Figure 12, Guatemala’s demographic window of opportunity has already begun. The child dependency ratio has begun its decline and the old-age dependency ratio has not yet started to increase, resulting in a temporary dip in the total dependency ratio. This dip is the opportunity that can, under the right circumstances and with the right policies and investments, can allow for the demographic dividend. Later this century the total dependency ratio will again begin to climb, as the phenomenon of population aging becomes prominent, and the window of opportunity for the demographic dividend closes. Figure 12: Total, Child, and Old Age Dependency Ratios, 1990–2100

100

80

60 64 40 15 - 20 Population Population per 100people, ages

Dependency ratio <15 Dependency ratio >65 Total (<15 and >64) Dependency Ratio

Source: United Nations Population Division, 2017 What is the Link between Demography and Violence? Evidence from the field of political demography—the study of how population size, characteristics, and changes affect patterns of political identities, conflict, and governance (Kaufmann and Toft, 2012)—demonstrates that countries with young age structures have an increased likelihood of experiencing armed conflict (Leahy et al., 2007; Yair and Miodownik, 2016; Urdal, 2011; Staveteig, 2005; Cincotta, 2017). Armed conflict has typically been defined and measured in three ways based on the perpetrators and victims of force—these are state-based, non-state-based, and one-sided conflict (see Box 2) (Uppsala Conflict Data Program, 2017).

11 Guatemala Population Dynamics: 2015–2055

Box 2. Key Concepts and Definitions for Political Demography

Age structure: The distribution of age groups across the population. Armed conflict, state-based: A type of intra-state conflict; a contested incompatibility that concerns a government and/or territory where the use of armed force between two parties, of which at least one is the government of a state, results in at least 25 battle-related deaths in one calendar year. Armed conflict, non-state-based: The use of armed force between two organized armed groups, neither of which is the government of a state, which results in at least 25 battle- related deaths in a year. Armed conflict, one-sided: The use of armed force by the government of a state or by a formally organized group against civilians which results in at least 25 deaths in a year. Interpersonal violence: Refers to violence between individuals and is subdivided into family and intimate partner violence and community violence. The former category includes child maltreatment; intimate partner violence; and elder abuse, while the latter is broken down into acquaintance and stranger violence and includes youth violence; assault by strangers; violence related to property crimes; and violence in workplaces and other institutions.

Two key factors have been shown to account for this population-conflict link. First, demographic dynamics have an impact on the size of the youth cohort, the population most at risk of radicalization and/or recruitment. Second, youthful age structure may exacerbate proximate conflict drivers. For example, large youth groups are a challenge for the labor market, which can result in joblessness or under-employment and lower relative earnings (Urdal, 2011; Easterlin, 1987). Large youth populations can also strain the educational system, decreasing public sector investment per student, which can lead to decreased quality and schooling opportunities (Bricker and Foley, 2013). These conditions can aggravate inequality, marginalization, and may impede young people’s preparation for adulthood and its accompanying financial independence. In the absence of effectual means of creating change, young people may redress these grievances through violent means (Urdal, 2011).

Between 1970 and 2000, 80% of civil conflicts occurred in very young age structure countries (Leahy et al., 2007). In 2016 alone, approximately 70% of civil conflicts4 occurred in countries with very young age structure—or a median age of less than 26 years, which is higher than Guatemala’s median age of 19.7 years (Cincotta, 2017). In these countries, high fertility rates keep the age structure young and dominated by children and young adults. As fertility declines, each successive cohort is smaller in size while the large group of youth— often referred to as a youth bulge—moves toward older ages. As age structures mature, conflict risks decrease. Demography can exacerbate conflict causes, but it is not the primary driver.

While these analyses have focused on traditional notions of armed conflict, youth criminal violence in urban post-war settings—like Guatemala—exhibits key similarities. These common factors include the presence of non-state armed actors, diverse conflict motivations related to a weak state and resulting grievances, high casualties, and the crucial role of youth as actors (Kunkeler and Peters, 2011). As a result, the political demography lens is applied to Guatemala’s youth-related violence.

4 State-based violence, non-state group conflict, and either state-based or non-state-based violence against civilians.

12 Guatemala Population Dynamics: 2015–2055

Study Methodology and Scenarios

Overview of Methodology This study explores the impacts of various scenarios of demographic change, especially as impacted by family planning and education, on future population size and composition, reproductive health, economic outcomes, and stability in Guatemala. The study team utilized multiple linked analytic tools to capture the ways in which demography and socioeconomic development impact each other. Figure 13 illustrates the connections between the three modules used in this study. It also shows the four different scenarios, with the key variables that differentiate the scenarios in red. Figure 13: Conceptual Framework

Scenario 1: Scenario 2: Family Scenario 3: Scenario 4: Family Base Planning Only Education Only Planning + Education

Demographic Demographic Demographic Demographic Dividend Dividend Dividend Dividend Inputs: MYS, EYS, Inputs: MYS, EYS, Inputs: MYS, EYS, Inputs: MYS, EYS, CPR CPR CPR CPR Outputs: GDP, GDP Outputs: GDP, GDP Outputs: GDP, GDP Outputs: GDP, GDP per capita, per capita, per capita, per capita, employment employment employment employment

Demographic Demographic Demographic Demographic Projection Projection Projection Projection Inputs: demographic Inputs: demographic Inputs: demographic Inputs: demographic data data data data Outputs: population Outputs: population Outputs: population Outputs: population projections & age projections & age projections & age projections & age structure structure structure structure

RAPID RAPID RAPID RAPID Inputs: Population by Inputs: Population by Inputs: Population by Inputs: Population by age, sex, location age, sex, location age, sex, location age, sex, location Outputs: sectoral Outputs: sectoral Outputs: sectoral Outputs: sectoral resource resource resource resource requirements requirements requirements requirements

 = TFR and life expectancy;  = population projection EYS = expected years of schooling; MYS = mean years of schooling

The DemDiv model serves a few purposes in this study. First, it estimates the economic impacts of the demographic changes calculated by DemProj. The size of the adult population (ages 15 and over) impacts both employment and investment, two of the determinants of GDP. Total population size is the denominator of GDP per capita, meaning that a smaller population leads to a higher GDP per capita. Second, the DemDiv model quantifies the well- documented and two-way relationship between female education and contraceptive use. The tools use the proximate determinants of fertility (Bongaarts, 1978), in which a decrease in

13 Guatemala Population Dynamics: 2015–2055 marriage leads to a decrease in fertility. Because increasing female education often delays marriage, it also decreases fertility (Aryal, 2007; Islam and Ahmed, 1998). DemDiv also includes a feedback loop, in which decreases in TFR lead to further increases in female education. For further methodological information, please see Modeling the Demographic Dividend: Technical Guide to the DemDiv Model (Moreland, 2014).

At the heart of this study is population projections, carried out using the DemProj module of the Spectrum suite of policy models. DemProj uses a cohort component methodology to project a population by age and sex, using baseline and future patterns of fertility, mortality, and migration. In addition to feeding into DemDiv, DemProj outputs are also used to inform the political demography analysis—with a focus on age structure (by age and sex) and median age.

Additionally, HEP+ used the Resources for the Awareness of Population Impacts on Development (RAPID) module of Spectrum to estimate the resources required in various social sectors by a growing population. This module utilizes population outputs from DemProj to look at the growth in certain segments of the population–for example, children of primary school age–and the concomitant resources, such as teachers and schools, that will be needed to serve them. These results concretize what population growth will mean for public services.

The analyses mapped in Figure 13 were carried out separately for eight different populations: national, Huehuetenango, Quetzaltenango, Quiche, San Marcos, Totonicapán, indigenous population, and non-indigenous population.

Finally, the political demography analysis leverages the DemProj outputs as noted above, but also drew heavily on existing literature profiling the levels, trends, and causes of violence in Guatemala. Specifically, HEP+ examined Guatemala’s national age structure profile, alongside the present burden of interpersonal violence, and theorized about how demography may drive conflict directly, due to its impact on the youth cohort, and indirectly, through demography’s potential impact on aggravating proximate violence drivers. Using the above-mentioned DemProj projections for Guatemala, HEP+ highlights the implications of various projection pathways for the country’s national security prospects. Scenarios The conceptual framework described in Figure 13 was applied four times to each of the eight populations considered. The scenarios are:

1. Base 2. Family Planning Only 3. Education Only 4. Family Planning + Education

These scenarios are designed to explore the impacts of meeting Plan K’atun goals in family planning and/or education. Under scenarios two and four, the goal of meeting baseline unmet need for family planning by 2032 is achieved and the CPR is assumed to remain constant. The CPR is left constant between 2032 and 2055 because, at 74.5%, it is already near the maximum, commonly-observed levels. Under scenarios one and three, family planning use increases half as much as under scenarios two and four.

Similarly, in scenarios three and four, the educational enrollment goals of Plan K’atun are assumed to be met by the year 2032. Because these do not result in adult education levels that are near international maximums, education is assumed to continue increasing at a constant rate between 2032 and 2055.

14 Guatemala Population Dynamics: 2015–2055

As noted in Table 2, the fourth scenario–Family Planning + Education–combines the policy assumptions of the Family Planning Only and Education Only scenarios, which serve to isolate the impacts of only meeting the family planning or, alternately, education goals.

Table 2: Scenario Assumptions

Scenario Baseline Value Area Family Planning Family Planning (2015) Base Education Only Only + Education Family 48.9% modern Half the Meeting unmet Half the Meeting unmet Planning 11.7% traditional increase of the need by 2032 increase of the need by 2032 family planning (62.8% modern; family planning (62.8% modern; scenario (55.9% 11.7% scenario (55.9% 11.7% modern; 11.7% traditional) modern; 11.7% traditional) traditional) traditional) Education Mean Years of MYS of 25-year- MYS of 25-year- Full graduation Full graduation Schooling (MYS): olds in 2032 olds in 2032 of diversificado of diversificado 4.35 increases half increases half by 2032 by 2032 women/5.18 as much as in as much as in men/7.10 both the education the education Expected Years scenarios scenarios of Schooling (EYS): 10.y women/10.8 men/10.75 both

Family Planning The main family planning variables in this study are the contraceptive prevalence rate and the unmet need. HEP+ interprets the Plan K’atun Result 1.1E of “universal access to contraceptives” as eliminating unmet need. When unmet need decreases, CPR increases. The 2014 ENSMI measured in-union unmet need at 13.9%. Thus, our family planning scenarios eliminate baseline unmet need by 2032, increasing the CPR by 13.9 percentage points. The base scenario assumes half this rate of increase, as show in Figure 14. In both scenarios, all CPR growth comes exclusively from modern methods.

Figure 14: Contraceptive Prevalence Rate, 2015–2055

80% 74.5%

60% 67.6% 40%

20%

0% Percentage of Women in Union

Base Scenario Family Planning Only Scenario

Source: HEP+ analyses

15 Guatemala Population Dynamics: 2015–2055

Education Mean years of schooling (MYS) refers to the average number of years of schooling received by a subset of the population. The MYS for all adults 25 years and older in the population reflects the economic impact of enrollment rates decades earlier, when today’s adults were children. We therefore see a lag between changes in enrollment rates and their economic impact via MYS for adults 25 years and older.

Figure 15 shows the MYS for adults 25 years and older by five-year age groups in Guatemala in 2014. Drastic changes in the amount of schooling in the last few generations are evident by the steep decline in MYS of older cohorts. As younger, more educated, generations move into the adult (25 years and older) population–and as the older, less educated generations die–the overall mean years of schooling of Guatemalan adults rises. Figure 15: Mean Years of Schooling by Age, 2014

8 7.1 7 5.9 6 5.1 4.8 5 4.4 3.9 4 3.3 2.8 3 2.2 1.8 2 1.7 1.6

Mean Mean Years of Schooling 1 0 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+ Age Group

Source: ENCOVI, 2014

As reviewed in the section Guatemala Tomorrow: Plan K’atun, Guatemala’s educational goals are based on enrollment. HEP+ translated enrollment rates into mean years of schooling by:  K’atun enrollment goals: The study team assumed that, per Plan K’atun, by 2032 all children ages 0–18 will be enrolled in the age-appropriate grade. This means that everyone completes diversificado, which corresponds to 12 years of schooling. However, the first cohort with full enrollment through diversificado will not reach age 25 until 2038, meaning that mean years of schooling will only begin to be affected by this goal in 2038.  Tertiary education: A percentage of all diversificado graduates will go on to tertiary education (Figure 16). Thus, an increase in diversificado graduates will lead to an increase in tertiary education, even if the transition rate remains constant. The study team assumed that the transition rate from diversificado to tertiary education would remain constant at the levels found in the 2014 ENCOVI. HEP+ applied that diversificado-tertiary transition rate to the burgeoning number of diversificado graduates in our projections.  Accounting for mortality: The study team accounted for the mortality of older Guatemalans when estimating the future mean years of schooling. Applying age- and sex-specific mortality rates, the original population of adults 25 years and older in 2015 accounts for a decreasing share of the 25 years and older population—and a decreasing proportion of mean years of schooling—in future years.

16 Guatemala Population Dynamics: 2015–2055

 Cap on mean years of schooling: Based on international data, HEP+ capped mean years of schooling for 25-year-olds at 16.5, which represents completing diversificado plus 4.5 years of tertiary education. Figure 16: Percentage of Adults Reporting Highest Level of Education Achieved as Diversificado or Tertiary, by Age and Sex, 2014

35%

30%

25%

20%

15%

10%

5% Level Level of Education Achieved 0% Percent Percent of Adults Reporting Highest 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+

diversificado - women teritiary - women diversificado - men teritiary - men

Source: HEP+ analysis of ENCOVI, 2014

The results–which are intermediary results in our study framework–for women are shown in Figure 17. Male results show a similar pattern, though at a slightly higher level. The dashed lines show the mean years of schooling for 25-year-olds only, while the solid lines show the mean years of schooling for those 25 years and older. The data points for mean years of schooling for 25-year-olds are labelled for 2038, which is the year the first cohort to achieve the Plan K’atun goals reaches age 25. The 2038 value for the education scenario is 13, representing 12 years of education due to universal completion of diversificado, plus one additional year of tertiary education, based on the diversificado-tertiary transition rate (ENCOVI, 2014). Figure 17 also illustrates that the slope for 25-year-olds’ mean years of schooling is half as steep for the base scenario as it is for the education scenario. It also shows the lag in mean years of schooling for those 25 years and older, as compared to the 25- year old population.

The total impact of Plan K’atun for women 25 years and older–as shown in Figure 17–is an increase in mean years of schooling from 4.4 years in 2015 to 11.2 years in 2055. Under the base scenario women’s mean years of schooling only reaches 8.9 years in 2055. For men (not shown), from a 2015 value of 5.18 years of schooling, the education scenario would result in 11.7 years of schooling in 2055, while in the base scenario would only reach 9.4 years.

17 Guatemala Population Dynamics: 2015–2055

Figure 17: Mean Years of Schooling, Women, 2015–2055

18 16 13.0 14 11.2 12 9.9 10 8 6 8.9 4

Mean Mean Years of Schooling 2 4.4 0

MYS of 25yos: Base Scenario MYS of 25yos: Education Scenario MYS of 25+: Education Scenario MYS of 25+: Base Scenario

Source: HEP+ analyses

Mean years of schooling is used in the DemDiv model to estimate GDP based on employment, via an estimate of total factor productivity. Figure 18 illustrates how average years of education affect the relationship between employment and GDP. Figure 18: Economic Submodule of DemDiv Model

GDP Per Total Pop 15+/Pop Pop 15+ Capita (t-1) Population

GCI: Financial GCI: Labor Efficiency Investment/ Employment Capital Stock Flexibility

GCI: ICT Average Years of Gross Education Domestic GCI: Public Total Factor Product Institutions Productivity

GCI: Imports as % of GDP GDP Per Capita

GCI = Global Competitiveness Index; GDP = gross domestic product; ICT = information and communications technology; Pop = population

The DemDiv model also accounts for expected years of schooling (EYS), defined as the total number of years of schooling a child can expect to receive, assuming the probability of them being enrolled in school at future ages is equal to the current enrollment rate at those ages (United Nations Statistics Division, 2014). It is sometimes called the school life expectancy because it is a parallel calculation to life expectancy, where dropout replaces mortality. Also, like life expectancy, and unlike mean years of schooling, expected years of schooling can change quickly because it reflects current conditions in any given year.

18 Guatemala Population Dynamics: 2015–2055

As with the MYS cap, we assumed that EYS would reach 16.5 years (diversificado plus 4.5 years of tertiary) by the year 2055 (Figure 19). Like mean years of schooling, the EYS in the base scenario increased by half as much as in the education scenario. Figure 19: Expected Years of Schooling, Men, 2015–2055

18 16.5 16 14 12 13.7 10 8 10.8 6 4 2

Expected Expected Years of Schooling 0

Base Scenario Education Scenario

Source: HEP+ analyses

Estimated years of schooling is used in DemDiv to estimate the impact of girls’ education on total fertility. TFR is projected using the proximate determinants of fertility (Bongaarts, 1978). One of the proximate determinants, union, is inversely related to girls’ education. RAPID RAPID is a module in the Spectrum suite of models that estimates the social and economic consequences of fertility and subsequent population growth. The HEP+ team ran RAPID for all four scenarios for the education, health, urbanization, and agriculture sectors:

Education. In the education sector, RAPID uses gross enrollment ratio to project students by level. The HEP+ team calculated the baseline gross enrollment ratio at the national and departmental levels based on the 2015 Anuario Estadístico de la Educación from the Ministry of Educatio. For the base and family planning only scenarios, HEP+ assumed 100% gross enrollment by 2055; for the Education Only and FP + Education scenarios, gross enrollment reaches 100% by 2032 (Figure 20). To isolate the impacts of population growth, the study team kept the student to teacher ratio, student to school ratio, and recurrent expenditure per student constant. HEP+ used departmental data for gross enrollment, teachers, and school.

19 Guatemala Population Dynamics: 2015–2055

Figure 20: Scenarios for Gross Enrollment Ratio for Diversificado by (a) 2055 and (b) 2032

(a) 100% Enrollment by 2055 (b) 100% Enrollment by 2032 1.00 1.00 0.90 0.90 0.80 0.80 0.70 0.70 0.60 0.60 0.50 0.50 0.40 0.40 0.30 0.30 0.20 0.20 Gross Enrollment Gross Enrollment (%)

Gross Enrolmment (%) 0.10 0.10 0.00 0.00 2015 2018 2021 2024 2027 2030 2033 2036 2039 2042 2045 2048 2051 2054 2015 2018 2021 2024 2027 2030 2033 2036 2039 2042 2045 2048 2051 2054 Source: HEP+ analyses

Health. Similarly, in the health sector HEP+ kept the ratio of population per doctor, nurse, health center, hospital, hospital bed, and per capita expenditure constant through 2055. Again, this was done so that projections can be interpreted as resulting from population growth alone. For the departmental analyses, HEP+ adjusted the ratio of population per health center and hospital center based on the official number of hospitals and health centers in each department in 2015 (Table 3). Table 3: Number of Health Centers and Hospitals in 2015 by Department

Huehuetenango Quetzaltenango Quiche San Marcos Totonicapán Health 30 19 25 30 9 Centers Hospitals 2 3 4 2 1

Source: MSPAS, 2016

Urbanization. For the national analysis, used a baseline urbanization of 49.5% (ENCOVI, 2014) and assumed a 2032 urbanization of 63.7% (Plan K’atun). The 2015–2032 rate of change was maintained through 2055, resulting in a population that is 82.9% urban. The percent urban population living in Guatemala City was estimated to decrease from 34.8% in 2015 to 25.3% by 2055. This decrease was based on historic trends from World Bank data from 2005–2014. For the departmental analyses, HEP+ applied the national rate of urbanization for 2015–2032 to estimate both urbanization and the urban population living in each department’s largest city5 by 2055 (Table 4).

5 Plan K’atun had data on the urban population sizes for: Huehuetenango and Chiantla, Quetzaltenango (city), Santa Cruz del Quiche, San Marcos and San Pedro Sacatepéquez, and Totonicapán (city).

20 Guatemala Population Dynamics: 2015–2055

Table 4: Urban Population by Department and their Largest City, 2015–2055

Department Quetzaltenango Huehuetenango Totonicapán San Marcos Quiche

Year 2015 2055 2015 2055 2015 2055 2015 2055 2015 2055 Urban Population in 59.6 91.2 31.1 62.7 48.0 79.6 29.7 61.3 32.6 64.2 Department (%) Urban Population in 58.6 90.2 24.3 55.9 27.2 58.7 22.1 53.7 9.7 41.3 Largest City (%)

Source: HEP+ analyses

Agriculture. RAPID uses data on arable land and the production of a major crop to project changes on its production and consumption. HEP+ used estimates from the Food and Agriculture Organization on the production and consumption of maize in Guatemala in 2009. HEP+ estimated the annual growth in production from Food and Agriculture Organization data on the production of cereals from 2012-2016. Limitations One of the limitations of the DemDiv model used in this study is that it does not account for all the factors that can influence GDP, such childcare effects on labor supply, population- induced technical progress, and the role of land in production. The model also does not consider how improvements in the quality of education may impact both fertility and GDP. Moreover, the statistical relationships in DemDiv are based on international, cross-sectional data that are assumed to apply to Guatemala, but may not be fully applicable.

The demographic projections in DemProj linked the family planning components of all the scenarios to the DemDiv and RAPID models. The education components, however, had to be calculated separately as the models utilized different education inputs. As a result, HEP+ had to approximate the relationship between the DemDiv inputs (mean and expected years of school) to those in RAPID (enrollment) in creating these scenarios. RAPID does not factor repetition rates and assumes all students are in the grade corresponding to their age. As a result, the education scenarios in RAPID assume that the gross and net enrollment have the same value by the time coverage reaches 100% for each schooling level. HEP+ assumed the student per teacher and school ratios do not change, even when they are low and could increase. While Guatemala may want to change these ratios in the future, we kept them constant in this study to ensure the results reflect changes in contraceptive prevalence rate and educational attainment only.

As the last census in Guatemala took place more than 16 years ago, the availability of updated demographic data is an important limitation to this study and other population-based analyses and planning. Table 5: Mean Years of Schooling in the Population HEP+ also calculated model inputs using official data (25+) Estimates (National) from Instituto Nacional de Estadística when these were not readily available in the report. For example, HEP+ UNDP HEP+ applied the UNESCO Institute of Statistics Females 4.35 4.4 methodology to calculate the baseline mean years of schooling for all eight populations using the 2014 Males 5.18 5.4 ENCOVI data set. The HEP+ estimates are slightly Sources: HEP+ analysis of ENVOCI, lower than those presented in a 2016 United Nations 2014 and UNDP Development Program (UNDP) report (Table 5).

21 Guatemala Population Dynamics: 2015–2055

However, the UNDP report does not clarify what methodology they employed and if they considered the incomplete years of schooling, which HEP+ did.

Data on education, the economy, and urbanization were less readily available for the subnational analyses. In those cases, HEP+ used national values or trends to produce the subnational model inputs. This may mask important socioeconomic differences that could in turn affect the results.

22 Guatemala Population Dynamics: 2015–2055

Results

Results presented in this section are illustrative. A complete compilation of results is available in a separate data file, available at http://www.healthpolicyplus.com/ pubs.cfm?get=8222. Because this study covers many topics for the eight populations covered (national; five departments: Huehuetenango, Quetzaltenango, Quiche, San Marcos, Totonicapán; and two ethnicities: indigenous and non-indigenous), it is not possible to present and analyze all results in this report. Rather, in this section we set out to explain the types of results available in the Annex. HEP+ recommends that readers refer to the Annex, which is organized in the same order as this section, to review the results of the population and indicators of interest. Projections Reproductive Health and Population The population size in 2055 will largely depend on fertility trends. Halving the unmet need for family planning by 2032 – the Base scenario – would reduce the TFR in Guatemala to 2.39 by 2055 (Figure 21). This would require increasing investments in family planning to reduce unmet need and keep up with a growing number of women of reproductive age. Under this scenario, HEP+ estimates Guatemala’s population will grow from 16 million people in 2015 to nearly 30 million people by 2055. Figure 21: Total Fertility Rate, 2015–2055

3.3 3.1 2.9

2.7 2.50 2.5 2.39 2.3 2.42 2.24 2.1 2.01 1.92 1.9 Children per woman per Children 1.95 1.7 1.8 1.5 2015 2020 2025 2030 2035 2040 2045 2050 2055 Base Family Planning Only Education Only Family Planning + Education

Source: HEP+ analyses

Meeting the Plan K’atun 2032 goals for universal access to reproductive health and education would further decrease fertility in Guatemala. HEP+ estimates that investing in primary and secondary education for girls, as seen in the black line (Figure 21), would reduce the TFR to 2.24, for a projected total population of 29.1 million by 2055. Eliminating unmet need for family planning by 2032, as seen in the orange line, has a more pronounced effect on future fertility trends, resulting in a TFR and population size of 1.92 and 26.8 million by 2055, respectively. HEP+ estimated the combined impact on fertility of attaining both the educational and family planning goals of Plan K’atun 2032, as shown in the purple line, to be a TFR of 1.8 and a population of 26.2 million people by 2055.

The subnational analyses suggest that eliminating unmet need alone is enough to decrease the TFR to at least 1.83 by 2055 in four of the districts: Huehuetenango, Totonicapán, San

23 Guatemala Population Dynamics: 2015–2055

Marcos, and Quetzaltenango. Quiche, the department with the highest baseline Table 6: Impact of Educational Attainment TFR (4.1), was the only department with on TFR by Ethnicity a projected TFR greater than the national average by 2055, across all scenarios. By Additional TFR in the Education Only Scenario Compared to Base Scenario ethnicity, TFR decreased the most when Year the indigenous population achieved the Indigenous Non-indigenous educational attainment goals for females (Table 6). This may reflect the lower 2020 0.10 0.01 baseline educational attainment for 2025 0.16 0.03 indigenous women compared to the non- 2030 0.19 0.04 indigenous population. For Guatemala to achieve the Plan K’atun 2032 goals, it 2035 0.22 0.05 would need to invest sufficient resources 2040 0.25 0.06 to eliminate the disparity in educational attainment between indigenous and non- 2045 0.26 0.08 indigenous girls, so that all have 2050 0.28 0.08 universal access to education. 2055 0.29 0.09

In 2015, nearly 6.4 million child Source: HEP+ analyses dependents represented 39.5 % of the Guatemala’s population. HEP+ estimates child dependents will account for a smaller proportion of the population by 2055 across all scenarios, decreasing to 24.6% and 20.7% in the base and family planning only scenarios, respectively. This means that there will be 13.5% more child dependents in 2055 if Guatemala only halves, rather than eliminates, its unmet need by 2032. Eliminating unmet need would result in 5.3 million child dependents by 2055, an 11.3 % decrease compared to 2015.

HEP+ also considered changes to the total dependency ratio: the proportion of the economically-dependent population (children ages 0–14 and elderly adults aged 65 and over) to the economically-productive population (adults ages 15–64). The team estimated the total dependency ratio would decrease from 0.79 in 2015 to 0.5 by 2044 in the base scenario (Figure 22). In the family planning + education scenario, lower fertility trends lower the dependency ratio to 0.43 in 2040 before increasing to 0.44 in 2054. This increase suggests Guatemala’s population structure will be transitioning to a mature structure. HEP+ estimates the percentage of Guatemalans who will be 65 years or older will increase from 4.5% in 2015 to 8.9% and 10.6% by 2055 in the base and family planning + education scenarios, respectively.

By ethnicity, the non-indigenous population reached its lowest dependency ratios in the scenarios three to four years before the indigenous population. This is due to the differing age structures of these two populations, which can be seen in their median ages. In 2015, the median age for the non-indigenous population was 23, while it was 19 for the indigenous population. We project that the 2055 median age for the indigenous population will continue to be lower, although the difference between the two ethnic categories shrinks when we consider strong family planning and educational programs. The youngest population considered was Quiche, which also had the highest TFR.

24 Guatemala Population Dynamics: 2015–2055

Figure 22: Percent of Dependents in the Total Population (National), by Scenario

100% 4.6% 8.9% 10.3% 9.2% 10.3%

80%

55.9% 60% 66.5% 69.0% 67.2% 69.0%

40%

20% 39.5% 24.6% 20.7% 23.6% 20.7% 0% % of Dependents in the Total Population Guatemala Base (2055) Family Planning Education Only Family Planning + (2015) Only (2055) (2055) Education (2055)

0-14 15-64 65+

Source: HEP+ analyses

HEP+ projects that Guatemala will have an estimated 18,718 maternal deaths by 2055 in the base scenario. Eliminating the unmet need for family planning and improving the educational attainment of females will avert 4,965 and 1,248 of these maternal deaths, respectively (Table 7). Investing in both education and family planning could prevent 46% of the expected maternal deaths in the base scenario. The subnational analyses suggest lowering fertility will avert a similar proportion of maternal deaths in the indigenous population and most departments. Table 7: Number and Percent of Additional Maternal Deaths Averted by 2055 Compared to Base Scenario

Family Planning Only Education Only Family Planning + Education Huehuetenango 923 (30%) 442 (14%) 1,395 (45%) San Marcos 230 (29%) 166 (11%) 604 (39%) Totonicapán 230 (28%) 100 (12%) 355 (41%) Quiche 695 (27%) 225 (10%) 1,016 (40%) Quetzaltenango 165 (21%) 58 (8%) 219 (29%) Indigenous 3,302 (29%) 1,627 (14%) 4,820 (42%) Non-indigenous 1,350 (24%) 221 (4%) 1,409 (26%) National 4,965 (36%) 1,248 (9%) 6,260 (46%)

Source: HEP+ analyses DemDiv Results DemDiv models how investments in family planning and education could influence economic growth in Guatemala through 2055. We estimate that Guatemala may have a GDP of $220 billion and a GDP per capita of $7,378 by 2055, in 2015 USD (Figure 23). Providing universal primary and secondary education was shown to have the greatest impact on GDP growth, increasing GDP by an additional $9 billion by 2055. While eliminating unmet need for family planning would only marginally increase the total GDP, the reduced population

25 Guatemala Population Dynamics: 2015–2055 growth would result in a higher GDP per capita of $8,230 (2015 USD). Reducing fertility and increasing educational attainment further increased the GDP per capita to $8,667 (2015 USD), the highest amongst the scenarios. Figure 23: Gross Domestic Product per Capita by Scenario, 2015–2055

$10,000 Family Planning + Education, $8,667 $8,000 Family Planning Only, $8,230 $6,000 Education Only, $7,858 $4,000 Base, $7,378

GDP per GDP per Capita (2015, USD) $2,000

$0 2015 2020 2025 2030 2035 2040 2045 2050 2055

Source: HEP+ analyses

We also considered how these scenarios affected the employment gap, defined as the difference between the total labor force and the population, ages 15–64. The DemDiv model estimated the employment gap will increase from 3.26 million people in 2015 to six million people by 2055 in the base scenario. Eliminating unmet need for family planning reduces the employment gap by 844,309 thousand, and educational attainment will further reduce it by 355,120 (Table 8). Table 8: Employment Gap by 2055 Compared to Base Scenario (millions)

Scenario Employment Gap by 2055 Difference between Base Scenario Base 6.00 --- Family Planning Only 5.11 .84 Education Only 5.60 .36 Family Planning + Education 4.83 1.13

Source: HEP+ analyses Resource Needs Health The analyses assumed a baseline health workforce, including both the public and private sectors, of nearly 5,000 doctors and 13,000 nurses at the national level in 2015. Without a significant decrease in future fertility trends, Guatemala will have to nearly double its health workforce to 9,100 doctors and 24,300 nurses to keep pace with the demands of its population (Figure 24). The health infrastructure demands will similarly change from 382 hospitals and health centers in 2015 to 704 by 2055 in the base scenario. Lower fertility trends can reduce the national demand for additional health infrastructure and workforce by 12%. Achieving the Plan K’atun goals for education and reproductive health will also decrease the national cumulative health expenditures from 2015 to 2055 by $11.2 billion (USD).

26 Guatemala Population Dynamics: 2015–2055

These analyses assume that current ratios of population to health workers are maintained through 2055. If the health workforce does not keep pace with population growth, these ratios will decrease and access to high-quality healthcare may suffer. Alternately, increase access to high-quality healthcare would likely require increasing these ratios. Figure 24: Number of Health Workers Required by Scenario, 2015 and 2055

40,000

30,000

20,000

10,000 Number of Health Workers

0 Baseline (2015) Base (2055) Family Planning Education Only Family Planning Only (2055) (2055) + Education (2055) Nurses Doctors

Source: HEP+ analyses

The subnational demand for health infrastructure is similarly affected by fertility trends. Demand in Totonicapán and Huehuetenango for another hospital may be delayed by at least 10 years if they invest in both family planning and education. Likewise, these investments reduce the demand for another hospital in San Marcos, Quiche, and Quetzaltenango by 2055. Demand for health centers fell by at least 9.7% with lower fertility. Education In 2015, Guatemala had an estimated 3.6 million students in the primary, lower secondary (basico), and upper secondary (diversificado) levels. Figure 25 shows the annual number of students enrolled in primary, basico, and diversificado by scenario. The scenarios in graphs (a) and (b) both assume Guatemala reaches universal education by 2055, while the scenarios in graphs (c) and (d) assume it is reached by 2032. HEP+ estimates that Guatemala will have 5.7 million students in the base scenario. Lowering fertility trends by eliminating unmet need for family planning reduces the growth of children in the respective schooling age. As a result, there are fewer students in school most years under the family planning only scenario, while maintaining the same enrollment rate as in the base scenario. At the subnational level, Quetzaltenango was the only department where the number of students in 2055 decreased compared to 2015 when unmet need for family planning was eliminated. In Totonicapan, Huehuetenango, and Quiche, estimates for total number of students more than doubled by 2055 without additional investments in family planning or education.

27 Guatemala Population Dynamics: 2015–2055

Figure 25: Number of Students per Year by Level of Schooling and Scenario, 2015–2055

(a) Base Scenario (b) Family Planning Only 6.0 6.0

5.0 5.0

4.0 4.0

3.0 3.0

2.0 2.0

1.0 1.0

.0 .0 Number of students(millions) Number of students(millions) 2015 2018 2021 2024 2027 2030 2033 2036 2039 2042 2045 2048 2051 2054 2015 2018 2021 2024 2027 2030 2033 2036 2039 2042 2045 2048 2051 2054 7-12 Primary 13-15 Básico 16-18 Diversificado 7-12 Primary 13-15 Básico 16-18 Diversificado (c) Education Only (d) Family Planning + Education 6.0 6.0

5.0 5.0

4.0 4.0

3.0 3.0

2.0 2.0

1.0 1.0

.0 .0 Number of students(millions) Number of students(millions) 2015 2018 2021 2024 2027 2030 2033 2036 2039 2042 2045 2048 2051 2054 2015 2018 2021 2024 2027 2030 2033 2036 2039 2042 2045 2048 2051 2054

7-12 Primary 13-15 Básico 16-18 Diversificado 7-12 Primary 13-15 Básico 16-18 Diversificado Source: HEP+ analyses

Providing universal education from primary through diversificado by 2032 will require an upfront investment in education, especially in departments and schooling levels with low enrollment rates. HEP+ estimated cumulative education expenditures from 2015–2055 at $149,700 million (2015 USD) if Guatemala achieves universal education by 2055 in the base scenario (Figure 26). Eliminating unmet need for family planning under the family planning only scenario was projected to save $15,300 million (2015 USD) by 2055 compared to the base scenario. Interestingly, providing universal education by 2032 without additional investments in family planning resulted in higher cumulative education expenditures of $159,000 million (2015 USD). However, Guatemala could still pursue both education and family planning investments and reduce the education expenditures by $6,100 million (2015 USD) compared to the base scenario.

28 Guatemala Population Dynamics: 2015–2055

Figure 26: Cumulative Education Expenditures by Scenario and Level of Schooling, 2015–2055

$150,000

$120,000

$90,000

2015USD) $60,000

$30,000 Education Expenditures (millions, $ Base Family Planning Education Only Family Planning + Only Education

Primary Básico Diversificado

Source: HEP+ analyses

Across all departments except Totonicapán, the projected education expenditures under the family planning + education scenario led to lower education expenditures as compared to the base scenario. Totonicapán has some of the lowest enrollment rates across all levels of schooling, so the base scenario costs were much lower when compared to the cost of scaling- up enrollment to 100% by 2032.

Guatemala must also consider investments in teachers and schools to meet the growing demand from population growth and to provide universal education. To this end, Guatemala may have to increase the number of national teaching positions by 84% and schools by 66% by 2055 in the base scenario. Demand for teaching positions and schools more than doubled in the departments with the lowest enrollment rates, namely Totonicapán, Quiche, and Huehuetenango. Demand increased the least in Quetzaltenango with a projected20% increase in teaching positions and 17% increase in schools by 2055. Urbanization We estimated the total urban population will vary from 21.7 in the FP + Edu scenario to 24.7 million in the Base scenario. Urban youth currently account for 29.5% of the urban populations in Guatemala. As the age composition of Guatemala matures, urban youth will represent 19.3 and 22.0% by 2055 in the low and high fertility scenarios, respectively (Figure 27).

Guatemala City will go from representing 18.5% of the country’s population in 2015, to 23.1% by 2055. Guatemala City will have to build dwellings to accommodate 900,000 new households between 2015 and 2055 to accommodate this growth. Investing in education and family planning to reduce fertility trends will reduce the number of new households by 78.8%. Despite the estimated population growth in Guatemala City, more than 75% of the demand for new urban households will come from other urban centers.

In urban areas, 98.4% and 77.5% of the population had access to improved water sources and sanitation services in 2015. However, Guatemala will have to ensure urban planning considers the role of population growth and the increasing urbanization to provide infrastructure necessary to promote economic growth and protect people’s health.

29 Guatemala Population Dynamics: 2015–2055

Figure 27: Urban Population by Age Group in 2015 and 2055

25.0

20.0

15.0 72% 72% 76% 76% 10.0

5.0 58%

Number of people of people Number (millions) 28% 24% 28% 24% 42% .0 Baseline (2015) Base (2055) Family Planning Education Only Family Planning + Only (2055) (2055) Education (2055)

Urban Youth (ages 12-25) Urban Population (ages 0-12 and 26+) Source: HEP+ analyses Agriculture The RAPID model estimates the current 600 square meters of arable land per capita will halve by 2055 in the base, education only, and family planning only scenarios. The results suggest Guatemala can maintain 400 square meters of arable land per capita by 2055 if it invests in both family planning and education. RAPID also estimates that Guatemala produced 292,617 metric tons of maize more than it consumed in 2015. HEP+ estimates this surplus will decrease under both the base and education only scenarios. Lowering future fertility trends by eliminating unmet need for family planning will increase the surplus of maize to over 300,000 metric tons. Interpersonal Violence Violence in Guatemala While Guatemala experienced civil conflict in the second half of the 20th century, modern- day violence is interpersonal in nature and dominated by homicide. Homicide rates peaked in 2009, at 46.4 deaths per 100,000 people, and have since declined to 27.3 deaths per 100,000 in 2016 (see Figure 28a) (Instituto Igarapé, 2017). The victims of homicide are overwhelmingly young people, with 60% of victims between the ages of 12 and 25, mostly young men (87%). Homicide is concentrated in the department of Guatemala (Figure 28), predominantly in the urban and peri-urban communities of Guatemala City. While a precise account of homicide causes is not available, it is likely that up to 40% of this violence is tied directly to youth gangs and an additional 20% is driven by organized crime and drug trafficking (Dudley, 2016).

The two major gangs operating in Guatemala are Mara Salvatrucha (MS-13) and Barrio 18, both of which predominantly consist of young members. While estimates vary, it is assumed there are over 400 chapters of MS-13 and Barrio 18 in Guatemala, as well as other local gangs, exceeding 22,000 gang-members in total (International Crisis Group, 2017). These groups predominately use violence for gaining and maintaining social and economic power and enforcing solidarity in the gang, e.g., initiation rituals (Winton, 2004). From the mid- 1980s to 1996, youth gangs operated almost exclusively in the capital, and activities were mostly related to petty theft and drug consumption. Between 1996 and 2003 these groups consolidated and expanded to other regions, increasing the spread of criminality (Kurtenbach, 2014). Today, youth gangs are known to engage in economic violence (e.g.,

30 Guatemala Population Dynamics: 2015–2055 pick-pocketing, mugging, theft/robberies), organized crime (e.g., kidnapping, robberies, arms and drug trafficking, racketeering of buses and taxis, extortion of protection money from local businesses), and social violence (e.g., territorial conflict, rape, vandalism) (Winton, 2004; Jütersonke et al., 2009). Figure 28: Homicides in Guatemala

a. Homicide Rate, 2000–2016 b. Highest Homicide Rates by Department, 2016 Homicide Share of Total 50 Department Rate Population Guatemala 73.8 20.6% 40 Zacapa 64.8 1.5% 30 Escuintla 64.1 4.7% El Progreso 56.3 1.0% 20 Izabal 55.2 2.8% Chiquimula 55.1 2.5% 10 Jalapa 37.2 2.2%

Homicides per Homicides per 100,000People Jutiapa 36.2 2.9% 0 Santa Rosa 32.7 2.3%

Source: Instituto Igarapé, 2017 Youth and Drivers of Violence Youth violence has its origins in Guatemala’s civil war and the post-war structural, institutional, interpersonal, and individual environment. The civil war displaced thousands, many of whom immigrated to the US. These individuals had limited schooling, depended on low-wage jobs, and lived in poverty (International Crisis Group, 2017). A share of these immigrants joined gangs in the Los Angeles area, primarily the 18th Street gang (Barrio 18) and MS-13. During the wave of US deportation of Central Americans starting in the 1990s, immigrants— including gang members—were repatriated to their countries of origin. Faced with limited access to school, social services, and a weak job market, some replicated gang structures locally.

Post-war societies are high-risk contexts for youth participation in violence due to the negative effects of war on both the social fabric of a nation and the governance capacity of the state. The latter is manifested in the state’s inability or unwillingness to provide equitable economic, educational, and social services and opportunities, further aggravated by the large shares of young people concentrated in cities with growing socioeconomic needs (Kurtenbach, 2014). Combined, these conditions become push and pull factors for youth seeking alternative identities and livelihoods. Among youth ages 18–25, security concerns— including crime, kidnapping, and violence—are perceived as the most important problem facing Guatemala today (see Figure 29) (Latin America Public Opinion Project, 2017).

31 Guatemala Population Dynamics: 2015–2055

Figure 29: Youth Perceptions of the Most Important Problems Facing Guatemala

Other Poor 7% Governance Poor Economy 10% 24%

Weak Social Services 8%

Insecurity 51%

Source: Latin American Public Opinion Project, 2017

The loss of parents and family members, the destruction of communities, and the displacement of individuals negatively impact the development of personal identities and social networks. In the case of Guatemala, thousands of individuals migrated during and after the civil war, resettling in marginalized urban or peri-urban segments of Guatemala City. Poor living conditions—due to the dearth of social infrastructure and basic services, the absence of parents due to geography or excessive working hours, and the lack of youth integration programs—caused high levels of fragmentation and the loss of social cohesion (Winton, 2004; Kurtenbach, 2014). As a result, existing gangs became a way to establish identity and regain social networks (International Crisis Group, 2017).

The weakened capacity of the state to provide services and economic opportunities post- conflict caused marginalization and economic exclusion (Kurtenbach, 2014; Umana and Rossini, 2012), negatively affecting the ability of youth to transition to adulthood.6 After moving to urban areas, Guatemalans encountered few opportunities for employment and education. In the 1980s, Guatemala had the third highest level of inequality in the world.7 Gang life offers alternative opportunities for economic independence through illicit economies, and for many becomes a rational choice for survival (Kurtenbach, 2014). Even today, young people are overwhelmingly pessimistic about the current state of the national economy, though they see their own economic status staying constant or improving (see Figure 30) (Latin American Public Opinion Project, 2017).

6 Transition to adulthood has three components: family formation; economic independence; political citizenship/participation. 7 Across those countries with available data (47 in total).

32 Guatemala Population Dynamics: 2015–2055

Figure 30: Youth Perceptions of the Economic Situation in Guatemala

70

60

50

40

30

20

10

Percent Percent of Youth Respondents 0 Better Same Worse

State of Country's Economy Personal Economic Situation

Source: Latin American Public Opinion Project, 2017

Finally, young people turn to gangs and violence in response to governance deficits and injustice. Along with other gang-prone Central American countries, Guatemala resorted to aggressive approaches to quell violence. Measures included extra-legal abuse of suspected youth gang members by the police and arbitrary, and often violent, entrances of security forces in slums and poorer areas. These initiatives generated perverse effects, including excessive acts of brutality and retaliation by gang members (Jütersonke et al., 2009; Kurtenbach, 2014). The government now pursues softer approaches to gang violence, including investing in jobs and education. Nonetheless, Guatemala continues to have one of the worst corruption scores, ranked 136 out of 176 countries, indicating the continuation of untrustworthy and badly functioning public institutions like the police and judiciary (Transparency International, 2017). Prospects of Stability Guatemala’s youthful population did not emerge overnight. It is the result of sustained, high levels of childbearing over the last several decades. However, the fertility rate has declined significantly in recent years to 3.1 children per woman, and the use of contraception—one of the key drivers of decreased childbearing—has increased over time. Today, 60% of Guatemala’s women in union use some method of family planning. However, nearly 12% are using traditional, less effective methods (Ministerio de Salud Pública y Asistencia Social (MSPAS), Instituto Nacional de Estadística (INE), ICF International, 2017). As a result, a significant share of Guatemala’s in-union population remains susceptible to unintended pregnancy.

Considering the security challenges Guatemala faces, continued investment in family planning and education, through 2032 and beyond, is critical for transitioning the age structure toward a smaller share of young people.  Base Scenario: If Guatemala fails to eliminate unmet need, the country’s population could reach nearly 30 million by 2055, resulting in a median age of 32, an “intermediate” age structure (Figure 31; Spectrum estimates and projections generated by HEP+).  Family Planning Only: Investing in family planning only offers significant benefits to the country’s age structure, enabling Guatemala to reach a median age of 35.6—the threshold for age structure maturity.

33 Guatemala Population Dynamics: 2015–2055

 Education Only: Targeted investments in education only, while critical for building human capital and meeting the population’s needs, would result in only a slight reduction in total population numbers and an intermediate age structure by 2055.  Family Planning + Education: Continuing to invest in family planning alongside education would have the biggest impact on transitioning the age structure. By 2055, the median age of the population could reach 36.4, marking a full transition to age structure maturity—the point at which the risk of conflict or violence decreases markedly. In this investment scenario, 40.6% of the population would be under the age of 30, compared with 47% in the base scenario. Figure 31: Guatemala's Future Projected Age Structure, 2055

Base Scenario Family Planning Only

M F M F

6 4 2 0 2 4 6 6 4 2 0 2 4 6 Median Age: 31.6 Median Age: 35.6 Population under 30: 47% Population under 30: 42% Population ages 15-24: 16% Population ages 15-24: 14% INTERMEDIATE MATURE

Education Only Family Planning + Education

M F M F

6 4 2 0 2 4 6 6 4 2 0 2 4 6 Median Age: 32.5 Median Age: 36.4 Population under 30: 46% Population under 30: 40% Population ages 15-24: 15% Population ages 15-24: 13% INTERMEDIATE MATURE

Source: HEP+ analyses

34 Guatemala Population Dynamics: 2015–2055

With such varying demographic trajectories, slowing down investments in family planning would challenge Guatemala’s economic and educational absorptive capacities and its social services, likely contributing to continued instability. Beyond targeted investments in family planning, addressing violence also requires concerted efforts to tackle other drivers, through a range of interventions, including:  Implementing governance reforms, including anti-corruption efforts and prosecution of extra-judicial measures by police and security forces. These measures are an effective means of countering the perverse incentive to scale-up violence as retribution by those on the receiving end of bad governance.  Expanding youth prevention/deterrence and rehabilitation efforts, including community approaches.  Promoting greater social cohesion and engagement of youth in their communities. Strategies should target improving working conditions and leave policies for parents of at-risk youth and increasing wages.  Investing in improving the access and quality of education. Though not a proximate driver of violence, these investments are key for keeping youth in school, thereby decreasing the appeal and opportunity of joining a gang. These investments also ensure that young people are better prepared for the job market and have marketable skills that allow for financial independence.  Promoting job growth aligned with the skills of those entering the labor market to enable youth a smooth transition to adulthood. This approach minimizes the frustrations and grievances that result from inadequate employment opportunities and neutralizes the pull toward alternative—and potentially illegal— income-earning activities. Importantly, promoting job growth can create opportunities in both urban and rural settings. A focus on the latter may decrease the need to migrate to urban centers, where competition for work—and exposure to violence—is highest.  Expanding re-integration programs for migrants, especially youth, in key areas of domestic re-entry (e.g., urban areas). This intervention could mitigate the consequences of more restrictive immigration measures abroad and possible mass deportation of Guatemalan migrants from the US.

35 Guatemala Population Dynamics: 2015–2055

Conclusion

Achieving the family planning and educational goals of Plan K’atun would have long-term impacts on Guatemala’s development and security. Both are multi-generational strategies; family planning reduces future resource strains and contributes to decreasing the risk of violence, while educational investment in children today pays off in stronger economies in the future. In addition, the two interact: female education lowers fertility, and family planning use today increases future GDP per capita through its impact on age structure. For example, the maturing age structure that would result from achieving both the family planning and education goals of Plan K’atun could help Guatemala grow the economy by producing a demographic dividend. A more mature age structure would also facilitate greater stability by decreasing the share of young, urban potential gang members/recruits, and by alleviating the potential violence-inducing grievances that may result from trying to accommodate a large youth cohort. Moreover, increasing school enrollment now could lead to higher productivity in tomorrow’s labor market, taking full advantage of the maturing population. Finally, ensuring investments also reach those who have historically lagged in social indicators—such as rural and indigenous populations—could help reduce inequities and increase social cohesion.

36 Guatemala Population Dynamics: 2015–2055

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