Some Issues in Population and Human Resource Development in Egypt

Report No. 3175EGT SomeIssues in Population FE Copy andHuman Resource Development in Egypt Public Disclosure Authorized May 12, 1981 Population and Human ResourcesDivision Development EconomicsDepartment FOR OFFICIAL USEONLY Public Disclosure Authorized Public Disclosure Authorized

Docurnentof the World Bank Public Disclosure Authorized

Thisdocument has a restricteddistribution and may be used by recipients only in the performanceof their official duties.Its contentsmay not otherwise be disclosedwithout World Bankauthorization. CURRENCY EQUIVALENTS

1 Egyptian Pound (LE) US$1.43

1 US Dollar = LE 0.70

WEIGHTS AND MEASURES

I hectare 2.38 feddans

I feddan 1.04 acres

1 acre 0.96 feddans

1 square kilometer 238.00 feddans

FISCAL YEAR

January 1 - December 31 FOR OFFICIAL USE ONLY

SOME ISSUES IN POPULATION AND HUMAN RESOURCE DEVELOPMENT IN EGYPT

This report is based on the findings of a mission to Egypt in

May-June 1979. Members of that mission and their principal assignments were:

K. C. Zachariah, mission chief

Susan H. Cochrane, deputy mission chief

Khalid Ikram, liaison

Catherine S. Pierce, health

Mansour Oubouzar, education

Richard H. Sabot, employment

Zafer Ecevit, manpower

Lance Taylor, macro economic issues (consultant)

In addition to the above contributions, Amr Mohie El-Din

(consultant) prepared a background paper on rural employment. We would

like to thank Richard Herbert and Lac Khanh Truong for their editorial

assistance and Kalpana Nandwani, Jane Armitage and Y. Boutros-Ghali for

their research assistance. Mary Jeanne Bowman (consultant), Kemal Dervis,

Hugo Diaz-Etchevehere, Graeme Donovan, Fredrick Golladay, Stephen Heyneman,

Dean Jamison, Basil Kavalsky, Timothy King, Ann MacNamara, and Oey Meesook

provided valuable comments and suggestions on earlier drafts of the report.

In addition, many individuals within Egypt have provided help through the

provision of data and insights into the population and human resource issues

through formal and informal conversations. We would like to express our

appreciation for their time and trouble.

This docurent has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization.

SOME ISSUES IN POPULATION AND HUMAN RESOURCE DEVELOPNENT IN EGYPT

TABLE OF CONTENTS

Page No.

MAP 15288

INTRODUCTION AND CONCLUSIONS ...... i - v

I. AN OVERVIEW ...... 1 Susan H. Cochrane

POPULATION PRESSURE ...... 2 THE DETERMINANTS OF POPULATION GROWTH ...... 3

Fertility ...... 3 Mortality ...... 0 ...... *...... 5

REACTIVE STRATEGIES ...... 6

Food Imports ...... 6 Labor Export ...... 7 Educational Strategy ...... 10

STRATEGIES TO CONTROL POPULATION PRESSURE...... 13

Land Expansion ...... 14 Fertility and Family Planning ...... 15

SUMMARY AND CONCLUSIONS ...... 20 REFERENCES ...... 22

II- FERTILITY AND FAMILY PLANNING IN EGYPT: RECENT TRENDS AND DETERMINANTS ...... 23 K. C. Zachariah

SUMMARY ...... 23 INTRODUCTION ...... 26 FERTILITY LEVEL AND TRENDS .. . 26

Deriving Fertility Measures ...... 26 Fertility Trends ...... 27

FERTILITY DIFFERENTIALS AND THEIR DETERMINANTS ...... 32

Differentials ...... 32 Determinants of Fertility Differentials ...... 32

FUTURE FERTILITY ...... 38 REFERENCES ...... 51

APPENDIX IIA THE FAMILY PLANNING PROGRAM: ITS DEVELOPMENT AND IMPACT ...... 52 Susan H. Cochrane -2-

Page No.

III. THE MORTALITY AND HEALTH SITUATION IN EGYPT: RECENT TRENDS AND PATTERNS ...... 65 K. C. Zachariah and Catherine S. Pierce

SUTMMARY ..... *...... -65 RECENT MORTALITY PATTERNS ...... 69

Mortality Levels ...... 69 Socioeconomic Differentials ...... 74 Future Trends ...... 75

THE HEALTH SITUATION ...... 76

Health Status ...... 76 Morbidity ...... **...... *so 79

THE DETERMINANTS OF HEALTH ...... 82

The Health Delivery System ...... 82 Issues in the Health Sector ...... 88

REFERENCES ...... 95

IV. EDUCATIONAL DEVELOPMENT AND POPULATION GROWTH IN EGYPT ...... 97 Susan H. Cochrane and Mansour Oubouzar

SUMM4ARY ...... 9 7 INTRODUCTION ...... 101 RESOURCE ALLOCATION TO EDUCATION ...... 101 ADULT EDUCATIONAL STATUS ...... 104

Historical Trends ...... 104 The Educational Production Process ...... 109 Enrollments ...... 110 The Primary Level ...... 110 Preparatory Education ...... 123 Secondary Education ...... 128 Higher Education ...... 130 Technical and Vocational Training ...... 132

SUMMARY AND ISSUES ...... 134

The Consequences of Alternative Rates of Population Growth for Primary Education ...... 134 The Consequences of Population Growth for Preparatory Education ...... o ...... 136

APPENDIX IVA SELECTIVE MIGRATION'S EFFECT ON THE EDUCATIONAL PROFILE OF THE RESIDENT POPULATION: A NOTE..... 141

APPENDIX IVB ADULT LITERACY PROGRAMS: A NOTE ...... 143

REFERENCES ...... 144 -3- Page No.

V. LABOR FORCE GROWTH, EMPLOYMENT AND EARNINGS IN EGYPT: 1966-1986 ...... 145 R. Sabot and L. Taylor with Y. Boutros-Ghali

SUM14MARY ...... 145 EGYPT'S "EMPLOYMENT PROBLEM" . ... 148 SOME CONTRADICTORY EVIDENCE ...... 161

Rural Surplus Labor ...... 161 Wage Trends ...... 163 Unemployment Trends and Other Evidence of a Tight Labor Market ...... 168 Some Explanations ...... 170

WHAT LIES AHEAD? ...... 171

The Base Run ...... 173 Variants 1 and la: Increased Labor Supply ...... 179 Variant 2: Increased Labor Supply and Decreased Aggregate Demand ...... 180

CONCLUSIONS ...... 182

ANNEX VA TABULAR SUPPLEMENT ...... 184

APPENDIX A THE MODEL AND THE DATA ...... 194

REFERENCES ...... 208

VI. POPULATION AND FOOD ...... 209 Susan H. Cochrance

SUIMMARY ...... 209

INTRODUCTION ...... 211 THE CURRENT SITUATION ...... 214 PROJECTED FOOD NEEDS ...... 217 EGYPT'S ABILITY TO PRODUCE FOOD REQUIREMENTS ...... 220 ALTERNATIVE POPULATION PROJECTIONS ...... 227 NEW LANDS...... 230 INCREASING YIELDS ...... 231 INCREASING CONSUMPTION LEVELS ...... 234 CONCLUSIONS ...... 239 REFERENCES ...... 241

APPENDIX VIA: CALCULATION OF INPUTS: A TECHNICAL NOTE .... 242 -4-

Page No.

LIST OF TABLES AND FIGURES

Table

2.1 MARITAL FERTILITY, EGYPT, 1960 and 1975...... 40 2.2 REPORTED CRUDE BIRTH RATE, EGYPT, 1960-1978...... 41 2.3 AVERAGE AGE OF FEMALE FIRST MARRIAGES AND ADJUSTED MARRIAGE RATES, EGYPT, 1965-1975...... 42 2.4 AGE-SPECIFIC MARITAL FERTILITY RATES OF CONTINUOUSLYMARRIED WOMENBY AGE AND REGION, EGYPT, 1975 ...... 43 2.5 ESTIMATED FERTILITY RATE OF ALL WOMEN, EGYPT, 1970-1975 ...... 44 2.6 FERTILITY DIFFERENTIALS BY MAJOR REGIONS, EGYPT, SELECTED YEARS 1947-1976 ...... 44 2.7 STANDARDIZEDAVERAGE PARITY BY EDUCATIONAL STATUS OF WOMENBY MAJOR REGIONS, EGYPT, 1960, 1974/75, 1976.. 45 2.8 MARITAL STATUS DISTRIBUTION, FEMALES 16 YEARS AND ABOVE, EGYPT, 1960 AND 1976 ...... 45 2.9 PROPORTION MARRIED BY AGE, FEMALES, EGYPT AND CAIRO, 1960 AND 1976 ...... 46 2.10 PERCENT MARRIED AMONGFEMALES 16 YEARS AND ABOVE, EGYPT AND MAJOR REGIONS, 1960 AND 1976 ...... 46 2.11 AVERAGENUMBER OF CHILDREN EVER BORN BY AGE AT FIRST MARRIAGE, EGYPT, 1974 ...... 47 2.12 USE OR NONUSE OF FAMILY PLANNING METHODSBY AGE GROUP, EGYPT, 1974 ...... 47 2.13 USE OR NONUSE OF FAMILY PLANNING METHODSBY RESIDENCE STATUS OF WOMEN, EGYPT, 1974 .47 2.14 USE OR NONUSE OF FAMILY PLANNING METHODSBY EDUCATIONALATTAINMENT, EGYPT, 1974 .48 2.15 EXPECTED IMPACT OF FAMILY PLANNING ON THE FERTILITY RATES, EGYPT, BY MAJOR REGION AND EDUCATIONAL LEVEL, 1975 .48 2.16 DESIRED FAMILY SIZE BY PARITY AND AGE, EGYPT, 1974/75 49 2.17 USE OF CONTRACEPTIVES BY MEN, EGYPT AND MAJOR REGIONS, 1974/75 .49 2.18 PROJECTIONS OF RESIDENT POPULATION: SIZE, AGE STRUCTURE, BIRTH RATE, DEATH RATE, AND RATE OF INCREASE UNDER THREE ALTERNATIVE ASSUMPTIONS, EGYPT, 1980-2000 .50

2.A.1 NUMBEROF FAMILY PLANNING CENTERS IN RURAL AND URBAN AREAS, EGYPT, 1955-1979.53 2.A.2 NUMBER OF PILL CYCLES DISTRIBUTED TO WOMEN FROM FAMILY PLANNING CLINICS AND TO PHARMACIES, FROM ALL SOURCES, EGYPT, 1966-1979.55 2.A.3 NUMBER OF IUDs INSERTED ANNUALLY AT FAMILY PLANNING CENTERS, EGYPT, 1966-1979 .56 -5-

Page No.

Table

2.A.4 NUMBER OF CLINICS AND PILL CYCLES DISTRIBUTED IN AVERAGE MONTH PERIOD BY CLINIC TYPE AND LOCATION, EGYPT, 1977-1979...... 58 2.A.5 REGRESSION EQUATIONS FOR FERTILITY LEVELS AND CHANGES IN FERTILITY LEVELS ON FAMILY PLANNING SERVICES AND FEM2ALELITERACY FOR 21 GOVERNORATES ...... 60 2.A.6 REGRESSION EQUATIONS FOR FERTILITY LEVELS AND CHANGES IN FERTILITY LEVELS ON FAMILY PLANNING SERVICES AND FEMALE LITERACY FOR 21 GOVERNORATES (NON-URBAN: 17 GOVERNORATES) ...... 61

3.1 MORTALITY INDICES, EGYPT, 1975-1979 ...... 70 3.2 MORTALITY INDICES BY REGION, EGYPT, FOR SELECTED INTERVALS ...... 71 3.3 TRENDS IN MORTALITY, EGYPT, 1960-1979 ...... 72 3.4 MORTALITY DIFFERENTIALS BY SEX, EGYPT, 1940-1965...... 74 3.5 PERCENTAGE DISTRIBUTION OF DEATHS BY CAUSE OF DEATH, EGYPT, SELECTED YEARS 1937-1970 ...... 77 3.6 PROPORTION OF INFANT DEATH BY CAUSES OF DEATH, EGYPT, 1963-1972 ...... 78 3. 7 NUMBERAND COVERAGEOF BASIC RURAL HEALTH UNITS, EGYPT, SELECTED YEARS, 1946-1979 ...... 84 3.8 THE HEALTH TEAM IN RURAL FACILITIES ACCORDING TO MOH STANDARDS, EGYPT ...... 85 3.9 RATES OF UTILIZATION OF RURAL HEALTH SERVICES, EGYPT, 1952-1972...... 86 3.10 DISTRIBUTION OF HOSPITAL BEDS ACCORDING TO GOVERNORATES AND JURISDICTION, EGYPT, 1977...... 89 3.11 NUMBER OF GRADUATES TRAINED IN MEDICINE, PHARMACY, AND DENTISTRY, EGYPT, 1969-1976 ...... 90 3.12 GRADUATES OF NURSING SCHOOLS, EGYPT, 1970-1976 ...... 90 3.13 DIFFERENTIAL ACCESS TO SAFE WATER, EGYPTIAN REGIONS, 1976 ...... 93

4.1 GOVERNMENT EXPENDITURES ON EDUCATION, EGYPT, 1901976...... 102 4.2 CAPITAL AND RECURRENT EXPENDITURE ON EDUCATION BY LEVEL OF EDUCATION, EGYPT, 1973 AND 1 9 7 6 103 4.3 PERCENT DISTRIBUTION OF POPULATION 10 YEARS OLD BY EDUCATION AND SEX, EGYPT, CENSUS YEARS 1937, 1947, 1960, AND 1976. 105 4.4 PROPORTION OF POPULATION OVER 10 YEARS OF AGE WITH VARIOUS LEVELS OF EDUCATIONAL ACHIEVEMENT, EGYPT AND MAJOR REGIONS, 1976 107 4.5 COMPARATIVEILLITERACY AND URBANIZATION RATES, EGYPTIAN GOVERNORATES, 1960-1976. 108 4.6 ENROLLMENTRATES BY EDUCATIONALLEVEL, EGYPT AND SELECTED COUNTRIES, CIRCA 1980 . .111 -6- Page No.

Table

4.7 POPULATION AGE 6-11 PROJECTED FROM REGISTERED BIRTH, EGYPT, 1960-1979 ...... 113 4.8 ENROLLMENT RATES, CLASS SIZE AND PROPORTION OF FEMALE STUDENTS, EGYPT, SELECTED YEARS 1955-1978 ...... 115 4.9 EGYPT, GOVERNORATE LEVEL DATA ON PRIMARY EDUCATION: POPULATION 6-11, ENROLLMENT RATES, AVERAGE CLASSROOM SIZE, AND PROPORTION OF STUDENTS (FEMALE), 1977-1978... 117 4.10 FIRST-YEAR ENROLLMENTSTO POPULATION OF ENTRY AGE, EGYPT, 1960/61 TO 1979/80 ...... 119 4.11 DROPOUT RATES FOR SIX SUCCESSIVE FIRST YEAR ENROLLMENTS, BY GRADE AND SEX, EGYPT, 1966/67 TO 1971/72 ...... 122 4.12 PREPARATORY ENROLLMENTS, EGYPT, 1960-1979 ...... 125 4.13 PREPARATORY ENROLLMENTS BY GOVERNORATE, EGYPT, 1977-1978. 127 4.14 ENTRY INTO AND PROGRESS THROUGH PREPARATORY SCHOOL, EGYPT, 1971/72 - 1975/76 ...... 129 4.15 EXPANSION OF SECONDARY EDUCATION, EGYPT, 1960 TO 1979 ...... 131 4.16 CLASSES NEEDED FOR PRIMARY EDUCATION, EGYPT, 1980-2000 ON VARIOUS ASSUMPTIONS ...... 137 4.17 CLASSROOMS NEEDED FOR PREPARATORY SCHOOL UNDER ALTERNATIVE POPULATION GROWTH AND ENROLLMENT RATE ASSUMPTIONS, EGYPT, 1980-2000 ...... 139

5.1 LABOR FORCE PARTICIPATION RATES, EGYPT, SELECTED YEARS 1937-76 ...... 150 5.2 POPULATION CLASSIFIED BY ECONOMIC ACTIVITY IN CENSUS, EGYPT, CENSUS YEARS 1937 TO 1976 ...... 151 5.3 POPULATION CLASSIFIED BY ECONOMIC ACTIVITY IN CENSUS, EGYPT, CENSUS YEARS 1937 TO 1976 (INDEX NUMBERS) ...... 153 5.4 INDEX OF AGRICULTURAL POPULATION PER SQ. KM., EGYPT, CENSUS YEARS 1882-1976 ...... 154 5.5 THE OUTPUT ELASTICITY OF DEMAND FOR LABOR, EGYPT, 1961-1966 AND 1971-1976 ...... 155 5.6 WHITE-COLLAR WORKERS AS A PROPORTION OF TOTAL EMPLOYMENT IN VARIOUS SECTORS, EGYPT, 1960 AND 1974 .... 160 5.7 INDICES OF REAL WAGES IN RURAL EGYPT, SELECTED YEARS, 1938-1974 ...... 164 5.8 TRENDS IN AVERAGE WAGES PER WORKER IN VARIOUS SECTORS, EGYPT, 1974-1979 ...... 167 5.9 RATES OF UNEMPLOYMENT BY ECONOMIC ACTIVITY: EGYPT, 1957-1972 ...... 169 5.10 RATES OF ADULT MALE URBAN UNEMPLOYMENT, EGYPT ...... 168 5.11 VALUES ON THE LABOR SUPPLY AND DEMAND VARIABLES INCLUDED IN THE BASE RUN ...... 176 5.12 BASE RUN COMMODITY PRICES AND OUTPUT ...... 177 5.13 INCREASES IN DEMAND FOR MANUAL LABOR IN VARIOUS SECTORS, EGYPT, 1976-1981 ...... 178 5.14 WAGE INCREASES IN THREE SECTORS ...... 178 5.15 VARIANT 2 COMMODITY PRICES AND OUTPUT . .181 -7- Page No.

Table

V Al EGYPTIAN ARABS BY SEX, EMPLOYMENTAND ECONOMIC ACTIVITY, 1960 AND 1976 ...... 185 V A2 EMPLOYMENTSTATUS BY SEX AND ECONOMIC ACTIVITY, EGYPT 1960 AND 1976 ...... 186 V A3 AGRICULTURAL POPULATION PER SQ. KM. CROP AREA, SELECTED COUNTRIES, 1975 ...... 187 V A4 URBANIZATION PATTERNS IN EGYPT AND IN A SAMPLE OF OTHER LESS DEVELOPED COUNTRIES, 1975-2000 ...... 188 V A5 EMPLOYMENTIN SERVICES, EGYPT 1959-1965 ...... 189 VA6 EDUCATIONAL EXPANSION, EGYPT, 1951-1971...... 190 V A7 EGYPTIAN ARABS BY EMPLOYMENT STATUS, SEX AND EDUCATIONAL STATUS ...... 191 V A8 EMPLOYMENT STATUS BY EDUCATIONAL DEVELOPMENT, EGYPT, 1960 AND 1976...... 192 V A9 TRENDS IN GDP AND ITS SUBAGGREGATES, EGYPT, 1974-1979...... 193

Al BASIC EQUATION OF THE E.C.M MODEL .195

A2 MAPPING FROM NINE TO TWELVE SECTORS .204

A3A THE BASE PERIOD EMPLOYMENT METRIC: PRIVATE SECTOR...... 206

A3B THE BASE PERIOD EMPLOYMENTMETRIC: GOVERNMENT SECTOR .207

6.1 FOOD CONSUMPTION PER CAPITA, EGYPT, 1948/50-1976/77 212 6.2 DAILY PER CAPITA CALORIE SUPPLY, COUNTRY GROUPINGS,1977 213 6.3 FOOD CONSUMPTIONPER CAPITA, DOMESTIC AND IMPORTED, EGYPT, 1972/73, 1976, 1977 . . .215 6.4 PROJECTED FOOD NEEDS USING MEDIUM POPULATION PROJECTION AND CONSTANT CONSUMPTIONLEVELS, EGYPT, 1976-2000 . . .219 6.5 AREA CROPPED, EGYPT, 1950-1975 ... 221 6.6 ESTIMATION OF CROP YIELDS, EGYPT, 1970-74. . 224 6.7 LAND AREA NEEDED FOR VARIOUS CROPS ASSUMING MEDIUM POPULATION PROJECTION, EGYPT, 1970-2000.. 225 6.8 CROPPED AREA NEEDED AND AVAILABLE WITH CONSTANT CONSUMPTIONLEVELS, CONSTANT LAND AREA AND CONSTANT YIELDS AND A MEDIUM POPULATION PROJECTION, EGYPT, 1980-2000 .... 227 6.9 LAND NEEDED RELATIVE TO LAND AVAILABLE UNDER ALTERNATIVE ASSUMPTIONS WITH CONSTANT PER CAPITA FOOD INTAKE, EGYPT, 1980-2000 . . 228 6.10 YIELDS OF FIELD CROPS IN TONS/HA, AND AS INDEX NUMBERS, EGYPT, 1950-1976 . . 232 6.11 LAND NEEDED RELATIVE TO LAND AVAILABLE UNDER VARIOUS ASSUMPTIONS FOR INCREASING LEVELS OF PROTEIN CONSUMPTION, EGYPT, 1980-2000 ... 236 -8- Page No.

Table

6.12 LAND NEEDED FOR MEDIUM POPULATION GROWTH WITH CONSTANT CONSUMPTION LEVELS AND INCREASING CONSUMPTION OF ANIMAL PROTEIN, EGYPT 1980-2000 ...... 238

6A.1 ANIMAL PROTEIN YIELD: PRODUCTION AND ANIMAL STOCKS, EGYPT, 1972/73 ...... 245 6A.2 STARCH EQUIVALENTS AND DIGESTIBLE PROTEIN NEEDS FOR ANIMALS AND POULTRY ...... 246 6A.3 EXAMPLE OF CALCULATION OF 1980 ANIMAL NEEDS ...... 247 6A.4 FOOD REQUIREMENTS FOR MEAT, MILK AND EGG PRODUCTION, 1980 ...... 248 6A.5 PRODUCTION REQUIRED TO PRODUCE MILK, MEAT AND EGGS ..... 249

Figure

2.1 CRUDE BIRTH RATE FOR EGYPT: (I) 1930-1947 AND (II) 1960-1977. 29 2.2 WIFE'S EDUCATION, DETERMINANTS OF NATURAL FERTILITY, DESIRED FMAILY SIZE, AND CONTRACEPTIVE EVER-USERS, URBAN EGYPT, 1975 . .37

3.1 TREND IN INFANT MORTALITY RATE AND CHILD DEATH RATE, EGYPT, 1960-1975 ... 73

4.1 PRIMARY AGE POPULATION UNDER ALTERNATIVE POPULATION PROJECTIONS, EGYPT, 1960-2000 .135

5.1 MONEYWAGE, REAL WAGE AND COST-OF-LIVING INDICES FOR AGRICULTURAL LABOURERS, EGYPT, 1938-1974 .165 5.2 AGGREGATESUPPLY SIDE ALTERNATIVES 174 Al FLOWCHARTOF THE MODEL.197

6.1 LAND NEEDED IN PROCESS OF WHAT WOULDBE AVAILABLE UNDER ALTERNATIVE POPULATION, YIELD AND LAND INCREASE ASSUMPTIONS (CONSUMPTIONLEVELS HELD CONSTANT) .229 6.2 LAND NEEDED IN EXCESS OF WHAT WOULDBE AVAILABLE UNDER ALTERNATIVE POPULATION, YIELD AND LAND INCREASE ASSUMPTIONS (PROTEIN CONSUMPTIONFROM ANIMALS PER CAPITA INCREASING FROM 12.5 GRAMS IN 1976 TO 30 GRAMS in 2000, KEEPING CALORIES CONSTANT). .237 30 Population by Governo,ate RAS Y CENSUS, NOV. 19726

U(D.. 0 IfCAIRO 5,084.4S3 E Yl,kh 7 /3 2ALEXANDRIA 2,318,600 - 2~~~~~~~~~EORTAAID ~ ~~~~262,620 4 SUEZ 194,015

11, E W 65~~~~~~~~~~~~~~~~~~'4t ISMAILIYA 351,060 DAMIETTA 557,115 24 ~ ' B > t Ra 8 O 8 3j%OroF=ro f7 SAKAHILIYA 2,732,7E5 SSHARKIYA 2,621,208 9 QALIURIYA 1,674,006

130K5A-EL SH9EIKH 1,403,369 I I GHARBIYA 2,294,303 12 MENCOUPIYA 1,710,982 13 BEHEIRA 2.54S,246 14 GIZA 2,419,247 1,108,615 -30- 30,-~~~~~~~~~~~~~~~~~~~~~~~~~~71IS BENI-SUEF 16FAYQUM 1,149245 IlMINIA 2,055,739 IS ASSIuCr 1,665,376 19 H06 1,024,960 ZOQ ENA 1,705,094 21 ASWAN 6199,32 22 RED SEA 56,191 23 EL-WAADIELSGEDID 56,691

A6 ~~~~~~~2551NAI16,104

TOTAL 36,4666180

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SOME ISSUES IN POPULATION AND HUMAN RESOURCE DEVELOPMENT IN EGYIPT

INTRODUCTION AND CONCLUSIONS

In the last twenty years Egypt has experienced a variety of economic and demographic developments. In the period between 1960 and 1965 per capita income grew at an annual rate of 4.2 per cent. Growth slowed substantially due to the expenses and disruption of war in the period 1966 to 1973. A large portion of the economic growth that did occur in this period was eroded by population growth of 2.4 per cent annually, and per capita income ?rew at a rate of only 1 per cent a year. After the October war of 1973 Egyptian economic situation shifted dramatically as a result of the Al-Infitah Policy. In the post 1974 period GDP in constant prices has been growing at 8 per cent annually while population growth has slowed to about 2 per cent as a result of increased emigration.

While the early years following Al-Infitah were marked by a series of foreign exchange crisis, today Egypt is in a more secure position due to increases in foreign exchange that have resulted from the reopening of the Suez Canal, increased capital inflow, increased workers remittances and large increases in the revenues from petroleum exports. Today, the Egyptian people can afford to look beyond short run crisis to the long run probleLms. The continued high growth rate of population is one of the major long run problems that must be addressed. Egypt's high rural density, extreme urban crowding and heavy dependence on food imports make population pressure obvious. What has been less obvious is how these pressures can be relieved.

Closely related to the population problem is the issue of human resource development. In the short-run the pressures of a rapidly grow;ing labor force have been relieved by labor export, but it seems unlikely that other countries will continue to accept net increases in Egyptian workers. The educational qualifications of the Egyptian population make the human resource issue even more complex. There is a surplus of the highly educated and a deficit of those with basic education. This explains both labor market imbalances and the failure of fertility to fall among some groups.

The purpose of this report is to address these population and human resource issues. The report was designed to document the trends in population growth, educational development and labor market evolution. In addition, the causes of these trends were analyzed, where possible, to determine what policies could be used to alter the trends where desirable. Lastly, an attempt was made to examine the probable consequences of future population growth on educational development, employment and food requirements. These are only some of the variables that will be influenced by demographic trends, but they are the most important factors given Egyptian goals of achieving universal primary education, increased income levels and the maintainance of adequate food consumption for the entire population. - ii -

The timing of this report was dictated by the availabilityof the 1976 Census results in early 1980. The last complete census in Egypt was conducted in 1960. Since thiattime, only fragmentarydata have been available on these topics. Not all the census results have been published. For this reason and also because of the lack of other kinds of data, it was not possible to achieve all the objectives of the report. In particular, it has been impossible to document internationalor internal migration satisfactorily. This is the most serious limitation of the report. While internationalmigration is always difficult to document, internal migration can be studied more thoroughlyonce all the census data are available. At that time it will also be possible to give a more thorough analysis of urban- rural differentialsin demographicand economic variables. The other major limitation of this report is that while we could document mortality differentials and trends, it was :impossibleto analyze the causes of health status and mortality sufficientlyto determine whether mortality is kept high by lack of access to health facilit:Lesand personnel, low living standardsor lack of basic health knowledge on the part of the population. Census data alone will not be sufficient. More specific health sector data will have to be collected to address this question.

Despite the limitationsof the data and the inevitable scarcity of time, it was possible to resolve a large number of questions about population and human resource developmentin Egypt and to reach a somewhat smaller number of conclusionsabout the policies that can be used to affect future developments.

The most importantdescriptive conclusions can be briefly summarized as follows:

1. The crude birth rate fell between 1960 and 1972 but most of the decline took place between 1966 and 1972. After 1972 it began to rise again and by 1977/78 it was only marginal:Lylower than in 1960. The rebound in the birth rate resulted from an increase in the proportion of women of childbearingage. If there had been no compensatingdecrease in the proportion of women married, the crude birth rate in 1977/78 would have been higher than in 1960.

2. Fertilitywithin marriage was almost the same in 1977/78 as in 1960 at the national level. This was the result of offsetting changes. In rural areas, particularly in Upper Egypt, marital fertility increased probably as the result of improvementin health while in urban areas marital fertilitydecreased as the result of increases in contraceptiveuse. If the 26 percent of the women who were reported using contraceptiveswere not doing so, Egyptian marital fertilitywould have shown a significantincrease. - iii -

3. Mortality has fallen substantially in the last 20 years. The crude death rate has fallen 32 percent, the infant mortality rate by 14 percent and the child death rate by 53 percent.

4. While Egypt has mortality and life expectancy equal to that of most countries with comparable income, its situation is much worse than that of countries with comparable levels of health facilities and health personnel. The reason for this is a major unresolved question.

5. There are dramatic differences in mortality within Egypt. Life expectancies in Lower and Urban Gov- ernorates are almost identical but that in Upper Egypt is about 11 years less. Child death rates vary substantially by urban and rural areas and between Upper and Lower Egypt. Child mortality in urban Upper Egypt is twice that of Urban Governorates while urban Lower Egypt has lower mortality than either. In rural Upper Egypt child mortality is three times that of the Urban Governorates and twice that of rural Lower Egypt.

6. Egypt has shown uneven progress in educational development. Despite relatively high expenditures on education, illiteracy remains high and primary enrollments remain low for a country with its level of income. This is the result of large allocations to post-primary education. Egypt-s expenditures and achievements in post-primary education are above average for a country with its levels of income.

7. The employment situation has changed dramatically since the 1960s, particularly in the post 1973 period. Agricultural and construction labor markets have tightened substantially and wages in those occupations have increased faster than inflation and faster than wages in services in the 1974-1978 period. Wages of women and children in agriculture have also increased, even more rapidly than male wages. Increases in agricultural wages, however, have not been uniformly large throughout Egypt.

8. The labor market for highly educated workers appears to still be in surplus as evidenced by continued pressures on government to guarantee employment to college graduates. It is unclear, however, whether the market is less in surplus than previously as a result of large labor emigration. Documenting the - iv -

earnings of the well-educated is difficult because of the prevalence of second and third jobs in addition to the tenured government employment.

9. The future requirements for food depend on population growth and consumption levels while production depends on increases in yields and land area cropped. The projections used here indicate that the difference between feasible (high and low) rates of population growth are large enough to consume any increase in food production that can feasibly be brought about by increases in land area by the year 2000.

10. Egypt can obtain self-sufficiency in food by 2000 given the current production patterns only if fertility declines at the maximum rate (3 per cent a year), agricultural yields increase at the maximum rate (2 percent a year) and cropped area increases by 3.3 million feddans. This scenerio appears unlikely given that only 1.1 million feddans were added to cropped area between 1954 and 1974. If an attempt is made to increase the consumption of animal protein, self sufficiency will be impossible under any set of assumptions. Given relative efficiencies, it appears that the export of agricultural crops such as wheat to pay for the import of meat might prove to be a better strategy.

The major policy conclusions can be briefly summarized as follows:

1. Fertility remains high because of low female education, particularly in rural areas. While other factors also contribute to high fertility, education is the clearest and best documented.

2. The role of increased availability of health and family planning facilities has had different effects in different areas of Egypt. In those areas where fertility has been kept low by poor health, increases in fertility have been observed as a result of increases in income and health. In those areas where fertility is higher than desired there has been a substantial fertility reduction as a result of the adoption of family planning. Therefore, the current family planning program which emphasizes both development to decrease the demand for children and increased access to family planning for the motivated seems to be best in the Egyptian environment. - v -

3. The analysis of primary education data suggests that enrollment rates, particularly the enrollment of females, remains low by a lack of primary school places. Enrollments in rural areas also appear to be low where child agricultural labor is scarce relative to male adult labor, but this is second in importance to the availability of school places. Therefore, it appears that enrollments rates could be increased by an increase in the per capita availability of school places.

4. Given past population trends, the number of new primary school places scheduled to be built under the 1978-82 Plan was insufficient to maintain current enrollment rates of 74 percent, much less achieve universal primary enrollments by 1985. In the next 20 years the cost of achieving universal primary and preparatory education will be highly dependent on the rate of growth of the population.

5. A cross sectoral comparison indicates that expenditures to reduce the food deficit may be more productive when they are spent towards educating a girl through preparatory school and thus reducing fertility than when they are spent on reclaiming a feddan of land. For example in 1976 prices 1000 LE could be used to bring a new feddan into production. By the year 2000 this could feed between 2.5 and 5 people. Alternatively 1000 LE could educate 3.3 girls through preparatory school and when they are grown they would each have on the average at least one less child than if they remained uneducated.

These conclusions and others are contained in the six chapters of the report. Five of the chapters are devoted to specific sectors: fertility and family planning, mortality and health, educational development and population growth, employment and earnings, and population growth and food supply. These five chapters give in depth treatment to each topic. The other chapter of the report, the overview, makes an attempt to put these issues in a broader context and to sketch out the trade-offs between policies in the various sectors. The overview does not represent a summary of all the issues covered in the report and must be considered as a supplement to rather than a substitute for other chapters. Summaries are presented at the beginning of the five major chapters for those interested in details on specific subject.

This report is as comprehensive as possible at this point in time. In the future more data will be available from the 1976 Census and various surveys. It is hoped that this report will provide useful background material for a policy dialog on these issues and for designing new research and be a useful framework for integrating on-going research on population and human resource issues in Egypt.

SOME ISSUES IN POPULATION AND HUMAN RESOURCE DEVELOPMENT IN EGYPT

CHAPTER I

AN OVERVIEW 1/

The basic fact about population and human resources in Egypt is the enormous scarcity of cultivable land relative to people. In addition to the high density, there is no evidence that the rate of population growth is slowing substantially. While density is not destiny, as Japan, Hong Kong, Singapore and the Netherlands have shown, the fact that Egypt has a population per inhabitable area of 2,671 per square mile places serious constraints on the development of a country which still has 48 percent of its labor force and 29 percent of its production in agriculture.

The strategies that have evolved to circumvent these constraints have been varied and often successful, at least in the short run. The strategies to control the underlying situation have been less successful. The most interesting strategies to accommodate 40 million people in the narrow belt of land of the Nile valley and Delta_(see map) will be discussed in this chapter. The consequence of these strategies have often been unexpected and are not fully documented. These severe constraints, combined with the varied public policies and private strategies that have developed to circumvent them, have led to an extremely complex economic and demographic situation which challenges the data and the theory to provide adequate analysis. What follows in this chapter and the five subsequent chapters is a modest attempt to describe the situation, to explain its direct causes where possible, and to hazard a guess at the interconnecting links and probable future consequences. From this analysis emerge a few recommendations about what policies have been neglected which might useful in solving Egypt's population problem.

There are three strategies that have evolved in response to the current demographic dilemma in Egypt and three strategies that could be used to control further deterioration. The three major reactive strategies are conceptually simple: (1) import of foods, (2) export of labor, and (3) the use of human capital accumulation in the form of high levels of post-primary education to substitute for the scarcity of non-human resources. Inter- national research on human capital suggests that high levels of education are in fact more likely to be complements to, rather than substitutes for, physical capital. This suggests that this strategy may not be successful in alleviating the fundamental problem. The three major strategies designed to correct the underlying population problem are also conceptually simple (1) the expansion of land area, (2) the reduction of population growth, and (3) the development of economic activities which are not land intensive. These corrective strategies are, of course, closely related to the reactive strategies, but since they are more ambitious, they have been less successful. Before reviewing these strategies we shall first describe the current demographic situation and its consequences.

1/ This chapter was prepared by Susan H. Cochrane. POPULATION PRESSURE

In the seventy years from 1897 to 1966 the Egyptian population approximately tripled. The growth rate, which was initially 1.5 percent annually at the beginning of this century, fell and then began rising rapidly after World War II, reaching a rate of approximately 2.5 percent in the early 1960s. The 1976 census gives a figure of 38.2 million Egyptians of which 36.7 million reside in Egypt and an estimated 1.4 million reside outside Egypt. The growth rate for the 1960-76 period depends on which figure is used in the calculation, but both the figures indicate that growth has slackened somewhat since the 1947-60 period. It is clear that emigration has increased substantially since 1973. This has tended to slow the growth rate of the resident population for the 1966-76 period. The growth rate of the de lure population has not shown the same trend, and, in fact, shows a slight increase in the period 1966-76 from 2.40 to 2.43 percent annually.

The size and growth rate of Egypt's population cannot be apprecia- ted without realizing the very limited amount of land that is habitable. Ninety-six percent of the land area is uninhabitable desert. This gave Egypt density rates in its habitable area of 2,671 per square mile (1,031 per square kilometer) in 1976. If Egypt had a highly developed modern sector, this high density would be a less serious constraint on living standards. Egypt's population, however, is still 56 percent rural and in terms of agricultural population per square kilometer of cropped area Egypt's density was 687 in 1975 compared with 289 for Japan and 107 for the Netherlands. The only countries whose agricultural density approaches that of Egypt are Bangladesh with 660, the Republic of Korea with 641 and Nepal with 586. These countries differ greatly in their living standards, but high density is a severe constraint on improving living standards. Ambitious plans to increase cropped area by 3.3 million feddans by the year 2000 seem overly optimistic since only 1.1 million feddans were reclaimed over the period 1951/53 to 1974/75 and most of this was added in the ten-year period between 1960/61 and 1969/70 after the completion of the Aswan High Dam. Therefore, additional land cannot be expected to relieve agricultural density substantially in the next 20 years.

This land scarcity has resulted in a substantial food deficit in recent years. Egypt has historically enjoyed the advantage of having very high yields in agriculture, and for the period 1890 to 1940 total agricultural production grew faster than population as a result of increased cropped area, increasing yields and a shift toward more valuable products. (Hansen and Wattleworth, 1978). 1/ From 1940 to 1968 population growth exceeded the growth of production in all years except two. This trend, plus a government commitment to maintain high levels of food consumption through subsidies, has led in the 1970s to very large increases in food imports. The subsidies and imports have enabled the per capita calorie consumption to increase substantially since 1960 despite decreasing output relative to population. Of the increased food consumption over the 1960-76 period, 51 percent resulted

1/ References cited will be found at the end of the chapter. - 3 - from increase in population, 35 percent from increases in calories and 14 percent from an interaction of the two (consumption by the added population at levels above what the 1960 population consumed). The major part of the increase in calorie consumption per capita has occurred in the post 1373 period. So food consumption increases between 1960 and 1976 were primarily the result of population growth, but the increase in food imports since i973 has been the result of increased consumption levels.

As a consequence of the high rates of natural increase and also the emigration of working-age adults, a high proportion (40 percent) of the population is under 15. The implications of rapid population growth are most evident in the growth of the school-age population. While the res;1er population increased by 41 percent between 1960 and 1976, the population - primary school age (6-11) increased by 70 percent. This has created onormous pressure on the primary school system and the creation of school places has barely kept up with the growth of children of primary age. As a consequence, the enrollment rate in primary school has remained constant at slightly over 70 percent in the period 1960-1976. 1/

Another consequence of the rapid population growth has been --he rapid growth in the population of working age (15-59). This grotip increesel 21 percent in the period. Because of emigration, this is not as large as could be expected given past growth in population. The working popuilat.eol has grown by 32 percent over the period.

THE DETERMINANTS OF POPULATION GROWTH

The causes of population increase in Egypt are hard to document precisely. Our data on natural increase (birth and death rates) are much better than our data on migration. It is only possible to estimate the number of Egyptians outside Egypt very imprecisely and it is impossible to determine tnr rates of migration in any year.

Fertility

The present (1977) fertility level of Egypt may be defined by tne following parameters: a crude birth rate of 40 per 1,000 population, a total fertility rate of about 5.0 per woman, and a total marital fertility of about 7.5 per woman. It is generally believed that Egyptian fertility has dec-lined substantially in recent years. This report supports this conclusion with some reservations. The total fertility rate of all women has declined by abouit I percent per year since 1960. However, the Egyptian planners can tav. !itt+e comfort from this trend because of conflicting trends in two other fertility indices.

The trend in population growth rate is more directly related to the trend in the crude birth rate than the trend in total fertility rate.

1/ Some estimates indicate it has actually fallen. - 4 -

The crude birth rate declined from about 43 in 1960 to 36 in 1972, but it rebounded and rose to 40 in 1977. Thus, at the end of the 1960-77 period, the birth rate was only marginally lower than in the beginning.

The marital fertility rate was characterized by an altogether different trend. Although the rate has declined substantially in Cairo and some other urban areas, it did not change much at the national level. The decreases which took place in Cairo, Alexandria, etc., were partly offset by increases in other governorates, particularly those in Upper Egypt. The lack of any significant decline at the national level is particularly disheartening in the context of a relatively long history of official interest in family planning programs and an apparently widespread use of contraceptives.

There are significant fertility differentials between geographic subregions and socioeconomic groups. The differentials have undergone some significant changes in recent years. Fertility is lower in Cairo, Alexandria, and the urban areas than in the other governorates. This was not the pattern in 1960; urban fertility was higher. Fertility is lower among the more educated. Over the past several years, fertility differentials by educational attainment have become more pronounced. Fertility declined among the educated women and increased among some of the illiterate women.

The main determinants of the recent trend in the crude birth rate have been changes in age composition, in age at marriage and, to some extent, in marital fertility. The overall trend was affected by changes in the proportion of women married and marital fertility, but the oscillation was caused by a similar oscillation in the number of women in the prime reproductive ages. Had there been no reduction in the proportion married, the crude birth rate in 1977 would have been higher than that in 1960.

Fertility trends and differentials were affected by changing age at marriage, contraceptive use and fecundity related variables. The proportion of married women has declined substantially between 1960-1976, causing a 14 percent decline in the total fertility rate at the national level. Family planning caused substantial fertility reduction in some governorates (27 percent reduction in Cairo) but fertility increases in other governorates wiped out those decreases, leaving the 1970-76 national marital fertility at the same level as that in 1960.

The change in fertility is not an indicator of the success or failure of a family planning program in Egypt or elsewhere. The Egyptian population is heterogeneous with respect to the stage of development in fertility transition. The population in Cairo and Alexandria has gone much further in its fertility transition than has the population in the other governorates, particularly those in Upper Egypt. During 1960-76 when the national marital fertility declined only marginally, that in Cairo and Alexandria declined substantially. If the 26 percent of the women who were reported to be using contraceptives were in fact not using contraceptives at all, Egyptian marital fertility would have shown a significant increase. This potential increase was prevented by the family planning program. Future increases in the proportion using contraceptives is likely to be more effectively reflected in marital fertility decline at the national level. -5-

Mortality

Mortality has been falling in Egypt over the last 30 years. In 1940, life expectancy at birth was 40 years. By 1975 it had increased to 55 years. But the decline has not been uniform over time, or across age, sex and socioeconomic groups.

Since 1960, the crude death rate has fallen by 31.5 percent; the infant mortality rate by 14.1 percent; the child death rate by 52.9 percent; and life expectancy has increased by almost 6 years. The mortality decline slowed in the period 1960 to 1965, but has since accelerated. The age pattern of mortality has also changed since 1960. At that time mortality rates for young children (ages 1-4) were abnormally high for a country at Egypt's level of life expectancy, but recent data for 1974/75 indicate that this is no longer the case, since child mortality rates have fallen much faster than either infant mortality or the crude death rate.

Mortality differs substantially by residence and socioeconomic status. It appears that Lower Egypt has the lowest mortality as measured by infant mortality, followed by the Urban Governorates with Upper Egypt having the highest mortality. Life expectancies in Lower and Urban Governorates are almost identical but that in Upper Egypt is about 11 years less. Child death rates vary substantially by urban and rural areas within the governorates of Upper and Lower Egypt. Child mortality is lowest in urban Lower Egypt followed by the Urban Governorates, then the rural areas of Lower Egypt. Child mortality in urban Upper Egypt is twice that of Urban Governorates, while in rural Upper Egypt it is three times as high.

While mortality trends and differentials can be documented, it is more difficult to determine the factors that have been responsible for these trends. The major unresolved analytical question is what proportion of the past decline has been the result of improved living standards and what proportion has resulted from improvements in preventive and curative medicine. The major unresolved policy question is to what extent mortality is kept relatively high as a result of low living standards and to what extent by lack of access to medical care. For the country as a whole, medical facilities per capita are far above the average for middle-income countries. Population per physician in Egypt is 1,190 compared to 2,826 in the average middle-income country and the population per hospital bed is 460 in Egypt compared with 571, but mortality as measured by infant mortality is 110 per 1,000 compared with 48 per 1,000 and child mortality is 19 per 1,000 compared with 8.6 per 1,000 in the average middle-income country. Therefore, Egypt has adequate numbers of health personnel and facilities, but has a relatively high level of mortality for its level of health inputs. The relatively poor health performance may result from problems of health delivery or from lack of health knowledge among the population, due to the relatively low literacy rate, particularly among rural women.

Natural increase has not shown a substantial adjustment to the high population pressure. It is possible that mortality levels are kept high relative to health facilities because of low living standards, but most of the demographic adjustment has been in the form of migration. This has only been a small part of the overall adjustment that is necessary, however. The mechanisms for coping with population pressure will be described in the next section.

REACTIVE STRATEGIES

The reactive strategies of food import, labor export and investment in higher education represent a combination of conscious and unconscious, governmental and personal responses to the economic and demographic situation.

Food Imports

Pressure of population on food supply has been averted by imports, but these cost $2 billion of foreign exchange in 1978. The proportion of calories imported grew from 11 percent in 1972/73 to 26 percent in 1977 and the proportion of proteins imported increased from 12 percent to 28 percent. By 1978, over three fourths of the wheat and wheat flour was imported. Thus the direct economic consequences of the commitment to cheap food combined with population growth faster than the growth of agricultural production have been substantial. Other indirect consequences exist as well. The series of price controls and output controls needed to keep food prices low, while not having farmers shift out of production, has led to substantial distortions in allocative efficiency and appears to have resulted in a transfer of resources from the rural to the urban population. (See Cuddihy, 1980) While there is no direct evidence on this, it is reasonable to expect that this has had the demographic consequence of encouraging more migration out of rural areas than might have occurred otherwise.

There may have been other demographic consequences of increasing caloric intake as well. Mortality rates have fallen substantially in recent years and improved nutritional status may have been an important cause. There also appears to have been an increase in natural fertility among the poorer portions of the population and this may have been in part a result of improved nutritional status.

While there is not direct evidence supporting the demographic consequences of the policies to maintain (and increase) consumption levels through food imports, one can fairly clearly see what the consequences of future demographic trends are likely to be for food imports. These consequences are traced out in the chapter on population and food.

In that chapter alternative assumptions are made about increases in population growth, consumption levels and yields. The analysis shows that if yields increase at 2 percent a year the land needed to meet food requirements will be 62 percent less than if yields remain constant. If the consumption of animal protein increases to the level of Latin America by the year 2000, the land needs under existing technology will be 40 percent larger than if consumption levels remain constant. If population grows at its most rapid rate, the land requirements for food needs will be 15 percent higher than if population growth slows substantially. If yields remain constant, the difference in land requirements between high and low population growth are sufficient to cancel out a 30 percent increase in cropped area by the year 2000. Only under the most optimistic assumptions, maximum increase of yields, minimum increases in population, constant consumption per capita and a 30 percent increase in cropped area (3.27 million feddans of cropped area) between now and the year 2000 could selfsufficiency in food be obtained. This possibility seems highly unlikely given that in the period 1951/53 to 1974/75 only 1.1 million feddans of cropped area were brought into production. If an attempt is made to increase the consumption of animal protein from its current low levels, it will be impossible even under the most optimistic assumptions to reduce the food deficit from the 1976 levels.

A policy of continued food imports particularly of animal products is not unreasonable if Egypt can develop a source of foreign exchange to pay for those imports. The ability to do so depends on how large the deficits are. The 1976 deficit of 3.3 million feddans 1/ was associated with a food and commodity import cost of $1.4 billion. The differences in deficits between highest and lowest population growth ranges between 2.1 million and 4.6 million feddans. Therefore at 1976 prices the approximate import cost difference of slow versus fast population growth in the year 2000 is between $.9 billion and $1.9 billion a year depending on what assumptions are made about yields, consumption levels and increases in land. Thus the course of population growt h will be quite important in determining the ability of Egypt to pay for its food imports.

The productivity per dollar or pound in solving the food problem through increasing yields, increasing land area and reducing population growth should be compared with the productivity of projects to increase export earnings to pay for continued food imports. While our information is not sufficient to make such precise calculations, it seems that programs to decrease population growth may well be under-funded relative to policies to increase land area. This issue will be discussed later in the section on corrective policies.

Labor Export

The import of food to relieve population pressure is in part the direct consequence of a government policy to subsidize food. The export of labor to relieve pressure is the result of private decisions to improve individual well-being and a government policy to permit such migration. The benefits of such decisions to the individual are therefore unquestionable. The benefits to Egypt as a whole are less certain.

1/ The number of feddans needed to feed the Egyptian population under various assumptions is discussed in Chapter VI. - 8 -

While an enormous amount has been written about the Egyptian migration (see Choucri et al., 1978, Choucri, 1979, Mohie El-Din and Omar, 1978, IBRD, 1979), there is little firm evidence about the volume and characteristics of the migrants and the estimates available vary substantially. The 1976 census reported 1.4 million Egyptians resident abroad, and indirect estimates of migration range from under one million to over two million Egyptians living abroad in 1976.

Other estimates of migration focus, not on total population abroad, but the number of workers outside Egypt. A Bank study of labor migration in the Middle East and North Africa gives an estimate of 298,000 Egyptian expatriate workers in the region in 1975. (IBRD, 1979) These estimates come from examining the censuses of labor importing countries in the regions and more recent data are not available. An MIT study has estimated the number of Egyptians working abroad in 1976 as 600,000 (Choucri et al., 1978), but this seems far too high given Bank estimates. All of these estimates however are subject to substantial error. While the volume of migration has increased substantially since the pre-1973 period and its economic impact has been substantial, its demographic impact is less certain.

Using an overall range of 1 to 2 million Egyptians outside Egypt and using current estimates of population growth in Egypt of 1 million added every 10 months, the number of Egyptians living outside Egypt amounts to at the most 20 months of natural increase if migration itself has no effect on the rate of natural increase. Since it seems unlikely that other countries will willingly absorb a substantially increase in the number of Egyptians abroad, it is unlikely that emigration can substantially reduce population growth in the future. Therefore the impact it has on reducing population pressure at the aggregate as opposed to the individual level must be through its economic effects.

The most obvious economic consequence of the migration is the increased availability of foreign exchange that results from workers remittances. While the exact magnitude of these flows is unknown it can be estimated from the "other private services" portion of the balance of payments. This category has increased from a net figure of $58 million in 1969 (7.9 percent of exports and 6.6 percent of imports) to $514 million in 1977 (25.8 percent of exports and 12.6 percent of imports) [Pennisi, 1980, Table VIII-1]. Alternative calculations which include own exchange imports gives much larger figures $1425 million in 1977 (66 percent of exports and 27 percent of imports) [Pennisi, 1980, Table VIII-2]. Even using the most generous of the estimates for remittances, they would not cover the costs of food and commodity imports in 1977 which was $1.8 billion.

The economic and demographic impact depends on the characteristics of the migrants as well as their number. It is clear that the most educated are over represented in the labor force working outside Egypt, but unskilled labor has migrated in substantial numbers as well. Seven percent of those working abroad have professional, managerial, technical and administrative jobs. This compares with three percent of the resident male population with - 9 - college certificates. At the lower levels of clerical, sales and service the proportion of those working abroad is not much greater than the proportionof male resident populationwith primary and secondarycertificates. At the lower levels of skill it is difficult to compare the migrant workers with resident population.There is strong evidence that the migration of workers from agricultureand constructionhas been substantial,but as with other data, the estimates of its impact vary. Using Ministry of Planning figures, wages in these two sectors appear to have increased slightly over 52 percent between 1974 and 1978 compared to an increase in services of 20 percent (Chouci, et al., 1978, 48). It is unclear whether these figures represent increases in real wages or money wages. Other data on average daily money wage rates for rural governoratesgive a somewhat different picture.

The data from the Ministry of Agricultureshows that over the 1974 to 1978 period male wages in rural Egypt rose 150 percent and the wages of females and children increased 165 percent. This is substantiallyabove the figures given by Choucri for agriculture.(Choucri, et al., 1978, p.48) 1/ It is difficult to judge how much of this increase is the result of inflation. Mohie El Din estimatesan increase in prices in the rural areas of about 18 percent a year since 1973 (officialfigures give 12 percent). (Mohie El-Din, 1979) The real increase over the period was 29.1 percent for males and 36.5 for non-males using the 18 percent rate of inflationand 59.5 and 67.6 respectively using the 12 percent annual rate of inflation. Thus both the Ministry of Planning and the Ministry of Agriculture estimates indicate substantial real increases in agriculturalwages since the period of the opening up of the Egyptian economy in 1973.

The increases in agriculturalwages have not been uniform throughout Egypt or between male and non-male labor. For males the increaseshave been highest in the two governoratesclosest to Cairo (Giza and Qaliubiya). These real increasesaveraged 36 or 68 percent depending on which rate of inflation is used. Increases in the Lower and the rest of Upper Egypt were quite similar for males (28 or 58 percent depending on the rate of price increasesused). For non-males the picture is quite different. Real wage increaseswere almost identical for non-males in Lower Egypt and Giza and Qaliubiya (21 in both using 18 percent, or 50 and 41 respectivelyusing 12 percent, inflationrates). For the rest of Upper Egypt the rate of increase for non-male wages was between 64 and 103 percent depending on the inflation rate. The fact that male and non-male wages have not moved together throughout Egypt is rather surprisingand the causal factors cannot be determined without much more data on the migration of males and non-males. But what is clear is that emigrationmay well have resulted in substantialincreases in the wages of the poorest participantsin the labor force. The fact that non-male wages rose even more than male wages may have resulted from decreases in supply as a result of an income effect as well as increase in demand as a result of substitutionof non-males for males. For the moment these questions must remain unansweredwith existing data.

1/ Levels of wages seem to be lower in the Ministry of Agriculture figures but the rates of increase much higher. - 10 -

One question that can tentatively be addressed is whether the movement or differentials in the wages in non-male wages could explain the low level of participation in primary education, particularly in Upper Egypt. This is a question we shall address in our discussion of the educational strategy.

Educational Strategy

The government of Egypt has made a strong commitment to educational development since the 1952 revolution. The form this development has taken, however, has often been, not the result of careful planning, but the reaction, passive and active, to demographic and political pressures. Currently Egypt spends approximately 5 percent of its gross domestic product on education which is quite high relative to its level of per capita income.

The allocation of these expenditures reflects the political pressures exerted on the government to provide the urban, middle class with opportunities for secondary and higher education as well as conscious policies to support technical education as a strategy for development. The pressures for high expenditures at secondary and higher levels of education have not been counterbalanced by political pressures to expand primary education. Therefore expenditures on primary education are below the proportion usually found in developing countries while expenditures at higher levels are above average and the rural population has substantially lower participation in all levels of education.

The low proportion of expenditure going to primary education combined with fairly rapid population growth has meant that the growth in primary school places has barely kept up with the growth of children of primary ages and at some times the growth of school places has fallen behind. As a consequence the enrollment rate has remained practically stationary over the 1960 to 1978 period at about 72 percent (and using some population estimates, enrollment rates may have actually fallen). Illiteracy rates have fallen somewhat over the period, however, from 70 percent in 1960 to 57 percent in 1976 and this is perhaps attributable to a greater tendency of those who enter primary school to eventually finish it, but there is only very indirect evidence on this trend.

The low primary enrollments are a problem of low female enrollments. Over 85 percent of males of primary age are enrolled in school but only about 56 percent of the girls in the age group are enrolled. This is lower than the average primary enrollment rate for girls in other Middle Eastern and North African countries, 68 percent, and of the middle income countries, 81 percent. In addition there appears to have been only a slight improvement in the enrollment of girls in primary school in the 1960 to 1977 period. The proportion of primary students who are female has only increased from 37 percent to 39 percent.

It is difficult to say conclusively that low primary and low female primary enrollments are the result of lack of supply of school places rather - 11 - than a lack of demand for schooling. However, most of the time series and cross sectionalevidence indicates that enrollment rates are highly correlated with the availabilityof school places. To a somewhat lesser extent, this is also true for female enrollment. The only exception appears to be rural Upper Egypt. There enrollment rates and class sizes are below the Egyptian norm for the availabilityof school places. Whether this results from a lack of demand or from a failure of the statistics on school places to reflect accurately the true availabilityof education because of teacher absenteeismor geographic distributionof school places is unclear. The importance of teacher absenteeism in causing dropouts has been suggested in the preliminaryanalysis of a study of Egyptian primary education. (Chaibderraine,1978) There does not appear to be a scarcity of primary teachers for Egypt as a whole since there are more primary teachers on the payroll than primary classrooms. This is manifest in the double shifting of classrooms,but not of teachers. There may, however, be problems of teacher quality as manifest in lack of motivation (absenteeism)and perhaps a mismatch of teacher and pupil characteristics: a scarcity of female teacher affecting and affected by low female enrollment and incompatibilitybetween students and teachers from different regions of Egypt - perhaps due to problems of dialect. There may well be a scarcity of teachers in the future as the school age population increases and enrollment rates rise.

There are importantregional differentialsin participationin primary educationas well as urban-ruraldifferentials. Primary enrollment in Lower Egypt is substantiallyhigher than in Upper Egypt. The differentials are even larger between the rural areas of Upper and Lower Egypt (53 and 68 percent respectively). While the availabilityof school places explains a major portion of the differentialsin enrollment in rural areas, it does not appear to explain all the difference. Data on rural wages are suggestive, however. While both male and non-male (women and children)wages in the rural sectors are positively related to enrollment rates, the higher non-male wages are relative to male wages, the lower primary school enrollment rates. Thus it may be that while the most importantvariable explaining enrollments in rural areas is the number of school places per capita, the scarcity of child labor relative to adult labor in agriculturehas a significanteffect on keeping enrollmentslow in some rural areas.

The economic and demographicconsequence of stagnationof primary enrollmentsvary for males and females. As shown above even the most illiterate workers have presumably benefited from the export of unskilled labor abroad. However, this is the group that is most vulnerable to replacement in the labor importingMiddle Eastern countries. At the unskilled level there is a growing tendency to import Asian labor and in fact to import entire teams of labor and management from East Asia. These labor imports in the Middle East will seriously jeopadize the export of unskilledEgyptian labor.

The lack of literacy probably keeps women from participatingmore actively in the labor force, particularlyin non-manual occupations. The greatest effects of high female illiteracy,however, appear to be demographic. Female illiteracy directly and indirectly (through low female participation in modern sector jobs and high child mortality) keeps fertilityhigh. - 12 -

Women with primary education want a half a child less than women who did not go to school, and women with preparatory school desire one less child than the uneducated. Differences in contraceptive behavior between women of different educational levels are even greater. Twenty six percent of those with no schooling have used contraceptives, compared with 53 percent of those with primary and 69 percent of those with preparatory education. Age standardized numbers of children actually born, however, shows that women with some schooling have slightly higher fertility than those without education, but those with preparatory education have half a child less. This relationship will be explained in greater detail in the last section of this paper where we discuss policies to reduce fertility.

It also appears that illiterate women have lower survival rates for their children. While detailed data are not available for Egypt, studies of a wide variety of countries show that for every additional year of schooling a mother has, 9 per 1000 fewer infants and children die. (Cochrane, et al., 1980) High child mortality is, of course, one reason that fertility must remain very high to achieve desired family sizes.

Because of the current rate of population growth, improvements in primary enrollments will require more investment in primary education than planned. In the 1978-82 Development Plan 600 new schools are scheduled for construction. At 10 classes per school, this represents only 90 percent of the additional schools needed to maintain constant enrollments between now and 1982 given the number of children that have already been born. Attempts to achieve increases in enrollment will not be possible unless more than the planned schools are built.

In the long run, the trend in fertility will make an enormous difference in the number of schools that will be needed at the primary level and to a lesser extent at the preparatory level. By the year 2000 the number of classes needed to just maintain current enrollments under the highest growth rate would be more than enough to obtain universal primary enrollment under the lowest assumed rate of population growth.

At the other end of the educational spectrum achievement is much higher in Egypt than is true of comparable countries. Once the examinations at the end of primary school are passed a very high proportion of students (male and female) go on to preparatory, secondary and higher education. Over 20 percent of the male population (12 percent female) have certificates below university and over 3 percent of the males (1 percent females) have college education or above.

As a consequence of the high level of investment in post primary education there are relatively large numbers of professional personnel per capita. This is manifest in the high ratio of doctors and nurses per capita and, in general, in a high number of white collar workers relative to blue collar workers. The consequences of this distribution have been complex and have manifested themselves in numerous ways, but detailed data on this phenomena are hard to obtain. The most straightforward manifestation is the - 13 - export of highly skilled personnel. This is a pattern that existed to a considerable extent even before the opening up of the Egyptian economy in 1973. Given the language advantage, Egyptian professional and technical expatriate workers have had a fairly firm monopoly position in the Arab world. However, as the education systems in those countries have expanded, these are now pressures to replace Egyptian professionals and technicians with locals. This seems a trend that is inevitably likely to continue.

Domestically, the consequences of a high rate of expansion of higher education have been quite serious. Political pressures have resulted in a situation in which every college graduate is guaranteed a job in the government sector. While it appeared that there was a movement away from this policy and a short period in which is was suspended, it has now been reinstituted. The nepd to employ so many graduates on a limited budget has resulted in a system of relatively low paying civil service jobs with high job security. The system approaches a system of sinecure. The motivation to work well is very low and the need to supplement the low salary by outside employment is quite high. Without extremely conscientious and careful management such a system would quickly degenerate into one where incentives have to be paid to get any task done by the civil servants combined with a high degree of absenteeism on the part of workers who are supplementing their income with second and third jobs. With a few exceptions in well managed segments of the Egyptian government this is what has happened.

The problem of teacher absenteeism mentioned earlier is only one manifestation of this problem. The failure of doctors to spend time at their assigned rural clincs in order to serve a private practice in urban areas is another manifestation of the same problem. It is widely believe that this is the cause of the high mortality and low utilization of health facilities despite apparently high levels of medical personnel and clinics per capita. Again the evidence is that, as with primary education, utilization is lowest and mortality is highest in rural Upper Egypt despite higher numbers of clinics per capita. Whether this results from a lack of demand for health services on the part of the rural Upper Egyptian population or the greater absenteeism by medical personnel in the region is unclear. Whatever the cause is, however, the large investment in higher education - particularly medical education, is not being equally shared by the urban and rural population as evidenced by lower enrollment primary rates and higher mortality.

Therefore there are demographic as well as economic consequences of the expansion of higher education at the expense of lower levels of education. Mortality is kept high and it seems quite possible that fertility is kept high as well.

STRATEGIES TO CONTROL POPULATION PRESSURE

The strategies described above to cope with the problems of high density have been fairly successful -- at least in the case of the food import - 14 - and labor export strategies, but at some cost. The long term viability of the strategies are uncertain, however. The educational strategies of individuals and the government have had mixed results. There is undoubtedly a large pool of well educated manpower available to Egypt, but it is unclear to what extent this can be utilized effectively to the benefits of all segments of the population and the cost of this high quality manpower has been the slow progress made in the lowest levels of education, especially for women. This in turn has had the demographic consequence of keeping fertility high and maintaining population pressure.

Demographic pressure can be relieved by slowing population growth through reducing fertility or increasing emigration. Alternatively, it can be eased by increasing the availability of land or diversifying the economy out of agriculture into other non-land intensive economic activities.

The success with economic diversity has been slow. In the late 1970s, 51 percent of the labor force and 29 percent of output were in agriculture. This compares with 58 and 30 respectively in 1960. While there is undoubtedly potential for development in this direction, we shall not concentrate on these policies here, but refer the reader to the basic economic report. (IBRD, 1978).

Land Expansion

The policy of the expansion of land area has been a slow and expensive one. While there is little information readily available, the estimates of the cost of increasing land area by one feddan in 1975 ranged from LE 600 to LE 1,000 and between LE 1,150 and LE 1,500 in 1980. It is estimated that to bring a new feddan to the point at which it can cover current cost takes 15 years. To bring it to full production takes even longer.

The 1978-82 Development Plan proposes that 2.5 million feddans be brought into production by the year 2000. At our estimates of cost per feddan this would represent between LE 1.5 and LE 2.5 billion or between $2.2 and $3.6 billion in 1976 prices. The effect of this new agricultural land on population pressure depends on whether or not the land could be double cropped by the year 2000.

The feasibility of the planned increment in agricultural land is difficult to evaluate. However, in the entire period between 1952/53 and 1974/75 and 0.9 million feddans were reclaimed, but due to various losses this gives a net figure of 0.7 million and the cropped area increased by 1.1 million. This was the period in which the Aswan Dam was opened. It is also estimated that the new lands brought into production since the High Dam contribute only about 5 percent to the agricultural output of Egypt in 1980. Thus it seems highly unlikely that the new land strategy can substantially reduce population pressure given past experience and the fact that it has been found that "Instead of the 3 to 5 years initially planned, the reclamation authorities have experienced a period of about 15 years of capital absorption before earning enough to even cover operating expenses." (World Bank, 1978, p. 47.) - 15 -

The probable impact of bringing land into production is best seen by examining the number of feddans of cropped area needed per person. This figure would have been 0.4 in 1976 if there had been no food imports. The highest estimate of population growth would require an additional 11.8 million feddans cropped area while the slowest feasible population growth rate would require 8.3 million additional feddans. Therefore, slowing population growth from the fastest to slowest rate would result in a larger "land savings" than would the planned increase in agricultural land unless it could be double cropped by the year 2000 which seems highly unlikely given the long time lags involved. While all these figures are highly speculative, they nevertheless indicate that the cost of policies to reduce population growth should be considered in comparison with the costs and feasibility of bringing new land into production. Given the magnitude of the population pressure, Egypt needs to pursue policies of both increasing land and reducing population pressure.

Fertility and Family Planning

The determinants of fertility are quite complex in any environment and Egypt is particularly difficulty to analyze because of the great diversity between urban and rural areas, Upper and Lower Egypt. The composite picture must be briefly described before one can discuss what policies might be useful for reducing fertility. While female education and family planning programs seem the most obvious policy instruments to use in the Egyptian context, the effects of these variables on fertility in Egypt are not uniform. Female employment is often considered a policy to reduce fertility but the evidence of its effectiveness is less clear than for education both in Egypt and elsewhere. More research is needed on its policy potential. It appears in Egypt that fertility increases slightly with small amounts of education. It also appears that at low levels of density of health services that increases in health services per woman and (since family planning units are associated with health units) increase in family planning services are associated with increases in fertility. Evidence from Egypt and from a large number of developing countries indicate that these increases in fertility are offset at higher intensity of family planning efforts by reduction in fertility. In addition it appears that these increases in fertility such as have occurred in rural Egypt in recent years are the result of improvements in health resulting from higher incomes and therefore would occur in the course of development regardless of the family planning program.

The reason for this is that in the course of development several factors are operating to change fertility. First, at low levels of development, the desire for children is often higher than the number of children that parents can have, given their own poor health and the high mortality of their children. Therefore parents are not favorably disposed toward contraceptives since they want additional children. This can be referred to as stage I. As development proceeds fertility may rise as health improves, but as fertility increases other forces are also operating which lower the demand for children so that in stage II fertility begins to exceed desired family size. However, due to the monetary and psychological costs of using contraception, parents do not use birth control despite excess fertility. Once the costs of fertility control fall and excess fertility increases, people begin to adopt contraceptives. This is stage III. In stage IV contraceptive costs become so low - 16 - that people regulate fertility perfectly and have only the number of children they desire. A policy to reduce fertility would be one that reduced the demand for children so that fewer people are in stage I and lower the cost of fertility regulation so that the lag in adopting contraception and the amount of excess fertility are minimized.

Various groups of people in Egypt are at different stages in the process. The major differences are between urban and rural areas, but within rural areas there are also differences between Upper and Lower Egypt. Within geographical groupings there are also differences among socio-economic groups. The rural-urban differences in stage of transition can explain to some extent why marital fertility was falling in urban Egypt between 1972 and 1977 while it was rising in rural areas, particularly in Upper Egypt.

The proportion of women who do not want additional children varies greatly by region. Since women who want no more children are the most likely to adopt contraceptives, it is therefore to be expected that the success of family planning programs (as traditionally defined) will vary by region. Urban areas are in stage III and in 1975 over 50 percent of the women wanted no more children (67 percent in Cairo and Alexandria) and most of these women are doing something about it. Fifty-three percent of the women in Cairo and Alexandria were using contraceptives (43 percent in urban Lower Egypt and 34 percent in urban Upper Egypt). In rural areas we find big differences between Lower and Upper Egypt: in the former, 42 percent of the women wanted no more children in 1975 and 19 percent of them were using contraceptives: in the latter, only 21 percent did not want any additional children, and only 6 percent were using contraceptives. This shows some potential for increased usage if husbands agree with their wives about additional children, but the potential is not unlimited.

The implication of this model is that as fertility increases due to improved living standards, and as desired family size falls as women obtain more education and as more children survive, more women will move into stage II. In addition, as the cost of contraceptives is reduced by improved access those who are in stage II will increasingly adopt family planning. Thus education and family planning play roles at different stages in the transition.

The complex situation in Egypt explains why there has been so much debate on the appropriate direction of family planning programs. In the donor community there is a perception that the direction of policy has shifted several times. From 1966 to 1972 the program was focused on increasing access to family planning. But in 1972 the slow progress in adoption led to a shift towards an emphasis on development to reduce desired family size. In 1975 the direction shifted again to one of a balance of family planning access and development. Clearly a balance is needed, because some parts of Egypt are in stage I where they will be unlikely to use contraceptive regardless of how accessible, while other groups are in stage II and III where increased access will increase usage and lower fertility.

Pursuing development and increasing access are not simple matters. Despite a great deal of discussion about stimulating economic and social - 17 - development to reduce desired family size, female education is seldom mentioned by the Family Planning Board. Although many Egyptian demographers have emphasized the role of education, the Board has given more attention to female employment. The main reason for this is probably that it is perceived as being a very long run strategy. If education is considered in the context of land reclaimation, however, the time period does not seem unreasonable. As mentioned earlier, it takes 15 years for a feddan of reclaimed land to begin to cover current cost. For education, 15 years after a six year old enters school a 21 year old woman is already well into her potential child bearing years. Part of education-s effect on fertility is to lead to later marriage and thus slowing population growth through postponing the first birth as well as reducing births over the entire reproductive life. We do not have data for the relationship between education and age of marriage in Egypt so we cannot quantify this first effect.

We do have data on children ever born adjusted for the age of the woman or marital duration. These data, of course, reflects both the positive (transitory) effects of education on health and higher natural fertility and the negative effects of education on the desire for children and contraceptive knowledge. These data show that for Egypt as a whole women with no schooling and those with education up through primary school have about the same fertility, about four children. Women who have had preparatory school have a half to 7/lOths fewer children than those less educated women. The pattern differs in urban and rural areas with education having a stronger negative impact in urban areas. The negative impact of education increases with marital duration and the figures above reflect the average for all women. After 10 years of marriage women with even the smallest amount of education have lower fertility than those with no schooling (3.94 versus 4.62 children for the uneducated). Between marital durations of 10 and 20 years there is a difference of approximately one child between those with no school and those with preparatory school (3.68 versus 4.62 for the uneducated). For marital durations of 20-29 years the difference is one and a half (4.8 versus 6.28 for the uneducated). While this cross sectional data is not a perfect predictor of changes over time, it is highly suggestive.

Perhaps even more suggestive of the possible future relationship between fertility and education is the relationship between desired family size and education. This shows big changes between 1974 and 1975 from an average for uneducated women of 4.7 to an average of 4.4. The relationship shows in both years that women with primary education want at least half a child less than women with no schooling. Women with preparatory school want about one child less (0.9 in 1974 and 1.4 in 1975). Women with secondary school want 1.8 fewer children and university graduates want over 2 children fewer than the unschooled.

The policy implication depends, then, on whether one looks at the positive and negative effects of education or just the negative effects. If one believes that the positive effects are transitory or will occur in the course of development regardless of education, then one should focus on the relationship between desired fertility and education. A more conservative position would examine the relationship between education and actual fertility. Therefore the range of possible effects of primary education on - 18 - fertility, are between zero and half a child for the women of average age who has had 4 children. For preparatory education the effect is between a half a child and one (or one and a half for long marital durations). This impact needs to be compared with the cost of education.

The cost of educating a child for 6 years of primary school was approximately LE 120 in recurrent cost in 1976. For 3 years of preparatory school the recurrent cost was LE 81. Capital cost are difficult to estimate. Estimates from Ministry of Education plans for 1980-84 give cost per primary school place of between LE 160 and LE 215, but to make them comparable to 1976 figures these would have to be discounted by the rate of inflation. This would give a figure of 103 to 138. However, all of this capital cost for a school place cannot be attributed to one child unless the productive life of the school place is only 6 years. If it is 10 years the figure should be between 62 and 83. If the period over which it would totally depreciate is 20 years then the capital cost per student would be between 31 and 41. An alternative estimate of the capital cost per student can be obtained by observing for the early 1970s the change in school places associated with capital expenditures. For 1973-74 this figure was LE 56 while in 1976-77 the figure was LE 35. While these techniques do not permit precise estimates of costs of educating a child through primary school, they indicate that in 1976, the figure was not above LE 200 (120 of which is recurrent).

Similar estimation for preparatory school indicates that capital cost between LE 15 and LE 30. Therefore, the 3 year preparatory cycle would cost slightly over LE 100 of which LE 81 is recurrent. This would give a cost of 9 year cycle of about LE 300.

Therefore for the cost of LE 200 for educating a girl through primary school the population impact would range from no change in fertility to a reduction in half a child for the women of average age and 4 children. For LE 300, the population impact would range from 1/2 to one children for women of average age and 1.5 for women later in childbearing. It is clear from this that the marginal population payoff of preparatory education is higher than that at primary school. This impact can be compared to the cost of bringing a new feddan into production which has been estimated to be between LE 600 and LE 1000 in 1976. (In addition to Bank estimates see U.S. Department of Agriculture, 1976, page 37.) Figures for 1980 on land reclamation are between 2,000 and 4,000 LE per feddan for land development and cost for settlement on the land. Discounting to 1976 would give estimates substantially above the figures used here. Thus one new feddan reclaimed does not necessarily payoff any faster than female education and in 1976 prices it costs between 2 and 3.3 times more than educating a child through preparatory school and between 3 and 5 times more than primary school. One feddan of cropped area in 1976 fed approximately 2.5 people. The new feddan's impact would depend on whether it was single or double cropped, just as education-s impact depends on whether differential actual fertility or differential desired fertility is used to estimate its impact. Clearly single cropping at the high cost figure is less effective in reducing population pressure on land than preparatory education for women using the middle range estimate of 1 child fewer for preparatory education than for no education (3.3 fewer people for education and carry capacity for 2.5 more people for land development.) - 19 -

Primary education alone can only compare with new land production if new land is estimated at the higher cost and the fertility impact of primary schooling is at its maximum estimate of 1/2 child. While these figures are highly imprecise they give the magnitude of the relevant comparisons. If anything they overestimate the benefits of new land since only land needs for agriculture are taken into account. If land area for living space is included, the "carrying capacity" of new land would have to be reduced.

The effect of education in reducing population pressure relative to the effect of land reclamation depends on whether actual or desired fertility is used. The theory outlined above suggests that which estimate is more realistic depends on the accessibility of family planning. If family planning were both economically and psychologically costless, the impact of education would be greater. While education alone helps reduce psychological cost, a well designed family planning program by minimizing economic cost would reduce excess fertility and increase usage.

The data available to evaluate the impact of the Egyptian family program are insufficient to enable one to come to firm conclusions. It does appear that in recent years the highly motivated urban population has moved away from family planning clinics as a source of supply and has begun to obtain pills increasingly from pharmacies. Recent government policies to reduce the price of pill cycles from pharmacies from 25 to 5 piasters may have some effect on increasing usage among the poorest portions of the urban population, but the price elasticity of demand for contraceptives in this low range is unknown.

In rural areas, there has been increased acceptance of contraceptives from clinics, but whether this is the result of improved reporting or actual increased acceptance is unclear. It should be noted that in urban areas efficiency in reporting on contraceptive usage has deteriorated, while in rural areas it has improved.

What is clear from the data is that the number of clinics alone does not have the effect on birth rates that one would expect. Part of the reason for this is that improvements in health brought about by clinics has a positive impact on fertility in very poor areas. Only with higher density of clinics does the impact on fertility become negative. This fertility increasing effect, however, is the result of the process of development itself and should not be attributed to the clinics per se.

Changes in fertility over recent years seem to be more a function of the efficiency of family planning clinics than their number. While it is easy to point to inefficiencies in the family planning program, it is difficult to obtain data which gives enough detail to quantify either the cost or benefit of improved efficiency. However, some of the more obvious problems in the family planning program have been recognized and are being corrected through programs such as the rural pioneers and household-based versus clinic- based programs. - 20 -

SUMMARY AND CONCLUSIONS

While there are many puzzles remaining with respect to the population and human resource situation in Egypt, several things are clear:

(1) Food imports are playing an increasing role in reducing population pressure in Egypt, but the long-run viability of this strategy depends on the ability to pay for imports either from remittances or increased exports.

(2) Labor emigration has provided an escape from individual poverty for those who have left Egypt, but for the economy as a whole remittance cannot even cover the cost of food imports much less the other costs of population pressure. The possibilities for increased volumes of emigration seem limited and it cannot be a long-run solution to the population problem.

(3) The attempt to substitute human capital in the form of higher education for non-human capital has had very mixed blessings for the Egyptian population. The more educated have individually benefited in some instances through migration and in many instances through job security in the civil service and outside incomes in second jobs. But the consequence of the pattern has been that the poorest groups have been deprived of primary education in many instances and have not had the benefit of many of the higher skilled people such as doctors and teachers who often neglect their government jobs.

It is impossible to examine the whole range of policy choices open to Egypt for ameliorating the effects of increased population growth. What seems clear, however, is that education at the primary and also at the preparatory education level has been under-funded.

The family planning program has shown very mixed success. This appears to result from the fact that there are inefficiencies in the program and a lack of access to clinics that has kept contraceptive use lower than might have the case under a better system, but it is also a result of the different stages of demographic transition in different parts of Egypt. In urban areas where the demand for contraceptives is high, private sources have become increasingly utilized and in cognizance of this the government is reducing the price of contraceptives available through pharmacies (and hopefully not reducing the incentive for pharmacies to distribute pills).

In rural areas the slow progress in increasing contraceptive usage is not surprising given the stage of demographic transition in these areas, particularly in rural Upper Egypt where few people have more children than they want. There was evidence of some unmet demand for contraceptives in rural areas in the 1974/75 fertility survey and since that period acceptance - 21 - rates from rural clinics appear to have increased. The data is not sufficient to determine if this is a real as an apparent increase. When the 1980 Egyptian Fertilitysurvey data are availablea number of these questionscan be more satisfactorilyanswered.

Thus while many questions are unanswered about the population and human resources in Egypt, this report provides a basis for understanding the situation and a starting point for further analysis when more data becomes available from the 1976 census,various labor force surveys, the education retention study and the Egyptian Fertility Survey. - 22 -

REFERENCES

Chaibderraine, M. "Educational Wastage at the Primary Level." Linkoping Studies on Education. Dissertation No. 9, 1978.

Choucri, Nazli. "Labor Transfers in the Arab World: Growing Interde- pendence in the Construction Sector." Massachusetts Institute of Technology, 1979.

Choucr., Nazli, Richard S. Eckaus and Amr Mohie El-Din. "Migration and Employment in the Construction Sector: Critical Factors in Egyptian Development." Cairo University/Massachusetts Institute of Technology, Technology Adaptation Program, 1978.

Cochrane, Susan H., Donald S. O'Hara and Joanne Leslie. "The Effects of Education on Health." World Bank Staff Working Paper No. 405, July 1980.

Cuddihy, William. "Agricultural Price Management in Egypt." World Bank Staff Working Paper No. 388, April 1980.

Hansen, Bent and Michael Wattleworth. "Agricultural Output and Consumption of Basic Foods in Egypt, 1886/87-1967/68." International Journal of Middle East Studies 9(1978), pp. 449-469.

Kutcher, Gary P. "Master Plan for Water Resources Development and Use: The Agro Economic Model." Technical Report 16. UNDP-EGY/73/024, May 1980.

Mohie El-Din, Amr. "Rural Employment Problems in Egypt: Questions to be Answered." Cairo University, 1979. Unpublished.

Mohie El-Din, Amr and Ahmed Omar. "The Emigration of Universities Academic Staff." Prepared for the Project on Egyptian Labor Migration, Cairo University/MIT Technology Planning Program, July 1978.

Pennisi, Giuseppe. "Development Manpower and Migration in the Red Sea Region: The Case for Cooperation." Red Sea Project, RS/1980, Rome, May 1980. Preliminary Draft.

U.S. Department of Agriculture. Egypt: Major Constraints to Increasing Agricultural Productivity. Foreign Agricultural Economic Report No. 120, Washington, D.C., June 1976.

World Bank. Arab Republic of Egypt: Economic Management in a Period of Transition, Vols. I and III. Report No. 1815-EGT, May 1978.

World Bank. "Interim Report: Assessment of Migration Situation in 1975 and Preliminary Projections of Labor Importing Country Manpower Requirements to 1985." Research Project on Labor Migration and Manpower in the Middle East and North Africa, December 1979. - 23 -

SOME ISSUES IN POPULATION AND HUMAN RESOURCE DEVELOPMENT IN EGYPT

CHAPTER II

FERTILITY AND FAMILY PLANNING IN EGYPT RECENT TRENDS AND DETERMINANTS 1/

SUMMARY

The replenishment and augmentation of the Egyptian population is a dynamic process with crucial implications for educational development, economic growth, and labor force characteristics. This chapter accordingly sets the following chapters in a demographic context by investigating fertility level and trends, and fertility differentials and their determinants. It pays particular attention to the Egyptian family planning program.

What parameters define the fertility level of the Egyptian population? Three of them may be defined using a 1977 data base: a crude birth rate of 40; a total fertility rate of about 5.0; and a total marital fertility rate of about 7.5. It is generally believed that the Egyptian fertility has declined substantially in recent years. This analysis supports this conclusion with some reservations. The total fertility rate of all women has declined by about 1 percent per year since 1960. The Egyptian planners can take little comfort from this trend, however, because of a conflicting trend in two other fertility indices.

The trend in the population growth rate is more directly related to the trend in the crude birth rate than the trend in the total fertility rate. Although the crude birth rate declined from about 43 in 1960 to 36 in 1972, it recovered and rose to 40 in 1977. Thus, at the end of the 1960 to 1977 period, the birth rate was only marginally lower than it was in the beginning.

The marital fertility rate was characterized by an altogether different trend. Although the rate has declined substantially in Cairo and some other urban areas, it did not change more than 2 to 4 percent at the national level during the 1960 to 1976 period. The decreases which took place in Cairo, Alexandria, etc., were partly offset by increases in other governorates, particularly those in Upper Egypt. The lack of any significant decline at the national level is particularly disheartening in the context of a relatively long history of official interest in family planning programs (budgetary support being provided from 1965) and an apparently widespread use of contraceptives.

There are also significant fertility differentials between geographic subregions and socioeconomic groups. The differentials have undergone some

1/ This chapter was prepared by K.C. Zachariah. - 24 - significant changes in recent years. Fertility is lower in Cairo, Alexandria, and the urban areas in the other governorates; this was not the pattern in 1960 when urban fertility was higher. Fertility is lower among more educated women, and in recent years fertility differentials by educational attainment have become more pronounced. Fertility declined among the educated women and increased among some of the illiterate women.

The main determinants of the recent trend in the crude birth rate have been changes in age composition, in the age of women at first marriage, and, to some extent, in marital fertility. The overall trend was affected by changes in the proportion of women married and in marital fertility, but the oscillation was caused by a similar oscillation in the number of women in the prime reproductive ages. Had there been no reduction in the proportion married, the crude birth rate in 1977 would have been higher than that in 1960.

The fertility trend and differentials were affected by changing age at marriage, by contraceptive use, and by fecundity related variables. The proportion of married women declined substantially between 1960 and 1975, causing a 14 percent decline in the total fertility rate at the national level. Family planning caused substantial fertility reduction in some governorates (a 27 percent reduction in Cairo) but fecundity increases in other governorates wiped out those decreases, leaving the 1970 to 1975 national marital fertility rate at the same level as that in 1960.

The absence of a significant decline in marital fertility at the national level does not imply that the Egyptian family planning program was a complete failure. Egyptian population is heterogeneous with respect to the stage of development in fertility transition, and the population in Cairo and Alexandria has gone much further in its fertility transition than the population in the other governorates, particularly those in Upper Egypt. During the 1960 to 1975 period when the national marital fertility remained constant, that in Cairo and Alexandria declined substantially. If the 26 percent of the women who were reported to be using contraceptives were in fact not using contraceptives at all, then Egyptian marital fertility would have shown a significant increase. This potential increase was prevented by the family planning program. Now that much of the potential increase has already materialized, future increases in the family planning user rate are likely to be more effectively reflected in a decline in martial fertility at the national level.

The preceding paragraphs have attempted to capture the essentials of the discussion that follows. After a brief introduction identifying its point of departure, the analysis sets out the main features of the 1977 fertility level and associated trends, and then focuses on the impact of age-sex composition; marital status; emigration; completeness of birth registration; and martial fertility. The following section then addresses geographical distribution and maternal education as differentials of fertility and examines determining factors by assessing the proportion of the population married, the use of contraceptives, and specific fertility trends in - 25 -

Cairo. The chapter ends by assessing future fertility,and is supported by an appendix that examines in more detail the developmentand impact of the family planning program.

The main data sources drawn on for the discussion are the Census of 1960, the fertilitysurvey of 1974-75,results where available of the November 1976 Census, and other statisticalseries and sources listed in the references at the end of the chapter. - 26 -

INTRODUCTION

The Egyptian crude birth rate has followed an unexpected upward trend since 1972. The reported rate was 39.8 live births per thousand population in 1977, and 39.0 for the three-year period from 1976 to 1978. But it was 35.6 in 1972 and 36.2 for the three-year period from 1971 to 1973. There was thus a significant increase in the crude birth rate during this period: 4.2 points between 1972 and 1977 and 2.8 points between the periods 1971 to 1973, and 1976 to 1978.

The earlier trend had been downward, for between 1960 and 1972 the crude birth rate declined by 7.5 points. This sinkage was a continuation of an overall downward trend since the end of World War II. The recent upsurge was not only out of line with the historical trend in Egypt, but was also contrary to the expectations of most demographers. 1/ Its implications are momentous, for they cast considerable doubt on any claim that fertility has declined in Egypt, on the efficiency of the family planning program, and on the accuracy of the fertility and family planning statistics. Important questions are in turn posed: What is the correct fertility level in Egypt now? Has the fertility been declining? Has the Egyptian family planning program been influencing the country's fertility level and differentials? Is the reported increase in the birth rate real? If so, how can it be reconciled with presumed fertility decline?

Although population-related data in Egypt are not as good as one would wish to have available, they are adequate enough to give at least some provisional answers to most of these questions. These data and these answers will be examined in this chapter.

FERTILITY LEVEL AND TRENDS

Deriving Fertility Measures

In 1978 the crude birth rate was 39.3, only half a point less than the peak value of 39.8 in 1977. There is no independent estimate of the degree of completeness of registration of births for these years. Rough estimates of the degree of underregistration are available for earlier years: 5 percent for 1960 and 12 percent for 1974. The Egyptian registration system seems to have deteriorated since the 1967 war. Is it valid to extrapolate this trend to 1977 and 1978? Probably not, as the system could have improved after the 1973 demobilization. The completeness of registration in 1977 and 1978

1/ For example the U.N. population projection made in 1973 assumed a 2.3 point decline in the birth rate during this period. The U.N. projections made in 1978 assumed a 2.4 point decline. Similar declines were also assumed in comparable World Bank projections. - 27 - could be very much higher than that for 1974. Thus, a crude birth rate one or two points above the reported rate, or about 40 to 41, is not likely to be far from the true rate.

It is fairly easy to move from a crude birth rate to more refined fertility measures if the distribution of births by age of mother is also available. Since these data are not available for 1976 other sources and indirect methods have to be applied to derive fertility measures for current periods.

An indirect method using a standard age-specificfertility pattern, the 1976 age-sex compositionof the population,and the 1976 total birth figure gives a total fertilityrate of 5.4 for 1976 - a finding that indicates a 12 percent decline in that rate during the 1960 to 1976 period. (The total fertilityrate representsthe number of children that would be born per woman, if she were to live to the end of her child-bearingyears and bear children at each age in accord with prevailing age-specificferility rates.) Similarly, the general fertilityrate for 1960 was 189 live births in that year per thousandwomen aged 16-49 years and that for 1976 was 161, indicating a decline of almost 15 percent.

An independentsource of recent fertilitylevel in Egypt is the 1974-75 Egyptian Fertility Survey which gives age-specific marital fertility rates for the period from 1970 to 1975, and also for 1960 (see Tables 2.1 and 2.5). 1/ These rates correspond to a total fertility rate of 7.75 for married women and 5.6 for all women (see Tables 2.1 and 2.5 for method of calculation). The total fertilityrate for all women for the 1970 to 1975 period shown in Table 2.5 is significantlylower than the 6.12 rate for 1960.

Thus, it can reasonablybe concluded that by an estimate obtained from registration data, the fertility level in Egypt as of 1977 may be measured by a crude birth rate of 40 and a total fertility rate of 5.4.

FertilityTrends

Between 1960 and 1976 the total fertilityrate among married women declined in some age groups and increased in some others. The net change is relatively small: a decline of between 2 and 4 percent. The total fertility rate of all women, however, declined by about 12 percent. A third measure of fertility, the crude birth rate, followed an entirely different trend: a decline of 17 percent during the 1960 to 1972 period, and an increase of 10 percent during the followingperiod from 1972 to 1978 (see Table 2.2). A reconcilationof these apparently conflectingtrends requires an analysis of the factors underlying the trend in the birth rate.

A birth rate calculated from registration data, as in the example given in Table 2.2, is affected not only by marital fertility, but also by the

1/ Tables and references will be found at the end of this chapter. - 28 - marital status and the age-sex compositions of the population, and the degree of completeness of registration. An analysis of the relative importance of these factors follows.

Age-Sex Composition. Egyptian age data are subject to considerable reporting errors. They are also not accurate enough to distinguish small changes in the proportion of population in specific five-year age groups. Unadjusted data for 1960 and 1976 show a small gain in the proportion of women in reproductive ages (that is, between age 15 and 49), from 22.6 percent in 1960 to 23.4 percent in 1976. The increases in the younger age groups (15-24 years) are partly compensated by losses in higher ages. The net effect of these changes is on the whole marginal, being about 0.2 points (per thousand) on the crude birth rate.

A slightly different picture emerges if we examine the historical trend in the birth rate. Figure 2.1 indicates graphically the birth rates for two periods with a lag of 30 years (the approximate length of a generation): 1960-77 and 1930-47. An average Egyptian woman who gave birth in 1960 would have been born in 1930, while one who gave birth in 1961 would have been born in 1931, and so on, respectively, through 1977 and 1947. The cumulative births in the period from 1960 to 1977 are thus mostly to mothers who were born during the 1930 to 1947 period. If the number of births in 1930 (or after) was relatively large, other things being equal, the number of potential mothers in 1960 would be correspondingly large and likewise the number of births in 1960; similarly, if the number of births in 1930 was small the number at risk of motherhood and births a generation later would also be small. This is known as the echo effect. Examination of the graph displayed in Figure 2.1 indicates that there is a close resemblance in the shape of the two curves. There was a decline in the birth rate during the 1936 to 1942 period and increase during the 1942 to 1947 period. A generation later there was a similar trend in the birth rate: a decrease during the 1966 to 1972 period, and an increase during the 1972 to 1977 period. The decline in the birth rate during the late 1960s and the early 1070s, and increase since 1972 could, therefore, at least partially, be an echo effect; the rates fluctuated during the 1966 to 1977 period because of similar fluctuations in the numbers of girls born a generation earlier.

Marital Status. The mobilization of young men for military duty and the associated economic and social problems following the 1967 war could have affected the Egyptian marriage rates from 1967 until the 1973 demobilization. The published data do indeed show some fluctuations. The number of marriages and the rate of marriage were both at their lowest in 1967, since which time there has been a continuous increase, with a minor aberration in 1973, the year of the Yom Kippur war. Has the marriage trend anything to do with the trend in the birth rate?

Registration data indicate that the average age at marriage has changed very little during the 1965 to 1975 period (see Table 2.3). The correlation between the marriage rate and birth rate is weak, even with 2-4 years lag. A weak correlation is, of course, not unexpected as the annual - 29 -

FIGURE 2.1R: CRUDE BIRTH RRTE FOR EGYPT (1930 1947)

46.0 45.0 44.0 43.0 42.0 41.0 Crt40 .0 LUJ >.-39 .0 38.0 37.0 36.0 35 .0 34.0 1930 1932 1934 1936 1938 1940 1942 1944 1946 CRUDE BIRTH RRTE

FIGURE 2.1B: CRUDE BIRTH RRTE FOR EGYPT (1960 1977)

46.0 45.0 44.0 43.:0 42 .0 O 41.0 r0 C 40.0 LUJ >- 39.0 38.0 37.0 36.0 35.0 34.0 rI 1960 1962 1964 1966 1968 1970 1972 1974 1976 CRUDE BIRTH RRTE - 30 - marriages only augment the stock of married females in the reproductive ages by about 5 percent. At the governorate level trends in marriage rates also show little association with the trend in the birth rate. The correlation coefficients between five-year changes in marriage and birth rates are not statistically significant.

The census data indicate that the proportion of women who are married has declined at the younger ages (16-34) and has increased slightly at older ages (35-49). At age 16 years and above, the proportion of those women who never married increased from 12 percent in 1960 to 20 in 1976. Much of this increase was in the ages below 30 years: from 68 to 80 percent in ages 16 to 19 years, from 26 to 41 percent in ages 20 to 25 years, and so on (Table 2.9). On the other hand, Table 2.9 also shows that the proportion of married females increased from 79 to 87 percent at ages 35 to 39 years.

On the whole, it appears that neither the temporal variation nor the areal variation in the birth rate can be adequately explained by the variations in the marriage rate. The observed decline in the birth rate during the 1960 to 1972 period, and the increase during the 1972 to 1977 period (Table 2.1 and Figure 2.1) are both too large to be explained by the changes in the marriage rates alone. While the decline in the birth rate during the 1960 to 1972 period could be explained partly by the decline in the proportion of women married, the increase since 1972 could not be explained by the marriage factor.

Emigration. Emigration from Egypt has increased substantially since 1973. This increase could explain, at least partly, the increase in the birth rate in recent years. The 1976 Egyptian Census estimates 1.4 million Egyptians abroad. In calculating the crude birth rates shown in Table 2.2, the de facto population of Egypt is used in the denominator, that is, the population excluding the Egyptians abroad. It is possible that most of the emigrants have their families living in Egypt. Even if the family lives outside the country, the wife could return to Egypt at the time of birth of their children. In these cases, it is more correct to include the Egyptians abroad in the denominator. If this is done, the birth rate in 1977 would be less, but the increase since 1972 would still be substantial, as shown below:

Birth rate using: 1972 1977 increase

(a) De facto population 35.6 39.8 4.2

(b) De jure population 34.4 37.6 3.2

Completeness of Birth Registration. Part of the explanation for that portion of the decrease in the birth rate that took place during the 1967 to 1973 period, and for the subsequent increase, could be variations in the completeness of birth registration. The administration of the vital registration system seems to have suffered from 1967 to 1973 because of the 1967 war, the population dislocation which followed it, and the diversion of national resources for war efforts. For the same reason, some improvement in the registration system could reasonably be expected after 1973. - 31 -

Some empirical evidence to support this conclusionmay be given from El-Badry'swork on this question. He estimated that the overall completeness of birth registrationwas about 95 percent in 1960 and 88 percent in 1974. Thus, part of the observed decline in birth rate during the 1967 to 1973 period could simply be due to the deteriorationof the registration system. There are no firm data to show that the registrationsystem has improved since 1973; some inferences,however, can be made. According to El-Badry,birth registrationis more complete in Cairo and Alexandria than in other governorates(El-Badry, 1965). The increase in the birth rate during the period from 1970-72 to 1975-77 was much less in Cairo (+1.1 points) than in the country as a whole (+5.8 points). This finding lends support to the possibilitythat the 1972-77 increase in the birth rate was due in part to improvementsin the birth registrationsystem.

Marital Fertility. Table 2.1 gives information on average number of children ever born by currently married women in 1960 and in 1974-75, and also presents estimates of marital fertilityin 1960 and over the 1970 to 1975 period. On the whole, the changes are marginal. The average number of children ever born in 1960 and in 1974-75was nearly identical. But Table 2.1 also shows that there are some small, but noticeable, increases in both parameters among women below 25 years of age, some decreases among women of 25-40 years of age, and increases among older women. The increase for those under 25 years could be due to changes in age distributionof currently married women within the five-year age groups. The decrease in the 25-40 age groups, although very small, is significant inasmuch as it could be attributable to the effects of the family planning program. The increasesat ages above 40 years are more perplexing. These women were certainly less educated and probably less open to adoption of family planning. The older women of 1975 could be relatively healthier, and thus with a higher fecundity, than those of a decade ago, and this fecundityfactor could explain the fertility increase. The increasesand decreases shown in Table 2.1 are so small, however, and the factors related to the changes are so numerous, that it is difficult to assign specific reasons for the changes.

The age specific fertility rates given in Table 2.1 are derived from relatively independent sources, but they point to more or less the same conclusion: there has been very little change in the overall fertility rate of currentlymarried women in Egypt during the 1960 to 1975 period. At the same time, Egyptian family planning efforts have had some impact on the fertility of women in the 25-40 age group.

Summary. The above analysis supports the following four conclusions:

First, the fertilityof all women, as measured by the total fertility rates, declined by about 12 percent during the 1960 to 1975 period because of the decline in the proportion of women married.

Second, the marital fertilityrate for Egypt as a whole shows only a marginal decline. This national figure,however, masks real declines in marital fertility that took place in Cairo, Alexandria, and urban areas of other governorates. These decreases were offset by increases in Upper Egypt. - 32 -

Third, the crude birth rate declined during the period from 1960 to 1972 but increased during the period from 1972 to 1978. The principal explanation for this latter trend is the relative increase in the number of married women in the reproductive ages. The undulating trend in the recent period is in essence the echo effect of the trends in the number of births a generation ago, accentuated by the number getting married at younger ages.

Fourth, it is likely that the reported rise in the crude birth rate is less than the actual increase because the underregistration was probably greater in 1972/73 than in 1977/78.

FERTILITY DIFFERENTIALS AND THEIR DETERMINANTS

The Egyptian fertility rate is quite high, and the overall decline since 1960 was moderate, about 1 percent per year. There are, however some significant differentials between geographic subregions and between socioeconomic groups. More significantly, these differentials have changed over time. What are the principal differentials and the factors which determine them?

Differentials

Geographic Differentials. In 1960 the urban fertility in Egypt was higher than the rural fertility (Table 2.6). The standardized average parity 1/ was about 7 to 8 percent higher in Cairo and in Alexandria than in other governorates. By 1975, the situation appears to have been reversed: in Cairo and Alexandria the average parity was 8 to 10 percent lower then else where. The 1960 vital statistics data indicate that the general fertility rate in Cairo was higher than that in Lower and Upper Egypt considered as a whole, while similar data for 1976 indicate the opposite pattern. The 1974/75 Egyptian National Fertility Survey also shows that the total marital fertility rate in Cairo and Alexandria was significantly lower than that of Lower and Upper Egypt.

In comparing Lower and Upper Egypt, it emerges that fertility has usually been higher in the former area, but in recent years the patterns have been changing. The differentials have narrowed and in all probability the total fertility rate is now higher in Upper Egypt (see Table 2.4).

Fertility by Education of Mother. Educated women in Egypt had fewer children compared with those who were illiterate or those who could barely read or write. In Cairo and Alexandria the inverse relationship was found through the entire range of educational level (Table 2.7). At every educational level, women in these cities with higher educational attainment had

1/ Average parity resulting from the observed age specific average parity and a standard age distribution of women. - 33 - fewer children. But in other governorates, the highest average parity was observed among those who could read or write; illiterate women in those areas had have fewer children than those who could read or write. Such lower fertility among the illiterate is also observed in other societies where the average mortality level is relatively high.

The inverse relation between education and fertility has become stronger in recent years. The slope of the curve is sharper in 1974/75 and in 1976 than in 1960. Similarly, the difference between the fertility rates of those who can read and write and of those who are illiterate has become smaller in recent years. As health improves and mortality decreases further, the difference might disappear altogether.

Two other characteristics of the data are worth noting. First, in 1960, the illiterate women in Cairo and Alexandria had larger families than the illiterate women in the governorates of Lower and Upper Egypt, but at higher levels of education, women in the urban governorates had fewer children. Thus, the higher fertility in Cairo and Alexandria (in 1960) compared with that in the nonurban governorates was contributed by the illiterate women; even in 1960, educated women in Cairo and Alexandria had distinctly lower fertility. Second, although the comparisons are not strictly valid, the fertility rate of illiterate women has changed little between 1960 and 1975. On the other hand, there have been some significant decreases in fertility among the educated women.

Determinants of Fertility Differentials

Several factors cause the differences in fertility between geographic regions and by socioeconomic groups. The principal among these are the changes in the proportion of women married, and the practice of family planning and fecundity. By definition fertility is independent of changes in age-sex composition. Little information is available on differentials in sterility and subfecundity in Egypt.

Proportion Married. In Egypt, most births take place within marriage and therefore the fertility rate is directly related to the proportion of married women in the childbearing ages. Marriage registration data do not indicate any significant increase in the mean age at marriage during the 1966 to 1975 period: it remained fairly stable at about 19-20 years. The census data do however indicate substantial change in the proportion of women who are never married, widowed, etc. (Table 2.8). The proportion of never married women 16 years of age and above increased 7.6 percentage points. This increase was compensated by a decrease of 4.8 percentage points among the widowed and divorced group and a decrease of 2.8 percentage points among the married. Changes by age group amongst married females are shown in Table 2.9.

Intergovernorate variations in changes in the proportion of women who have never married, and in those who were married, are shown in Table 2.10. In 1976 the proportion of women married was 60 percent in Cairo and - 34 -

Alexandria; 68 percent in Upper Egypt and 65 percent in Lower Egypt. Also in 1976 the proportion of women who have never married was 27-28 percent in Cairo and Alexandria; 15 percent in Upper Egypt and 20 percent for lower Egypt.

At the governorate level, there is a close positive correlation between the general fertility rate in a governorate and the proportion of women who are married. The correlation coefficient is +0.75, which is highly significant for 17 observations. The corresponding correlation with the proportion of women who have never married is even higher +0.77. A good part of the intergovernorate variation in fertility rates is thus associated with intergovernorate variation of marital status composition.

At the national level, decrease in the total fertility rate during the 1960 to 1975 period can be explained almost entirely by changes in the population of married women in reproductive ages. Although other factors may also have been involved (as will be discussed below) the net decline the total fertility rate in this period is almost equal to expected decline due to changes in marital status distribution. Other factors, some negative and some positive, seem to have cancelled each other.

When women marry late, not only does the proportion of married women decrease, but more women would have died before having married and thus would never be exposed to the risk of reproduction. The fertility rate of the married women could also decrease. The data in Table 2.11 show that the completed family size of women who marry late (with a marriage duration of 30-34 years) is usually smaller. Women who marry late are usually better educated and more of them use contraceptives. The average age at first marriage of illiterate women and those with primary education is only 19 years, while that of women with a secondary education is 22.7 years and that of women with college degree is 23.5 years. The use of birth control practices is much higher among the educated (see the discussion in the next section). Increases in the age at first marriage thus reduce fertility in twn ways: (i) by reducing the proportion of women married and thus reducing the number of women exposed to the risk of childbearing; and (ii) by reducing the marital fertility due to increased use of contraceptives and a reduced time span for childbirths.

Contraceptive Use. Differentials in marital fertility may also be caused by differentials in the family planning practices, by sterility (primary or secondary), and by subfecundity, etc. The main reason underlying such differentials, however, is the use or nonuse of family planning practices.

Available data 1/ indicate that family planning practices vary substantially by age groups, by place of residence, and by socioeconomic

1/ Data on contraceptive use come from two sources: the 1974/75 survey and the service statistics. This section of the paper covers data derived from the service statistics and Appendix IIA to the chapter reviews the service statistics and the development and rate of the Family Planning Program. - 35 - characteristics. The 1974/75 fertility survey showed that family planning practice was highest in the 30-39 age group (see Table 2.12); about 42 percent of these women had ever used a birth control method and 35 percent were practicing a method at the time of the survey. In Cairo and Alexandria as many as 66 percent of the women had practiced family limitation methods, while in rural Upper Egypt only 9 percent of the married women fell in that category (see Table 2.13). The urban-rural differentials were very substantial, not only between the major urban centers and the villages, but also between the urban and the rural areas within Upper Egypt and Lower Egypt.

Family planning practice varied substantially by the educational attainment of the women. More than three-fourths of all women with a university degree had practiced birth control methods, and more than half of the women with at least a primary education had used family planning methods (see Table 2.14). The differences between illiterate women and those with secondary or higher education were indeed substantial. Pills and the IUD were the principal family planning methods used, accounting for about 85 percent of the total. The use of the pill did not vary significantly by educational level.

The effectiveness of family planning in reducing marital fertility depends on the fertility rate of the women at the time of use, and the effectiveness of the method in preventing births. As mentioned earlier, the practice of birth control among Egyptian women was highest when they were in the 30-39 age group. The average age of those who had ever used birth control was 35 years. Thirty-six percent started the first use of the method when they had five children or more. About 85 percent of contraceptive users were employing one of the effective methods: pills 75.0 percent and IUD 9.6 percent. Rough calculations using the age distribution of the contraceptors, the estimated marital status fertility of nonusers (based on the rural data in Upper Egypt), and assuming that contraception was 100 percent effective show that family planning should reduce the marital fertility in Egypt by about 24 percent (Table 2.15). That is, had there been no family planning practice at all by any woman in Egypt, the total fertility rate would have been higher by about 30 percent.

Regional data show that there is a fairly close relationship between expected differences in fertility on the basis of the use of family planning methods, and the observed differences. Family planning is most widely used in Cairo and Alexandria, and the fertility rate is lowest in those cities. It is least used in rural Upper Egypt, where the fertility rate is highest. A similar correspondence is observed when family planning practice and fertility differentials by educational attainment of women are compared. It does not appear, however, that the extent of fertility differentials by socioeconomic groups can be explained entirely by family planning practices.

The data show considerable variation in the use of contraceptives between rural Lower Egypt. and rural Upper Egypt. On this basis the fertility levels of rural Upper Egypt should be considerably higher. But the actual data indicate little difference. Similarly, the fertility level of illiterate women is lower than the expected rate on the basis of their limited - 36 - use of family planning methods. It is likely that differences in fertility levels between rural Upper Egypt and rural Lower Egypt and between illiterate women and those with primary education are determined not only by the extent of family planning but also by differences in the natural fertility, secondary sterility, subfecundity, etc, of the groups involved.

A recent analysis (see Figure 2.2) has indicated that the higher the level of a wife's education, the lower is the level of her foetal loss and the mean duration of breast feeding, and the higher is the level of her fecundity as measured by the regularity of the menstrual cycle. The combined effect of these "intermediate variables" raises the natural fertility of educated women. The natural fertility level of the rural Upper Egypt women, and especially of those who are illiterate, may thus be lower than that of the more literate women in other parts of the country.

Factors Related to Fertility Trends in Cairo. More recent information on the fertility trend and its determinants is available for Cairo where the decline was large and the data are more accurate. 1/ The crude birth rate in Cairo declined by 34 percent during the 1960 to 1976 period and much of this decline was due to fertility control by married women, as shown below:

Percent

Net change in crude birth rate, 1960-1976 - 16.5 -100 - due to changes in age-sex composition + 3.8 + 23 - due to changes in marital status - 6.6 - 40 - due to changes in marital fertility - 13.7 - 83

Had there been no change in the fertility rates, the birth rate would have increased by 18 percent as the 1976 age-sex composition was more favorable for births than the 1960 composition. The principal factor underlying the change in the birth rate was changes in marital fertility which accounts for 83 percent of change in the birth rate. With more than 50 percent of women practising contraception, the decline should have been even larger.

The overall fertility decline was about 40 percent, and the total fertility rate for all women was about 6.83 in 1960 and 4.20 in in 1976. About 70 percent of this decline was due to changes in marital fertility as shown below:

Percent

Decline in total fertility rate 1960-1976 - 2.63 -100 - due to changes in marital status - 0.82 - 31 - due to changes in marital fertility - 1.81 - 69

In Cairo the impact of family planning is thus more fully reflected in the marital fertility than in the country as a whole. On the other hand, changes in marital status played a lesser role in the reduction of the

1/ The 1976 Census volume for Cairo was available to the mission. - 37 -

Figure 2.2: WIFE'S EDUCATION 1/, DETERMINANTSOF NATURAL FERTILITY, DESIRED FAMILY SIZE AND CONTRACEPTIVEEVER-USERS, URBAN EGYPT, 1975

65~~~~~~~~N

55 FYetal Mortality _ " 45 ~~~~~~~~~~~Race

c ~~~~~~~~~~~Durationof o s 15 3esc'eedi^g c ?I rths)

:10

90o

~80 w Menscrusal Cycle~ 6 c

?roporticn cf C'_idrer 0- no died amonng :- #

-: 00,05.

.4 Desired family size

,. 2

05 %> fA _ *60 Percent of Conctaceptlves eC==40 Ever-Users 40 0 -

4 Mean ZEB 3L

2 ,C1

Sever Elementary Socon ary x Attended & Internedxace Coilege School HIGHEST EDUCAT'CNAL =ETV)

Notes: 1/ Women married continuouslyfor less than 30 years, all figures are standardized for marriage duration distributionon the basis of the whole urban sample distribution. 2 CEB = Children ever born.

Source: Mahmoud S. Abdou Issa, "Modernizationand the Fertility Transition,Egypt, 1975." A paper presented at the Annual Meeting of the PopulationAssocia- tion of America, Denver, April 1980. - 38 - total fertility rate in Cairo than in the rest of the country, both in absolute and relative terms. The pattern in Cairo may well be an indication of the shape things to come in other parts of the country.

FUTURE FERTILITY

The total fertility rate in Egypt was about 6.12 in 1960 and 5.4 in 1975. The crude birth rate was 43 in 1960 and probably about 40 in 1977, but in the interim it fell to a low of 36. What is the likely trend in the birth rate and fertility rate during the remaining years of the century?

Our earlier analysis has indicated that the principal reasons for the short-term fluctuation in the Egyptian birth rate were similar undula- tions in the birth rate a generation ago, and the decrease in the proportion of those married among the younger women; that is, the fluctuations in the number of married women in the prine reproductive ages. On this basis, we expect a relatively stable birth rate till 1981 and a declining trend during the ensuing five years. This decline in birth rate will most likely be accentuated by decline in marital fertility rates. In assessing the scope for future fertility declines two factors have to be considered, namely, possible changes in age at marriage and in the extent of contraceptive use.

The age at marriage has increased considerably in recent years, and yet there is scope for still further increase. The proportion married in the 20-24 years age group is quite high in many governorates in comparison with that in Cairo and Alexandria. If all governorates in Egypt were to have the same marital status distribution as in Cairo in 1976, the Egyptian fertility rate would decline by 22 percent. This gives a rough indication of the extent to which the marriage factor can contribute further to the future fertility decline.

In assessing the potential contribution of the family planning factor, it is useful to consider separately the possible changes in the proportion of women who will be using contraceptives and the net effect of future contraceptive use on national fertility.

According to the 1974/75 survey, 26 percent of all married women in reproductive ages were using some form of contraception. The official family planning statistics gives a total of 2,962,000 pill users and 579,000 IUD acceptors or a total about 3.5 million during the 1966-1975 period. Applying model continuation rates to the IUD acceptors, and then adding the total pill users, it would appear that the proportion of married women (16-49 years) who would be using contraceptives would not be more than 12 percent in 1975. 1/ This finding calls into question the 26 percent given by the survey.

1/ Model continuation rates were derived from various continuation rate surveys that had been taken in North African countries. The rates for the pill were: 1 year - 45.0%; 2 years - 26.6%; and 3 years - 16.1% The rate for the IUD were: 1 year - 71.3%; 2 years - 55.2%; 3 years - 45.9% and 4 years - 38.7%. - 39 -

If the recent past is any guide, there is no reason to believe that there will be a tremendous breakthrough in the family planning acceptor rate in the coming years. All evidence indicates that the demand for family planning services is very limited: the desired family size is quite high, higher than the number of children already born (Table 2.16); more than 50 percent of the women do not use contraceptives because they want additional children; and contraceptive practice among men is very limited, even in places like Cairo and Alexandria (Table 2.17). In the light of the demonstrated weak demand, and the poor support system, it will be unrealistic to assume that there will be any dramatic and rapid increase in family planning acceptance in Egypt.

At the same time, there is reason to believe that the contraceptive supply system might improve considerably due to the contribution of the private sector. Secondarily, the recently stepped-up information and educational effort might improve the demand side of the system. In any case, the net effect of family planning acceptance on marital fertility would be larger in the future than it has been in the past. The first and main reason is that the proportion of the Egyptian population among whom fertility could increase due to fecundity increase would have decreased considerably. Therefore, fertility declines in any section of the population would be more fully reflected in the national rate in the future than in the past. Secondly, the average age (hence higher fertility) of the contraceptors has been decreasing. Thirdly, future contraceptors would be more educated and therefore, should be able to utilize the contraceptives more effectively.

This analysis is not sufficient to predict precisely the future course of Egyptian fertility. It nevertheless suggests that Egyptian fertility will be 'leclining in the coming years. A continuation of the recent 1 percent decline per year may be taken as a minimum for the remaining years of the century. This will result in a total fertility rate of about 4 by the year 2000. The actual decline would be faster. If a 1 percent decline due to family planning is superimposed on a 1 percent decline due to the marriage factor, the total fertility rate at the end of the century would be 3. This is the assumption considered most probable for Egypt in the Bank's World Development Report, 1980. This, however, does not mean that the Egyptian fertility rate could not decline faster. As the discussion in the following chapters makes clear, there are few countries in the world where population pressure, whether it is on agriculture in the rural areas, or on housing or employment in the urban areas, is felt more acutely than in Egypt. This circumstance alone should prompt the government to pursue an intensive program to reduce fertility in Egypt in the coming years and pressure individuals to change their behavior. If this happens, the rate of fertility decline would be faster. A 3 percent annual decline would result in a total fertility rate of 2.3 by the end of the century. This is very close to a replacement fertility level. Thus, the future fertility rate in Egypt, depending as it does on the strength of the official family planning program, could vary between a total fertility rate of 4 and 2.3. If we have to pick a single estimate, that of a total fertility rate of 3 appears to be the most probable.

The implications of these fertility trends for population growth in Egypt during the next 20 years are worked out in Table 2.18. The population size, the growth rate, and the proportion of the population under 15 all vary substantially under the three projections. This has significant implications for education, employment and food requirements, and these will be explored in later chapters. - 40 -

Table 2.1: MARITAL FERTILITY, EGYPT, 1960 AND 1975

Children ever born Change Specific fertility rate (per 000) Change Age 1960 1974/75 1960-75 1960 1/ 1970-75 2/ 1960-75

Below 20 0.41 0.62 +0.21 107 327 +220 20-24 1.48 1.50 +0.02 298 367 + 69 25-29 2.97 2.76 -0.21 388 343 - 45 30-34 4.28 4.05 -0.23 407 238 -169 35-49 5.32 5.16 -0.16 248 283 + 35 40-44 5.74 5.91 +0.17 73 125 + 52 45-49 6.16 6.36 +0.20 24 67 + 43 50+ 6.20 6.01 -0.19 - -

All ages 4.35 4.38 +0.03 7.62 3/ 7.75 3/ +0.205

Notes:

-- = Not applicable.

1/ Specific fertility rate derived from vital statistics (Population and Development, September 1978, p. 115) divided by proportion married (from 1960 Census).

2/ From the 1974/75 Fertility Survey.

3/ Four times specific fertility rate under 20 years + 5 times the rates at higher age groups. - 41 -

Table 2.2: REPORTED CRUDE BIRTH RATE, EGYPT, 1960-1978

Year Crude Birth Rate - Official Estimates (per '000) of Crude Birth Rate

1960 43.1 43.1 1961 44.1 44.1 1962 41.7 41.5 1963 43.4 43.0 1964 42.8 42.3 1965 42.2 41.7 1966 42.0 41.2 1967 40.3 39.2 1968 39.4 38.2 1969 38.2 37.0 1970 36.9 35.1 1971 36.3 35.1 1972 35.6 34.4 1973 36.9 35.7 1974 36.9 35.7 1975 37.4 36.0 1976 37.9 36.4 1977 39.8 37.2 1978 39.3 38.5

Source: 1/ Registered births divided by census based estimates of total population (excludingEgyptians abroad).

2/ CAPMAS estimates include Egyptians abroad. - 42 -

Table 2.3: AVERAGE AGE OF FEMALE FIRST MARRIAGES AND ADJUSTED MARRIAGE RATES, EGYPT, 1965-1975

Average Age of Adjusted Year Female First Marriage Marriages 1/ Rates 2/

1965 19.7 18.5 1966 19.8 18.6 1967 20.0 18.7 1968 19.9 16.3 1969 19.8 17.8 1970 20.0 18.4 1971 20.0 19.2 1972 20.1 19.7 1973 20.0 17.9 1974 20.3 19.1 1975 19.7 18.8

Notes:

1/ Calculated from registration data using mean age of 18 for those married below 20 years, 22 for those married between 20 and 25 years, 28 for those married between 25 and 30 years, etc.

2/ Population and Development, September 1978, p. 96, Table 2.27. - 43 -

Table 2.4: AGE SPECIFIC MARITAL FERTILITYRATES OF CONTINUOUSLY MARRIED WOMEN BY AGE AND REGION, EGYPT, 1975. (per 000)

Urban Urban Rural Rural Urban Rural Cairo & Lower Upper Lower Upper Age Egypt Egypt Egypt Alexandria Egypt Egypt Egypt Egypt

15-19 327 159 327 150 169 158 353 306 20-24 334 373 337 356 386 377 353 316 25-29 278 251 294 227 249 281 296 292 30-34 225 195 253 153 199 242 247 261 35-39 248 120 176 87 134 144 167 188 40-44 73 58 92 38 67 73 86 99 45-49 23 17 30 13 11 30 29 31

Total fertility rate 1/ 5.4 5.1 5.9 4.4 5.2 5.7 5.9 5.9

Note:

1/ Excluding the age group 15-19 years.,

Source: Fertility Survey, 1974-75. - 44 -

Table 2.5: ESTIMATED FERTILITY RATE OF ALL WOMEN, EGYPT, 1970-1975

Specific fertility Estimated specific Age rate of married Proportion fertility rate of Group women (per '000) 1/ married 2/ all women (per '000)

16-19 183 0.211 39 20-24 367 0.590 217 25-29 343 0.827 284 30-34 283 0.877 248 35-39 220 0.876 193 40-44 125 0.810 101 45-49 65 0.768 50 Total Fertility Rate 7.75 5.7

Notes:

1/ From 1974/75 fertility survey report p. 31 Table 1-11 (last column divided by 5). 2/ Census Report, 1976.

Table 2.6: FERTILITY DIFFERENTIALS BY MAJOR REGIONS EGYPT, SELECTED YEARS 1947-1976

Standardized Average Parity Fertility Rates

General Fertility Total Fer- Rate tility Rate 2/

Regions 1947 1/ 1960 1/ 1974/75 2/ 1960 3/ 1976 3/ 1970-75 (married Women)

Cairo 3.67 4.26 ( 3.25 191 110 ( 5.9 Alexandria 3.57 4.22 ( 156 104 ( Lower Egypt 3.38 3.90 3.57 173 140 8.2 Urban - - 3.51 - - 6.7 Rural - - 3.59 - - 8.1

Upper Egypt 3.35 3.73 3.55 155 143 8.2 Urban - - 3.50 - - 7.0 Rural - - 3.58 - - 8.1

Note: - = Not available. Comparison over time is not valid as different standard populations have been used. Source: 1/ El-Badry, "Trends in and the Components of Population Growth in the Arab Countries of the Middle East," Table 7 and 8. 2/ Fertility Survey 1974/75, p. 34-35. 3/ Birth registration data: The denominator is female population 16-64 years (15-49 data were not available). The standard age distribution is that for the country as a whole. - 45 -

Table 2.7: STANDARDIZED AVERAGE PARITY BY EDUCATIONAL STATUS OF WOMEN BY MAJOR REGIONS, EGYPT, 1960, 1974/75, 1976

Woman's Educational Status 1/ Region and Year 0 1 2 3

1960 2/ Cairo 4.45 4.02 3.56 2.89 Alexandria 4.68 3.68 3.59 2.73 Lower Egypt 4.15 4.72 4.46 3.82 Upper Egypt 4.11 4.62 4.39 3.71 Egypt 4.21 4.53 4.26 3.59

1974/75 2/ Egypt 4.21 4.37 3.66 2.80

1976 Suez 4.6 4.3 2.3 2.1 Port Said 4.3 3.9 2.5 2.4

Notes:

1/ 0 = illiterate, 1 = read and/or write; 2 = elementary certificate holders; 3 = secondary and higher

2/ The standard population used for 1974/75 and 1976 is different from that used in 1960.

Source: (for 1960) El-Badry (1965) Table 9 p. 152.

Table 2.8: MARITAL STATUS DISTRIBUTION, FEMALES 16 YEARS AND ABOVE, EGYPT, 1960 AND 1976

Marital Status 1960 1976

Never Married 12.1 21.3 Married 67.5 63.0 Divorced, Widowed, etc. 20.4 15.7

Total 100.0 100.0

Source: Census Reports, 1960 and 1976. - 46 -

Table 2.9: PROPORTION MARRIED BY AGE, FEMALES, EGYPT AND CAIRO, 1960 AND 1976

Egypt Cairo Age 1960 1976 1976

16-19 32 21 11 20-24 74 59 45 25-29 88 83 77 30-34 90 88 88 35-39 79 88 87 40-44 79 81 83 45-49 76 77 77

Source: Census Report, 1960 and 1976.

Table 2.10: PERCENT MARRIED AMONG FEMALES 16 YEARS AND ABOVE, EGYPT AND MAJOR REGIONS, 1960 AND 1976

Percent Never Married Percent Married Governorate 1960 1976 1960 1976

Egypt 12.1 21.3 67.5 63.0

Cairo 16.5 28.1 66.6 58.9

Alexandria 18.7 30.9 64.1 56.6

Lower Egypt 11.4 21.0 67.7 63.1 Damietta 11.8 21.7 69.0 63.7 Dakahliya 10.7 19.9 68.3 63.9 Sharkiya 9.1 19.8 69.9 64.2 Qaliubia 6.9 21.6 72.9 64.6 Kafr-el-Sheikh 15.5 23.9 64.4 60.2 Gharbiya 12.5 23.8 65.8 60.1 Menoufiya 9.8 18.6 68.6 63.9 Beheira 14.9 19.9 64.5 64.1

Upper Egypt 10.3 16.6 67.7 65.9 Giza 10.1 20.1 70.3 65.9 Beni-Suef 11.3 13.2 63.7 64.9 Fayoum 9.3 12.9 67.3 67.2 Minia 9.7 17.3 67.3 64.7 Assiut 12.2 16.4 68.1 67.0 Souhag 12.4 20.8 66.9 63.7 Qena 8.0 12.0 69.5 69.1 Aswan 6.9 14.3 67.0 65.5

Source: Census Report, 1960 and 1976. - 47 -

Table 2.11: AVERAGE NUMBER OF CHILDREN EVER BORN BY AGE AT FIRST MARRIAGE, EGYPT, 1974

Age at first Average number of Completed family size (with marriage children ever born marriage duration 30-34 years)

Less than 16 years 5.20 6.78 16-19 4.51 6.32 20-24 3.95 5.37 25-29 3.44 4.82 30 and above 2.78 3.60

Source: Fertility Survey, 1974-75.

Table 2.12: USE OR NONUSE OF FAMILY PLANNING METHODS BY AGE GROUP, EGYPT, 1974

Percent of Woman Ever Still Stopped Using Never Planning Not piana- Don t Age Group Used Using and Unknown Used to Use ning to use know

15-19 6.7 4.8 1.9 93.3 18.1 56.4 i. 8 20.4 18.6 13.1 5.5 81.4 19.1 48.4 13.9 25-29 33.7 26.4 7.3 66.3 14.5 40.7 11.1 30-34 43.3 34.9 8.4 56.7 11.4 35.6 9.7 35-39 41.4 34.5 6.9 58.6 9.2 40.8 8.6 40-44 39.9 32.9 7.0 60.1 6.4 45.2 8.5 45-49 33.5 23.1 10.1 66.8 3.3 55.6 7.9 All ages 33.5 26.5 7.0 66.5 11.2 44.7 10.6

Source: Fertility Survey, 1974-75.

Table 2.13: USE OR NONUSE OF FAMILY PLANNING METHODS BY RESIDENCE STATUS OF WOMEN, EGYPT, 1974

Percent Women Cairo Lower Egypt Upper Egypt Alexandria Urban Rural Urban Rural

A. Have used birth control method 65.5 53.9 23.8 42>6 8.8 1. Still using 52.9 42.9 18.7 34.0 6.0 2. Stopped using 11.8 10.1 4.6 8,3 2.6 3. Unknown 0.8 0.9 0.5 0.3 0.2

B. Never used 34.5 46.1 76.2 57.4 91.2 1. Planning to use 8.9 13.5 15.7 10.6 7.0 2. Not planning to use 19.4 23.3 43.7 39.5 76.0 3. Don-t know 2.7 4.5 12.2 5.2 5.6 4. Unknown 3.5 4.7 4.6 2.1 2.6

Total 100.0 100.0 100.0 100.0 100.0

Source: Fertility Survey, 1974-75. - 48 -

Table 2.14: USE OR NONUSE OF FAMILY PLANNING METHODS BY EDUCATIONAL ATTAINMENT, EGYPT, 1974

Percent Women Illiterate Primary Preparatory Secondary College

A. Ever users 26.1 53.2 68.5 76.2 78.2 1. Still using 20.1 41.6 55.2 68.5 69.4 2. Stopped using 5.7 10.7 11.6 7.4 8.8 3. Unknown 0.3 0.9 1.7 0.3 0.0

B. Never used 73.9 46.8 31.5 23.8 21.8 1. Planning to use 11.4 11.5 9.1 11.5 14.3 2. Not planning to use 51.1 26.7 15.5 8.9 3.4 3. Don't know 11.4 8.6 6.9 3.4 4.1

Total 100.0 100.0 100.0 100.0 100.0

Source: Fertility Survey, 1974-75.

Table 2.15: EXPECTED IMPACT OF FAMILY PLANNING ON THE FERTILITY RATES, EGYPT, BY MAJOR REGION AND EDUCATIONAL LEVEL, 1975

Fertility Rates Among Married Women Expected Actual Total Total Fertility Fertility Groups of Women Rate Percent Rate Percent

1. Hypothetical total fertility rate for Egypt without any family planning practice 9.1 100 9.1 100

2. By region Egypt 6.95 76 7.75 85 Cairo, Alexandria 4.71 52 5.9 65 Urban: Lower Egypt 5.51 61 6.7 74 Upper Egypt 6.28 69 7.0 77

Rural: Lower Egypt 7.55 83 8.1 89 Upper Egypt 8.60 95 8.1 89

3. By Education: Illiterate 7.44 82 5.98 66 Primary 5.65 62 6.36 70 Preparatory 4.52 50 4.63 51 Secondary 3.42 38 3.58 39 College 3.34 37 3.00 33 - 49 -

Table 2.16: DESIRED FAMILYSIZE BY PARITY ANDAGE, EGYPT, 1974/75

Desired Family Size by Parity 1/ All Age Group 1 2 3 4 Parity

20-24 3.8 3.9 3.9 4.2 4.8 3.9 25-29 3.3 3.5 3.7 4.5 4.8 4.1 30-34 3.4 3.5 3.6 4.2 4.5 4.5 35-39 2.8 3.6 3.5 4.2 4.7 4.8 40-44 2.1 3.6 3.6 3.8 4.4 5.0 45-49 2.7 2.8 3.2 3.8 3.3 4.7

Note:

1/ Figures for higher parities not shown separately.

Source: Fertility Survey, 1974/75.

Table 2.17: USE OF CONTRACEPTIVESBY MEN, EGYPT AND MAJOR REGIONS, 1974/75

Region Percent of men using contraceptives

Cairo, Alexandria 9.3

Urban: Upper Egypt 4.0 Lower Egypt 2.5

Rural: Upper Egypt 0.1 Lower Egypt 0.4

Egypt: 2.7

Source: Fertility Survey, 1974/75. - 50 -

Table 2.18: PROJECTIONS OF RESIDENT POPULATION: SIZE, AGE STRUCTURE, BIRTH RATE, DEATH RATE AND RATE OF INCREASE UNDER THREE ALTERNATIVE ASSUMPTIONS, EGYPT, 1980-2000

Category/Assumption 1980 1985 1990 1995 2000

Population 1 39,948 45,022 50,677 56,776 63,342 Size 2 - 44,648 49,368 54,111 58,817 ('000) 3 - 44,340 48,232 51,765 54,881

Proportion 1 39.8 39.0 38.3 37.3 36.3 Under 15 2 - 38.5 36.7 34.2 32.1 (percent) 3 - 38.0 35.2 31.3 27.7

Birth Rate (per '000) 1 35.7 34.5 32.7 31.0 2 33.8 30.5 27.9 25.5 3 32.3 26.9 23.3 20.2

Death Rate (per '000) 1 11.8 10.8 9.9 9.1 2 11.6 10.4 9.5 8.8 3 11.4 10.0 9.2 8.5

Rate of 1 23.9 23.7 22.7 21.9 Increase 2 22.3 20.1 18.4 16.7 (percent) 3 20.9 16.8 14.1 11.7 - 51 -

REFERENCES

Arab Republic of Egypt. Central Population and Housing Census, 1960. CAPMAS (Central Agency for Public Mobilization and Statistics), Cairo.

Arab Republic of Egypt. "Egyptian Fertility Survey, 1974-75." CAPMAS (Central Agency for Public Mobilization and Statistics), Cairo. Mimeo.

Arab Republic of Egypt. "The Preliminary Results of the General Population and Housing Census in Egypt, 1976." CAPMAS (Central Agency for Public Mobilization and Statistics), Cairo. 1976.

Arab Republic of Egypt. General Population and Housing Census, 1976, Cairo Governorate. CAPMAS (Central Agency for Public Mobilization and Statis- tics), Cairo. 1978.

Arab Republic of Egypt. "Population and Development: A Study on the Popu- lation Increase and its Challenge in Development in Egypt." CAPMAS (Central Agency for Public Mobilization and Statistics), Cairo. September, 1978.

Arab Republic of Egypt. Monthly Service Statistics Report (various years). Population and Family Planning Board, Statistics Office, Cairo.

El-Badry, M.A. "Trends in and the Components of Population Growth in the Arab Countries of the Middle East: A Survey of Present Information." Demography, vol. 2, 1965.

Issa, tMahmoud S. "Modernization and the Fertility Transition, Egypt, 1975." Paper presented at the Annual Meeting of the Population Association of America, Denver. April 1980.

Omran, Abdel R. "The Fertility Profile." Egypt: Population Problems and Prospects. Edited by Abdel R. Omran. North Carolina: Carolina Population Center, University of North Carolina at Chapel Hill, 1973. - 52 -

APPENDIX IIA

THE FAMILY PLANNING PROGRAM: ITS DEVELOPMENTAND IMPACT 1/

The preceding chapter has documented fertility rates and contraceptive use from Egyptian survey and census data. In this appendix we shall briefly document the developments in the family planning program in Egypt and attempt to assess not only the extent to which contraceptive use is constrained by the availability and quality of family planning delivery but also the extent to which it appears to be limited by the demand for contraception. This is an extremely important policy issue but unfortunately can only be tentatively answered at this point, given data limitations.

Before attempting to analyze the effect of the family planning program on usage we shall briefly describe the development of the family planning program and policy in Egypt.

POPULATION POLICY AND PROGRAM

The 1962 National Charter recognized for the first time that increasing population pressure was an obstacle to Egyptian economic development, but budgetary support for clinical services was not provided until 1965. The administration of the program has been fairly complex, with a Supreme Council, an Executive Board, the Ministry of Health and the Ministry of Social Affairs all assuming a role in, the management and operation of the program. While this complex division of responsibilities may have caused some inefficiencies in the program this issue will not be discussed in this appendix. 2/

The emphasis of the official family planning policy and also its organization have changed several times since 1965. From 1962 through 1973 emphasis was on increasing the availability of family planning services. Between 1973 and 1975 the emphasis was shifted toward socioeconomic development to increase the demand for family planning by reducing desired family size. After 1975 the policy has equally emphasized both the supply side (services delivery) and the demand side.

Table 2.A.1 illustrates the expansion of the number of both urban and rural service points from 1955 to 1965, when only private centers were available, until 1979. In 1966 there was an enormous increase in service points once family planning became available through public health clinics. This increase does not, however, reflect perfectly the availability of services since the health and family programs are not completely integrated. Ministry

1/ This appendix was prepared by Susan H. Cochrane.

2/ See National Academy of Sciences, 1979 and World Bank, 1978. [References cited will be found at the end of this appendix.] -53 -

Table 2.A.l: NUMBEROF FAMILY PLANNING CENTERS IN RURAL AND URBANAREAS, EGYPT 1955-1979

Year Urban Rural Total

1955 8 0 8 1956 12 0 12 1957 12 6 18 1958 12 12 24 1959 13 12 25 1960 13 13 26 1961 14 13 27 1962 14 14 28 1963 20 14 34 1964 24 14 38 1965 49 49 98 1966 575 1,416 1,991 1967 854 1,731 2,585 1968 893 1,781 2,674 1969 912 1,821 2,733 1970 973 1,879 2,852 1971 1,026 1,928 2,954 1972 1,066 2,001 3,067 1973 1,111 2,077 3,188 1974 1,999 2,120 3,319 1975 1,222 2,231 3,453 1976 1,239 2,239 3,478 1977 1,272 2,278 3,500 1978 1,305 2,330 3,635 1979 1,316 2,387 3,703

Source: 1955-65, Tables 2 and 3 in Husein, 1966. 1966-77, Population and Family Planning Board. - 54 - of Health personnel and clinic locations are used to distribute family planning services, but not during regular operating hours. Thus a woman who wanted both immunization for her child and also to make use of family planning services would have to go to the same clinic twice. This delivery system reflects the Egyptian practice of working for incentives after normal working hours. Family planning services are offered on an incentive basis in the late afternoon and a recent survey in two governorates showed family planning services were available on the average six hours a week at each center (Hassouna, 1980).

Despite these shortcomings Egypt has a far wider spread of health facilities than do most developing countries, and thus potentially its family planning and maternal and child health (MCH) services can reach a large majority of the population. In urban areas MCH or general health centers each provide MCH services for between 50,000 and 100,000 people, while family planning clinics attached to these or to other government health facilities, together with the 450 clinics affiliated to the Egyptian Family Planning Association (EFPA), and other private clinics, each serve on average urban populations of about 14,000. In rural areas the 2,300 health units and centers serve on average populations of about 9,500, all providing primary health care, MCH services, and family planning. All family planning clinics provide contraceptive pills and condoms, although only about one fourth of the clinics provide IUD services. Pills and condoms are also distributed through commercial pharmacies, and condoms through street vendors and other commercial outlets. Sterilization, both male and female, is legal and is available at some hospitals on request, but is not officially promoted and has been adopted by less than 1 percent of the women. 1/ Abortion is illegal except in medical emergencies. The primary method of contraception has been and remains the pill, selected by over 80 percent of contraceptors.

CONTRACEPTIVE DISTRIBUTION

Tables 2.A.2 and 2.A.3 show the distribution of oral contraceptives and IUDs in the years since 1965 when the official program began. These figures cannot be used to estimate total use because there is evidence that the private sector has a very large role in the distribution of oral contraceptives and condoms. Although the data in Table 2.A.2 indicate that the number of pill cycles distributed to pharmacies in 1978 by the Ministry of Health represent only 23 percent of the totals supplied to women by the clinics and pharmacies together, a 1978 sample survey of 1,980 women indicated that 48 percent of the 376 women using contraceptives obtained them from nongovernmental sources: 38 percent from pharmacies. In that study the use of nonpublic family planning sources ranged from 41 percent in rural areas to over 50 percent in large cities. (See Anderson, et al. 1979.) Since until recently pills cost 25 piasters in pharmacies and only 5 piasters in public

1/ The 1974/75 Fertility Survey did not tabulate sterilization but 1.1 percent of the women had used a method other than pill, IUD, rhythm, breastfeeding, diaphram, cream or foam. - 55 -

Table 2.A.2: NUMBER OF PILL CYCLIFSDISTRIBUTED TO WOMEN FROM FAMILY PLANNING CLINICS AND TO PHARMACIES, FROM ALL SOURCES, EGYPT, 1966-1979

Distributed by Clinics Distributed Year Urban 1/ Rural 1/ to Women to Pharmacies Total

1966 94,006 39,536 133,542 1967 118,768 49,081 167,849 1968 157,165 56,620 213,785 1969 191,232 66,372 257,604 1970 232,049 79,725 311,774 1971 260,771 89,420 350,191 1972 287,501 96,161 (375,989) (7,673) 3/ 383,662 1973 293,449 99,158 (384,755) (7,852) 392,607 1974 274,023 77,099 (344,101) (7,022) 351,122 1975 313,307 86,552 (387,863) (11,996) 399,859 1976 347,281 5,239 352,520 1977 273,736 72,849 346,557 59,418 405,975 1978 (195,723)2/ (78,575)2/ 275,311 80,805 356,116 1979 (148,419) (89,672) 248,316 66,115 314,431

Notes:

1/ Most of the women practicing accept at Family Planning Units. From 1966-1971, all acceptance figures refer to family planning units; 1972-1975 figures include pills distributed to pharmacies. For 1976-1979, the urban and rural figures refer to clinic distribution only.

2/ Urban-rural breakdowns estimated from monthly volumes and translated to a 12 month basis. Figures in parenthesis are indirect estimates and may not add to totals exactly due to rounding.

3/ These figures are obtained from indirect estimates and may not add up because of rounding.

Source: 1976-1979 from December issues of Monthly Service Statistics, Population and Family Planning Board. - 56 -

Table 2.A.3: NUMBER OF IUDs INSERTED 1/ ANNUALLY AT FAMILY PLANNING CENTERS, EGYPT, 1966-1979

Year Urban Rural Total

1966 2/ 4,376 14,701 19,077 1967 40,443 695 41,138 1968 31,071 725 31,796 1969 33,608 987 34,595 1970 42,312 1,863 44,175 1971 53,994 2,230 56,224 1972 64,243 2,728 66,963 1973 67,237 2,759 69,996 1974 60,983 4,136 65,119 1975 70,842 5,172 76,014 1976 69,194 4,398 83,592 1977 94,547 1978 57 737 1979 63,655

Notes:

1/ No distinction is made in the reporting between first insertions and re-insertions. Thus the numbers listed are probably an overstatement of IUD acceptors.

2/ There appears to be some discrepancy between the numbers listed for 1966 and 1967. The Population and Family Planning Board (PFPB) lists them as above, but the number of insertions in rural areas appears to be quite implausible; S. Gadalla in "Comparative Report on Family Planning Services," shows the number listed above for 1967 as the 1966 totals.

Source: PFPB; 1977-1979 December issues of Monthly Service Statistics. For these years no urban rural breakdowns of acceptance are available in service statistics. - 57 - clinics, these data suggest that access to, or the quality of services in, public clinics was unacceptable to many women who wanted to use contraceptives. This is a point we shall return to later.

The data in Tables 2.A.2 and 2.A.3 indicate a recent decline in the acceptance of oral contraceptives and IUDs. This decline is very sharp since 1977, which appears to be an abnormally good year. While IUD insertions rebounded somewhat between 1978 and 1979, the acceptance of oral contraceptives in 1979 was lower than for any year since 1970.1/ This decline is even more dramatic in the figures on clinic distribution than in those for total distribution because of the apparent substitution of pharmacies for clinics as a source. In 1972-74 pharmacies accounted for less than 2 percent of total distribution. In 1975 and 1976 it was 3 and 1.5 percent respectively. A sharp increase in distribution to pharmacies occurred in 1977 when the percentage became 14.6. In 1978 it was 22.7 and in 1979 it was 21 percent. Breaking the data into urban and rural pill acceptors we find that the decline has been an urban phenomenon, while in rural areas pill acceptance from clinics has gone up since 1977.

More detailed data in Table 2.A.4 for the 1977 to 1979 period indicate that acceptance data from clinics can be broken down into several factors -- number of clinics in operation, proportion of clinics reporting on the average and the monthly average number of cycles accepted per reporting clinic. These data are available separately by type of unit (top half of Table 2.A.4) and location (lower half of Table 2.A.4). For all areas the number of clinics in operation in 1979 was higher than in 1977, but some types of units were less numerous, for example maternal and child health units (212 versus 214) rural health units (579 versus 589) and other, probably private units (157 versus 188). Overall, the total number of units increased by only 153 over the period 1977 to 1979, or by 2 percent a year. Despite the small increment in units 2/ the average number of cycles distributed per unit dropped dramatically from 263 in 1977 to 130.5 in 1979. This decline in average cycles per month per clinic occurred between 1977 and 1978, and 1978 and 1979 and in all clinic categories except "other."

Part of the change in acceptors between 1977 and 1979 resulted from changes in reporting. In rural areas reported acceptors went up despite the decrease of average acceptance per reporting unit because a much larger percentage of units were reporting (58 in 1979 versus 32 in 1977). In urban areas, however, not only did average acceptors per reporting unit go down, but the proportion of units which made reports declined from 56 to 45.

1/ There is reason to believe that the data for 1978 are underreported due to a shift in reporting method, but since the downward trend continued in 1979 when no incentive existed for underreporting, this trend is real rather than merely apparent.

2/ If there had been a very large increase in the number of units, diminishing returns could have occurred, but the very small numerical increase in units cannot explain a large decrease in acceptance per unit. Table 2.A.4.: NUHBER OF CLINICS AND PILL CYCLES DISTRIBUTED IN AVERAGE MONTHPERIOD BY CLINIC TYPE AND LOCATION, EGYPT, 1977-1979

1977 1978 1979 Average cycle Percentage Average cycles Clinic Type Percentage per month reporting per month and Region Units Reporting per clinic Units coverage per clinic Units Reporting Average

Maternal and Child Hlealth 214 76 491 214 66 503 212 71 359

Health Bureau 286 66 517 219 58 511 289 55 347

Rural Health 589 39 117 584 49 113 579 65 98

Rural Unit 1,569 28 95 1,633 45 70 1,701 62 59

Hospitals 267 44 314 273 45 267 276 52 166

Ministry of Social Affairs 442 51 309 472 13 247 489 11 215

Other 188 30 358 168 13 304 157 11 377 1

Total .3,550 40 263 3,635 43 194 3,703 53 131

Urban 1,272 56 419 1,305 42 391 1,291 45 276

Rural 2,278 32 109 2,330 44 84 2,387 58 69

Urban Governorate 411 59 550 420 44 523 429 43 346

Lower Egypt 1,738 46 219 1,773 49 168 1,806 63 128

Upper Egypt 1,350 27 174 1,380 34 116 1,406 44 75

Frontier 51 33 105 62 54 88 62 60 69

Source: Compiled from monthly volumes of Family Planning Reports. - 59 -

The proportion of units reporting may depend on the general efficiency of family planning clinics in a region or the efficiency of a certain type of clinic. Alternatively, it may depend on whether or not a clinic has anything to report. These of course are probably closely related. If no contraceptives were distributed, there is probably a tendency not to file a report. In practice the percentage of units reporting is probably explained by both phenomena to some degree. Therefore it is difficult to determine a priori whether high acceptance in rural areas (low in urban) was the cause or consequence of higher proportions (lower proportion) reporting. This is a point we shall explore more fully shortly, but the increase in use of pharmacies by urban women suggests a deterioration in in the quality of service in urban units reporting. Since there are very few detailed data points in our time series, only 1977, 1978, and 1979, we cannot explore these issues systematically with longitudinal data. Therefore, we shall attempt to examine the relationship between the quantity and quality of the family planning delivery system using cross-sectional data and regression analysis.

CROSS-SECTIONAL DIFFERENCES IN DISTRIBUTION

We have governorate level data on the number of family planning units per woman aged 15-49 for 1976, 1977, and 1978. We also have data on the proportion of family planning clinic in a governorate reporting in December of each year. While these data are not perfectly correlated with this average percentage reporting over the entire year, they are probably fairly close. For the one year in which we have data for all 12 months, the 12 month average is 40 percent and the December average is 42 percent. We also have census data on the level of female literacy and urbanization in the governorate in 1976. These two factors affect the demand for contraceptives. Since urbanization and female literacy are highly correlated, we have only used literacy in the regression and have separately analyzed the rural governorates to see if they differ.

To determine the impact of family planning quantity (units per women), quality (percentage of units reporting) and socioeconomic development (literacy), appropriate correlations and regressions were examined. These are summarized in Tables 2.A.5 and 2.A.6. In interpreting these results it is important to realize that quantity of family planning also reflects the availability of other health services and may in fact be a better measure of health services, than of anything else.

The simple correlations show that births per women in 1976, 1977 and 1978 are inversely related to female literacy in 1976 with correlation coefficients of -.57, -.50 and -.45, respectively. Service points per woman are positively correlated with births per woman (.72, .73 and .66). Proportion of units reporting were negatively correlated with births per woman in each of the three years (-.39, -.50 and -.21). In nonurban governorates, literacy was not significantly related to fertility, but service points were. - 60 -

Table 2.A.5: REGRESSION EQUATIONS FOR FERTILITY LEVELS AND CHANGES IN FERTILITY LEVELS ON FAMILY PLANNING SERVICES AND FEMALE LITERACY FOR 21 GOVERNORATES

Clinics Proportion Dependent Clinics per Women of Clinics Female -2 Variable per Women Squared Reporting Literacy R

Fertility Level

Births/women, 1976 418.68* -29617 -.051 -.019 50 (2.00)** (1.43)

Births/women, 1977 456.10** -330718 -.027 -.019 54 (2.19) (1.60)

Births/women, 1978 371.52* -251620.9 -.019 -.021 43 (1.99)** (1.45)

Inputs Lagged by 1 Year

Births/women, 1977 515.84** -374133 .010 .016 53 (2.57) (1.89)*

Births/women, 1978 432.45 -3334184 -.068 .046 49 (1.96)* (1.53) (1.88)*

Fertility Change (Inputs Base Year)

Births 1977-Births 1976 278.27 -242340 .081 .241 9 Births 76 (1.68)

Births 1978-Births 1977 -149.67 -10711 -0.185** 1.38 16 Births 77 (2.30)

Births 1978-Births 1976 140.58 -289107 -0.158 .356* 17 Births 76 (1.84)

Inputs Lagged (1 year from base)

Births 1978-Births 1977 144.85 -33957 -0.232** .093 20 Births 77 (2.57)

Significance at: * 10 percent ** 5 percent *** 1 percent - 61 -

Table 2.A.6: REGRESSION EQUATIONS FOR FERTILITY LEVELS AND CHANGES IN FERTILITY LEVELS ON FAMILY PLANNING SERVICES AND FEMALE LITERACY FOR 21 GOVERNORATES (Non-Urban: 17 Governorates)

Clinics Proportion Dependent Clinics per Women of Clinics Female -2 Variable per Women Squared Reporting Literacy R

Fertility Level

Births/women, 1976 690.58 -5490847 -.020 -.057 22 (2.04)* (1.74)

Births/women, 1977 755.16** -593297* -.025 -.038 31 (2.41) (2.05)

Births/women, 1978 510.14 -362410 -.007 -.001 11 (1.79)* (1.50)

Inputs Lagged (1 Year)

Births/women, 1977 714.04 -554086 .011 .040 32 (2.14)* (1.79)*

Births/women, 1978 773.46 -630407 -.091 .041 22 (2.18)** (1.92)* (1.76)

Fertility Change (Inputs Base Year)

Births 1977-Births 1976 315.85 338231 -0.178 -.133 6 Births 76 (1.95)*

Births 1978-Births 1977 28.70 95951 -0.339 .003 51 Births 77 (3.99)***

Births 1978-Births 1976 -68.10 -53604 -0.184 -0.103 9 Births 76

Inputs Lagged (1 year from base)

Births 1978-Births 1977 260.7 -398691 -0.349*** .027 39 Births 77 (3.27)

Significance at: * 10 percent ** 5 percent * 1 percent - 62 -

The positive relationship between service points and births is counter to expectations. The explanation may simply be that those areas with more clinics also have better registration. Alternatively, those areas with more family planning clinics per women have higher levels of health facilities per capita, and data cited in the chapter preceding this appendix has shown that particularly in Upper Egypt and among the poor in many parts of Egypt, fertility has been rising due to improved health (Issa, 1980). Therefore, those areas with more family planning centers (health facilities) have higher fertility for similar reasons. Further investigation of the relationship between service points and births shows that the effect appears to be nonlinear. The positive relationship only operates at very low levels of service points.

Several dependent variables were used. First the birth rate was related to clinics per women, clinics squared and proportion of clinics reporting, and female literacy for each year 1976-1978. It should be emphasized that there is considerable underreporting of births as explained earlier in the main chapter and this may not only introduce "noise" in the data but may be systematically related to other variables.

The regressions in Table 2.A.5 and 2.A.6 (nonurban governorates) indicate that in general births per women are positively related to the number of family planning clinics for women, and that this variable is generally significant; the number of clinics squared is negative in all cases for fertility level and marginally significant in several cases. This suggests that at higher densities, clinics would have a negative rather than a positive relationship with fertility.

For rural areas where data or wage levels are available these results can be replicated to determine the extent to which the positive relationshipbetween health delivery and births is in part an income effect. These regressions, not shown, indicated that for 1976 and 1977 the wage has a positive significant relation with births and its inclusion reduces the significance of the positive clinic variable. For 1978, however, clinics retain a positive significant coefficient.

In terms of fertility change, however, the most important factor in both data sets is the quality of family planning services, as measured by the proportion of clinics reporting, and this is negative and highly significant in half the cases.

If one is willing to accept the proportion of family planning units reporting on contraceptive usage in any year as a proxy for the efficiency of the clinics, then these data therefore indicate that higher clinic efficiency is associated with declines (or at least smaller increases) in the births per woman aged 15 to 49. These data also indicate that at low levels of density more health and family planning clinics increase fertility, but at higher densities and especially increased clinic efficiency leads to reductions in birth rates. - 63 -

SUMMARY AND CONCLUSIONS

The preceeding discussion gives a partial picture of the development of the family planning program and the relationship between certain program characteristic and fertility levels. In Egypt the decline in contraceptive usage and the substitution of pharmacies for family planning centers has been recognized and policymakers responded in late 1979 by lowering the price of oral contraceptives obtained at pharmacies from 25 to 5 piasters. This would increase the incentives for women to switch from family planning clinics to pharmacies and will increase the incentives for some women to adopt the pill. Whether the pharmacies will have the same incentive to distribute pills as they did previously is unclear without detailed knowledge of how the subsidy is administered.

In the rural areas the problems of delivery have also been recognized and new distribution channels are being tried. In rural areas new programs in household distribution have bee introduced which will simplify supply and re-supply. (See Gadalla, 1980 for a description of one such program.) Efforts are also continuing to stimulate the demand for family planning through information, education and commnication programs, but more fundamental changes such as improving female literacy seem to be lagging. Chapter IV in this report, on education, shows that only 60 percent of girls ages 6-11 are in primary school and the proportion of primary students who are female has changed very little since 1960. While the importance of general development for increasing the demand for family planning is widely recognized, female literacy per se has not been emphasized despite the large differencs in usage observed by wife's education in survey data. This problem will be more thoroughly discussed in the chapter on education. - 64 -

REFERENCES

Anderson, John E. , et al. "Family Planning Use and Child Health in the Arab Republic of Egypt." Atlanta, Georgia. US HEW, Center for Disease Control, 1979.

Gadalla, Saad, "Comparative Report on Family Planning Services," mimeo.

Gadalla, Saad, et al. "Household Distribution of Contraceptives in Rural Egypt." Studies in Family Planning, vol. 11, no. 3, March, 1980.

Hassouna, N. T. "Assessment of Family Planning Service Delivery in Egypt," Studies in Family Planning, vol. 11, no. 5. (May, 1980)

Husein, Hasan, "United Arab Republic," in Berelson, Bernard et al. eds. Family Planning and Population Programs, Chicago: University of Chicago Press, 1966.

Issa, Mahmoud S. "Modernization and the Fertility Transition, Egypt, 1975." Paper presented at the Annual Meeting of the Population Association of America, Denver. April 1980.

National Academy of Sciences, Health in Egypt, Washington, D.C. January 1979.

Population and Family Planning Board. Statistics Office Monthly Service Statistics Report.

World Bank, Report and Recommendations of the President of the International Development Association to the Executive Directors on a proposed Develop- ment Credit to the Arab Republic of Egypt for a Second Population Project, 1978. - 65 -

SOME ISSUES IN POPULATION AND HUMAN RESOURCE DEVELOPMENT IN EGYPT

CHAPTER III

THE MORTALITY AND HEALTH SITUATION IN EGYPT:

RECENT TRENDS AND PATTERNS I/

SUMMARY

The preceding chapter has discussed the processes whereby the Egyptian population is replenished and augmented. This chapter complements that review by analyzing recent mortality patterns affecting that population, and presents its own overview of the health situation in Egypt, its determinants, and issues in the health sector. In so doing, it completes the characterization of the demographic processes which provide the context for the discussions on educational development, the labor force, and food production found in subsequent chapters.

Ilortality indices for the 1975 to 1979 period put the crude death rate at 13 deaths per thousand population, the infant mortality rate at 110 infant deaths per thousand live births, and total life expectency at birth for both sexes at 55.8 years. Like most other developing countries, Egypt experienced a considerable decline in mortality during the past thirty years. This decline, however, has not been uniform across geographic regions, time intervals, age groups or between sexes.

Mortality levels are highest in Upper Egypt, lowest in Lower Egypt with the urban governorates of Cairo and Alexandria occupying an intermediate position. With regard to the infant mortality rate, recent data reveal that there were pronounced differences between Upper Egypt (where the rate was about 140 per thousand births) and Lower Egypt (about 102 per thousand) but little difference between rural and urban areas within each region. There were, however, marked differences in the child mortality rates for rural and urban areas. In rural Upper Egypt, the child death rate (that is, the rate per thousand of deaths occuring between one and four years of age) was 36 compared to 24 for urban places; similarly, in rural Lower Egypt, the rate was 17 in rural areas and 9 in urban places. Infant mortality in Cairo is comparatively high at approximately 114; the child and adult mortality rates in Cairo are lower than in all the other governorates.

Egypt's infant mortality rate of 110 is considerably above that of the average middle income country as defined by the World Bank, where the rate is 48. But given the fact that Egypt is the poorest middle income country a better comparison is with the 15 poorest members of the 52 countries in that

1/ The section on mortality was written by K.C. Zachariah; the section on health was written by Catherine S. Pierce. - 66 - group. Although there are no infant mortality data for this group, comparisons can be made with respect to child mortality. For these 15 countries the average child death rate of 17 compared to Egypt's child death rate of 16, and a life expectancy of 54 compared to Egypt's rate of 56.

Available evidence supports the conclusion that the decline in child mortality has been faster than the fall in infant mortality. Heretofore the Egyptian mortality pattern has been well known for its elevated level of child mortality; it now appears that child mortality is in line with overall mortality levels. It also appears that the mortality decline was faster among males than among females. The infant mortality rate for females, which was well below that of males in 1950 (180 v. 191), had reached the same level in 1960; by 1965 the female rate was higher than the male rate (140 v. 137). While there is a paucity of information on socioeconomic differentials, the data available indicate a positive correlation between educational level of mothers and child survival. Likewise the higher the occupational level of the father, the better the chances for the survival of the child.

Future trends in Egypt's mortality will be tied to progress made on a number of fronts, including environmental sanitation, the availability and utilization of public health services, and improvements in educational levels. Several studies have demonstrated the key role that the mother's education plays in determining the quality of health in and the hygiene practices of the household. The failure to achieve more rapid advances in female literacy is a discouraging sign and the persistence of high birth rates and the increasingly acute population pressure on the land and other natural resources could well compromise prospects for the pace of future declines in mortality.

Changes in mortality reflect to a considerable extent changes that have occurred in the health status of the population. Available data indicate that diseases of the digestive system have remained the leading cause of death from 1937 to the present, although the proportion of deaths from this cause has declined from about 35 percent (1937) to about 30 percent (1970). Diar- rheal diseases are responsible for the largest proportion (about 46 percent in 1972) of infant deaths. Statistics as to cause of death afford only a limited perspective on changes in health status; ideally, they should be supplemented by data on morbidity and debility. Unfortunately, Egypt, like most developing countries, lacks such detailed information.

Schistosomiasis, a chronic helminthic (parasitic worm) infection marked by blood loss and tissue damage, has been endemic to Egypt since pharaonic times. The overall prevalence rate of schistosomiasis in the Nile Delta area declined from 83 per thousand in 1935 to about 41 in 1966. Government sponsored eradication programs have had notable impact. Certain differentials have been observed. The disease is more prevalent among males than females, swimmers than nonswimmers, and among farm laborers compared with those involved in nonfarm employment.

The sparse documentation regarding the incidence and prevalence of other major diseases affecting the Egyptian population -- gastrointestinal - 67 - disorders, typhoid and paratyphoid infection, measles, polio and tuberculosis -- limits any analysis of morbidity patterns. Adequate nutrition, a subject explored in the last chapter of this report, is also a key factor in determining health status. With a daily intake of over 3,000 calories, the diet of the Egyptian meets the quantitative caloric requirement needed to sustain a person at normal levels of activity and health, but this intake is highly unbalanced. Cereal grain accounts for 80 percent of the calories and about 70 percent of the protein consumed.

Of the three systems which comprise the Egyptian health care delivery network, the government sector, which includes all Ministry of Health (MOH) hospitals and health centers, was the principal focus of this report. The health care pyramid as defined by the Ministry encompasses four levels of services: village health units, which provide basic curative and preventive services; district health centers; general hospitals, and university hospitals. In principle, a referral system governs the passage from one level to the next; in actual practice, however, the referral concept tends to be rather ineffective.

There are about 3,000 health units throughout the country; over 75 percent of these are located in rural areas. This provides a distribution of approximately one health facility for about every 9,000 persons or about one per 1.8 villages. Although utilization of health services has increased, it still remains below the level envisaged by the Ministry, and it is estimated that 80 percent of the births that take place in rural areas are unattended. The urban health care network is characterized by a fragmentation of services; clients must visit several points to receive different services. In rural areas the MOH is seeking to make services both more accessible and culturally acceptable; in urban localities, it is trying to establish health centers which will offer a full range of primary care services.

Egypt, in contrast with most developing countries, enjoys a favorable ratio of health professionals to the target population. There is approximately one physician per 1,500 population; however, there is a marked concentration of physicians in Cairo and Alexandria areas. The government has made a considerable investment in training health manpower. Over 3,500 doctors were graduated in 1976, compared with 1,695 in 1970; the number of nursing graduates also doubled during the same period.

Although notable gains have been made, the question might legitimately be raised as to why gains on the health front have not been more extensive, given the density of health facilities and supply of medical manpower. Infant mortality still remains high, especially in Upper Egypt, and gastroenteritic diseases still exact a heavy toll across all age groups. It would appear that in spite of numerical adequacy, there may be some deficiency in the qualitative aspect that has resulted in underutilization of available health services. It might also be concluded that insufficient attention has been given to the question of environmental sanitation.

If the health status of the Egyptian population is to be improved, environmental sanitation will have to be upgraded, female eduction must - 68 - improved,and the effectivenessof the health care delivery system greatly increased. The former will involve expandingaccess to potable water and adequate sewage facilities. The latter will require better management of available resources and improvingthe quality of care offered. The health strategy in the 1978-82 Plan has emphasized communityparticipation in health planning and has underscoredthe necessity for health personnel to be responsive to the needs of the client community.

Given this background, the first portion of the chapter deals with mortality levels, socioeconomicdifferentials, and future trends. The second part reviews the health situation in terms of indices of health status and of morbidity; assesses the determinantsof health; reviews the components of the health delivery system, including the roles of rural and urban infrastructure, hospitals, and health manpower; and assesses the issues in the health sector. - 69 -

RECENT MORTALITY PATTERNS

Egypt, like most developing countries, has experienced a significant decrease in mortality during the past 30 years. The expectation of life at birth, which was about 40 years in 1950, rose to about 55 years by 1975, an increase of 15 years over a 25 year period. The decline in mortality, however, has not been uniform. There was considerable variation across time intervals, geographic regions, age groups and between sexes. These variations will be examined below.

Mortality Levels

The reliability of available mortality data is barely sufficient to fix either levels or trends. The principal sources for recent periods are registration data and the 1974/75 Egyptian Fertility Survey.l/ The registration data indicate that the crude death rate for 1974-1976 was 12.6 deaths per thousand persons. It is estimated that underregistration of deaths during this period was about 12 percent; on this basis the corrected crude death rate for 1974-1976 would be about 14.1. 2/

Infant and child deaths (deaths that occur between one and four years of age) are more likely to be underregistered than deaths at older ages. Infant mortality rates may, however, be less affected by this factor than would be expected because part of the underregistration of infant deaths is offset by the underregistration of births. The infant mortality rate based on registration data was 93 for the three-year period, 1974-1976; the child death rate for the same period was 20.5.

The 1974/75 Fertility Survey provides an independent source of information on infant and child death rates. This survey showed an infant mortality rate of 119 for the period from 1970 to 1974 compared with that of 107 derived from registration data thus implying an underregistration of about 23 percent for infant deaths and thus an 11 percent lower infant mortality rate. The 1974/75 survey data indicated a five-year mortality rate (5 q0) of 0.18 at birth. Together with an infant mortality rate (q ) of 119 this implies a child mortality rate (4ql) of 0.073 and a child death rate (4mI) of 19 per thousand. This estimate agrees very closely with that obtained from the registration data.

Assuming that the infant mortality rate of 119 (derived from the 1974/75 Survey) is generally correct for the 1970-74 period and that life

1/ References cited will be found at the end of the chapter.

2/ Estimates of underregistration by El-Badry and Ansley Coale. - 70 -

expectancy at birth increased by about 0.5 years per year, the following mortality parameters were obtained for the period 1975-79 (Table 3.1). These rates compare with an infant mortality rate of 48 and a child mortality rate of 9 for the average middle income country 1/, but perhaps a better comparison is for the poorest 15 of this group. For these 15 countries the child death rate is 17 and life expectancy is 54 years. For the area of the Middle East and North Africa the life expectancy is also 54 years. 2/ Therefore Egypt is performing slightly better than comparable countries with respect to mortality.

Table 3.1. MORTALITY INDICES, EGYPT, 1975-1979

Category Index

1. Crude death rate 13 Per thousand 2. Infant mortality rate 110 ' 3. Child death rate 16 " 4. Child mortality rate 62 " 5. Expectation of life at birth " Males 55.0 " Females 56.6 Total 55.8

There are significant variations of mortality levels across geographic regions (Table 3.2). In general Upper Egypt has the highest mortality rate, Lower Egypt the lowest, and the urban governorates led by Cairo fall in-between. This is the pattern shown by the 1974/75 Fertility Survey, but the registration data show a somewhat different pattern. According to the registration data the mortality level in Upper Egypt is lower than that of the urban governorates. This is most probably due to the relatively higher underregistration of deaths in this region. The geographic differentials which characterize the infant mortality rate may differ from those observed for mortality rates at higher ages. The infant mortality rate is highest in Upper Egypt, and lowest in Lower Egypt. Among the urban governorates, the infant mortality of Cairo is comparatively high; however, child mortality and mortality rates at higher ages are relatively low in Cairo, lower than those of all other governorates. It is the higher infant mortality rate in Cairo that accounts for the relatively high overall mortality rate observed for Cairo.

Within Upper and Lower Egypt the infant mortality rate varies very little between the urban and rural areas. The 1974/75 Fertility Survey shows

1/ World Bank, World Tables 1980, p. 449.

2/ World Bank, World Tables (1980, p. 442. - 71 -

Table 3.2: MORTALITY INDICES BY REGION, EGYPT, FOR SELECTED INTERVALS

Crude death Life expect- rate Infant mortality rate Child death rate ancy at birth (per -000) (per 000) (per -000) (years) Registered Survey Registered Survey Registered Region 1974/76 1974/75 1974/76 1974/75 1974/76 1975/79

Egypt 12.4 119 88 19 19 55.8 Urban governorates 10.3 124 103 12 11 58.6 Cairo 11.0 -- 114 ------Alexandria 9.6 -- 91 ------Lower Egypt 12.5 -- 79 -- 19 58.8 Urban -- 102 -- 9 -- -- Rural -- 103 -- 17 -- -- Upper Egypt 13.8 -- 91 -- 23 47.5 Urban -- 140 -- 24 Rural -- 145 -- 36

that in Lower Egypt it was 102 in urban areas and 103 in rural areas; a similar pattern holds in Upper Egypt. Child mortality rates, however, differ significantly. According to the 1974/75 survey, the child death rate was 36 in rural Upper Egypt but only 24 in urban Upper Egypt. The corresponding figures in Lower Egypt are 9 in the urban areas and 17 in the rural areas.

Egypt, like most other developing countries, has experienced a notable improvement in life expectancy during recent decades; however, the downward trend in Egypt was not uniform over time. Life expectancy in Egypt increased by 11 years during the decade from 1940 to 1950 and by 8 years for the 1950- 1960 period (1.1 and .8 years annually). In the period from 1960 to 1965 the rate of increase slowed even more (annual increase of about 0.2 years). After 1965, the trend in the average annual increase in life expectancy turned upward in Egypt with an average gain of about 0.4 years between 1965 and 1975.

The reasons for the apparent recent acceleration in the mortality decline are not quite evident. In fact, even verification of the acceleration will require additional empirical support. It should be noted that it took place at a time when, as discussed in the preceding chapters, the birth rate showed considerable increase. Thus if the accelerated decline in the death rate were to be attributed to a deterioration of the registration system, the same trend should have been reflected in the birth rate. The fact that a similar decline was not observed in the birth rate is an indication that the decline in the death rate is not due to the deficiency of the data. The mortality decline in Egypt therefore decelerated more steeply than the overall - 72 - trend in developing countries in the 1960s, but the speed of decline seems to have been picked up once again in the 1970s and especially after the 1973 war. Figure 3.1 and Table 3.3 summarize trends in Egyptian mortality.

Two other characteristics are notable in recent Egyptian mortality trends: the decline in mortality has not been uniform across age groups, and

Table 3.3. TRENDS IN MORTALITY, EGYPT, 1960-1979

Infant Crude death mortality Child death Year rate rate rate Life expectancy (per '000) (per '000) (per '000) (years)

1960 19 128 34 48.9

1965 18 129 31 49.7

1970-74 16 119 19 53.3

1975-79 13 110 16 55.8

Source: World Bank estimates. it was faster among males than females. The Egyptian mortality pattern is well known for its relatively high child mortality. For a given overall mortality level ( e ) child mortality ( 4 qI) is reported to be higher in Egypt than in most other countries. For example, child death rate ( 4 mI) in Egypt was 34 in 1960 when the expectation of life at birth was 49 years. The expected child death rate for this overall mortality level is between 17 and 26 (extremes in the four families of Coale's model life tables). The Egyptian child death rate was thus at least 30 percent higher compared with the average experience of other countries. There are some indications that the decline in child death rate has been faster than that in the infant mortality rate and that at present there is very little "excess" child mortality in Egypt. The child death rates for 1975-1979 estimated from the 1974/75 fertility survey and recent registration data both indicate that it is in line with the overall mortality. Additional empirical support is nevertheless needed.

The mortality decline was faster among males than among the females (Table 3.4). Male mortality was higher than female mortality in earlier years (before 1950) but in recent years female mortality seems to be higher. This reversal in male-female mortality differentials implies a faster mortality decline among males. Among infants the reversal took place around 1960; - 73 -

Figure 3.1: TRENDIN INFANTMORTALITY RATE AND CHILD DEATHRATE, EGYPT, 1960-1975

Infant Mortality Rate 140

130 =9606

120 - 1960-76

1T0 _ 100

30 \9~~96 Child Mortality Rate

25 - 1960

20_

15 I I l1'960 1965 1970 1976

YEAR - 74 - since then female infant mortality has always exceeded that of males. The reversal in the childhood ages took place even earlier, perhaps around 1950. For all ages combined, however, the death rate is higher among the males than among the females.

While no comparable data are available for recent years, another set of data, unadjusted for underregistration, is available for 1936 to 1970. 1/ If patterns of registration by sex have remained constant, then the ratios of male to female deaths can be used to supplement the above data even if levels are unreliable. This supplementary data shows that from 1940 to 1970 the ratio has declined from 1.14 to .84 for infant mortality. For mortality in ages one to five the same pattern of more rapid decline in male than female mortality is shown over the period 1940 to 1970.

Table 3.4. MORTALITY DIFFERENTIALS BY SEX, EGYPT, 1940-1965

Death rate per '000 Under one year of age 1 - 4 years All ages Year Male Female M/F Male Female M/F Male Female M/F

1940 245 219 1.12 67 66 1.02 29.07 24.34 1.19 1945 214 194 1.10 57 56 1.02 28.24 23.42 1.21 1950 191 180 1.06 44 45 0.98 21.15 18.41 1.15 1955 169 167 1.01 39 42 0.93 19.00 17.41 1.09 1960 141 141 1.00 34 37 0.92 17.69 16.11 1.10 1965 137 140 0.98 22 30 0.73 15.58 15.02 1.04

Source: Cairo Demographic Center, Population Analysis of Egypt, 1972, Table 13, p. 34.

Socioeconomic Differentials

Very little information is available on socioeconomic characteristics. There seems to be a strong negative correlation between child mortality and educational attainment of the mother. The data presented below indicate a strong negative relationship, but they are not standardized with respect to the age of the mother. It is very likely, however, that the negative relationship would hold even if women were classified further by their age.

1/ Nour (1979), Tables 3 and 4. - 75 -

Educationalattainment Percent of children surviving of mother Women of all 3 or less parities parities

1. Illiterate or less than primary 78 86 2. Primary 84 91 3. Secondaryor higher 90 93

A recent paper using 1976 data for Cairo adjusted for the mother's age group shows that the proportion of children surviving increasedwith education. These data show that even a small amount of education increases the proportion surviving.

Proportion of Children Surviving by Age and Education of Mother, Cairo, 1976

Educational Level 25 - 29 30 - 34 35 - 39

Illiterate .8479 .8314 .8152 Read and write .8803 .8732 .8613 Primary .8908 .8901 .8815 Preparatory .9212 .9184 .9122 Secondary .9385 .9361 .9255 High diplomia .9415 .9445 .9097 University .9513 .9540 .9449

Source: Abou - Gamrah, 1980

Future Trends

The mortality level of a populationis a function of many variables (environmentalsanitation, availability and utilizationof public health services,income, education,and so on) operating individuallyand synergisti- cally. Future trends in Egypt's mortality will reflect the progress that is made on a number of fronts. If environmentalconditions are upgraded, if health services are improvedand better utilized, it is very likely that the mortality situationwill continue to improve. There is some reason to believe that utilization of availableservices will pick up in the coming years since today's adults (the generation born after 1952) are better educated and thus more likely to avail themselvesand their families of existing medical services. The upswing in female education in the 1950s and 1960s is a promising sign. A number of studies have shown that the educationallevel of the mother is a key determinantof the quality of the health and hygiene practices of the household. 1/ Indeed, the accelerationin the mortality decline that appears to have occurred in the 1970s could well be due to the improvementin the educational level of mothers. On the other hand, high birth rates and increasingly acute population pressure on the land and other resourcesmay well compromise this sanguine prognosis.

1/ See further the Proceedingsof the WHO Meeting on the Socioeconomic Determinantsand Consequencesof Mortality,Mexico City, June 1979. - 76 -

THE HEALTH SITUATION

The changes observed in a country's mortality pattern suggest in rather broad brush fashion the underlying changes in the health status of its population. The preceding section has documented the improvement that occurred in Egypt's mortality situation over the past 30 years and analyzed its salient characteristics. The ensuing discussion will explore some of the health developments that account for the decline in mortality. It will detail the changes that have taken place in the morbidity profile of the Egyptian people and will examine the health care delivery system.

Health Status

Measuring the health status of a population in developing countries is at best an imprecise exercise. Mortality statistics afford only a partial perspective and ideally should be supplemented with information on morbidity and debility if an accurate account of the health situation is to be delineated. Egypt, like other developing countries, lacks the detailed data which would permit such a thorough analysis; however, registration data on the cause of death permit us to discern what changes have occurred in the importance of various disease categories as causes of death.

From Table 3.5 it can be seen that the ranking of various disease categories as causes of death has remained largely the same over the 1937 to 1970 period with diseases of the digestive system accounting for the largest number of deaths and respiratory ailments as the second leading cause. Diseases of the digestive system were responsible for over 35 percent of all deaths in 1937, 1947, and 1960 and declined to about 30 percent in 1970. Diseases of the respiratory system accounted for 18.4 percent of male deaths and 19.4 percent of female deaths in 1970, and this was very similar to the levels recorded for 1939 (19 percent of male, and 17 percent of female deaths). The force of infectious and parasitic diseases as a cause of death has declined, as would be expected given the impact of modern medicines and government sponsored environmental programs (e.g. spraying for disease vectors). The increase in the proportion of deaths due to circulatory illness is consonant with what one would expect, given the inroads of urbanization and modernization.

Diarrheal diseases account for the largest proportion of infant deaths although the percentage of deaths from this cause has declined from 58.5 percent in 1963 to 45.8 percent in 1972. The data indicate that for the more recent years lower respiratory infections (pneumonia and bronchitis) are figuring more prominently as causes of death than the congenital anomalies than was the case in 1963 (Table 3.6). 1/ Recent estimates place maternal

1/ This is surprising since during the course of development the proportion of deaths due to exogenous factors should decrease relative to endogenous (congenital factors). Table 3.5. PERCENTAGE DISTRIBUTION OF DEATHS BY CAUSE OF DEATH, EGYPT SELECTED, YEARS 1937-1970

Diseases Diseases of of Diseases Infectious Circula- Respira- of Ill and tory tory Digestive defined Other Years Sex Parasitic System System System Conditions Diseases

1937 Male 6.7 4.6 19.2 34.0 7.6 27.9 Female 5.3 3.8 17.3 36.6 10.9 26.1

1947 Male 8.6 3.1 13.2 36.7 7.8 30.6 Female 6.7 2.9 12.1 40.5 10.4 27.3

1960 Male 4.3 8.5 14.1 35.1 13.1 14.9 Female 3.2 7.2 14.2 40.7 14,0 20.6

1970 Male 3.2 12.6 18.4 28.4 17.9 19.5 Female 2.1 10.1 19.4 31.2 21.7 15.5

Source: Bothaine El-Deeb, "A Study of Mortality in Egypt with Reference to Cause of Death" paper presented at the Seminar on Mortality Trends and Differentials in Some Arab and African Countries (Cairo: Cairo Demographic Center, 1975). Table 3.6: PROPORTION OF INFANT DEATH BY CAUSES OF DEATH, EGYPT, 1963-1972 (Percentage)

Causes of Death 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972

Diarrheal and Enteritis 58.5 54.8 53.0 55.1 55.6 58.2 59.0 49.0 40.5 45.8

Pneumonia and Bronchitis 11.5 14.1 12.8 13.9 13.9 13.9 13.4 21.8 29.2 27/1

Congenital Anomalies 25.2 25.4 31.3 27.9 27.6 24.9 21.3 21.8 22.9 19.7 1

-4 Measles 0.2 0.6 0.2 0.6 0.2 0.6 0.2 0.4 0.2 0.3 c

Other Diseases 4.6 5.1 2.7 3.5 2.7 2.4 6.1 6.0 7.2 7.1

Source: I.M. Eid and M. N. Soleman, A Study on Infant and Early Childhood Mortality in Egypt," paper presented the Seminar on Mortality Trends and Differentials in Some Arab and African Countries (Cairo: Cairo Demographic Center, 1975). - 79 - mortality at 10 deaths per 10,000, a level which is not abnormally high by developing country standards. Considering that over 60 percent of the births are unattended and that most of the women receive sparse (if any) prenatal care, the maternal death rate is not as elevated as one might expect. Infec- tion and toxemia as well as complications associated with childbirth are the principal causes of maternal deaths. Poor nutrition and the resulting anemic condition raise the usual risk attached to childbearing.

Morbidity

Disease surveillance in Egypt is neither thorough nor uniform throughout the country and thus information on incidence and prevalence is at best sketchy. There is, however, general agreement that the following diseases pose the most serious problems for the health of the Egyptian people: schistosomiasis; gastro-intestinal diseases; thyphoid and parathyphoid infection; and tuberculosis.

Schistosomiasis, a chronic helminthic (parasitic worm) infection marked by blood loss and tissue damage, has been endemic to Egypt since pharaonic times and with the increasing conversion from basin to perennial irrigation the disease has become an ever present factor in contemporary Egyptian life. 1/ As a direct cause of death, schistosomiasis is not significant; however, many of the complications associated with it are often fatal. Attempts to assess debility are frustrated because of the way in which the data are collected; usually there is no distinction between those who are infected and those who are ill because of the disease. Recent research indicates that overall prevalence of schistosomiasis in the Nile Delta area is decreasing. The three surveys conducted in the governorate of Beheira in the Western Delta illustrate this trend. 2/

Percentage Prevalence

Year of Survey S. haematobium S. mansoni Either or both

1935 53 54 83 1955 46 31 -- 1966 29.7 28.5 40.9

Historically, S. haematobium was found throughout the Delta region and S. mansoni was confined to the North and Central Delta area; a 1976 survey in the governorate of Qaliubiya showed a marked increase in the

1/ Both S. mansoni and S. haematobium are found in Egypt. Perennial irrigation refers to the installation of pumps to raise the water level so that irrigation takes place throughout the year rather than waiting for the nine months until the next flood.

2/ U.S. Environmental Protection Agency, Schistosomiasis in Rural Egypt, December, 1979. - 80 - prevalence of S. mansoni in the South-Central Delta area. 1/ Surveys carried out in Upper-Middle Egypt 2/ have found that S. haematobium was uniformly distributed throughout the region at a level of prevalence similar to the Delta (approximately 30 percent). S. mansoni was not endemic to the area.

In Upper Egypt, the area from Assylut to Aswan, only S. haematobium is found and the results of a 1972 survey show that the converstion to perennial irrigation has augmented its transmission and spread. A 1978 study in 27 villages in Minea (Upper Egypt) showed incidences ranging from 68.8 to 8.2 percent (averaging 33.6). After control activities, the incidence was reduced to 27.1 and 2.5 percent (averaging 13.2). 3/ Similar dramatic reductions were found in Fayoum after a control program was introduced. The incidence was reduced from 45 percent in 1968 to 8.1 percent in 1978. 4/

Certain differentials characterize the epidemiological pattern of this infection. Prevalence is highest among young children, declines markedly during the teenage years and is followed by a more gradual decline and a general levelling off in middle age. Males show a higher prevalence than females and, as would be expected, swimmers show a higher prevalence than nonswimmers. Occupation has been found to be strongly related to the prevalence. Holding educational status constant, it was found that 61 percent of farmers and farm laborers were infected compared to only 23 percent of those in all other occupations. The difference held for all the educational classi- fications examined--50 percent of farmers with primary education or higher had schistosomiasis in contrast to 16 percent for those in other occupations. 5/ It should be noted, however, that prevalence statistics are not a sufficient indicator of the true impact of schistosomiasis. The intensity of the infection and its cumulative impact are perhaps more cogent considerations.

1/ M. A. Alamy and B.L. Clive, "Prevalence and Intensity of S. haematobium and S. mansoni Infections in Kalyubia, Egypt." American Journal of Tropical Medicine and Hygiene, 26 (3): 470-492.

The authors suggest that the use of a new and more sensitive technique for detecting the S. mansoni ova may account for the observed increase in the prevalence of S. mansoni.

2/ Area south of Cairo to Assyiut which includes the governorates of Giza, Fayoum, Beni-Suef, Minia, and Assyiut.

3/ Mobarak (no date).

4/ In 1968 the Ministry of Health and the German Federal Republic launched an intensive campaign to eliminate schistosomiasis. The program was facili- tated by the fact that water supply comes from a single source, the Bahr Youssef canal, thus effective application of molluscides could be made at one point rather than piecemeal to the 40,000 km. of canals. Niridazle was used for treating the population.

5/ M. Farooq et al., 1966. "The Epidemiology of Schistosoma haematobium and S. mansoni Infections in Egypt - 49 Project Area," Bulletin of the World Health Organization, 35: 293-318. - 81 -

Unfortuntely, the documentation for other major diseases is nowhere near as extensive as it is for schistosomiasis. The high mortality toll exacted by gastrointestinal diseases has already been noted; there is no information on the extent of the debility incurred by those who survive bouts with these diseases. The widespread occurrence of intestinal parasites, dysentery, and diarrheal disease is largely attributed to the poor standard of environmental sanitation and limited access to potable water. Typhoid and paratyphoid fever continue to be a major concern.

In spite of concerted government campaigns, tuberculosis still accounts for 8 deaths per 100,000 and a prevalence rate of 2 per 1,000 (as identified by positive lung x-rays). It is estimated that about 18 percent of school children have received BCG (anti-tuberculosis vacine). The government maintains an extensive network for the identification and treatment of tuberculosis and, while the situation is improving, the prevalence of tuberculosis is still of considerable magnitude. Progress has been made with viral diseases; smallpox has been eradicated and cholera has been brought under control; however, poliomyelitis and measles continue to be major problems. There was an average of 1,700 cases of polio per year between 1971 and 1976 in spite of the fact that vaccination against polio has been mandatory since 1969. 1/ Immunization against measles has been required since 1977. It is estimated that measles is the cause of two-thirds of the deaths attributed to infectious and parasitic diseases among children aged one to four years. Trachoma and other acute eye infections, hepatitis, and rabies also persist as serious health problems.

Nutrition plays a key role in determining health status. With a daily intake of over 3,000 calories, the diet of the Egyptian people, on the average, meets the quantitative requirement. This caloric intake is, however, unbalanced with cereal grain accounting for 80 percent of the calories, and about 50 percent of the protein, consumed. Traditional dietary habits, as well as the unavailability of certain foods (particularly in rural areas), result in diets deficient in vitamins A and C and B-complex vitamins. The 1977-78 Nutrition Survey 2/ to determine the nutritional level of preschool age children found that about 23 percent of the children in the sample were chronically undernourished (those having a height for their age of less than 90 percent of the median of the reference population developed by the National Center for Health Statistics), and 27 percent were anemic. In the

1/ Time Series data for the number of polio vaccinations administered at Maternal and Child Health (CICH)Centers show that between 1972-75 an average 43,000 vaccinations per year were administered. In 1976 there were 191,000 and in 1977, 315,000 immunizations. This would indicate that about 30 percent of the children between two and four years of age received polio vaccinations through the MCH Centers. Data on polio immunizations given at other health facilities were not available.

2/ Survey conducted by the Nutrition Institute (Cairo), the Ministry of Health and the U.S. Center for Disease Control. Preliminary results have been published in Use of Nutrition Surveys for Family Planning Program Evaluation. John E. Andersen, et al. (Atlanta, Georgia: U.S. Dept. of Health, Education and Welfare, Center for Disease Control, 1979). - 82 - larger cities 11 percent of the children were chronically undernourished compared to 26 percent in the rural areas. About 14 percent of urban children were anemic, while 32 percent of rural preschool group were affected. Water supply in the home was used as an indicator of socioeconomic status. It was found that 13 percent of those having taps in the home were chronically undernourished, and 18 percent were affected by anemia. The corresponding numbers for those children without access to water in the house were 27 percent and 31 percent respectively.

THE DETERMINANTS OF HEALTH

The health of a population is determined by a number of factors. Geography and climate determine the kinds of vectors that may exist while living standards (income and educational levels) influence the risk and resistance to disease. The availability of health facilities for curative and preventive care is also actual. What is less obvious but hardly insigni- ficant is the role of individual behavior, e.g., the decision to utilize the health facilities and the inclination to follow basic health and hygiene practices within the household. All of these factors are of course inter- related and it is impossible to discern to what extent a country's health situation is attributable to each of these.

In analyzing the health situation in Egypt, it is useful to keep this configuration of interacting determinants in mind. As will be seen in the discussion which follows, Egypt has a very favourable distribution of health facilities and ratio of medical manpower to the population compared to other middle income developing countries. It appears, however, that this advantage is offset by a number of factors: a low level of environmental sanitation; high population density; low female literacy which helps to explain poor health and hygiene practices within the household; and less than expected levels of utilization of health facilities.

The lack of data prevents an in-depth analysis as to how these various factors operate to slow the improvement in health. Since data are most available for health infrastructure, we shall examine the health delivery in some detail. The relationship between delivery systems and individual behav- iour must, however, be kept in mind in analyzing the performance of the health system.

Egypt has high levels of medical facilities per capita compared with middle income countries. Population per physician is 1,190 compared to 4,310 for middle income countries as a whole. The respective figures for population per nurse are 1,150 and 1,860. For population per hospital the figures are 460 for Egypt and 571 for middle income countries. How these resources are deployed in Egypt will now be discussed. The Health Delivery System The Egyptian health care network comprises three principal systems: 1. The Government Sector which encompasses the Ministry of Health (MOH) hospitals, health centers, bureaux, and units as well as all university hospitals under the jurisdiction of the Ministry of Education. Services offered in these facilities are free. - 83 -

2. The Public Sector which includes the Health Insurance Organi- zation and the Curative Organizations of Cairo and Alexandria. The former provides curative services to government employees (not their families) and maintains its own facilities and medical staff. Approximately 1.2 million persons are covered under it. The Curative Organizations of Cairo and Alexandria were set up in an effort to compensate for the high cost of curative services provided through the private sector. A number of companies provide medical care for their employees through these organizations.

3. The Private Sector which comprises private clinics and hospitals. It is estimated that about 80 percent of government-employed physicians maintain a private practice.

Other components of the health care system include the military sector and various allied agencies such as pharmaceutical companies, drug control agencies and health related institutes. In principle, the vast majority (approximately 75 percent) of Egyptians must avail themselves of the services provided by the MOH; therefore, the focus of this section will be on the health infrastructure and services that come under the the government sector category.

The health care pyramid defined by the MOH includes four levels of services: village health units, which provide basic curative care and preventive services; at the base are the district health centers, which dispense more specialized care on both an outpatient and inpatient basis; general hospitals, where all medical specialties are available; and, at the apex of the pyramid. the university hospitals and teaching institutes in Cairo and Alexandria. In principle a referral system governs the passage from the village to the district level facilities; however, a number of utilization studies have indicated that in urban areas there appears to be little sem- balance of an effective referral mechanism. 1/ The following sections present a more detailed account of MOH activities in rural and urban areas.

The distribution of health facilities in rural areas is quite good by international standards. A recent study showed that in 1978 there were 9,215 people per health unit, 6,558 people per physician and 3,203 people per nurse. By all these measures Upper Egypt is better served than is Lower Egypt; yet, as we have frequently pointed out, mortality in Upper Egypt is persistently higher. 2/

Rural infrastructure. Putting primary health care within the easy reach of the rural population has been a major objective of Egyptian planners. At present there are about 3,000 health units throughout the country; over 75 percent of them are located in rural areas. The integrated rural health

1/ The Health Insurance Organization and the Curative Organization of Cairo and Alexandria (in the public sector) have implemented a referral system which appears to function fairly efficiently.

2/ See Mobarak (no date), p.21. The figure given for population per health unit in 1979 is 8,258 - much below the 1978 figure. It is unclear if this is a real difference or a difference in methods of calculation. - 84 - program has its origins in the Rural Health Reform Decrees of 1942. Over the years a number of experiments were undertaken to ascertain the type of facility best suited to the needs of the target population as well as the optimum density pattern. Table 3.7 chronicles both the evolution in types of health infrastructure and the increasingly favorable ratio of units per population. In an effort to augment utilization, it was decided in the early 1970s to abandon the building of Combined Units (a community development unit which included a health center) and Social Centers in favor of smaller more rudi- mentary units at closer geographic intervals.

Table 3.7 NUMBER AND COVERAGE OF BASIC RURAL HEALTH UNITS, EGYPT, SELECTED YEARS, 1946-1979

Type of Unit 1/ Ratio Year R.H.C. C.U. S. C. R.H.U. R.H. Total Unit/Population

1946 103 - - - - 103 1/121,612 1952 222 - 67 - - 189 1/ 48,028 1962 267 275 133 200 - 875 1/ 18,795 1972 589 - - 1,363 - 1,952 1/ 10,245 1976 568 - - 1,661 23 2,252 1/ 9,129

1979 547 - - 1,791 34 2,372 1/ 8,258

1/ Key: R.H.C. - Rural Health Center C.U. - Health Center in a Combined Unit S.C. - Social Center R.H.U. - Rural Health Unit R.H. - Rural Hospital

Notes: (i) 1972 - Health Centers in the Combined Units were considered as Health Center 1972 - Health Services in Social Centers were substituted by Rural Health Units 1976 - Some Rural Health Centers were developed into Rural Hospitals

(ii) The "recommended staffing pattern" for each of these units is found in Table 3.8.

Sources: Ministry of Health, the Egyptian Experience in Primary Health Care, (Cairo, 1977) and Mobarak (no date). - 85 -

The present rural infrastructure provides a health facility for about every 9,000 persons, giving an approximate average ratio of one per 1.8 villages. The network is designed so that every village is either directly serviced by a health unit or is within 3 kms of one. The MOR'S target staffing pattern for each type of unit is presented in Table 3.8. All the rural health installations deliver the basic services--maternal and child health care, vaccinations, screening for endemic and parasitic diseases, environmental

Table 3.8. THE HEALTH TEAM IN RURAL FACILITIES ACCORDING TO MOH STANDARDS, EGYPT

Rural Rural Rural Categories of Personnel Hospital Health Center Health Unit

Surgeon 1 General practitioner 1 2 1 Dentist 1/ 1 1 1 1/ Pharmacist 1 - - Sanitarian 1 1 1 Lab technician 1 1 - Radiology technician 1 - - Chief nurse I I - Graduate nurse 2/ 8 6 2 2/ Assistant sanitarian - - I Lab. assistant - 1 1

Source: Ministry of Health

Notes:

1/ Only in the units which have dental clinic. 2/ The number may increase according to population coverage. sanitation, health education, family planning (as described in the preceding chapter and its appendix), and, of course, curative medical care. This last service is rendered on an outpatient basis by the Rural Health Units which numbered 1,661 in 1976. Rural Health Centers (approximately 568 in 1976) have between 10 and 20 beds and are usually equipped with an operating room. A number of these centers have been upgraded to RuiralHospitals (RHs); as of the end of 1976, there were 23 such facilities.

Utilization has improved as the density of rural health service points increased (Table 3.9) but it still remains below the level that the Mnistry of Health would like to see. Table 3.9 notes that on the average 47 percent of the deliveries in 1972 were attended by health teams; it was, however, indicated to the mission that at present in many of the rural areas about 60 percent of the births are unattended by MOH personnel. It appears from the most recent data that utilization rates as measured by outpatients' visits and attended deliveries have declined. Utilization at mothers' clinics dropped over the period 1962 to 1978. Only the child health clinic utilization has shown uniform increases and then a levelling off. It appears that Table 3.9: RATES OF UTILIZATION OF RURAL HEALTH SERVICES, EGYPT 1952-1972

Year 1952 1962 1972 1978

(1) (11) Rate Rate Rate Rate of Services Target No. of of Util- Target No. of of Util- Target No. of of Util- Utiliza- Population Contacts ization Population Contacts ization Population Contacts ization Target Contacts tion

Out- patient clinic 13,888,000 2,619,119 0.19 16,446,000 11,898,961 0.82 19,999,300 17,409,615 0.78 19,821,020 13,851,253 .70

Mother's clinic 62,024 287,814 4.6 201,604 789,599 3.9 318,401 862,956 2.7 280,432 846,456 3.0

Child clinic 1,114,491 603,144 0.54 1,236,723 2,566,081 2.0 1,180,430 3,595,570 3.8 1,406,889 5,315,170 3.8

Delive- ries attended 611,047 57,030 0.09 662,767 164,631 0.25 626,555 293.479 0.47 749,420 226,268 .36 >

Source: Ministry of Health and Mobarak (no date)

Note: Outpatient clinic: Target pop. is the total rural pop. Contacts were defined as total visits to the units.

Mother's clinic: Target pop. is the registered expectant mothers. Contacts were defined as the total visits for the registered expectant mothers.

Child clinic: Target pop. number of children below two years. Contacts were defined as the total visits healthy and with sick events.

Deliveries: Target pop. the total births. Contacts were defined as the deliveries attended by health team. - 87 - while the accessibility of health services has been enhanced, much still remains to be done to make these services acceptable to the target groups. The MOH has embarked on a campaign to extend the outreach capacity of the rural health network. The project calls for: improving the transportation and communication support systems: home visiting on a regular basis by nurses and sanitarians; and experimenting with a number of schemes to improve health coverage in remote areas (e.g. posting resident nurses, training community health workers, and arranging for mobile teams to visit on a regular schedule). Concurrently, the ministry is also reviewing the rural health delivery system seeking to identify these aspects which may act as cultural barriers inhibit- ing utilization.

A critical aspect of preventative medicine is vaccination. Data on vaccinations reflect utilization of this system. One of the most interesting aspects of the utilization is that it is higher in Lower Egypt despite greater service points per capita in Upper Egypt. This is true for smallpox (97 versus 92), polio (92 versus 85), DPT (88 versus 86) and measles (66 and 47). 1/ This differential utilization in preventative services for children may explain why mortality is so much higher for children in rural Upper Egypt. While this is indicative of the causes of regional differentials in mortality, there is no ready explanation of why utilization patterns differ.

The Urban Infrastructure. The urban health sector covers about 44 percent of the population and encompasses the four urban governorates, the capitals of the remaining 21 governorates and 113 district capitals. In addition to university, general, and district hospitals, it comprises about 317 Health Bureaus which serve on the average 5,500 people; 221 MOH centers, each having a target population of 7,500 persons; and a school health service consisting of 144 School Health Units, 50 polyclinics, 26 specialized school Health Units and 5 Children's Hospitals carrying on school health programs.

In contrast to the highly integrated rural health care delivery system, the urban network has been characterized by fragmentation of services and a preponderance of specialized facilities. The notion of a health care system responsive to "community needs" has yet to become a reality in urban areas. In seeking preventive or curative care, the consumer frequently must visit several service points. Maternal and child health services are in principle taken care of by the MCH centers; however, immunizations, essential component of preventive health care for children, are dispensed by the Health Bureaus. The Health Bureaus also have the responsibility for the control of communicable diseases, environmental surveillance, food inspection, and registration of vital events. The ensuing confusion as to where particular services may be obtained had resulted in a pattern of overuse of the outpatient facilities of government hospitals to the neglect of peripheral stations. The MOH is seeking to revise the delivery of primary health care in urban areas; plans are underway for establishing Urban Health Centers which offer a full range of primary health care. It is anticipated that such a system would reduce the demands on hospital outpatient units by putting appropriate services within easier reach of the target community.

1/ From Mobarak (no date). - 88 -

Hospitals. Table 3.10 presents the distribution of hospital beds by governorate and jurisdiction. Approximately 36 percent of all hospital beds are found in Cairo and Alexandria; 23 percent of these are operated by the MOH while the rest come under the auspices of the private sector, the Health Insurance Organization and the Curative Organization (the public sector) and other ministries. Although there was a 10 percent increase in the number of hospital beds between 1969 and 1977, the rapid rate of population growth has kept the ratio of hospital beds about the same, 2.1 per thousand persons. In order to preserve this ratio, the MOH estimates that it will be necessary to add 8,870 beds during the period of the 1978-82 Plan.

Health Manpower. In contrast to many other developing countries, Egypt enjoys a favorable ratio of health professionals to target population. As of 1977 there were about 24,000 resident physicians, giving a ratio of about one doctor per 1,500 population; given the present enrollment in medical schools, it is expected that this ratio will be 1 per 1,300 in 1982. The MOH network includes about 5,000 support personnel--sanitation, laboratory, x-ray and dental technicians. 1/

The Egyptian Government has made considerable investment in the training of health manpower, as can be seen in Tables 3.11 and 3.12. Over 3,500 doctors graduated in 1976 compared to 1,695 in 1970. Likewise, the number of nursing graduates more than doubled (2,117 to 4,687) during the same period. Many have observed, however, that the rapid growth during the 1970s has attenuated the quality of medical education. The student-faculty ratio ratio soared and laboratory facilities were severely strained. 2/ Greater efforts are now being made to tailor the curriculum to the type of health problems likely to be encountered in rural settings have at best been halting.

Issues in the Health Sector

The above discussion of health facilities and medical manpower certainly supports the conclusion that Egypt appears to have an adequate health infrastructure. Thus it is even more puzzling why the health status of the Egyptian population hovers at a fairly low level. What the situation in Egypt appears to confirm is that "adequacy" simply from a quantitative standpoint is no guarantee of positive impact on health status. It appears that the health care delivery system in Egypt is fraught with a number of "qualitative inadequacies" which have resulted in low rates of utilization by the target populations.

1/ National Academy of Sciences, Health in Egypt (1979). Of the 32,000 physicians registered with the Egyptian Medical Syndicate approximately 27,000 were employed by the MOH; about 8,000 were abroad--either working or pursuing postgraduate studies; only about 400 physicians were engaged in private practice on a full-time basis.

2/ It was mentioned to the mission that it was not unusual for an instructor to lecture to a class of 1,000 students. - 89 -

Table 3.10. DISTRIBUTION OF HOSPITAL BEDS ACCORDING TO GOVERNORATES AND JURISDICTION, EGYPT, 1977

Ministry Public Private Other Governorates of Health Sector Sector Ministries Total

Cairo 3,113 2,266 2,032 6,696 20,607 Alexandria 3,816 1,628 72 2,612 8,128 Port Said 969 101 32 10 1,116 Suez 753 86 100 - 939 Ismailiya 574 96 - - 670 Damietta 1,081 22 - - 1,102 Dakahliya 3,135 165 110 689 4,099 Sharkiya 2,600 140 25 543 3,308 Qaliubiya 5,458 311 - 377 6,146 Kafr-El-Sheikh 1,551 - 14 - 1,565 Gharbiya 3,113 604 300 783 4,800 Menoufiya 2,327 90 35 597 3,049 Beheira 2,902 112 7 20 3,041 Giza 3,858 148 649 150 4,805 Beni-Suef 1,835 60 25 60 1,980 Fayoum 1,676 35 21 - 1,732 Minia 2,737 70 4 50 2,861 Assiut 2,070 116 - 561 2,747 Souhag 2,211 70 - - 2,281 Qena 1,839 - 58 70 1,467 Aswan 1,254 57 50 - 1,361 Matrouh 192 - 12 - 204 El-Wadi El-Gedid 211 - - - 211 Red Sea 113 83 - - 196 Sinai 65 - - - 65

Total 55,453 6,760 3,550 13,118 78,881

Source: World Bank, "A Basic Needs Strategy for Egypt," (1978). - 90 -

Table 3.11: NUMBEROF GRADUATESTRAINED IN MEDICINE, PHARMACY AND DENTISTRY, EGYPT, 1969-1976

Graduates

Category 1969-70 1970-71 1971-71 1972-73 1973-74 1974-75 11975-76 1/

Medicine 1,695 2,783 3,223 2,686 3,209 3,550 3,523 Pharmacy 718 821 748 878 889 1,007 1,164 Dentistry 252 487 406 422 408 443 438

Total 2,665 4,091 4,377 3,986 4,506 5,000 5,125

Note: Not including Azhar University.

Source: World Bank, "A Basic Needs Strategy for Egypt," Table 4.5.

Table 3.12: GRADUATES OF NURSING SCHOOL, EGYPT 1970-1976

Graduates

Instruction 1970-71 1972-73 1973-74 1974-75 1/ 1975-76

Higher Institute of Nursing 121 160 177 125 139 Technical Health Institute (Nursing Branch) - - 32 42 94 Secondary Technical Nursing Schools - - - 3,760 3,730 Nursing Schools(Old Diploma) 725 470 460 42 - Assistant Nursing and Midwives Schools 843 748 403 !0$ 92 Health Visitors Schools 428 551 446 504 435 First Aid Schools - 41 40 121 197

Total 2,117 1,970 1,558 4,698 4,687

Note: 1/ In the early 1970s all hospitals added nursing programs so there was a rapid increase in the numbers of nursing graduates, at some cost to the quality of training.

Source: World Bank, "A Basic Needs Strategy for Egypt," Table 4.5. - 91 -

The delivery system has been faulted for low quality services, particularly at local health units, delivered by medical personnel who sometimes lacked both appropriate training and sufficient motivation. It is estimated that peripherial health units operate at 50 percent of their capacity, while the outpatient units of large hospitals are severely overburdened. A utilization survey in the Greater Cairo Region revealed that in the case of non-emergency illness, only 4.8 percent of the respondents sought treatment at the nearest MOH clinic. 1/

While it is a moot point to argue what is the optimum level of government spending for health, Egypt cannot be faulted for having flagrantly low appropriations for health in relation to the level of other government expenditures. In 1976 Egypt spent $8 per capita on health. Only 5 of the 20 countries with incomes of $300-$600 exceed this amount and no country with per capita income below Egypt's spends even half that much. 2/ It could of course be argued that monies within the MOH budget could be reallocated to categories where they would be likely to have a more direct impact on raising the health status of the more deprived groups--the rural population and the urban poor.

The first part of this chapter noted that while there has been a decline in infant mortality, the infant mortality rate, nevertheless, remains at a fairly high level (110 deaths per thousand live births) despite a well delineated maternal and child health (MCH) program. This may be explained by the high population density in villages and the low level of sanitation. The findings of a 1976 survey conducted by the MOH may help to explain the elevated level of this indicator. The survey revealed that although the MOH recommends 10 visits for the course of the pregnancy. 3/ Registered clients show an average of 3 visits for *978. In 1976, over 70 percent of the cases in rural MCH centers were five months pregnant at the time of the initial visit. The MOH prescribes 7 postnatal visits in rural areas and 4 in urban areas; in 1976 these averaged 1.9 visits in urban areas and 5.3 visits in rural places. The survey further noted that there was a drop of 6.3 percent in postnatal home visits in rural areas between 1975 and 1976. In urban locales, the number of such visits plummeted by 39.7 percent.

The surprisingly low use of hospitals and MCH facilities for childbirth in Cairo may explain to some extent the unexpectedly high infant mortality observed for this urban governorate. A survey in the Greater Cairo Area revealed that 56.9 percent of the respondents delivered in hospitals or MCH facilities and 36.3 percent used local dayas. In Heliopolis, about 50 percent of the women reported using dayas to attend them during childbirth. 4/

1/ USAID Project Paper, "Egypt: Urban Health Delivery System," (processed), October 1978.

2/ World Bank Health Sector Policy Paper (1980), Annex 3.

3/ Two of these must be home visits and the rest by the client to the center.

4/ USAID Project Paper, "Egypt: Urban Health Delivery System," (processed) October 1978. - 92 -

Most of these dayas lack formal training and thus are less prepared to deal with problems associated with complicated deliveries than MOH personnel. 1/

While faults can be found in health delivery system, other factors are basically responsible for high infant mortality especially in rural areas and slums in arban areas. The Egyptian village has developed historically under the constrainc of the narrow Nile valley and the summer Nile food which led to formation of very large compact and heavily populated settlements.

This overcrowded and compact situation led to a very high degree of environmental pollution which makes the control of morbidity of child diarrhea a long term process. However, in 1977 the MOH had launched 2 important programs: the compulsory vaccination against measles and the rehydration program to control mortality due to child diarrhea. This led to a substantial drop in child mortality as shown by the following figures.

Mortality of children and 5 years of age: 1977 23% 1978 17%

In a pilot study performed on control of mortality from diarrhea under the rural health strengthening project in Dakahlia governorate, mothers were involved in identifying and managing cases of child diarrhea. In areas where this was achieved child mortality was dropped by 50%.

If the health level of the population is to be improved, environmental sanitation will have to be markedly upgraded and the effectiveness of the health care delivery system greatly increased. The former will require that access to potable water and adequate sewage facilities become more widely available particularly in the rural areas. Table 3.13 indicates the gap between rural Upper Egypt and the more urban sections of the country in terms of access to safe water. Programs of health education will have to be more assiduously pursued in order to assist rural residents in raising the level of their health and hygiene practices. It was pointed out to the mission that one cause of the poor rural environmental conditions can be attributed to the fact that humans and animals share the same dwelling, frequently to the detriment of the health of the household.

Improved effectiveness of the health delivery system will require both better management of available resources and an upgrading in the quality of care provided. At present the health system is characterized by an unbalanced distribution of personnel, badly maintained physical facilities, and particularly in urban areas, fragmentation of services. In the past it has been difficult to recruit and retain doctors in rural areas. The starting salary of MOH physicians is low, LE 26 per month, and this coupled with the

1/ Between 1940 and 1969 the MOH sponsored a training program and licensed dayas. It was terminated in 1969 because the government felt that the dayas would be superfluous in view of the large number of trained midwives (hakimas) it had available. The hakima has not replaced the traditional daya in the minds of the client community; many have argued that the trained daya would be an asset to the MCH program and since she communi- cates "in the idiom of the women she serves," the daya could become a valuable agent of change. cf. Laila El-Hamamsy, The Daya of Egypt (Pasadena. Ca.: Caltech Population Program Occasional Papers) 1973. - 93 -

Table 3.13. DIFFERENTIALACCESS TO SAFE WATER, EGYPTIAN REGIONS, 1976

Regions

Urban Lower Governorates Upper Governorates Access Category Governorates Urban Rural Urban Rural

Tap in dwelling 72.5 54.1 5 43.9 2.3 30

Tap outside dwelling but inside building 10.6 6.0 1.9 7.3 1.6 5

Outside building 15.5 20.1 63.6 22.7 52.3 40

No source of safe water 1.4 19.8 29.5 26.1 43.8 25.2

Source: CAPMAS, PreliminaryReturns of 1976 Populationand Housing Census, Table 25. - 94 - drawbacksof a rural environmenthas encouraged a practice whereby physicians appointed to rural MOH posts maintain a private practice in nearby urban locales, putting in no more than token appearancesat the rural health station. Doctors made little effort to identify with or promote the health and welfare of the local community.

In formulatingthe health strategy for the 1978-82Plan, the government has sought to rectifymany of these conditions and to enhance the cultural acceptabilityof MOH services. It has emphasized community participationin health planning and has underscoredthe need for health personnel to be responsive to the needs of the client community. Such measures should raise the level of public confidence in the health delivery system and hence the utilizationof the essentialhealth services provided by the system. - 95 -

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Gwatkin, Davidson, R. "The End of an Era." Overseas Development Council (processed), July 1979.

Ministry of Health. The Egyptian Experience in Primary Health Care. Cairo, 1977.

Ministry of Health. "Health Expenditures in the Arab Republic of Egypt," (processed). Memo. No.4, 1978. - 96 -

Mobarak, Almotazbillah, Mostafa T. Hammany, Osmar M. El-Zemaity and M. Nabil Nassar. "Study on Coverage, Effectiveness and Efficiency of Rural Health Delivery Service in Egypt". Arab Republic of Egypt, Ministry of Health and World Health Organization (no date).

National Academy of Sciences. Health in Egypt. Washington, D.C. 1979.

Nour, El-Sayed. "Mortality Level, Problems and Differentials in Egypt". UNESCO, Economic Commission for Africa, Expert Group Meeting on Fer- tility and Mortality Levels, Patterns and Trends in Africa and their Policy Implications. Monrovia, Liberia, 26 November - 1 December, 1979.

USAID Project Paper. "Egypt: Urban Health Delivery System," (processed), October, 1978.

U.S. Environmental Protection Agency. Schistosomiasis in Rural Egypt, December, 1979.

World Bank. A Basic Needs Strategy for Egypt, 1978. - 97 -

SOME ISSUES IN POPULATION AND HUliAN RESOURCE DEVELOPMENT IN EGYPT

CHAPTER IV

EDUCATIONAL DEVELOPMENT AND POPULATION GROWTH IN EGYPT 1/

SUMMARY

This chapter reviews the educational status of the Egyptian adult population whose demographic characteristics have been reviewed in the preceding two chapters. In turn, it provides a background for the discussion of the labor force found in the following chapter. The present chapter focuses on the expansion and differential in enrollment at various levels of education. It does not address the more difficult questions as to the quality of schooling. Nor does it attempt to assess what the optimal allocation of educational resources should be, but the inevitable conclusion is that on a comparative basis and on the basis of stated goals of universal primary education in Egypt, there is underinvesting in that level. The specialized problems of technical education have recently been reviewed in a Bank appraisal report and are not discussed here.

Egypt has made a large commitment to education in recent years, spending more than 5 percent of its gross domestic product (GDP) on recurrent and capital outlays in the sector in the post 1973 period. This expenditure has been devoted more to secondary and higher education than is true in most developing countries. As a consequence, Egypt spends 30 percent of its educational outlay on primary education, compared with 42 percent for the average developing country. This expenditure pattern is reflected in the educational status of the adult population and enrollment rates at various levels.

It is possible that the low expenditure on, and participation at, the primary level results from a lack of demand for education. Our analysis suggests, however, that except for primary enrollment in rural Upper Egypt (especially female enrollment), there is a strong association over time and across governorates between the availability of classrooms per school age population and enrollment rates. It therefore appears that a major explanation for the stagnation of primary enrollments in the period from 1960 to 1977-78 has been the result of the failure of classrooms to grow faster than the school age population. This also appears to be true, although to a lesser extent, for female enrollments at the primary level. The fact that primary enrollments (and female enrollments at the primary

1/ This chapter was prepared by Susan H. Cochrane and Mansour Oubouzar. - 98 - level) in Egypt are below those of the average middle income country, of the poorest 15 of the middle income countries, or of the average country in the Middle East and North Africa, is not due to a lack of the demand for primary schooling, as is shown in the analysis in this chapter.

The picture at the preparatory level is quite different. Here, school places increased much more rapidly than the relevant population age group and enrollments rose dramatically over the 1960 to 1977 period. This increase in enrollments, however, was not simply the result of increases in supply. The demand for school increased even more rapidly than supply and this resulted in large increases in pupils per class.

At all levels of education above preparatory education, Egypt's performance surpasses that of the average middle income country or the average country in the Middle East and North Africa. At the secondary level, supply increased faster than the relevant population age group and enrollment rates doubled. At this level, as in the case of the preparatory level, the demand for education evidently rose faster than supply, resulting in increases in pupils per class. In higher levels of education it is difficult to use the simple demand/supply analysis because of the multitude of varying programs and types of education and the effect of demand on supply exerted through strong political pressures to maintain free and access to universities.

Population growth has one of its most immediate effects on the school age population. Since primary enrollments have been constrained by the number of school places per capita, it is necessary to explore the implications of alternative population growth for the number of school places needed. The three alternative population projections used have very different implications for the size of population aged 6-11 between now and the year 2000. If fertility falls by 3 percent per year, the population aged 6-11 in the year 2000 will only be slightly higher than that in 1980. If fertility rates fall by only 1 percent per year, the population age 6-11 in 2000 will be 49 percent larger than in 1980.

These differences can be translated into classroom (and teacher) requirements:

(1) By the year 2000, the number of classes needed to just maintain enrollments under high growth, 169,517, is more than enough to reach 100 percent enrollment with low growth, 157,667.

(2) The planned construction for primary schools for the 1978 to 1982 period is 600. At an average of 10 classes per school, this is a total of 6,000 classes to be added onto a base of 98,000 in 1977/78. This represents only 90 percent of what is needed to maintain constant enrollment rates in 1982.

While these projections are hypothetical, they are nonetheless indicative of a shortage substantial enough to result in falling enrollment rates. If any attempt were made to increase the quality of education, for - 99 - example,by eliminatingdouble shifting, the consequencesof any population growth would be even more difficult to cope with and the differencesin the consequences of alternative growth rates will be even more substantial.

Evaluating the consequences of population growth for preparatory education is much more difficult than in the case of primary education, since it is necessary to make alternative assumptions about the output of primary education. Two alternative sets of assumptions were used. First, we shall assume that primary entry, dropout and graduation rates remain constant and therefore that 50 percent of those of ages 12-14 continue to be enrolled in preparatoryschool. The second assumption reflects the goal of achieving universal enrollment in primary education. It will be assumed that 75 percent of those entering primary school eventuallygraduate from primary school and enter preparatoryschool. While this represents a very optimistic prospect for improved efficiency of the primary system, we have observed that the ratio of graduates.of primary schools to entrants six years earlier has increased from 39 percent in 1960 to 66 percent in 1976. In addition,the assumption of 75 percent enrollment in preparatoryschool is less ambitious than the proposal to increase the compulsory age for schooling to 15 by 1990.

With constant enrollment rates, the number of classroomsneeded by 1980 is not much above the 1976 figure of 35,888. Therefore,given planned expansion in classrooms,class size might be expected to fall slightly. By 1985, the planned expansion of classroomsby 7,843 would provide a very substantial surplus of classrooms over what is needed if constant enrollment rates continue (43,731 versus 38,128). This surplus could be used to expand enrollmentsor reduce class size.

Preparatoryenrollment rates are, however, limited by the number of students graduating from primary school. Therefore unless the proportion of those children entering primary school and being graduated from it increases, the planned expansion at the preparatoryschool level may in fact be wasted in the resultant under-utilizationin the short run.

In the long run the need for preparatoryclassrooms depends very much on the rate of population growth. If the fertility rate falls by 3 percent a year the number of classrooms needed is less than that which is projected to be available in 1984. Whereas if fertility falls only by 1 percent a year, the number of classrooms will have to increase by 29 percent over the low population growth figure.

If the primary school system can expand its rate of entrants and the proportion of those who graduate, the need for preparatory school places will increase substantially even under slow population growth rates. The enormous effect of primary enrollment rates on the need for preparatory classrooms is shown by comparing 1980 figures with those in 2000. With constant enrollments,53,000 places will be needed in 2000 if the population grows at its fastest rate. This is the number of classes needed in 1980 if enrollment rates of 75 percent were to be achieved. By the year 2000 the number needed to obtain 75 percent enrollment would increase to 62,000 if - 100 -

growth slows substantially and 79,000 if it slows only slightly. Thus the key to what happens to the need for preparatory places depends much more on what happens to the expansion of the primary level than to population growth. But such expansion could be more easily managed in the long run with slower population growth.

Given this background, the following discussion begins by exploring resource allocation to education and then focuses on the adult educational status and related historical trends. A detailed analysis of enrollments follows, with attention to entry and advancement and also, where appropriate, regional differentiation at the primary, preparatory, secondary, and higher education levels. A brief assessment of technical and vocational education is then followed by a concluding review of the issues. Two short technical appendices review, respectively, the effect of selective migration on the educational profile of the resident population, and the role of adult literacy programs. - 101 -

INTRODUCTION

Leaders of developing countries seek to define and consolidate a national identity through the rapid development and democratization of a national culture and education. It is also through this accelerated development that these leaders are seeking a long term solution to their country's problems of poverty. Sharing these common views, the authorities in modern Egypt, especially since the 1952 revolution, have made commendable efforts to develop and democratize its educational system, in the hope of gradually eliminating illiteracy and fostering economic development. But despite the achievements, serious bottlenecks and inequities remain.

Primary education requires special attention because of its relatively low levels of enrollment, the inequality in those enrollments, and the difficulties that arise in overcoming these problems when population is growing rapidly. To understand what is happening at the primary level, it is necessary to present a broad picture of the resources devoted to education in Egypt and of the distribution of education across the Egyptian population and then, given this context, examine the school system itself.

RESOURCE ALLOCATION TO EDUCATION

The importance given to education in the last 20 years is reflected in the financial resources allocated by the government to this sector (Table 4.1). Total government expenditure (recurrent plus investment) on education, which represented 3.84 percent of GDP valued at market prices in 1965-66, increased to nearly 4.4 percent in 1970-71, and to 5.2 percent after 1973. This is the upper quartile of educational expenditures as a percentage of GNP. 1/ Recurrent expenditure on education which grew mode- rately (7.6 percent annually) between 1965-66 and 1970-71 increased at an annual average rate of 17 percent between 1970-71 and 1976. The acceleration in the latter period, however, reflected mainly government wage adjustments. Total government financial commitments to education would have been greater if it were not for the constant state of war that had prevailed in the region for the last 20 years-- a constraint which limited considerably capital expenditure in this sector, and particularly that for primary education.

The allocation of educational expenditures by level is shown in Table 4.2 for 1973 and 1976. Approximately 30 percent is devoted to primary education, 14 percent to the preparatory level, 18 percent to secondary education and around 24 percent to universities. This outlay compares with median expenditures for developing countries of 42 percent on primary, 26

1/ World Bank, Comparative Education Indicators, January 18, 1980. [References cited will be found at the end of this chapter.] - 102 -

Table 4.1: GOVERNMENTEXPENDITURES ON EDUCATION, EGYPT, 1970-1976 (LE Million)

Item 1970/71 1971/72 1973 1974 1975 1976

1. Total government recurrent expenditure 947.6 1,143.1 1,111.0 1,435.0 2,079.0 2,340.0

2. Recurrent expenditure on education 129.84 137.65 171.6 191.16 224.1 283.86

3. 2/1 as percentage 13.7 12.04 15.45 13.33 10.78 12.18

4. Public Investment 358.3 414.4 451.4 564.0 913.1 1,374.9

5. Investment on education 9.67 16.5 25.74 18.1 39.8 41.1

6. 5/4 as percentage 2.7 4 5.7 3.2 4.4 3

7. Total expenditure on education 139.51 154.15 197.34 209.36 263.9 324.96

8. GDP at market price 3,202.1 3,429.5 3,806.3 4,197 4,886 6,276

9. 7/8 as percentage 4.4 4.5 5.2 5 5.4 5.2

Source: Ministry of Planning, Arab Republic of Egypt. Table 4.2: CAPITAL AND RECURRENT EXPENDITURES ON EDUCATION BY LEVEL OF EDUCATION, EGYPT, 1973 and 1976

Capital Expenditures Recurrent Expenditures 1973 1976 1973 1976 Category Amount % Amount % Amount % Amount %

LE'000 LE'000 LE'OOO LE-OOO

Ministry of Education:

1. Primary 7,304 28.6 2,172 8.4 52,434 30.8 81,598 29.1 2. Preparatory 2,205 8.5 2,304 9.4 24,391 14.3 38,294 13.7 3. Secondary 4,908 19.2 3,304 12.9 32,080 18.9 51,566 18.3 4. Teacher Training 885 3.5 98 0.4 4,984 2.9 7,686 2.8 5. Handicapped 197 0.8 32 0.1 495 0.3 742 0.3 6. Adult Literacy 49 0.2 50 0.2 490 0.3 817 0.37 7. Administration, 61 0.2 40 0.2 15,389 9.0 24,101 8.6 Sports, Culture

Subtotal 15,609 61.0 8,869 31.2 130,263 76.5 204,804 73.1

Ministry of Higher Education 2,757 10.8 4,380 17.0 7,174 4.2 4,786 1.7

Universities 7,066 27.7 6,391 24.9 31,457 18.5 66,489 23.1

Ministry of Industry 98 0.4 569 2.2 1,267 0.7 1,393 0.5

Ministry of Housing 18 0.1 5,475 21.4 245 0.1 2,791 1.0

Total 25,548 100.0 25,684 100.0 170,406 100.0 280,263 100.0

Source: USAID, 1977, pp. 63 and 65. - 104 - percent on secondary, and 18 percent on higher education levels. 1/ There- fore, Egypt's expenditures, which are quite high for a developing country, are also higher than average in the proportion allocated to post-primary levels of education. The consequences of this allocation will be discussed below.

ADULT EDUCATIONAL STATUS

While Egypt has a very long history of scholarly and intellectual achievement, it is only in this century, and in fact only in the last 30 or 40 years, that much progress has been made in educating a broad base of the population. Despite the progress made to date, the majority of the adult population is still illiterate. In this section, we shall examine the progress that has been made in educating the population and briefly highlight the major problems that still need to be solved.

The educational status of the adults in a country as measured by a census or a survey reflects not only the production of the school system but also migration if the latter is selective on the basis of education. Given the high level of emigration in Egypt, the data on educational status are not an accurate measure of the progress of the educational system. Regional figures suffer from the same distortions because of the important internal migration of the population. For these reasons the school system must carefully examined to determine how much of the shortfalls in basic education are due to the educational system itself, and how much to selective outmigration of the more educated. While the main discussion in this chapter focuses on the performance of the school system, an appendix note summarizes the selectivity of migration and another brief note reports on the role of adult literacy programs in affecting the educational profile of the adult population.

Historical Trends

Eighty-five percent of the Egyptian population was illiterate in 1937. By 1976 this level had been reduced to 57 percent, but progress for males and females alike has been uneven, as has the achievement at higher levels of education. Table 4.3 traces educational achievement at various levels for the population over 10 years of age for the period from 1937 to 1976. The 1960 to 1976 component of that period is the first in which the increase in the category of those who could read and write was greater for women than it was for men. But in no period have women shown more of an increase than men at higher levels of education. Thus it appears that while women have begun to catch up in simple literacy, the gap has widened at higher levels of education and in fact the gap between males and females has increased

1/ World Bank, Comparative Education Indicators, January 18, 1980. Table 4.3: PERCENT DISTRIBUTION OF POPULATION 10 YEARS AND OVER BY EDUCATION AND SEX, EGYPT, CENSUS YEARS 1937, 1947, 1960, and 1976

1937 1947 1960 1976 Education Status Male Female Total Male Female Total Male Female Total Male Female Total

Illiterates 76.5 93.9 85.3 66.2 88.3 77.1 56.6 83.9 70.3 42.7 72.3 57.4

Can read and write 20.5 5.6 13.0 29.5 10.7 20.1 32.8 12.5 22.6 28.6 13.0 21.0

Primary 1.8 0.4 1.1 2.1 0.8 1.6 2.2 1.1 1.7 o 17.0 9.5 13.2

Secondary 0.6 0.1 0.3 1.4 0.2 0.8 6.8 2.3 4.5 8.4 4.2 6.3

College 0.6 - 0.3 0.8 - 0.4 1.6 0.2 0.9 3.3 1.0 2.1

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 1/

Sources: Hassan (1972), Table 1; 1976 Census.

1/ For consistency with earlier years, population classified as "unspecified" were allocated propor- tionately to the other categories. - 106 -

slightly at the level of illiteracy. 1/ In 1960, the male illiteracy rate was 27.3 percentage points lower than that of females, while in 1976 it was 27. 8.

Egypt, which is the poorest of the middle income countries as defined by the World Bank, has a literacy rate of 44 percent compared with the average of those countries of 69 percent. The low-income countries have an average of 36 percent. Since Egypt is the poorest of the middle income group it is better to compare its performance with the poorer middle income countries. For the 12 of 15 countries in that group for which data are available, the average literacy rate was 65 percent, not much below that for the middle income group as a whole. Therefore, Egypt's progress in achieving literacy is closer to the performance of a low income than that of a middle income country. Two issues in educational achievement that stand out are the relatively slow progress in achieving literacy, and the particularly slow progress in female education. One cannot analyze this issue by income level alone. The cultural context must also be considered. Comparing Egypt's adult literacy rate with that of nine Arab countries 2/ one finds Egypt's performance is slightly above the average level of 40 percent.

Another major problem is the lack of uniform access to, or utilization of, educational opportunities throughout Egypt. Table 4.4 summarizes the regional differentials in achievement. The urban governorates have the highest educational achievement as might be expected. Of the rural governorates, those in Lower Egypt are better off than those in Upper Egypt or the frontier governorates at all levels of achievement, except university degrees. At the university level all nonurban governorates have the same level of achievement. This circumstance probably results from the fact that most university graduates in those regions are in government employment which is equally represented in all nonurban governorates. But it is, of course, at the university level that urban governorates are at the greatest advantage relative to rural governorates.

The rate of progress in reducing illiteracy has also differed substantially between governorates in the 1960 to 1976 period. Table 4.5 shows that for Egypt as a whole the illiteracy rate has dropped by 13.8 percentage points (13.4 for males and 12.9 for females). 3/ Some governorates achieved substantially greater progress than the national average (Aswan, Giza, Gharbiya, Qaliubiya and Damietta). Of these Aswan and Giza and

1/ This occurs because male advances at levels of above simple literacy more than cancelled out female gains in literacy.

2/ Egypt, Morocco, Tunisia, Syria, Jordan, Algeria, Libya, Kuwait, Yemen AR (Saudi Arabia figures were not available.)

3/ It seems inconsistent that the total dropped more than that for either group. This would imply that the 1976 population had a higher proportion of males than females than the 1960 population which seems unlikely given high emigration of males in 1976. Table 4.4: PROPORTION OF POPULATION 10 YEARS OF AGE AN OLDER WITH VARIOUS LEVELS OF EDUCATIONAL ACHIEVEMENT, EGYPT AND MAJOR REGIONS, 1976

Illiteracy Rates Proportion Proportion with Proportion with Who Can Read Certificate University Male Female Total and Write Below University Degrees

Urban Governorates 24 47 35 26 33 4.9

Lower Egypt 44 76 60 2] 17 1.3

Upper Egypt 52 80 66 17 13 1.4 C Frontier Governorates 42 69 55 21 17 1.7

Total 42 71 56 21 19 2.1

Source: 1976 Census. - 108 -

Table 4.5: COMPARATIVE ILLITERACY RATES, EGYPTIAN GOVERNORATES, 1960-1976

Illiteracy Rates Reduction in 1960 1976 Illiteracy 1960-1976 Male Female Total Male Female Total Male Female Total

1/ 1. Urban Governorates 36.90 64.11 48.56 24.11 49.73 35.02 -12.79 -14.38 -13.54

2. Damietta 52.92 74.50 63.54 39.77 60.21 49.85 -13.15 -14.29 -13.69

3. Dakahliya 52.54 82.57 67.72 41.66 73.74 57.53 -10.88 - 8.83 -10.19

4. Sharkiya 60.54 88.95 74.92 46.33 78.08 61.92 -14.21 -10.87 -13.00

5. Qaliubiya 53.94 89.88 70.76 36.42 72.80 53.93 -17.52 -17.08 -16.83

6. Kafr-El-Sheikh 72.47 92.66 82.76 56.69 83.99 70.37 -15.78 - 8.67 -12.39

7. Gharbiya 54.40 85.75 70.38 38.78 72.35 55.41 -15.62 -13.40 -14.97

8. Menoufiya 53.83 87.21 70.74 40.44 76.95 58.48 -13.39 -10.26 -12.26

9. Beheira 66.36 91.98 78.78 51.82 81.71 66.65 -14.54 -10.27 -12.13

10. Giza 54.37 82.84 68.64 37.10 66.92 51.59 -17.27 -15.92 -17.05

11. Beni-Suef 63.49 90.00 77.40 52.47 83.76 68.15 -11.02 - 6.24 - 9.25

12. Fayoum 70.18 89.58 80.13 60.84 83.52 72.04 - 9.34 - 6.06 - 8.09

13. Minia 66.62 90.30 78.54 56.39 82.18 69.03 -10.23 - 8.12 - 9.51

14. Assyiut 68.12 90.02 78.98 54.42 83.02 68.30 -13.70 - 7.00 -10.68

15. Souhag 72.08 93.82 83.13 56.34 84.19 70.26 -15.74 - 9.63 -12.87

16. Qena 74.34 93.13 83.81 56.81 86.03 71.32 -17.53 - 7.10 -12.49

17. Aswan 61.25 88.15 75.17 39.12 72.26 55.84 -22.13 -15.89 -19.33

Total 56.60 83.90 70.30 41.91 70.91 56.17 -14.69 -12.99 -14.13

Note:

1/ Includes Ismailiya..

Source: Censuses 1960 and 1976. - 109 - probably Qaliubiya had an inflow of migrants that were more educated. Therefore, only the others apparently achieved above average progress through their own educational efforts. All of these are Lower Egypt governorates. In addition, Menoufiya in Lower Egypt had slightly greater than average progress. Only in Qaliubiya, Damietta and the urban governorates did female illiteracy rates fall faster than male rates over the period. All Upper Egypt governorates, including Aswan and Giza, showed slower progress for females than males--as well as slower overall progress (excluding Aswan and Giza).

These issues in Egyptian education are widely recognized and some attempt has been made to address them. But despite recent feminist reforms in other areas, educational policy has not been included. In his December 1976 speech on education, President Sadat specifically mentioned increasing compulsory education to cover 100 percent of the population and correcting regional imbalances. 1/ The 1978-1982 five-year plan also addresses illiteracy as one of the major issues in Egyptian education. 2/ Neither document explicitly mentions the lack of educational achievement of women.

The following discussion will concentrate on these issues and only a brief subsequent description will be given of technical education and university education. The primary reason for the concentration on the lower levels of education, primary and preparatory, is not only that these are the levels of education which are most closely related to population growth, both as cause and consequence, but also that education at these levels is prerequisite for higher, more specialized education 3/ and it is here that equalization of opportunities between urban and rural residents, Upper and Lower Egyptians, and males and females must begin.

The Educational Production Process

The educational production process depends on the inputs of classrooms, teachers, books and supplies and, of course, pupils. When any portion of the system is performing counter to stated policy, the major question that must be answered is: What is the binding constraint? Is it a constraint on the supply of teachers or classrooms or a lack of demand for education manifest through low utilization or participation rates? More realistically of course all of these factors interact and are further blurred by problems of quality.

1/ AID report (1977), p.10.

2/ Plan, p.123.

3/ In Egypt primary school seems to be a more formidable obstacle than it is in many countries, but once through primary school, Egyptian children show a much higher propensity to go further. This is witnessed by school enrollment. In Egypt the ratio of primary to secondary to higher is 10:6:2 compared with 10:4:1 for the average middle-income country. (Kavalsky, p.28) - 110 -

In the analysis that follows an attempt will be made to separate out the importance of demand and supply constraint in primary and preparatory education in Egypt. While supply can be measured by the numbers of teachers or of classrooms per school age population, these indices may to some degree be determined in turn by the demand of the community, as opposed to that of the the family, for education. The individual's or family's demand for education is more difficult to measure. All that one can observe is the utilization. If one controls for changes in the supply of education, variations in utilization reflect difference in the demand for education. Thus in the following discussion supply will be measured and demand will be inferred from variations in utilization. The binding constraint probably varies by type of education and region and, of course, it varies over time.

Enrollments

The participation in levels of education in Egypt compared with that of other countries indicates that Egypt is lagging at the primary level and outperforming other countries at higher levels. Table 4.6 gives enrollment rates by education level for Egypt and for comparable countries--low income in the second column, middle income countries in the third column, the 15 poorest middle income countries in the fourth column, and other Arab countries in the last column. These figures show clearly that at secondary and higher levels of education Egypt has higher rates (total and for females) than have any of the comparable countries.

At the primary level, Egypt has lower enrollment rate (total and female) than any other group except the low income countries. It is particularly surprising that Egypt has lower primary enrollment (particularly female enrollment) than the other countries of the Middle East and North Africa. To what extent are primary enrollments limited by the provision of primary places and to what extent have they been limited by a lack of demand? Time series and cross sectional analysis can give some insight into this issue.

The Primary Level

Primary Enrollment. Primary enrollment figures represent a composite picture of the educational process at the earliest stage. Usually these are presented as the ratio of those enrolled in primary school relative to the population between the age of entry (six years in the case of Egypt) and the age of exit if one completed the cycle without repetition or interruption (age 11 in Egypt). If there were no overage pupils due to either repetition or to late entry, the enrollment rate could never exceed 100 percent. Given how frequent late entry and repetition are, however, enrollment rate can exceed 100 percent unless overage figures are separately reported. 1/ In the data given below on Egypt the figures include overage students, and therefore, give an overly optimistic picture of enrollments.

1/ If one had census data reporting on enrollment of specific children in relevant age groups, these kinds of problems would not arise. - 111 -

Table 4.6: ENROLLMENT RATES BY EDUCATIONAL LEVEL, EGYPT AND SELECTED COUNTRIES, CIRCA 1980 (Total and female where available)

15 Poorer Other Arab: Enrollment Low Middle Middle Middle East Rates Egypt 1/ Income 1/ Income 1/ Income 2/ North Africa 1/

Primary

Female 56 49 81 79 68

Total 72 63 89 86 88

Preparatory 4/

Secondary

Female 29 8 26 22 21

Total 42 14 32 29 30

Higher Education 3/

Total 14 4 11 8 8

1/ World Bank, World Tables (1980), p. 455 (most recent estimates).

2/ Calculated from ibid.

3/ World Bank, World Development Report, 1980.

4/ No comparable data available for the preparatory level.

Enrollment data seem to vary substantially depending on the source. Enrollment rates vary even more because until the very recent publication of the 1976 Census there were virtually no detailed data on the number of children of the relevant ages since the 1960 Census. Rough estimates from the enrollment data and projections from the 1976 Census indicated primary enrollment rate of between 73-74 percent for Egypt as a whole for 1977-78, depending on what population estimate is used. - 112 -

Table 4.7 shows the population aged 6-11 from 1960-61 through 1978-79 and the resulting enrollment rates. The population 6-11 was estimated by projecting the births since 1948 forward using life table survival rates. Since births are known to be underregistered, the birth survival technique will give enrollment rates that are too high since the base population is too low, but these rates more accurately reflect the fluctuations in enrollment rates that result from fluctuations in birth rates in earlier years (see the discussion on fertility in Chapter II). The enrollment rates resulting from the use of census data give more accurate estimates of levels if the census has a higher coverage rate than the vital registration system, but since the census reports only data for five-year rather than single-year age groups, any year-to-year fluctuations in cohort size are bound to be masked.

For 1976, the Census yields a lower estimate of 6-11 population than our birth survival technique (5,707,571 versus 5,780,727). 1/ Thus for 1976 the Census gives an enrollment rate of 72.7 versus the 71.8 obtained using the birth survival technique. For 1960 the Census gives higher values than birth projections and therefore lower enrollment rates (72 versus 77).

Although census data give somewhat different levels of enrollments, the pattern is generally the same: a slight increase in the early 1960s followed by a decrease in the second half of that decade and an upward trend after around 1970. 2/ The two methods differ with respect to whether enrollment rates have remained constant or fallen since 1960.

The year-to-year enrollment rates show dips in enrollments from 1966 to 1970 with a slight upturn, then a downturn in 1973-74, and then a fairly continuous, but slight, upturn. It is quite probable that the low 1973 figure was largely due to the 1973 war since not only enrollment rates, but actual enrollments fell in that year. The other fluctuations are less easily explained. But population growth seems to be partly responsible.

I/ Our census estimates were obtained by using population 5-9 and 10-15 and allocating population from these groups to age 5 and 10 and 11. Another technique is to use data on population 6-11 obtained from tables on Egyptians (not total population) by labor force participation. These tables yield 5,255,840 and 5,258,397, substantially below either of our estimates and would therefore yield higher enrollment rates even if one added an estimate of those in the age group who are residents in Egypt, but are not Egyptian citizens. Since the other techniques yielded independent estimates which were so close we decided to use those estimates.

2/ Enrollment Rates Census and Birth Survival Census Survival Year and Revival

1960 72 77 1965 75 78 1966 71 76 1971 69 71 1976 73 72 - 113 -

Table 4.7: POPULATION AGE 6-11 PROJECTED FROM REGISTERED BIRTH, EGYPT, 1960-1979 (Population from Birth Survival) 1/

Total Year Age 6-11 Enrollment Enrollment Rate

1960/61 3,392,834 2,627,303 0.77

1961/62 4,155,261

1962/63 4,216,994

1963/64 4,223,940

1964/65 4,280,328 3,330,500 0.78

1965/66 4,413,305 3,453,293 0.78

1966/67 4,569,620 3,482,500 0.76

1967/68 4,768,645 3,506,300 0.74

1968/69 4,911,370 3,550,119 0.72

1969/70 5,140,130 3,618,750 0.70

1970/71 5,305,989 3,740,551 0.70

1971/72 5,458,250 3,873,297 0.71

1972/73 5,581,242 3,989,139 0.71

1973/74 5,642,843 3,919,861 0.69

1974/75 5,731,853 4,074,893 0.71

1975/76 5,761,315 4,120,936 0.72

1976/77 5,780,727 4,151,956 0.72

1977/78 5,782,974 4,211,345 0.73

1978/79 5,774,140 4,287,124 0.74

1979/80 5,850,338 4,434,000 0.76

Note: 1/ Since births are underregistered, we expect that the population estimates are too small and enrollment rates too large. For example, in 1960 the Census count of 5-9-year olds was 3,799,003 while our estimate is 3,513,518. This represents an 8 percent underestimate. Correcting for this would give an enrollment rate of 72 in 1960. Source: 1960-1978 Enrollment, CAPMAS Statistical Yearbook (various years). 1979 Ministry of Education estimates. - 114 -

From 1962 to 1968 the size of the 6-11 age group increased yearly from an increase of 7,000 between 1961 and 1962 to 229,000 between 1967 and 1968. The annual increase did not fall below 100,000 until the 1971-72 period. From 1970 onward, except for 1973, enrollment rates continued to rise as the size of the new cohort continued to increase by smaller and smaller amounts until 1978 when the population 6-11 fell slightly and enrollment rates achieved an 11-year high. This seems to imply that slowing the rate of growth of the school age population increases enrollment rates. This then implies that at least in part enrollment is limited by the availability of school places.

It is difficult, however, to sort out how greatly supply has constrained an expansion of enrollments, because neither supply nor demand can be easily measured. Supply can be approximated by the number of schools, classes or teachers available to the school age population. It seems, however, desirable in the Egyptian situation to concentrate on schools and classes since what little evidence is available on teachers indicates that while they may have been a binding constraint in the early 1960s they are not in the late 1970s--at least not at the aggregate level. There may be problems of deficits of teachers in certain rural areas or a lack of female teachers.

It is obvious that a supply constraint exist when one examines the size of class that would be necessary to absorb all the school-age population (assuming an absence of overage students). This was 57 pupils in 1976, which was only slightly less than in 1960, when it was 58. 1/ Thus since 1960 the increase in classes has barely kept up with the increase in school age population at the primary level. Therefore, it is not surprising that enrollment rates in primary school have not increased.

The simple correlation between enrollment rates and population per class in the period was -.94. For population per school the correlation was lower, but still highly significant at -.74. 2/

It would be inaccurate, however, to attribute all the shortfall in enrollments to lack of school places. Certainly supply factors cannot explain why 87 percent of males aged 6-11 were enrolled in primary schools in 1977-78, and only 61 percent of the females. This may reflect the fact that education for daughters is in less demand than is education for sons, and that parents, and perhaps the school system itself, discourage girls from attending to allow room for boys. If this is the case then we would expect the enrollment of girls to increase somewhat when school places become more available. The proportion of students who were female for selected years for which data are available are shown in Table 4.8.

1/ Data indicate that the population aged 6-11 per primary teacher was 52 in 1966/67 (compared with 52 for classrooms), but in 1976/77 the ratio for teachers was 46 and for classrooms 57. (Calculated from Table 29 AID, 1977)

2/ Since there was not a strong time trend in this data these correlations are unlikely to be highly affected by auto-correlation. - 115 -

Table 4.8: ENROLLMENTRATES, CLASS SIZE AND PROPORTION OF FEMALE STUDENTS, EGYPT, SELECTED YEARS 1955-1978

Proportion of Primary Students Enrollment Enrollment Population Population Year Who are Female Per Class Rate Per School Per Class

1955/56 36.8 40.95

1960/61 36.8 44.7 .72 (.77) 1/ 470.7 55.0

1965/66 39.4 42.8 .78 533.2 51.5

1968/69 38.3 42.4 .72 628.4 58.7

1969/70 38.1 42.3 .70 632.8 60.1

1970/71 38.0 42.5 .70 630.5 60.3

1971/72 38.0 44.0 .71 632.2 60.6

1972/73 38.0 43.14 .71 568.3 60.4

1973/74 38.2 41.55 .69 576.3 59.8

1974/75 38.2 41.74 .71 565.3 58.7

1975/76 38.5 41.43 .72 556.9 57.9

1976/77 38.8 40.85 .73 547.0 56.9

1977/78 39.2 40.82 2/ .74 534.6 55.5

Notes:

1/ The larger figure is obtained using technique used in other years. The lower figure is obtained using 1960 census data.

2/ Tentative figure.

Source: Ministry of Education. CAPMAS, Statistical Yearbook 1975. CAPMAS, Statistical Yearbook 1978. - 116 -

These data indicate some slight tendency for female enrollment relative to male to increase when classes are more abundant and for the opposite to occur when school places are less available, 1/ but at no point have female enrollments exceeded 40 percent and the ratio in 1977 was no greater than it was in 1965. The low participation of females in primary education cannot be blamed on culture per se since Egypt has a lower female primary enrollment than the average for the Middle East and North Africa (Table 4. 6).

The aggregate data on enrollment, however, conceal as much as they reveal about the determinants of educational participation at the primary level for two reasons. First, primary enrollments differ greatly by governorate and urban and rural residence. Second, primary schooling is the result of two separate processes: entering school and successful advancement within the school system. We shall first discuss regional differentials in primary enrollments and later separately examine the determinants of entry and advancement/failure.

Regional Differentials in Primary Enrollment. As expected there are sharp urban/rural and Upper/Lower Egypt differentials in primary enrollments. The enrollment rate for urban governorates is 87 percent. For Lower Egypt it is 72 (83 in urban areas and 68 in rural). For Upper Egypt it is 60 percent (77 for urban areas and 53 for rural). But there is also high variation within regions. Cairo has the lowest enrollment rate of the urban governorates, while Damietta has the highest rate in Lower Egypt and a rate above that of Cairo, and Ismaliya has a rate equals to Cairo. In Upper Egypt, Aswan stands out with an enrollment rate of 86, slightly above Cairo's. Table 4.9 summarizes the enrollment rates for urban and rural areas in eachi governorate and the average class size in each case.

Table 4.9 indicates that the supply of school places varies substantially by urban and rural areas and region. The population aged 6-11 per class is 50 in urban areas and 63 in rural areas. Likewise, Lower Egypt has more classes per children aged 6-11 than does Upper Egypt in both urban and rural areas. Utilization, however, does not perfectly reflect these differences in supply. In Lower Egypt there are almost no differences in students per class in urban and rural areas (42 versus 41) but in Upper Egypt the utilization so measured is 43 versus 36. While these differences could reflect certain supply conditions such as density, 2/ they may also reflect differentials in the level of demand for schooling in the rural areas. In particular, the demand for education for daughters in rural

1/ The correlation between population per class and the proportion of students who are female is -. 41 for the 1960/61 to 1977/8 period. While this is significant it is not as high as that for overall enrollments.

2/ Density per habitable area appears to be higher in Upper than in Lower Egypt, so that demand is probably more important than access in this case. - 117 -

Table 4.9: EGYPT, GOVERNORATE LEVEL DATA ON PRIMARY EDUCATION: POPULATION 6-11, ENROLLMENT RATES, AVERAGECLASSROOM SIZE AND PROPORTION OF STUDENTS (FEMALE), 1977-1978

Urban Rural Enrollment Rate-/ Students/Class Population/ClassProportion Governorate Age 6-11 1/ Age 6-11 1/ Urban Rural Total Urban Rural Urban Rural Female

Cairo 687,524 - 0.85 - 0.85 41 - 48 - 47 Alexandria 317,565 - 0.89 - 0.89 44 31 49 - 47 Port-Said 32,561 - 0.95 - 0.95 36 52 39 - 48 Suez 28,470 - 1.03 - 1.03 39 38 37 - 47

Total Urban 1,066,120 - 0.87 - 0.87 42 36 48 - 47

Damietta 20,571 73,314 1.08 0.81 0.87 40 40 37 50 47 Dakahliya 92,458 346,241 0.79 0.72 D.74 41 40 52 55 42 Sharkiya 75,330 346,803 0.82 0.64 0.67 42 40 52 63 37 Qaliubiya 106,762 156,688 0.89 0.78 0.83 47 42 52 53 39 Kafr-El-Sheikh 43,610 192,079 0.76 0.57 0.60 46 40 60 71 36 Gharbiya 101,918 241,249 0.84 0.72 0.76 42 41 50 57 40 Mendufiya 47,737 213,534 0.92 0.82 0.83 42 41 46 50 39 Behelra 101,646 327,365 0.60 0.57 0.58 45 41 76 72 34 Ismailiya* 24,276 30,444 1.23* 0.54* 0.85 41 - 49 42

Total Lower 614,308 1,927,717 0.83 0.68 0.72 42 41 51 60 38

Giza 208,974 169,793 0.79 0.54 0.68 47 39 59 74 39 Beni-Suef 41,684 135,626 0.75 0.57 0.61 40 34 53 60 32 Fayoum 43,042 148,645 0.66 0.47 0.51 43 36 65 77 32 Menia 63,430 258,154 0.75 0.49 0.54 41 35 54 72 30 Assiut 68,349 204,272 0.72 0.53 0.58 42 39 58 73 31 Souhag 62,791 250,321 0.79 0.50 0.56 42 36 53 74 28 Qena 59,144 216,647 0.71 0.53 0.57 41 34 57 64 30 Aswan 36,891 61,731 0.94 0.81 0.86 43 37 46 46 42

Total Upper 584,305 1,445,189 0.77 0.53 0.60 43 36 57 69 32

Frontier 39 27

Total 2,264,733 3,372,906 42 39 50 63 39

* Rural data for Ismaliya are only approximate since only totals were reported. Source: 1/ 1976 Census for population data. 2/ Ministry of Education. - 118 -

Upper Egypt is probably weaker than in other parts of Egypt and female enrollments are lowest there with 32 percent female students in Upper Egypt compared with 38 percent in Lower Egypt and 47 percent in the urban governorates.

Simple multivariate analysis of governorate-level enrollments gives some insight into the causes of regional differentials. For the total enrollment rate in a gavernorate, the only significant relationship found was that Lower Egypt governorates had significantly higher total enrollment. 1/ If number of schools per school age population is used instead of classrooms per school age population, it becomes the only significant variable. Regressions for enrollments in rural areas showed that the number of schools per school age population significantly increased enrollments in addition to location in Lower Egypt. 2/ The proportion of primary students who were female was also significantly related to the number of schools per capita and Lower Egypt location. Data on wages show that in simple correlations, the wages of males and non-males (women and children) in rural areas is positively related to enrollments rates. Regression analysis shows that the wage of non-males relative to males had a significantly negative coefficient, but this variable was less important than the availability of school places. Therefore, both longitudinal and cross-governorate data indicate that increases in supply are associated with increases in enrollment. This is also true of enrollment of females. While demand factors such as the need for child labor may limit enrollment to some extent, particularly in rural Upper Egypt, supply is the most significant constraint.

The Educational Process at the Primary Level: Fntry snd AdvAnrement. The discussion of enrollment rates is only a first step in understanding the process of primary education. Low enrollments may result from low entry into school or high entry rates combined with high attrition rates. If entry rates are high and attrition is high, then low enrollments are more complicated than a simple reflection of lack of access and instead reflect either a low quality of the school system and/or a lack of demand for schooling.

The best estimate available to evaluate the proportion of students who enter school is the ratio of first-year enrollment to those who reach compulsory school age in a given year. These data are summarized in Table 4.10. The two estimates of population of entry age give slightly different entry rates, but the pattern is very similar and in the last few years the rates are identical.

1/ Variables included were the dependency rate, schoolage population per classroom, and dummy variables for urban governorates and Lower Egyptian governorates.

2/ Other variables included were classrooms per capita, agricultural wages for men and wages for women and children. None of these was significant. Table 4.10: FIRST-YEAR ENROLLMENTS TO POPULATION OF ENTRY AGE, EGYPT, 1960/61 TO 1979/80

Average Proportion Population Population Population First-Year Entry Rate Entry Rate First-Year Year Age 6 Age 7 6 to 7 Enrollment 1 2 Female

1960 711,856 691,749 701,803 526,954 74.0 75.1 39.7 1961 309,320 708,702 709,011 (545,000) 76.8 76.9 - 1962 733,249 706,178 719,714 (574,000) 78.3 79.8 - 1963 700,752 730,000 715,376 (614,000) 87.6 85.8 - 1964 775,791 697,648 736,720 (644,000) 83.0 87.4 - 1965 827,258 772,641 799,950 677,527 81.9 84.7 41.2 1966 867,890 823,900 845,895 (640,000) 73.7 75.7 -- 1967 908,978 864,366 886,671 (646,000) 71.1 72.9 - 1968 877,170 905,286 891,228 (687,000) 78.3 77.1 - 1969 932,170 873,608 902,889 (721,000) 77.3 79.9 - 1970 940,303 929,187 934,745 742,459 80.0 79.4 39.6 1971 977,989 937,294 957,642 721,933 73.8 75.4 39.5 1972 989,460 974,859 982,160 728,052 73.6 74.1 39.6 1973 969,621 986,294 977,958 576,202 59.4 58.9 40.2 1974 966,713 966,518 966,616 746,525 77.2 77.2 39.7 1975 959,769 964,161 961,965 756,426 78.8 78.6 40.3 1976 958,011 957,235 957,263 766,008 80.0 80.0 40.8 1977 978,474 955,481 966,978 786,005 80.3 81.3 41.1 1978 979,246 975,891 977,589 793,072 81.0 81.3 1979 1,038,397 976,661 1,007,529 823,914 79.3 84.4

Source: Unbracketed - Ministry of Education Bracketed - Ministry of Planniig, The Five-Year Plan, L978-982, 'abje 21. - 120 -

Table 4.10 shows that entry rates follow a pattern that is similar to, but more exaggerated than, the enrollment rates. Entry rates rose in the early 1960s, fell in the late 1960s, rose again then dipped slightly and then rose continuously after the dramatic, war-related dip in 1973. 1/

Entry rates are generally substantially above enrollment rates. This would imply that at least part of the low enrollment rates in Egypt result from a high dropout rate. But since entry rates have rarely exceeded 80 percent, one could not expect enrollment rates to exceed 80 percent even if there were no dropouts.

It is difficult to determine if low entry rates are the result of lack of demand or lack of supply. But in the period from 1971 to 1976, when the number of classes were growing at a more rapid rate than was the total schoolage population, entry rates were rising. In the period from 1965 to 1971, when classes were growing at a slower rate, entry rates were generally, but not uniformly, falling. In the period from 1960 to 1965, when classes were growing faster than population entry rates were again rising. There is no correlation between entry rates and population per school, but there is a negative correlation between population per class of -.41 and -.43 for entry rate 1 and 2 (as shown in Table 4.10) respectively. If the atypical year of 1973 is deleted, the correlations increase to -.50 and -.62. Although this is

LiwL dS clubely related as overall enrollments to supply factors, the relationship is impressively strong. Therefore, for the periods for which we have data, it seems that entry rates were closely related to the supply of classes relative to school age population. This is prima facie evidence of the importance of the supply constraint in determining entry into primary schools.

The evidence on the proportion of first year enrollees who were female is also interesting. This rate has remained remarkably constant at around 40 percent. This is remarkably close to the 38-39 percent observed for total primary enrollments. This reflects at least partially a lack of demand for schooling for daughters, or at least a lower demand for the schooling of daughters than of sons.

Unfortunately, data are not available on first year enrollments by governorate, so it is impossible to determine the extent to which enrollment rate differences between urban/rural and Lower/Upper governorates is a reflection of differentials in entry rates.

Dropout, Repetition and Promotion. There are very few data available on dropouts, repetition and promotion within the primary school system. This is a reflection of the fact that these data cannot simply be calculated by total enrollments within the school system and population estimates. To

1/ First enrollments in 1973 were 161,087 below the average of the two adjacent years. Therefore, the dip in total first year primary enrollment could completely explain the dip in primary enrollments, since primary enrollments were only 112,155 below the average of adjacent years. New figures provided by the Ministry of Education suggest the 1973 figure should be 738,032 not 576,202, but this figure does not agree with overall enrollment data. - 121 - get accurate data on progress through the school system much more sophisti- cated data collection is necessary since individuals must be followed through the school system. One such study was done by the Ministry of Education for the entering classes from 1966/67 to 1971/72. The data on dropout rates from that study are given in Table 4. 11.

These data show systematically higher dropout rates for females than for males and the rates increase generally up to the 4th grade. 1/ For the group of students entering primary school in 1970/72, 18 percent of the males and 28 percent of the females dropped out by the end of the fifth grade. If repeaters are deleted as well, only 65.9 percent of males and 57.4 percent of the females reach grade 6 without repeating. Therefore, of the 934,745 who reached school age in 1970 only 50 percent made it into school and to the sixth grade without repeating. Even when students reach the sixth grade, however, there is a high dropout rate before taking the 6th grade exam 2/ and only about 75 percent of those taking the exams actually pass.

Dropout, repetition and promotion result from the interaction of the school system, the child and the parents. Poor performance can result from the poor quality of instruction and physical facilities, lack of pupil motivation or lack of parental support. The relative importance of these various factors is difficult to determine, but a tracer study of Egyptian education is now being conducted and preliminary study on a small sample of 1,082 children has yielded interesting results. The sample contained 26 percent dropouts, 30 percent repeaters and 44 percent promoted students. 3/ These students were separated by sex and urban-rural residence. The study was designed specifically to determine the relationship between socioeconomic and school variables on progress through primary school. Two separate analyses were done: (1) comparison by means of multiple regression 4/ of successes (promotion) versus failures (dropout and repetition) and (2) remaining in (promotion and repetition) versus leaving school. The author concludes:

1/ Automatic promotion is allowed in the first four grades and between the fifth and the sixth. There are examinations at the end of grade 4 and 6. Repetition is permitted once at the 4th grade and twice at the 6th. (CAPMAS [1978], p. 237.)

2/ Another report on dropouts for 1974 reports that an additional 40 percent dropped out at the 6th grade (AID, 1977, p.57). The methodology of this study is not explained and the other report does not show repetition or dropping out in grade six. So there is an important gap in our information.

3/ Chaibderraine, 1978.

4/ Simple regression is not strictly appropriate when the dependent variable is a zero one variable, but it is a first approximation. Table 4.11: DROPOUT RATES FOR SIX SUCCESSIVE FIRST YEAR ENROLLMENTS BY GRADE AND SEX, EGYPT, 1966/67 TO 1971/72

1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Cumulative 1/ Year M F T M F T M F T M F T M F T M F T

1966-67 2.9 4.9 3.7 1.7 5.0 3.0 4.1 8.7 5.9 7.2 12.3 9.1 2.1 6.0 3.5 16.8 32.0 22.9

1967-68 2.3 5.2 3.5 2.3 5.8 3.7 3.6 6.9 4.9 6.8 11.2 8.5 2.0 5.6 3.3 16.0 30.3 21.8

1968-69 2.7 5.5 3.8 1.9 4.8 3.1 3.8 6.7 4.9 6.7 10.3 8.0 3.1 4.9 3.8 17.0 28.4 21.5

1969-70 2.0 4.6 3.0 1.9 4.2 2.8 3.5 6.7 4.7 5.8 8.5 6.8 4.4 6.7 5.3 16.5 27.2 20.7

1970-71 2.2 4.8 3.2 1.9 4.7 3.0 2.8 5.2 3.7 5.8 8.7 6.9 6.9 8.8 7.6 18.2 28.4 22.2

1971-72 2.2 5.0 3.3 2.0 3.8 2.7 2.4 4.7 3.3 9.8 11.6 10.5 8.5 8.9 8.6 22.8 29.9 25.6

1 / Calculated.

Note: M = Male, F=Female; T= Total Source: Ministry of Education. - 123 -

"The multiple-regression analyses based on data collected in Egypt stressed the fact that differences between failure and success, and differences between dropouts and repeaters are more marked in urban areas than in rural ones. The study also showed that dropping out against remaining in school is best predicted by variables measuring teacher characteristics, particularly teacher absenteeism and the origin of the teacher, together with predictors measuring the standard of living in the student's home.

"In the prediction of failure against success, teacher characteristics were important particularly in rural areas, although the socio-economic predictors, for example, the standard of living combined with the literacy of the father, were found more important in this analysis than in the previous one." (p.163)

Graduation from Primary School. Graduation from primary school requires passing a governorate-level exam produced under instructions from the Ministry of Education. In 1977-78 approximately 75 percent of those students who took the exams successfully completed them (73 percent in 1976-77). Of those who obtain the primary certificate, over 90 percent go on to preparatory school.

The pass rates vary by governorate and by sex. Overall, females and males have identical pass rates, but this varies by governorate. The regional patterns are not as simple to discern as in the case of enrollment. and a multiple regression analysis of the data showed no significant relationship. Perhaps this is to be expected, since standards vary as well as performance, given that exams are prepared at the governorate level.

Summary of Trends and Differentials in Primary Education. The demand for schooling for children may explain some part of the low enrollment and entry rates, particularly for daughters, and the regional differences in these. Our analysis shows, however, that the availability of schools, the size of class and the characteristics of teachers in those schools are systematically related to entry rates, to enrollment rates, and to success in school. While the evidence is fragmentary, it is fairly persuasive that performance at the primary level can be improved by devoting more resources to schools, classes and quality of instruction. This implies that unless the growth in primary school places keeps up with the growth in the school age population, enrollment rates will drop. In addition, enrollment rates will increase only if the number of primary school places grows faster than population.

Preparatory Education

Preparatory school comprises the three grades after primary school. In its current form it is preparatory for further education rather than being conceived as being a terminal level and accordingly it stresses theory over practice, but some experimental attempts are being made to integrate both practical and theoretical subjects into the curriculum. Preparatory school in Egypt is a transitional level between the high enrollment and low enrollment segments of the school system. - 124 -

Trends. The development of preparatory enrollment in Egypt from 1960 to 1976 is very different from that of primary schooling. Instead of fluctuations in enrollments around a fairly constant enrollment rate, we observe a dramatic, sharp upward trend in enrollment in preparatory schools and a definite upward trend in the proportion of girls enrolled in preparatory school. These trends are shown in Table 4.12 for the years in which the relevant data are available.

The enrollment rate at the preparatory level more than tripled over the period, from 16 percent of the population aged 10-14 in 1960 to over 50 percent of the population of those ages in 1976. The proportion of students who are female rose from 27 to 36 percent over the period. The major question that arises is whether this dramatic increase is the result of rapid increases in the supply of preparatory school places relative to the population in this age group, or whether it resulted from an increase in demand.

The prima facie evidences indicate that the supply of school places was primarily responsible. At an aggregate level, however, the provision of these places might be responsive to political pressure and thus reflect aggregate demand. The number of classes increased much more rapidly than did the relevant population. This is shown by the dramatic decrease in the population aged 12-14 per class from over 200 to 75. In contrast, at the primary school level the population per class was 58 in 1960 and 57 in 1976.

Although the expansion of preparatory places was dramatic and certainly accounted for the major portion of the increase in preparatory enrollments, there appears to have been an increase in the demand for school places as well as in the supply. The indirect evidence for this increase in demand is the increases in students per class from 32 in 1960 to 41 in 1975. If supply was expanding rapidly, but enrollment per class continued to increase, then obviously the demand for preparatory schooling was shifting upward faster than supply.

Before there is a demand for preparatory education, the child must first complete primary school and pass the exams at the end of grade six, so the logical question is to what extent has the increase in demand resulted from an increase in the proportion of primary school graduates who go on to preparatory school, and to what extent a higher proportion of primary school entrants are successfully completing and graduating from primary school. Unfortunately, we do not have time series data on the proportion of primary candidates graduating. We do have some time series data on dropouts. Those data show that over the 1966-1972 period there was a slight increase in dropouts from 23 to 26 percent over the first five years of primary school (see Table 4.11).

Indirect data, however, suggest that a larger proportion of those entering primary school are completing it. The number of primary graduates in 1965 relative to those who entered school in 1960 was 39 percent. In Table 4.12: PREPARATORY ENROLLMENTS, EGYPT, 1960-1979

Year Population/ Schools/2 lasses/2 Enrollments/2 Enrollment % Students Population Year12-14 Schoo- Female Total Ratio Female Per Class Per Class

1960 1,907,174 1,001 9,269 82,229 300,436 15.8 27.4 32 206 1961 ------1962 1,832,015 - - - - 1963 1,919,009 ------1964 2,031,649 ------1965 2,055,357 1,184 16,842 184,501 612,310 29.8 30.1 36 122 1966 2,073,722 - - 205,576 681,997 32.9 30.1 - - 1967 2,064,301 - - 231,286 744,614 36.1 31.1 - - 1968 2,102,458 - - 246,783 780,837 37.1 31.6 - - 1969 2,092,321 - - 254,472 797,965 38.1 31.9 - - 1970 2,159,079 1,362 21,797 275,058 851,936 39.5 32.3 39 99 1971 2,252,655 2,204/3 23,204/3 304,238 927,321 41.2 32.8 40 97 W 1972 2,417,663 2,369 25,195/3 340,002 1,019,812 42.2 33.3 40.5 96 1973 2,549,791 2,475 27,174/3 372,571 1,099,291 43.1 33.9 40.5 94 1974 2,600,703 2,663 29,782/3 412,747 1,199,554 46.1 34.4 40.2 87 1975 2,666,775 2,937 32,874 469,577 1,339,603 50.2 35.1 41.0 81 1976 2,699,905 3,119 35,888 510,230 1,435,529 53.2 35.5 40.0 75 1977 2,800,690 3,261 38,583 - 1,523,884 54.4 - 39.5 73 1978 2,858,328 1979 2,888,642

Sources: /1 Mission estimates. /2 CAPMAS, 1978, pp.2 4 8 -2 4 9 /3 CAPMAS Yearbook, p.14 9. - 126 -

1970 the ratio of graduates to entrants in 1965 was 45.6, while the comparable ratios in 1975, 1976 and 1977 were respectively 64.5, 66.0 and 65.5. Therefore, the rising "efficiency" of the primary school system increased the proportion of those aged 12-14 who were eligible to go on and therefore could demand higher education. 1/ This increase in progress through the primary school and exam system may reflect increased demand on some parts of the population for higher education. There is little direct evidence, but much hearsay evidence, on the high levels of expenditures on tutors to prepare children for examinations, another manifestation of demand.

The proportion of primary graduates who enter preparatory school has been very high in all years for which data are available but they fluctuated from over 100 percent in 1965 and 1977 to around 73 or 76 percent in 1975. In general from 1965 to 1975 the ratio dropped and then, after 1975, it increased.

In summary, therefore, it appears that the dramatic increase in preparatory enrollments between 1960 and 1976 was the result on the supply side of very substantial increases in the number of classrooms per population and on the demand side of a large increase in the demand for schooling which manifest itself in an increase in those who graduated from primary school relative to those who entered it six years earlier.

Regional Differentials in Participation in Preparatory School.

Preparatory enrollment relative to the population aged 12 through 14 differs substantially by urban-rural residence and by governorate. The patterns here are similar to those observed for primary education. Rural areas have lower enrollment rates than urban areas and Upper Egypt has lower enrollment rates than Lower Egypt. The proportion of students who are female follows the same pattern. Table 4.13 summarizes these results.

The patterns of preparatory enrollment, however, are strongly influenced by the patterns of primary schooling, since only those who graduate from primary school can enter the preparatory level. This relationship is confirmed by the data in the first column of Table 4.13. This shows the ratio of first year enrollments in preparatory school to primary graduates. Here we do not find the expected urban/rural, Upper/Lower differentials. In almost all areas over 90 percent of those graduating from primary school go on to preparatory. The only exceptions are Alexandria and Sharkiya where the ratios are 86 and 88 percent, respectively.

Preparatory School: Graduation and Progression. There are no available data on dropouts from preparatory school, but there are some time series data on the number of preparatory graduates and candidates and these can be related to the number of first year entrants in preparatory school three years earlier. Although this is a very imprecise way of measuring progression, it is all that is available.

1/ This proportion rose from 10 percent of those aged 12-14 in 1965 to 18 percent in 1975. This is approximately an increase from 30 to 54 percent of those of entry age 12. Table 4.13: PREPARATORY ENROLLMENTS BY GOVERNORATE, EGYPT, 1977-1978

Ratio of 76 Primary Census Enrollment/2 Total Proportion Governorate Passes to 76 First- Population Male Female Total Enrollment Female Year Enrollment/i 12-14 Rate

Cairo 92.8 389,243 158,881 138,210 297,091 76.3 46.5 Alexandria 85.5 177,410 62,439 56,706 119,145 67.2 47.6 Port-Said 98.0 19,994 8,670 7,746 16,416 82.1 47.2 Suez 115.1 16,169 7,863 5,506 13,369 82.7 41.2 Total Urban 91.5 602,816 237,853 208,168 446,021 74.0 46.7

Damietta 98.3 52,570 14,059 13,434 27,493 52.3 48.9 Dakahliya 96.6 241,399 84,673 47,825 132,498 54.9 36.1 Sharkiya 88.0 228,361 72,499 33,886 106,385 46.6 31.9 Qaliubiya 92.9 136,255 48,251 22,933 71,184 52.2 32.2 Kafr-El-Sheikh 95.8 122,588 32,541 12,853 45,394 37.0 28.3 Gharbiya 90.5 195,467 68,095 36,834 104,929 53.7 35.1 Menoufiya 95.3 142,942 53,420 24,961 78,381 54.8 31.8 Beheira 93.3 213,716 57,698 24,807 82,505 38.6 30.1 Ismailiya 100.1 29,360 12,113 7,589 19,702 67.1 38.5 Total Lower 92.6 1,362,658 443,349 225,122 668,471 49.1 33.7

Giza 94.4 180,196 57,645 33,434 91,079 50.5 36.7 Beni-Suef 95.4 83,177 20,555 8,040 28,595 34.4 28.1 Fayoum 98.0 91,388 19,962 8,748 28,710 31.4 30.5 Minia 95.6 147,497 40,441 14,272 54,713 37.1 26.1 Assiut 94.3 128,221 37,538 13,886 51,425 40.1 27.0 Souhag 93.4 150,504 42,198 12,016 54,214 36.0 22.2 Qena 96.6 128,192 40,653 10,474 56,117 39.9 32.2 Aswan 93,0 48,010 21,913 9,922 31,835 66.3 31.2 Total Upper 94.9 957,185 280,905 110,792 397,697 41.5 29.4

Frontier 94.2 7,314 4,381 11,695 37.5 Total 92.8 2,922,659 969,421* 554,463* 1,523,884* 52.1 36.4

* Includes Frontier governorates.

Sources: /1 AID, 1977, p.39 . /2 HRM, 1979, Appendix Table 3. - 128-

The data in Table 4.14 would imply that many students fail the exams and then repeat them and eventually pass them. This is consistent with a pass rate of only about two-thirds (shown in the sixth column), a graduate to entry ratio of 100 percent, and a ratio of candidates to entrants of 150 percent.

Graduation rates show some regional and sex differences. In general girls have a higher pass rate than boys, 68.6 versus 65.8 in 1977/78. 1/ Upper Egypt had lower than average pass rates in all cases except Fayoum and Giza while Lower Egypt had generally above average pass rates. Cairo and Suez had above average rates while Alexandria and Port Said had below average rates.

Advancement beyond the preparatory level is fairly high for those who graduate. In 1975/76 the proportion of those continuing was 79 percent. Thirty-six percent of those went on to general secondary schools, 40.5 percent went to technical agricultural or commercial establishments and 2.3 went to teachers schools. 2/ While this rate of advancement is impressive, it represents a substantial decline since the early 1970s when the continuation rate was 90 percent of higher. Despite this decline in advancement from preparatory to secondary levels we still find that in 1976 Egypt had an enrollment rate in secondary education of around 42 percent, which is substantially above the average (30 percent) of middle income countries. This above average performance continues at the higher education level where Egypt has an enrollment of 14 percent against an average of middle income countries of 10 percent.

Thus Egypt's relatively low performance at lower levels of education is matched with an exceptionally high rate of enrollment at the postpreparatory level.

Secondary Education

Secondary education is organized in Egypt along two different options; the general secondary and the technical secondary. The general secondary aims at preparing students for higher education while the technical secondary aims primarily at training midlevel technicians. Graduation from the general and technical secondary education had already reached a level of nearly 80,000 in 1965-66. By 1976-77 this level had reached over 230,000. Nearly 50 percent of the graduates come from the general secondary level, and they are the most likely to pursue higher education.

General Secondary. First year enrollments in the general secondary category increased from nearly 32,000 in 1955-56 to nearly 120,000 in 1976-77. Here again we find a considerable gain in female enrollment during this period. The share of females in total first year enrollments went up from 20.9 percent in 1955-56 to 36 percent in 1976-77. Total enrollments

1/ This was also true in 16 of the 22 governorates.

2/ AID, 1977, p.37 . Table 4.14: ENTRY INTO AND PROGRESS THROUGH PREPARATORY SCHOOL, EGYPT, 1971/72 - 1975/76

Entry First-Year Exit Candidates Graduates 2/1 3/1 3/2 Year Enrollments Year For Graduation (1) (2) (3) (4) (5) (6)

1971/72 277,290 1973/74 431,478 274,113 1.56 0.99 64

1972/73 294,843 1974/75 461,515 308,013 1.56 1.04 67

1973/74 312,948 1975/76 487,543 333,239 1.56 1.06 68

1974/75 345,634 1976/77 515,474 342,876 1.49 0.99 67

1975/76 378,775 1977/78 595,647 398,005 1.57 1.05 67

Source: CAPMAS, Statistical Yearbooks. - 130 - increased from nearly 110,000 in 1955-56 to 215,000 in 1965-66 and 390,000 in 1976-77. This represents an average annual growth of 6.5 percent during the last 20 years. During the same period total female enrollment increased at an average annual rate of 10.3 percent. Table 4.15 documents the trends in secondary enrollment in general and technical secondary education. Since 1960 the distributions of students have shifted substantially between these two kinds of secondary education.

Technical Secondary During the last 20 years Egypt has made strenuous efforts to develop technical secondary education. In 1960-61 total enrollment in technical secondary represented only 35.6 percent of total enrollment in general secondary. In 1976-77 the ratio was 51.9 percent. 1/ Egypt appears to have a higher proportion of secondary students in vocational training than other middle income or other Middle Eastern/North African countries (18 percent versus 12 and 5 percent, respectively). 2/ Enrollment in industrial secondary education went from 7,000 in 1955-56 to 20,000 in 1960-61; to 75,000 in 1970-71; and over 100,000 in 1976-77, of which total only 11,000 was female. Enrollment in agricultural secondary education increased from less than 4,000 in 1955-56 to nearly 42,000 in 1976-77, which gives us an average annual growth rate of 11.8 percent for the period. The most dramatic increase was registered in commercial secondary enrollments, with an average annual growth rate of 18.4 percent. Female enrollment grew at an incredible rate of 27.2 percent per year during the same period, giving a total enrollment which rose from 820 in 1955-56 to more than 128,500 in 1976-77. In the case of the primary teachers training secondary category, during this whole period total enrollment oscillated between 20,000 and 40,000, with nearly half of the students being female.

Recently a new 5 year technical training program has been established to follow preparatory schooling. To date 14 industrial, 2 agricultural and 4 commercial schools have been established. By 1983 there will be an estimated 5000 graduates annually from these schools.

Higher Education

Three general types of higher education are organized under the Ministry of Higher Education (MOHE): the Universities, the High Institutes, and the commercial and industrial technical institutes.

Universities. Total enrollment in the universities, which had already reached a level of 200,000 in 1971-72, grew at an astonishing annual rate of 15.7 percent thereafter, to reach a new high of more than 475,000 in 1977-78. As in many developing countries, enrollments in the humanities grew much faster than those in the sciences. Enrollments in humanities grew from 104,000 in 1971-72 to 291,000 in 1977-78 while in sciences they grew from 93,000 to 185,000 in the same period. Female university enrollment grew

1/ This ratio does not agree with data in the World Bank's World Tables (1980) probably for definitional reasons. If one excludes primary teacher training from technical secondary, the figures are much more consistent.

2/ World Tables (1980). Table 4.15: EXPANSION OF SECONDARY EDUCATION, EGYPT, 1960 TO 1979

Year Population Enrollments Enrollment Number of Population Population 15-17 General Technical Total Rate Schools Classes per School per Class

1960 1,292,661 135,704 75,090 210,794 .163 335 6,554 3,858.7 197.2

1965 1,814,363 215,633 101,204 316,837 .175 495 9,293 3,665.3 195.0 1966 1,901,003 - - - 1967 2,012,969 ------1968 2,036,409 276,339 197,054 473,393 .232 531 13,177 3,835.0 154.5 1969 2,054,594 293,144 241,590 534,734 .260 575 14,684 3,573.3 138.9 1970 2,046,537 298,117 271,339 569,456 .278 604 15,829 3,388.3 129.3 I-' 1971 2,085,554 312,489 289,812 602,301 .288 1,056 16,637 3,248.5 125.4 1972 2,076,497 321,803 297,350 619,153 .298 1,074 17,042 3,165.4 121.8 1973 2,142,795 323,603 319,050 642,653 .299 1,095 17,800 3,048.0 120.4 1974 2,235,738 340,326 344,624 684,950 .306 1,149 18,941 1,946.8 118.0 1975 2,400,456 358,319 374,036 732,355 .305 1,238 20,047 1,938.9 119.7 1976 2,532,554 392,861 403,550 796,411 .314 1,306 21,718 1,939.1 116.6 1977 2,583,895 416,200 432,109 848,309 .328 1,388 23,327 1,861.6 110.8 1978 2,649,554 1979 2,682,500

Source: CAPMAS, Statistical Yearbooks. - 132 -

faster than male enrollment (17.8 percent per year against 14.8 percent). Graduation from the universities showed the same trend: in 1971-72 these were more graduates from sciences than from humanities, while in 1977-78 there were almost twice as many graduates in humanities as in sciences.

Faculties and High Institutes. Total enrollment increased from 36,400 in 1970-71 to over 50,000 in 1974-75, while graduations from these institutions went from over 4,900 to 7,500.

Commercial Technical Institutes. Between 1967-68 and 1977-78 total enrollment rose from about 4,500 to over 26,500. This represented an average annual growth rate of 19.4 percent over this period. Enrollment growth rates for men (19.7 percent) and women (18.8 percent) were relatively close to each other, and female enrollments represented more than 86 percent of the total.

Industrial Technical Institutes. Total enrollment grew in these institutions at a much slower rate than in commercial institutes in spite of a severe shortage of industrial technicians experienced by Egypt; in fact total enrollment dropped from 11,000 in 1976/77 to about 9,900 in 1977/78.

Technical and Vocational Training

In spite of its generally university oriented educational system, Egypt recognized very early in its development planning the necessity of developing technical and vocational training to meet its growing demand for skilled labor. Also, as a consequence of the strong leaning toward formal education, technical and vocational training was for a long period of time an almost absolute monopoly of the Ministry of Education (MOE), which had the responsibility of devising and developing it. It is also true, however, that some other ministries, mainly those of industry and health, developed their own training centers to meet their specific demands in skilled labor. After 1974 the combination of accelerated economic growth and unprecedented emigration of large numbers of skilled Egyptian workers to neighboring countries (mostly to Libya and to Saudi Arabia) created an urgent need to review the technical and vocational training system to adapt it to the new circumstances.

As a consequence of this critical review of its past technical and vocational training experience, Egypt has charged six different ministries to formulate and implement a national manpower training program. This program has a double objective of upgrading the skills of the existing labor force and expanding the supply of technicians and skilled workers needed to meet the growing demand.

Ministry of Manpower. For the time being the training capacity of the ministry is very limited. It mainly concentrates on sponsoring and helping to organize training programs within industries themselves and providing advisory and supervisory services. It has the responsibility of determining the national demand in different skills and also the formulation of the development of a coherent national training program. - 133 -

Ministry of Industry (MOIMR). In addition to the formal training performed by MOE and MOHE in their technical institutes, the Ministry of Industry is operating an already well developed training program. In 1976 MOIMR was already operating 36 training centers capable of accepting 5,000 new apprentices per year. Many of these institutes are operating on double shifts. With World Bank financial and technical assistance the Ministry of Industry will increase its training capacity to nearly 13,000 trainees by 1987. Given the necessity of retraining or upgrading the skills of the existing workforce in the public sector, the Ministry of Industry will, however, undoubtedly have to make a much greater effort in expanding its training capabilities if Egypt is to achieve its targets in industrial growth for the next decade.

Ministry of Reconstruction and New Communities. In sharp contrast to MOIMR this ministry has much less experience in the training field. It is faced with an urgent need to carry out construction on an unprecedented scale on the one hand, while confronting a fierce bidding for skilled labor from neighboring countries on the other. As late as 1977 the MORNC had only nine training centers at its disposal. In order to overcome the dramatic shortage in infrastructure this ministry was forced to make use of the poorly equipped secondary technical school facilities to help meet the current demand. Moreover, in order to increase the immediate output, the ministry has shortened the training period from the usual six months to only three months. The existing centers offer somne 5,450 places with an output of about 16,000 per year. With the Bank's financial and technical assistance (Education I) 6,000 additional places were added by 1979, and total output reached nearly 32,000 for the same year. By 1982 the Ministry of Reconstruction intends to have a training capacity of 45,000 per year. This capacity would most probably cover the needs for skilled and semiskilled workers of the construction sector.

Ministry of Health. The training programs of the Ministry of Health are complementary to the Universities' health education programs. Middle level personnel are trained in five health institutes, 135 technical nursing secondary schools, and 22 other specialized institutions. The gradual replacement of the old nursing, assistant nursing and midwives schools by technical health institutes and secondary technical schools has greatly improved the quality of training. Total enrollment in the different training centers increased from 5,379 in 1970-71 to 14,142 in 1976, and total output from 2,117 to 4,687. In the early 1980s Egypt plans to graduate about 20,000 new nursing personnel per year and would thereby largely cover its needs in this respect for a long time to come.

The Ministries of Agriculture (MOAG) and Land Reclamation (MOLR). The efforts of this ministry have been concentrated on upgrading programs for trained personnel with little attention to courses for the farmers themselves. Of the 11 MOAG training centers five give some attention to training farm leaders and two have subsidizing programs in training laborers to semiskilled level. Extension advisory services of about 5,000 higher education graduates are provided at provincial, district and village levels. With the help of the third educational Bank project (under preparation) MOAG - 134 - is planning to add several farmer training centers, approximately eight mobile training units. and three agricultural and cooperative management training centers. This investment program would increase the output of the ministry's training centers by 1,390 new graduates annually. It would appear that the needed modernization of the Egyptian agriculture would necessitate a much greater effort in training in this sector.

The Ministry of Social Affairs. This ministry carries out pre- vocational training courses for the urban poor and rural boys and girls in simple trades for the former and home economics for the latter. Overall enrollments are only 3,500. Under the second and the coming third education projects the Bank is assisting the Ministry of Social Affairs in re-equipping the existing centers and creating 20 new handicraft skills training centers and one instructor training center. The tremendous challenge of meeting the training needs of all the children left out by the formal education system will, however, need a much more ambitious development of the training capa- bility of this ministry.

SUMMARY AND ISSUES

This overview of education suggests that progress at the primary level is poorer than desirable and that it is possible to improve primary enrollments by increasing resources devoted to primary education. At the postprimary level Egypt's educational performance is above what can be expected for a country at its level of income. Whether the allocation of resources between various streams of postpreparatory schooling is optimal is not a question that can be answered without careful examination of not only the costs of that education, but also the returns to higher education of various forms. While a formal cost-benefit analysis of the Egyptian education system is outside the scope of this report, the following chapter on employment and earnings provides evidence on the labor market consequences of past educational policies. Before examining the employment implications of Egypt's past educational development, it is necessary to consider the implications of population growth for future primary and preparatory education.

The Consequences of Alternative Rates of Population Growth for Primary Education

Given the fact that primary enrollment is constrained by the supply of school places, variations in population growth will have different impacts on the need for school places. We shall therefore examine the number of classes needed for primary schooling for the 1980 to 2000 period on the basis of alternative rates of population growth and alternative assumptions about enrollment rates.

Figure 4.1 shows that dramatic differences in the school age population will result from alternative assumptions about population growth. If fertility rates fall by 3 percent a year, the population age 6-11 in the year 2000 will be only slightly higher than it is in 1980. If fertility rates fall by only 1 percent a year, the population aged 6-11 in 2000 will be 49 percent larger than it is in 1980. - 135 -

FIGURE4.1: PRIMARYAGE POPULATIONUNDER ALTERNATIVE POPULATIONPROJECTIONS, EGYPT, 1960-2000

9 High fertility

8 edium Ferility

.o 7

Low fertility

*~5 ko ~ ~

'.3

0 60 65 70 75 80 85 90 95 2000 YEAR - 136 -

These differences can be translated into classroom (and teacher) requirements. In the calculation we shall assume 39 children per classroom since that is approximately the current size and the legal limit on students per classroom. These results are summarized in Table 4.16.

Panel A of that table assumes constant enrollment rates of 74 percent, while Panel B assumes that 100 percent enrollment is achieved by 1980. The results are difficult to put in context, but some simple comparisons are useful:

(1) By the year 2000, the number of classes needed merely to maintain enrollments under high growth (169,517) is more than enough to reach 100 percent enrollment with low growth (157,667). (2) The planned construction for primary schools for 1978-1982 is 600 (AID, 1977, p.61). At an average of 10 classes per school 1/, this is 6,000 classes to be added onto a base of 98,000 in 1977/78. This represents only about 90 percent of what is needed to maintain constant enrollment rates. Given that the school age population for 1982 has been already born, this is true regardless of what population projection is used.

While these projections are hypothetical, they are nonetheless indicative of a shortage substantial enough to result in falling enrollment rates. The class size necessary to maintain constant enrollment rates in 1980 given these projection of population and classrooms, is about 44 students. This is higher than has been observed at any time in the past and our preceding analysis suggests that when school age population grows faster than classes decreases in the enrollment rate will result, unless there is a large increase in demand for schooling.

The Consequences of Population Growth for Preparatory Education

Evaluating the consequences of population growth for preparatory education is much more difficult than in the case of primary education, since it is necessary to make alternative assumptions about the output of primary education. We shall make three sets of assumptions. First we shall assume that primary entry, dropout and graduation rates remain constant and therefore that 50 percent of those of ages 12-14 continue to be enrolled in preparatory school. The second assumption reflects the goal of achieving universal enrollment in primary education. It will be assumed that 75 percent of those entering primary school eventually graduate from primary school and enter preparatory school. While this represents a very optimistic prospect for improved efficiency of the primary system, we have observed that the ratio of graduates of primary schools to entrants six years earlier has increased from 39 percent in 1960 to 66 percent in 1976. In addition, the assumption of 75 percent enrollment in preparatory school is less ambitious than the proposal to increase the compulsory age for schooling to 15 by 1990. 2/ This is the third assumption.

1/ In 1977, the figure was 12.69 in urban areas and 8.31 in rural areas.

2/ AID, 1977, p.10 9 and World Bank Staff Appraisal Report of the Third Education Project, Arab Republic of Egypt, April 11, 1980. - 137 -

Table 4.16: CLASSES NEEDED FOR PRIMARY EDUCATION, EGYPT, 1980-2000, ON VARIOUS ASSUMPTIONS

Population Growth 1980 1985 1990 1995 2000

Panel A: Constant Enrollment Rates (.74)

High 113,562 128,153 141,112 155,438 169,517

Medium - - 135,989 138,418 141,606

Low - - 131,815 123,542 116,673

Panel B: 100% Primary Enrollment by 1980

High 153,462 173,179 190,692 210,051 229,077

Medium - - 183,769 187,051 191,359

Low - - 178,128 166,949 157,667

Note: See text discussion. - 138 -

Table 4.17 summarizes the number of classrooms needed under these alternative assumption if one assumes 39 students per classroom. With constant enrollment rates, the number of classrooms needed by 1980 is not below the 1976 figure of 35,888. Therefore, given planned expansion in classrooms, class size might be expected to fall. By 1985, the planned expansion of classrooms by 7,843 would provide a very substantial surplus of classrooms over what is needed if constant enrollment rates continue (43,731 versus 38,128). This surplus could be used to expand enrollments or reduce class size, but it is not a sufficient surplus to achieve the 75 percent enrollment rate, much less universal education through age 14.

Preparatory enrollment rates are, however, limited by the number of students graduating from primary school. Therefore, if the proportion of those entering primary school and being graduated from it does not increase, the planned expansion of preparatory school education may in fact be wasted in underutilization in the short run.

In the long run, by 2000 the need for preparatory classrooms depends very much on the rate of population growth. If the fertility rate falls by 3 percent a year the number of classrooms needed to maintain constant enrollments is less than what is projected to be available in 1984. 1/ Whereas if fertility falls only by 1 percent a year, the number of classrooms will have to increase by 29 percent over the low population growth figure.

If the primary school system can expand its rate of entrants and the proportion of those who graduate, the need for preparatory school places will increase substantially, even under slow population growth rates. The enormous effect of primary enrollment rates on the need for preparatory classrooms is shown by comparing 1980 figures with those in 2000. With constant enrollments 53,000 places will be needed in 2000 if the population grows at its fastest rate. This is the number of classes needed in 1980 if enrollment rates of 75 percent were to be achieved. Thus high population growth is roughly equivalent to a 50 percent expansion in enrollment rates 20 years earlier.

In the year 2000 the places needed to achieve universal enrollment through age 14 will be enormous regardless of the rate of population increase, but slow growth will require only 82,000 classrooms and fast growth will require 106,000.

Thus the key to what happens to the need for preparatory places depends much more on what happens to the expansion of the primary level than what happens to population growth. But such expansion could be more easily managed in the long run with slower population growth.

Preparatory education is the transitional level of schooling which links the lagging primary sector and the high achieving secondary and higher education systems. Once children graduate from primary school, they progress

1/ Ministry of Education, Five-Year Investment Plan 1980-84 gives estimates of 7,843 new classes in 1984. - 139 -

Table 4.17: CLASSROCMNEEDED FOR PREPARATORYSCHOOL UNDER ALTERNATIVE POPULATIONGRCWTH AND ENROLLMENTRATE ASSUMPTIONS,EGYPT, 1980-2000

Population Growth 1980 1985 1990 1995 2000

Panel A: Constant EnrollmentRates at 50%

High Growth 35,167 38,128 43,872 47,577 52,872

Medium Growth - - - 45,615 46,403

Low Growth - - - 44,064 41,090

Panel B: 75% EnrollmentRate

High Growth 52,750 57,192 65,808 71,365 79,308

Medium Growth - - - 68,423 69,904

Low Growth - - - 66,096 61,635

Panel C: 100% EnrollmentRate

High Growth 70,333 76,256 87,744 95,154 105,744

Medium Growth - - - 91,231 93,205

Low Growth - - - 88,128 82,179

Note: See text discussion.

Source: Mission projections. - 140 - forward at very high rates. The progress has been permitted by a rapid expansion of the school places at the preparatory level. The increased demand for preparatoryplaces has resulted,in large part, from the apparent increased efficiency of the primary sector. Once a child enters primary school, it is much more probably that he or she will graduate than was the case in 1960. Thus, despite fairly stagnant primaryenrollment rates, the primary school system has made progress.

The future of preparatoryenrollments therefore seems to depend much more on the progress of the primary sector in graduatingstudents than it does on the provisionof school places in the short run. - 141 -

APPENDIX IVA

SELECTIVE MIGRATION'S EFFECT ON THE EDUCATIONAL PROFILE OF THE RESIDENT POPULATION: A NOTE

If the 1.4 million Egyptians living outside Egypt have different educational levels from the average Egyptian living in Egypt, then census data on the educational achievement of those living inside Egypt would misrepresent the progress made by the Egyptian educational system.

It is very difficult to obtain data on the educational characteristics of those Egyptians outside Egypt, but it is well-known that both very highly skilled and unskilled workers have migrated to the oil exporting countries. What data are available show that about 7 percent of the Egyptians working abroad had professional, managerial, technical or administrative jobs. 1/ This is more than twice the percent of resident male Egyptians with college certificates (3 percent). Therefore, the achievement of higher education among resident males probably underestimates the real production of Egypt's higher educational system.

Twenty-three percent of Egyptians working abroad had clerical, sales and service jobs. These people probably come from those with at least primary or secondary certificates (20.4 percent of the male population). Therefore, these levels of education are probably somewhat underrepresented in the census. The remainder of the Egyptians working abroad were craftsmen, production workers and farmers. Since this group includes technicians, skilled and unskilled labor, it is difficult to estimate what level of educational achievement this group represents. Further, given the magnitude of this group it is difficult to get any accurate picture of the extent to which external migration distorts the picture of the achievement of the Egyptian system at the lower levels of education. 2/

There is, also, suggestive data from the 1960 Census that selective migration distorted the governorate-level educational profiles for males and there is reason to believe such a process is continuing. The 1960 evidence is indirect, however. One would expect that in an area where

1/ See Ecevit (1977), p.15.

2/ A 1975 CAPMAS study which examined the characteristics of migrants who were formally contracted to work abroad shows that 39.6 percent had above secondary education and 52.8 percent had secondary or intermediate education. This sample, however, is unrepresentative since it does not include more casual labor movements and thus underrepresents the less educated. (See Birks and Sinclair, 1978.) - 142 - education expansion is taking place, the younger cohorts would have a higher level of achievement than the older cohorts. But in 1960 we find that while this is always true for wmen, it is not always true for men. In those governorates with high immigration between 1947 and 1960 (Cairo, Alexandria, Giza and the Frontier governorates) the literacy rate of 15-19- year-old males was higher than that of 10-14-year old males. 1/

Data from the 1976 Census show that for males in Cairo at that time, the older the age group was then the higher was the illiteracy rate, except for the age group 30-34 which had a slightly lower rate than the 24-27 age group. (These are exactly the two cohorts that showed the abnormal pattern in the 1960 Census.) Whatever the cause of the abnormal pattern in 1960, the same factors were not operating in the same fashion in 1976.

Selective migration has indeed played a role in changing the educational distribution of the Egyptian male population. Educational progress cannot therefore be judged from data on adult achievement alone. One must also look at the schooling process itself. The differences in the achievement of a schooling program depend on a wide number of factors and these factors operate at every stage of the education process--entry, promotion, repetition and termination--and are repeated at every level of education.

Whether or not a child gets educated depends on what access he/she has to a school, and whether his/her parents permit, support or push him/ her into the system. At each stage these supply and demand factors are operative and of course interact. The more difficult the access to school in terms of distance to school or of fees, the fewer the parents who demand schooling for their children. In addition, the demand for schooling also depends on the quality of the school system and performance of the child in the system.

While it is extremely difficult to disentangle all these factors and to determine their relative importance in determining educational performance in Egypt, it is necessary to attempt such an exercise. Only if these root causes can be identified can appropriate policies be designed to improve education.

The major question to be addressed in this regard is to what extent high rates of illiteracy and high differentials in illiteracy are the result of the scarcity of school places and thus amenable to resolution by simple educational expansion. The answer to this question is necessary for correcting current educational inequalities and for predicting the effect of population growth on enrollments. Therefore, in examining entry, repetition, promotion and termination within the primary and preparatory system, it is necessary in each case attempt to piece together the existing evidence on the relative importance of supply and demand.

1/ This pattern is not universal, however. Ismaliya, Suez, Port-Said and Damietta which had significant rates of immigration did not show this pattern while Minia, an area of outmigration, did show it. - 143 -

APPENDIX IVB

ADULT LITERACY PROGRAMS: A NOTE

It is also important briefly to discuss the role of adult literacy programs in reducing illiteracy. The Egyptian authorities have long recognized the importance of adult literacy and by 1970 a literacy law was enacted which defined the responsibilities of all ministries, public organizations, trade union and enterprises in the planning, organizing and administering of a literacy program. The population concerned was defined as all illiterate or semi-illiterate people ranging from 8 to 45 years of age. In response to this law the Ministry of Education formulated a 10-year plan to eradicate illiteracy in Egypt. In 1971 LE 3.75 million was allocated accordinlgy to be spread over a 10-year period. The number of classes allocated for the literacy program by the Ministry of Education increased from 4,000 in 1972-73 to nearly 11,000 in 1977-78. Total enrollment for 1976-77 was estimated by MOE at 235,000, of which only 22,400 were female. Figures for 1978 show an enrollment of 320,000, but no data are available on the percentage of these who are female. To reach the rural population the Supreme Council of Adult and Literacy Education (established in 1972) reintroduced the one-class school system known as Kuttab in less populated rural areas. The number of Kuttabs established by MOE reached 1,000 in 1976, 1,800 in 1977 and nearly 3,000 in 1978. So far this process has achieved mixed results. It has suffered from:

(i) The lack of coordination. The Supreme Council of Adult and Education has not had a meeting in the last three years.

(ii) The very high rate of dropouts. This is mainly due to the fact that courses are given after working hours. Most of the illiterate workers attending these programs are probably too tired after a day's work to allocate more hours to attend school. Another reason for the high dropout rate can be explained by the limited objective of these programs, which aim only at teaching how to read and write and gives no promises of any sort of professional training. It is intended, however, that these programs be more closely integrated with training. Seven thousand centers equipped to offer functional literacy and skill training are being planned, four thousand for men and three thousand for women. A particularly important development under the first three IDA-assisted education projects has been the linking of literacy training with vocational training in construction trades training and handicraft training centers. (World Bank Staff Appraisal Report for the Third Education Project, Arab Republic of Egypt, April 11, 1980). - 144 -

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CAPMAS, Arab Republic of Egypt. 1975. "Main Features of the Temporary Migration Movements from the Arab Republic of Egypt, 1973."

1975. Statistical Yearbook.

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Chaibderraine, M. 1978. "Education Wastage at the Primary Level." Linkoping Studies on Education. Dissertation No. 9.

Ecevit, Z. 1977. "Labor Migration and Manpower in the Middle East and North Africa." Population and Human Resources Division, Development Economics Department, World Bank.

Hassan, S.S. "Report on Factors Affecting Regional Educational Difference in Egypt" paper presented at the seminar on "Demographic Factors in Educa- tional Planning in Arab Countries, Cairo Demographic Center, November, 1972.

Human Resources Management, Inc. 1979. Basic Education in Egypt. Report of the Joint Egyptian-American Team.

Ministry of Education, Arab Republic of Egypt.

Ministry of Education, Arab Republic of Egypt. The Five-Year Investment Plan, 1980-1984.

Ministry of Planning, Arab Republic of Egypt. 1977. The Five-Year Plan, 1978-1982.

USAID. 1977. "Education in Egypt." A Survey Report.

World Bank. 1980. Comparative Education Indicators. - 145 -

SOME ISSUES IN POPULATION AND HUMAN RESOURCE DEVELOPMENT IN EGYPT

CHAPTER V

LABOR FORCE GROWTH, EMPLOYMENT AND EARNINGS IN EGYPT: 1966-1986 1/

SUMMARY

Our concern in this essay is with the evolution of employment and earnings in Egypt, and in particular with the impact of the rapid population growth described earlier in this report on these labor market outcomes over the period from 1966 to 1986. The discussion is divided into three sections, supported by a tabular annex and an appendix. In the first section we consider the evidence in support of the oft stated and pessimistic assser- tions that Egypt suffers from a severe employment problem which, for the forseeable future, is likely to frustrate attempts to alleviate poverty and reduce the skew in the distribution of income. The second section is rather more cautious. A previous misinterpretation of Egyptian labor market conditions is discussed and evidence presented of labor market developments in the 1970s that run counter to the pessimistic forecasts. The third section assesses whether these recent favorable labor market trends are likely to be sustained or, repeating a familiar pattern in Egyptian economic history, to be reversed. A general equilibrium model of the Egyptian economy,based on 1975 data is used, for illustrative purposes, to trace the paths of output, employment and wages over a five year period under alternative assumptions regarding trends of labor supply and various components of aggregate demand. First to be considered is an optimistic scenario (Variants 1 and IA), in which external migration continues at recent rapid rates, remittances grow accordingly, and the growth of investment and exports nearly fulfills highly ambitious plan targets. The impact on employment and earnings of faster rates of growth of domestic labor supply and slower rates of growth of final demand is then assessed (Variant 2). The appendix describes the model and sources of data in some detail.

1/ This chapter was written by R. Sabot and L. Taylor, with Y. Boutros-Ghali. - 146 -

force is growing rapidly (2.1% p.a. on average between 1970 and 1976). The labor force is growing even faster; mission projections suggest that the population between the ages of 15 and 60 will grow over the 80s at an average annual rate of 2.6%, while since 1970 labor force participationrates appear to have been rising. Land is scarce, and with regard to employment,the agricultural,sector may have reached its absorptive capacity. Thus, nonagricultural sectors must bear most of the burden of absorbing the incrementsto the labor force. In manufacturing,construction and transport,however, labor productivityhas increased, i.e., employmenthas grown much slower than output, for example from 1971 to 1976, in manufacturingthe growth of output was 8.2% while employmentgrew at 3.1%, and in transport the rate of growth of output was double that of employment. Despite rapid growth of output, these sectors have employed a relativelysmall proportion of labor force increment over the past four decades. Onl.yin services has the growth of employment matched the growth of output; this sector has absorbed around 27% of the increase of the labor force and has markedly increased its share of total employment. At least in the government segment of the service sector there is little doubt that rapid employment expansionhas been associatedwith the accumulationof "surplus labor";workers, in this instance white collar workers, earn wages well in excess of their productivity. Wage trends provide perhaps the most telling evidence in support of the contention that Egypt is faced with a serious employmentproblem. Real earnings of unskilledworkers fluctuated between 1940 and the early 1970s but ended up at roughly the same level where they began. Secular stagnation,or even a decline of wages, is just what is predictedwhen labor demand is unable to outpace the growth of labor supply.

Nevertheless,since the early 1970s, evidence contrary to the pessimisticassertions regarding Egypt's employment problem has been accu- mulating. Open unemploymenthas been declining,wages of manual workers in agriculture and constructionhave been rising; between 1974 and 1977 average wages rose 52% in agricultureand 62% in construction,while consumer prices rose 32.7%. In some manual occupationsthere are growing numbers of unskilled vacancies and attempts to substitute capital for labor are apparent in construction and elsewhere. Labor exports and capital imports provide an explanation for the marked tightening of the Egyptian labor market. Egyptianshave been obtaining employment in the nearby oil producing countries in unprecedented numbers; by 1979 around 1 million Egyptianswere estimated to be working abroad. As a consequence,the rate of growth of the domestic labor force has been sharply diminished,from over 3% p.a. to around 2%. Simul- taneously, increasesin aid flows to Egypt, combined with large scale worker remittancesfrom abroad, have resulted in a surge in investment,output and labor demand. For example between 1975-77gross domestic product at constant factor cost grew at an average of 9.3% p.a., compared to 2.7% in 1974.

Has Egypt's employmentproblem been solved? Or will the underlying tendencies for growth of labor supply to outstrip demand reassert themselves? Our results caution against undue optimism in answering these questions. The - 147 -

labor market may be able to adjust quite easily to a substantialreduction in emigration if aggregate demand trends are sustained. Indeed, an increase in the domestic labor force may, in the short run, alleviate inflationarypres- sures, without adverse effects on wages. Taking acccount of moderate declines in the flow of remittancesdoes not alter this assessment. It is, of course, difficult to determinejust how sensitive the labor market is to changes in trends in aggregatedemand. Our results, however, do suggest that even moderate declines in export and investmentgrowth could rather quickly reverse the wage and unemploymenttrends of the 1970s. It is not for us to assess the likelihoodof a slowing of growth of exogenousdemand. What is clear is that as long as Egypt's population continuesto grow rapidly, extraordinarygrowth of demand aggregateswill be required to avoid yet another period of wage stagnationor decline. - 148 -

EGYPT'S "EMPLOYMENTPROBLEM"

Egypt has been characterized as an example, par excellence, of a developing country with a severe "employment problem." Generally this problem is defined in dynamic terms. A high and perhaps increasing rate of growth in the domestic labor force means that the growth of labor demand must be at least equally rapid to avoid downward pressure on earnings, and hence an erosion of the standard of living of that quite high and growing proportion of the population in wage employment. 1/ If such rapid increases in labor demand are not forthcoming then the country can be said to be suffering an employment problem in the dynamic sense. 2/

The adverse consequences of an employment problem of this type are not felt equally by all groups in the society. Those who derive their income from returns to capital may even benefit from a decline in wages. If, as is likely, the elasticity of substitution between capital and labor is less than unity, the share of wages in total income will fall. An increasing skew in the functional distribution of income may thus be another consequence of a dynamic employment problem. The wage gap between skilled and unskilled occupations may also widen. Because of a rationing of opportunities for higher education, or because of institutional barriers that limit mobility between occupations or sectors or otherwise protect the earnings of workers at the top of the socioeconomic hierarchy, adverse trends in the rates of growth of labor supply and demand may have a disproportionate effect on the wages of those near the bottom of the socioeconomic hierarchy.

1/ Table 5.A1 [in the tabular annex at the end of the chapter] indicates that in 1976 wage employees comprised more than 65% of the Egyptian labor force. Over the intercensal period, 1960-1976, the labor force increased by 33%; the number of wage employees increased by 73% implying an annual rate of growth that was more than twice as rapid. One qualification is in order. As Table 6.1A indicates, much of the increase in wage employment was concentrated in agriculture and was associated with a marked decline in the proportion of unpaid family or other workers in the total. Whether a change in definition rather than in employment status accounted for some of this shift is open to question.

2/ The "employment problem" is a misnomer, however, to the extent it implies that the problem's origins are in the labor market. The reasons why growth is not faster or more labor-demanding and why the labor force is rapidly expanding, stem from the whole gamut of development issues concerning domestic resource mobilization, foreign trade regimes, appropriate technology, the behavior of the household, etc. The labor market is the problem's immediate locus but aberrations in the interactions of suppliers and employers of labor services are unlikely to have a major impact on the dynamics of supply and demand for labor. - 149 -

A variety of evidence can be mustered in support of the contention that Egypt suffers from a serious dynamic employment problem. On the supply side of the labor market the principal causes of concern are the acceleration of population growth over the past 30 years and the current high rate of growth. Before World War II, population was growing at a rate of 1 percent per annum, taking approximately 90 years to double; it is estimated that during the 1970 to 1976 period it was growing at 2.1 percent per annum, taking less than 30 years to double. Even if the indications that population growth has begun to decelerate prove correct there will, moreover, be a long lag before this change influences the rate of growth of Egyptians of working age. It is projected that over the 1980s the population between the ages of 15 and 60 will increase by 7,000,000 at an average annual rate of 2.6 percent, higher than projected rates of growth of the population as a whole. 1/

The decline in labor force participation rates which characterized the period from 1937 to 1970 also appears to have been reversed, beginning in 1972 (see Table 5.1). The decline was to a large extent a reflection of the increase in the proportion of the youngest age groups, with their relatively low participation rates, in the working age population, a corollary of accel- erting population growth. It was also due, particularly in the 1950s and 1960s, to rapid increases in educational enrollment, particularly among females. With the slowing of increases in enrollment ratios, participation rates of males and females began to increase in the 1970s and are likely to continue to do so. 2/

On the demand side of the labor market the limited absorptive capacity of the agriculture sector is the principal source of concern. Over the past 30 years the sectoral structure of employment in Egypt has changed significantly. Table 5.2 indicates that the share of agriculture in total employment declined from 58.4 percent in 1947 to 47.7 percent in 1976. Until the late 1960s or early 19 70s, while agriculture's share of employment declined, agricultural employment continued to grow slowly (see Table 5.2). There is now, however, some evidence suggesting that agricultural employment actually peaked during the intercensal period and that the 1970s have witnessed a decline in the absolute number of agricultural workers.

1/ Mission estimate; demographic aspects are explored in more detail in Chapters 2 and 3 of this report.

2/ Educational development and population growth are explored in detail in the preceding chapter. - 150 -

Table 5.1: LABOR FORCE- PARTICIPATION RATES, EGYPT, SELECTED YEARS 1937-1976

(Percent)

Year Females Males Total

1937 7.9 65.1 37 1947 7.8 62.8 37 1960 4.8 55.2 30

1966 4.2 50.8 28 1970 3.5 49.5 26 1972 4.0 50.7 27 1976 9.2 52.9 31

Note:

1/ Note that the census data are not strictly comparable with the sample survey data as the population bases differ in age coverage and inclusion and exclusion of the military.

Sources: Population Census 1937, 1947, 1960, 1966 and 1976, and Labor Force Sample Surveys, Central Agency for Public Mobilization and Statistics (CAPMAS). [Detailed references will be found at the end of this chapter.] - 151 -

Table 5.2: EMPLOYMENT CLASSIFIED BY ECONOMIC ACTIVITY IN CENSUS, EGYPT, CENSUS YEARS 1937 to 1976

Economic Activity 1937 1947 1960 1976

Agric., forestry, hunting & fishing 4,020,431 4,085,670 4,406,379 4,881,009 % 69.2 58.4 57.0 47.6

Mining & quarrying 10,828 12,965 21,109 33,831 % 0.2 .2 .3 .33

Manufacturing 352,706 560,601 713,100 1,369,482 % 6.1 8.0 9.2 13.4

Construction 120,706 113,361 158,885 425,085 E 2.1 1.6 2.1 4.1

Electricity, gas, water & sanitary services 20,966 22,595 36,808 61,761 % .4 .32 .48 0.6

Commerce 439,542 590,380 641,408 861,286 % 7.6 8.4 8.3 8.4

Transport, storage & communications 138,911 203,335 260,210 482,253 % 2.4 2.9 3.3 4.7

Services 701,749 1,051,776 1,369,432 1,956,681* .X 12.1 15.0 17.7 19.1

Activities not adequately described 3,433 353,934 119,320 186,438 % 0.1 5.1 1.5 1.8

Total Working Population 5,809,272 6,994,617 7,726,651 10,257,825

* The classification system used in the Census changed between 1960 and 1976. In 1960 the UN classification system was used, and in 1976 the 1968 UN classification. In 1960 repairing activities were in manufacturing, and in 1976 they were put in services. Also in 1976, Banking and Finance figures are reported separately (88,392) but we have added them to services for consistency. Strictly speaking, we should only have added business services to services, and put the banking and real estate figures in Commerce. The numbers involved are not sufficiently large that our conclusions would be materially changed.

Sources: Population Census 1937, 1947, 1960 and 1976. - 152 -

Changes in the structure of output and employment are, of course, a virtually universal feature of economic growth. As incomes increase, differences in income elasticities of demand among consumer goods, and sectoral differences in capital intensities and the ease of factor substitution, will generate different sectoral growth rates. Thus the concern is not with structural change of employment per se, but rather with its direction, pace and causes. The concern is that in Egypt, the principal impetus for the rapid decline of the agricultural sector s share of employment has not been the rapid rate of growth of demand in nonagricultural, particularly industrial, employment, but the scarcity of land. Given the limits to the extension of Egypt's cultivable land area, technological innovation that is too slow or innovation of the "wrong" sort (labor-saving) implies rapidly diminishing returns to labor in agriculture.

The high population density in the 6 percent of Egypt's land area that is currently arable lends credence to concerns about the absorptive capacity of agriculture. Table 5.A3 contains information on agricultural land and on the population it now supports in 21 of the most densely populated developing countries together with Japan and the Netherlands. 1/ In 1975 agricultural population per square kilometer of cropped area was highest in Egypt; the level is historically unprecedented.2/ Moreover, the estimated per annum growth rate of agricultural area in Egypt over the 1970 to 1975 period was among the lowest cited in Table 5.A3. This explains why, since 1882, the index of total Egyptian population and of total population per square kilometer of arable land have increased at virtually the same pace (Table 5.4). Put another way, if indeed the agricultural sector has reached its absorptive capacity, then whether or not the growth of the domestic labor force will exert downward pressure on earnings depends entirely on the growth of demand for labor in nonagricultural activities.

The magnitude of the absorptive task faced by the nonagricultural sectors is sometimes illustrated with information on urbanization trends. With 48 percent of its population living in cities in 1975, Egypt is less urbanized than various Latin American countries (see Table 5A.4). It is roughly at the same level of urbanization as Algeria and Korea; and at more than twice the level of the Ivory Coast, Nigeria, India or Indonesia. Much of the shift of population from rural to urban areas in Egypt has occurred over the past 40 years: since 1937 the urban population has in fact quadrupled while the rural population increased by 70 percent. The absolute increase in population in urban areas was twice that in rural areas. Table 5.A4 also presents projections of Egyptian urbanization, albeit rather mechanical ones,

1/ Taiwan, China, North Korea, and the East Asian city-states also qualify for inclusion by having overall population densities in excess of 70 persons per square kilometer.

2/ The fact that so much of Egypt-s cultivable land is double cropped must, however, be taken into consideration. - 153 -

Table 5.3: EMPLOYMENT CLASSIFIED BY ECONOMIC ACTIVITY IN CENSUS, EGYPT, CENSUS YEARS 1937 TO 1976

(Index Numbers 1960 = 100)

Economic Activity 1937 1947 1960 1976

Agric., forestry, hunting & fishing 91.2 92.7 100 110.8

Mining & quarrying 51.3 61.4 100 160.3

Manufacturing 49.5 78.6 100 192.0

Construction 75.9 71.3 100 267.5

Electricity, gas, water & sanitary services 56.9 61.4 100 167.8

Commerce 68.5 92.0 100 134.3

Transport, storage & communications 53.4 78.1 100 185.3

Services 51.2 76.8 100 142.9

Activities not adequately described 28.7 296.6 100 156.3

Total Working Population 75.2 90.5 100 132.8

Sources: Same as Table 5.2. - 15ff-

Table 5.4: INDEX OF AGRICULTURALPOPULATION PER SQ. KM., EGYPT, CENSUS YEARS 1882-1976

(Index Numbers 1882 - 100)

Index of total Index of density of Year population agriculturalarea

1882 100 100.0 1897 142.6 142.7 1907 164.7 165.8 1917 186.7 189.0 1927 208.8 208.8 1937 233.8 237.7 1947 279.7 278.6 1960 382.4 393.9 1966 441.2 431.1 1976 538.2 525.3

Source: CentralAgency for Public Mobilizationand Statistics. Table 5.5: THE OUTPUT ELASTICITYOF DEMAND FOR LABOR, EGYPT, 1961-1966AND 1971-1976

1961 1966 1961-1966 1971 1976 1971-1976 Outpu2 2/ Labor Output N 2/ Labor Output Output Output - force Output elasticity 1/ Output 1/ Output- force Output elasticity Labor-! (1964/65 Labor- (1964/65 growth growth of demand Labor - (1970 Labor - (1970 growth growth of demand Sector force prices) force prices) rate rate(%) for labor force prices) force prices) rate rate for labor (1) (2) (3) (4) (5) (6) (7)=(5t6) (8) (9) (10) (11) (12) (13) (14)-(12)+(131

Manufacturing petroleum, mining 734 314.1 998 436.9 6.0 6.6 .90 1,045 640.1 1,210 701.0 3.1 8.2 .38 1

Construction 159 44.2 206 88.5 6.0 16.6 .36 295 118.9 134.5 2.6 .n

Transportation and communication 260 114.1 340 201.3 5.1 11.3 .45 324 143.6 422 239.0 6.0 13.3 .45

Public utilities 37 19.8 51 34.6 6.3 11.1 .57 26 54.1 47 94.5 11.2

Commerce 641 162.0 699 190.7 1.5 2.2 .68 808 274.2 1,016 392.9 5.1 8.7 .58

Other services 1,489 313.6 1,602 462.4 7.5 7.6 .99 1,541 693.8 2,276 97b.3 9.5 8.1 1.17

Notes:

j In '000.,

. In millions of Egyptian pounds.

Sources: R. Mabro (1974) Basic Economic Report - 156 - made by the U.N. to the year 2000. 1/ The projections indicate that the proportion of the population living in cities will increase from roughly one half to roughly two thirds. In absoute terms the urban population is expected to more than double, an increase of some 25 million in 25 years.

Certainly there are grounds for pessimism regarding the prospects for absorbing the increments to the Egyptian labor force in productive nonagricultural employment at rising, or even at constant, real wages. In particular, concern focuses on the relationship between output and employment growth. Table 5.5 presents measures of the output elasticities of demand for labor in various nonagricultural sectors for the periods 1961-1966 and 1971- 1976. The elasticities are purely descriptive: the lower they are the smaller the growth of employment associated with a given rate of growth of output, and the higher the implied increase in labor productivity. As in many other developing countries, in most sectors in Egypt the elasticities are well below unity. For example, in transport and communications in the period from 1971 to 1976 the elasticity was only .45 -- that it is an increase of output of over 66 percent was associated with an increase of employment of only 30 percent. In general, recent rates of growth of modern sector output in Egypt have been historically unprecedented, and indeed are higher than the more developed countries achieved during their periods of industrialization. Though much slower, modern sector employment growth has also been impressive when measured against prior experience in Egypt and in the industrialized countries at the turn of the century. It is only when measured against the unprecedented growth of supply of nonagricultural labor that the growth of nonagricultural labor demand appears inadequate.

There are exceptions to the rule of low output elasticities of demand for labor in Egypt. For the period from 1961 to 1966 the elasticity for the manufacturing sector (including petroleum and mining) is .9; for the periods 1961-1966 and 1971-1976 the elasticities for the "other services" sector are .99 and 1.17 respectively. These exceptions do not, however, allay concern about Egypt's employment problem. Rather they provide grist for the mill of those who see it as quite serious. The abnormally high elasticities in the two cases cited can be seen as symptoms of two potentially threatening complications of Egypt's employment problem. To counter the tendency for labor incomes to decline or for queues of job seekers to form when growth of labor supply outpaces demand, the government can artificially inflate labor demand. This can be accomplished, at least in the short run, either by direct hiring at wages in excess of the marginal productivity of labor by the public sector, or by compelling other enterprises to take on unnecessary labor.

1/ These are not linear projections. Some decline in the ratio of urban to rural population growth is assumed. Nevertheless they are extrapolated from past demographic experience rather than derived from a detailed forecast of economic developments. - 157 -

Mabro claims that the accelerationof industrialemployment growth in the 1960s (it averaged only 1.9 percent per annum between 1947 and 1960) was not due "to a higher rate of investment (hence the high output elasticity of demand for labor) but was a result of employment policies;after nationalization in 1961 and 1962 the Governmentcompelled public companiesto engage more persons than they actually required." 1/ Managementhad little reason to resist because the prevailing price system did not penalize inefficiency: high tariffs together with the cost plus method of setting prices allowed firms to pass on the increasedwage bill as higher prices. 2/ Even if they had the incentive,firms could not lower wages in response to the labor glut. They were prohibited from doing so by labor legislationwhich set out rigid wage schedules. Moreover the labor laws prevented employers from dismissing workers save in exceptionalcircumstances. 3/ Under such a policy regime there are, nevertheless,constraints on the accumulationof surplus labor in industrialenterprises. The effect of these plus the return to a more normal incentivesystem in both factor and product markets are reflected in the lower output elasticityof demand for labor in the industrialsector in 1971-76. As Table 5.5 indicates,from .90 in 1961-1966,it declined to .38 in 1971-1976.

Whether a high elasticity is a symptom of, or a solution to, Egypt's employmentproblems is quantitativelya more importantissue in the "other services"category than in the industrialsector. As Table 5.5 indicates, the high elasticitywas not a temporaryaberration but a persistent feature of the services sector. Furthermore,the services sector is considerablylarger than the industrialsector when measured in terms of employment. Table 5.2 reveals that between 1937 and 1976 roughly 57 percent of the total increment of 4.42 million to the Egyptian labor force was employed by the tertiary sector, which increasedits share of total employment from 24 to 38.6 percent. For each additionalworker employed in industry,three were engaged in the tertiary sector. As only an additional643,508 workers were employed in constructionand transport,most of the expansion took place in commerce and other services. Since 1960 changes in the sectoral pattern of employmenthave followed the same general trend. Table 5.2 indicates that between 1960 and 1976 the services sector had the second largest absolute increase in employment, and in fact absorbed 23 percent of the increment to the Egyptian labor force during this period.

The services sector can be divided into government services and private services,with a significantproportion of the latter falling within

1/ R. Mabro (1974),p. 208.

2/ Ibid., p. 137.

3/ Ibid., p. 138. - 158 -

what has come to be known as the "informalsector." Both segments of the service sector, it is claimed, harbor large numbers of "surplus"workers, surplus in the sense, discussedwith regard to the industrialsector, that earnings exceed marginal productivitywhich may be negligible or even zero. The two segments are distinguished,however, by the skill levels and incomes of participantsand by the mechanisms hypothesizedto give rise to the labor surplus.

The workers in the private segment, or at least that apparently large part of it that falls within the informal sector, are for the most part relativelylow-skilled and earn low incomes. Mabro claims that in Egypt "the transfer of labour from agriculture,where they would have become increasinglyunderemployed, to low-paid, low-productivityjobs in certain service activities is not akin to reallocationto industry. Labor in these activities ... does not generate an economic surplus; the growth of these activities is unlikely to contributeto economic developmentthrough external economiesor technicalprogress. The reallocationthat takes place ... is, to a large extent, a transfer of the locus of poverty, underemploymentand low productivityfrom one economic sector ... to another." The underlying model appears to be that of an easy entry monopolisticallycompetitive sector: the structure of the market permits more and more workers to get a share of the total income generated in the sector, even though they may not raise total output, or may raise it by an amount which is less than the income they earn. Private returns to labor exceed social returns.

Clearly, when viewed from this perspective,rapid growth of the private service sector in Egypt is a symptom of the larger employment problem. It is important to note, however, that while assertions and hypotheses regarding the economic role of this sector abound the evidence on income trends and labor utilizationnecessary to assess them does not appear to exist. All that can be said is that in Egypt today, as in many other developing countries,a higher share of the labor force is to be found in tertiary activities than in the now developed countriesat comparable stages of development.

There is a similar lack of hard evidence regarding the magnitude of the surplus of white-collar,high-income labor in government employment. In this case, however, there is a firmer basis for deducing a serious problem from informationabout apparent causes. The rapid growth of employment in government services reflects in part the government'scommitment to serve university and some secondary school leavers as an employer of last resort. The presumption is that when labor supply determinesdemand the efficiency with which labor is utilized is bound to suffer.

Though precise and up-to-date informationon the size and growth of government employment is not readily available, there is no doubt that the government accounts for a large and growing proportion of all employment in the service sector. (Table 5.A5, covering the period 1959-1965,illustrates - 159 -

a decline in the share of private services). The increase in educational opportunities was one of the fruits of the Egyptian revolution enjoyed by the general populace. The view was that "education, like water and air, should become a free good." 1/ Enrollments at all levels, but particularly at the postprimary level, have been increasing for three decades at rates between 5 and 10 percent annually (see Table 5.A6).

Table 5.A7 reveals the change during the intercensal period (1960- 1976) in the educational composition of the population aged 18 or over grouped by employment status. The absolute number of illiterates in the population, in the labor force and in the wage labor force, continued to increase but their proportion declined. The educational selectivity of the wage labor force is apparent. While the proportion of the population and of the labor force, with intermediate or higher certificates, increased from 5.2 to 7.9% and from 6.1 to 12.9%, respectively, the increase among paid employees was from 10.2 to 19.3%. Table 5.6 is suggestive of the accumulation (from 1960 to 1974) of a surplus of white-collar workers in government employment. The proportion of white-collar workers increased in all but the commerce sector. The largest increases were in services, transport, public utilities, and mining and quarrying, sectors in which the government presence is most prominent. The increase from 13 to 45 percent in the proportion of white-collar workers in public utilities is the most striking. It is difficult to imagine an explanation consistent with efficiency in the allocation of labor.

With low costs and guaranteed returns the private demand for education remains high. When the government succumbs to political pressures to expand higher education this exacerbates the problem of surplus labor in the public sector. Hansen's qualification of his conclusion (Hanson, 1969) that "government civil employment could be cut substantially with no negative effects on production, and probably even with positive effects" is, however, apt. Since highly efficient overemployed civil servants work together with the underemployed it would be a mistake to believe that large-scale indiscrim- inate cuts in government employment could be made without negative effects on the provision of services.

It does not follow, however, that an oversupply of school leavers in a country at Egypt's level of development is only a temporary phenomenon, imposing few long-term ill effects. When physical plant and equipment operate at markedly less than full capacity there is the potential for a rapid expansion of output in the short run. It is tempting to view the stock of underutilized human capital in Egypt in a similar way, particularly because, by comparison with the industrialized countries, that stock per capita remains relatively small. According to this view, the super-abundance of educated

1/ Statement by Taha Hussein who became Minister of Education just before the revolution. Quoted in Mabro (1974). - 160 -

Table 5.6: WHITE-COLLAR WORKERS AS A PROPORTION OF TOTAL EMPLOYMENT IN VARIOUS SECTORS, EGYPT, 1960 AND 1974 (Percent)

Professional, Clerical. Sector Technical, Administrative Workers All White-Collar

Agriculture: 1960 .1 .2 .3 1974 .5 .7 1.2

Mining/quarrying: 1960 5.1 4.7 9.8 1974 13.8 9.4 23.2

Manufacturing: 1960 2.4 3.9 6.3 1974 4.2 6.0 10.2

Construction: 1960 5.9 .1 6.0 1974 10.7 6.4 17.1

Public utilities: 1960 4.2 9.2 13.4 1974 23.5 21.8 45.3

Commerce: 1960 2.0 5.8 7.8 1974 1.8 3.1 4.9

Transport: 1960 3.7 8.1 11.8 1974 5.0 19.7 24.7

Services: 1960 18.7 11.8 30.5 1974 29.3 14.5 43.8

Source: 1960: Census; 1974: Labor Force Sample Survey in Choucri, et al., 1978. - 161 - labor in Egypt is more an opportunityfor gain than a costly squanderingof resources. But the analogy between human and physical capital with respect to the potential for rapid output gains when there is underutilizationbreaks down in three ways:

(a) The physical productivityof machinery does not decline when it is left idle, as long as there is minimal maintenance,nor is its working life shortened. By contrast human capital does depreciate,although we do not know how rapidly, when it is left idle and its working life is reduced.

(b) An idle machine does not affect the productivity of other machines. An unproductiveworker, throughhis effect on other workers, may have significantnegative externalities.

(c) Underutilizationof physical capital is often reduced simply by increasingaggregate demand. Such increasesmay result in pockets of labor scarcity but institutionalbarriers to mobility and lack of incentivesfor search may prevent underemployedgovernment workers from taking up productiveemployment opportunities.

SOME CONTRADICTORYEVIDENCE

The stylized facts considered above are suggestive of a serious employment problem: increases in the Egyptian labor force appear to be outstrippingthe capacity of the economy for generating productive employment opportunities. Before consideringthe adverse trends in wage levels and the distributionof income that are likely to follow, there is some contradictoryevidence to assess.

Rural Surplus Labor

The revision of early estimates, some of which date back to the 1930s, of the magnitude of rural surplus labor that followed the accumulation of new data, distinctlybetter both with regard to accuracy and relevance, should serve as a warning that with regard to labor utilization in Egypt appearancescan be deceiving. To the casual observersof 40 years ago it was striking how little the rural population devoted to activities normally considered work. Moreover, Egyptian workers did not appear to have an unusually strong preferencefor leisure relative to material goods. This implied that much of the observed leisure was not voluntary; people were willing and able to work if only there was productive work available. In the absence of such opportunitiessome of them were, in fact, unemployed, though in contrast to the industrializedcountries where the wage system is pervasive,unemployment was disguised -- in that people worked for part of the day or year -- by - 162 - work-sharingarrangements within the family. It was hypothesizedthat, unlike profit maximizing production units which, in theory at least, release labor when its marginal productivityis below the wage rate, family enterprises provide security against open unemployment. Even if they have a surplus of labor in the sense that labor's marginal product is zero or negligible, workers are not expelled. Rather they are kept on and paid labor's average product or some customary "minimum wage." A piece of land that could be cultivated fully by two, may actually support four if none of the four has a better employment opportunity.

The apparent abundance of leisure, the high proportion of the labor force working in peasant agriculture,and the abundance of labor relative to capital and land in Egyptian agriculturesuggested that the rate of disguised unemploymentmight be quite high. Indeed some estimates of that rate made in the 1940s and 1950s were strikingly high, 20-30 percent or even more of the farm population,as high as the unemploymentrate in the industrialized countries at the bottom of the Great Depression.

Assessmentsof the magnitude of rural surplus labor in Egypt have been revised. The percentagesnoted above have been shown to be gross over- estimates. Rural dwellers do not enjoy as much leisure as presumed. High labor inputs characterizemuch of present agriculture. Overall, Egyptians appear to work longer hours than people in industrializedcountries, and there is no clear tendency in Egypt for persons in agricultureto work longer or shorter hours than in nonagriculture. In part it was the marked seasonal variations in labor use in agriculture,with many hours being worked in some months, and few in others, that misled the early observers. According to one survey adult males in rural areas work an average of about 50 hours per week from March to October and less during the slack winter months. 1/ Even on very small farms of less than two acres labor is fully utilized for much of the year due to the availability of wage employment on large farms and outside agriculture. Self-employmentin nonfarm economic activities,trade and crafts, also absorbs productively much labor. Indeed, it is claimed that currently in some segments of the agricultural sector there is a problem of labor scarcity. The 55 percent decline between 1974 and 1978 in the production of onions, the third largest agricultural export crop, is cited as an example. 2/ The decline occurred despite an increase in delivery price of 68 percent during this period. The decline is generally attributed to labor scarcity and the associated doubling of the wage cost per acre for this labor intensive crop.

The evidence of generally high labor inputs and of pockets of labor scarcity should not, however, be taken to imply the complete absence of rural

1/ See B. Hansen (1969).

2/ See Amr Mohie-El Din (1979). - 163 - surplus labor. There are imperfectionsin the markets for labor and land that lead to pockets of surplus labor and to inefficienciesin the allocationof labor, in particular between large holdings which hire in labor and small holdings which hire out labor. The persistenceof interregionalfactor price differentialsprovides support for this hypothesis.1/ Neverthelessit is clear that any difficultiesnonagricultural sectors may face in absorbing in productive employment the annual increments to the Egyptian labor force are not, as was once generally believed, significantlyexacerbated by a large overhang of rural disguised unemployment.

Wage Trends

In a labor surplus economy of the type Egypt was for many years presumed to be, because of income sharing arrangementsin family enterprises, the marginal product of labor in "traditional"agriculture would be below the going wage in a "modern" sector characterizedby profit maximizing production units. A perfectly elastic supply of unskilled labor is thus guaranteed at a constant real wage. Only after the surplus is exhausted should wages increase. Likewise, constant or declining real wages is a symptom of an economy sufferingfrom a tendency for the growth of labor supply to outstrip increases in labor demand.

What do trends in wages tell us about labor market conditionsin Egypt? Table 5.7 indicatesthat the real wage for rural unskilled labor in 1974 was little more --25 percent more-- than it was in 1938. Money wages increased tenfold and so did the cost-of-livingindex. Though the data leave much to be desired, the impression they convey of stagnant real agricultural wages was often used to support the view that Egyptian agricultureharbors large reserves of surplus labor. Closer examination(see Figure 5.1) reveals, however, marked fluctuationsin real wages over time; such fluctuationsare more suggestiveof a relationship,if only indirect,between wages and the marginal productivityof labor, than of a wage linked to a "subsistence"level of consumptionor a customary level of consumption. If the supply of labor is infinitely elastic then shifts in labor demand will have no impact on the wage rate. Nor will variations in the growth of the labor force on family farms affect wages; they will only influence the magnitude of labor surplus. Fluc- tuations in wages thus point to a supply curve that is less than infinitely elastic, hence to wage rates influencedby shifts of labor demand and supply. 2/ Such a situationis not consistentwith rural disguised unemployment,as con- ventionallydefined, on a large scale.

1/ See R. Mabro (1974) and Amr Mohie-El Din (1979).

2/ If the income of surplus workers on family farms is directly linked to average productivity,rather than to a subsistenceor customary level of consumption,the wage may fluctuateand the labor supply curve still be infinitely elastic. Shifts in the supply curve could occur due to changes in average product on family farms. It does not appear, however, that cycles in productivityon family farms were sufficientlylong to explain the pattern of wage fluctuations. See B. Hansen (1969). - 164 -

Table 5.7: INDICESOF REAL WAGES IN RURAL EGYPT, SELECTEDYEARS, 1938-1974 (1938 - 100)

Average daily

Year Money wage Cost-of-living Real wage index index index

1938 100 100 100 1939 117 101 116 1941 120 132 90 1942 167 198 83 1943 210 238 87 1944 310 262 117 1945 310 262 117 1946 317 297 107 1948 333 271 123 1949 333 259 130 1950 387 264 147 1951 420 263 160 1952 400 265 151 1953 400 269 150 1955 '1 253 294 87 1956 333 342 97 1959 417 334 124 1960 417 337 123 1961 410 358 113 1962 450 367 122 1963 480 377 127 1964 609 438 138 1965 704 519 135 1966 801 468 170 1967 784 479 162 1968 784 499 156 1969 817 536 151 1970 801 576 138 1971 817 580 140 1972 880 613 143 1973 930 661 140 1974 1,001 792 125

Notes:

/1 This sharp decline is suspect, but in the absence of other data it was left unchanged since it does not affect the trend.

Source: ABDEL - FADIL (1975) Figure 5.1: MONEY WAGE, REAL WAGE,AND COST-OF-LIVING INDICES FOR AGRICULTURAL LABORERS, EGYPT, 1938-1974 (1938 100)

-4t - j- -.1 4~~~~~~~~~~~~~~~~4-

OCt . !-|- _ 1 & * | & - -s: - -'-4--1 -1-- t--- ~~~~co:n OF LIVINGC

Iya ~ ; .i. :0. ': - ..,..1.t'-; _ . 1t - i- ; i -4----i'--1.--4-it!-~ I

T-1~~~~~~~T- 41l I'

Source: ABDEL-FADIL (1975) - 166 -

The lack of a secular upward trend in rural wages is, however, highly suggestive of the type of dynamic employment problem that is our concern here. There may not be much surplus labor in the static sense. The wage trends in rural areas are nevertheless consistent with the evidence in the first section of this chapter indicative of a high elasticity of supply (due to rapid labor force growth combined with land scarcity) and to a development path in nonagricultural sectors that is insufficiently labor demanding. The fluctuations in wages do not qualify this interpretation. They simply suggest that Egypt has experienced periods of more rapid growth, or of more labor demanding growth, and that these have had a salutory effect on the earnings of unskilled workers. Such performance could not be sustained, however, and any gains achieved were subsequently eroded.

This historical perspective should influence our interpretation of post 1974 wage trends. Table 5.8 reveals that between 1974 and 1977 average wages in agriculture and in construction increased by 52 percent and 62 percent respectively. Consumer prices rose by 32.7% over the same period, 1/ implying a substantial increase in real wages in those sectors. 2/ Viewed in isolation this evidence of a tight labor market for workers in agriculture and construction, most of whom are relatively unskilled, is in sharp contradiction to the evidence summarized in the first section of the chapter that is used to forecast a severe dynamic employment problem in Egypt. Clearly if wages are rising for unskilled workers in the sectors least influenced by government wage regulations then, despite forecasts to the contrary, the growth of labor demand must be outstripping increases in supply. Since landless laborers and other agricultural wage earners are near the bottom of the socioeconomic hierarchy in Egypt increases in their real wages signifies that economic growth is trickling down and alleviating poverty. 3/ Our historical perspective on wages, however, does not permit us to be too sanguine.

When the increases in real wages in Egypt over the five years to 1977 are viewed in relation to wage trends over the preceding 35 years, fundamental questions are raised. Does the current upturn mark the

1/ This may somewhat underestimate the increase. A significant proportion of the items in the index are subject to price controls; changes in the index reflect movements in official prices rather than black market prices.

2/ Workers in the service, mining and industry sectors, on an average did not fair so well. The data suggest marginal declines in average real wages. The explanation for this marked divergence between sectors is, in large part, likely to be found in two factors: the high proportion of workers in the sctors with declining real wages in white-collar occupations; the high proportion of such workers in government employment. Other evidence suggests that wages of white-collar workers and government employees have not increased as rapidly as blue-collar and private sector employees.

3/ These wage increases likewise cast further doubt on the proposition that Egypt has large pools of unskilled surplus labor, either in agriculture or in services. - 167 -

Table 5.8: TRENDS IN AVERAGE WAGES PER WORKER IN VARIOUS SECTORS, EGYPT, 1974-1977 (in Egyptian pounds)

Year Construction Agriculture Services Mining & Industry

1974 233.2 70.8 295.0 297.0 1975 376.2 106.5 314.8 292.4 1976 378.7 107.0 327.1 305.0 1977 378.3 107.6 340.0 334.7

Total increase 1974-1977 62.3% 50% 15.3% 12.7%

Memo item: Increase in consumer prices, 1974-1977: 32%

Source: N. Choucri et al. (1978). - 168 -

beginning of a long period of sustained wage growth? Is it a break from the secular trend of stagnant real wages? Or are the recent increases simply the upward phase in another of the many wage cycles that have characterized Egyptian labor market history, to be followed by a period of erosion of real wages? We address these questions in the last section of the chapter. First, we consider some evidence that corroborates the curent tightness of the Egyptian blue-collar labor market and consider some explanations of the recent increases in relative wages.

Unemployment Trends and Other Evidence of a Tight Labor Market

Unemployment data in Egypt, as in most developing countries, suffer from problems of definition and measurement. The concept of "open unemployment" is most meaningful for educated urban workers, the very category protected from involuntary joblessness by public sector guarantees of wage employment. Changes in unemployment rates are nevertheless an indicator, if only a crude one, of changes in the balance between labor supply and demand.

Table 5.9 indicates a fairly steady decline in the aggregate rate of unemployment since 1957, from 5.1 to 1.4 percent. This decline coincides with the emergence of unskilled agricultural wage rates from one of their periodic troughs. The data run only through 1972. Estimates for more recent years, presented in Table 5.10, are not strictly comparable. They nevertheless reinforce the impression that open unemployment is not a problem and that in the 1970s the Egyptian market for manual labor has been progressively tightening. 1/ Likewise as Table 5.A7 indicates, in 1976 the census classified as unemployed less than 25 percent of the number of workers so classified by the 1960 census.

Table 5.10: RATES OF ADULT URBAN UNEMPLOYMENT, EGYPT

Male Year Percent Total

1968 5.6 5.8 1973 2.5 3.2 1975 2.9 4.4

Source: Labor Force Sample Surveys CAPMAS, population 12-65 years.

Wage increases in the construction sector in the 1974-1977 period were greater than in other sectors. These relatively rapid increases followed

1/ It is not uncommon in developing countries for rates of open unemployment to be four or five times those prevailing in Egypt. The Egyptian rates are unusually low. See Berry and R. Sabot (1978). - 169 -

Table 5.9: RATES OF UNEMPLOYMENTBY ECONOMIC ACTIVITY, EGYPT, 1957-1972

(percent)

Sector* Aggregate Agri- Manu- Cons- rate of Year culture facturing struction Commerce Services unemployment

(%)

1957 2.1 4.4 10.7 1.9 - 5.1 1958 1.8 5.1 13.7 2.4 - 3.4 1959 1.9 5.4 17.8 2.6 2.8 4.9

1960 2.2 6.0 15.3 2.5 3.1 4.8 1961 3.0 6.1 16.3 2.6 3.7 4.7 1962 0.4 2.9 5.6 1.2 1.3 2.2

1968 0.6 4.7 7.4 1.6 1.5 2.8 1969 0.4 2.3 4.7 0.9 1.0 2.5 1970 0.3 1.8 5.4 0.7 0.8 2.2 1971 0.1 0.8 0.8 0.7 0.3 1.7 1972 0.1 0.5 0.5 0.3 0.2 1.4

* Since a worker must have experience in order to be attributedto a sector, the sectoral rates of unemploymentare for experiencedworkers only.

Sources: Labor Force Sample Surveys, CAPMAS. - 170 - a period in which rates of unemployment declined faster than in other sectors. The impression that increases in labor demand exceeded increases in supply by a particularly large margin in construction is confirmed by other evidence. The recent rapid shift to more capital intensive construction techniques is readily apparent. There are, moreover claims of absolute scarcities of certain skills. That these persist despite rapid wage increases is explained by the cost and time involved in training skilled workers. It has even been suggested that given the crucial role of construction in capital formation, and the nontradeable nature of the sector's output, continued shortages of construction labor may place a binding constraint on the growth of aggregate output. 1/

Some Explanations

Explanations for the recent marked tightening of the market for manual labor in Egypt and the associated increase in real wages are to be found on both the supply and the demand side. On the supply side of the market the most notable contributing factor has been the external migration of workers. This migration has been occurring at historically unprecedented rates in the 1970s. Between 1968 and 1971 the number of Egyptians leaving annually to work abroad nearly doubled; between 1971 and 1973 the number doubled again, to over 500,000, and since then has remained at a high level. The development programs of the newly rich Arab oil exporting countries have generated demands for labor at all skill levels that exceeded by a wide margin domestic labor supplies. 2/ Rates of pay for Egyptians are five-to-ten times or more than what they can earn at home. The best, though still crude, estimate is that the stock of Egyptian workers abroad reached one million in 1979, nearly 10 percent of the entire Egyptian labor force.

Out-migration has decreased the rate of growth of the domestic labor by some 30 percent, from more than 3 percent per annum to roughly 2 percent per annum. This obviously implies, for a given rate of growth of domestic labor demand, a tighter labor market than there would have been otherwise. It is difficult to determine just how much of the post-197 3 increases in manual wages was accounted for by emigration. The experience of the construction sector labor market between 1966 and 1974 suggests that the impact there was significant. Average wages in construction increased by 28 percent between 1972 and 1974; over the previous six years the cumulative increase had been less than 10 percent. Yet output of the construction sector, hence presumably the domestic demand for labor in construction, was actually lower in 1974 than it was in 1972. The association between the increase in wages and the increase in the external demand for labor thus appears unambiguous.

1/ See N. Choucri, et al. (1978).

2/ The principal migrant receiving countries have been Libya, Saudi Arabia, Algeria and Kuwait. - 171 -

Other factors reduced further the rate of growth of the labor force to below the rate of growth of the Egyptian population of working age. Though their impact was clearly less than that of emigration, they contributed to the wage increases of the 19 70s and should be taken into account in forecasts of labor force growth. Sharp increases in military manpower requirements and increases in school enrollment ratios are the most notable. In addition, it has been suggested that the labor force participation rate of women and children declined in households headed by emigrant workers. 1/ The increased earnings of the household head meant that other household members could better afford increased leisure.

Simultaneous with the reduction of the rate of growth of the labor force there was an increase in the rate of growth of labor demand. Annual growth rates of gross domestic product (GDP) at constant factor cost accelerated from 2.7 percent in 1974 to an average of 9.3 percent over the following three years (see Table 5.A9). 2/ During the latter period investment as a proportion of GNP was one third greater than in 1974. This surge in investment and output growth was accomplished with the help of increases in the volumes of aid flows from OECD countries and of dramatic rises in worker's remittances, the demand side dimension of the impact of emigration. There is no doubt that these trends contributed to the tightening of the domestic market for manual labor and to the marked rises in real wages in the 1970s. Whether the unusually low rates of growth of domestic labor supply and the unusually high rates of growth of labor demand can be sustained in the years ahead, and the labor market consequences of not doing so, are assessed in the next section.

WHAT LIES AHEAD?

Among planners and policymakers some complacency about Egypt s employment problem would be understandable. The Egyptian labor market in the 1970s did not convey the impression of suffering the effects of a chronic tendency for growth of labor supply to outstrip demand. On the contrary, at least in manual occupations, increments to demand in nonagricultural sectors were more than adequate to absorb in productive employment annual increments to the domestic labor force; rather than declining, real wages rose sharply. The pessimistic predictions of the 19 60s and early 1970s clearly were not fulfilled.

1/ Table 5.A1 does indicate that in agriculture the absolute number of female workers actually declined between 1960 and 1976.

2/ For the period 1974-1977 the annual average growth of GDP was 7.6% which compares with a 3.9% average for 1967-1973. - 172 -

Viewed from a different, long term, perspective, the extraordinary performance of the 1970s did not, however, appear to alter the underlying trends that gave rise to the earlier pessimism. Nothing could be done to decrease the demographically predetermined high rate of growth of Egyptians of working age discussed in earlier chapters. Nothing was done to increase domestic savings as a proportion of investment, or to make the growth path of the economy more demanding of labor. The favorable wage trends were to a large extent a function of capital imports and labor exports. These flows are less stable and predictable, for a variety of economic and political reasons, than are the flows of commodity exports, on which other rapidly growing developing countries have based their success. It is thus pertinent to ask what the labor market consequences in the medium term will be if the favorable supply and demand trends of the mid 1970s are not sustained. Is the upward trend in wages likely to persist, marking a true break from the tendency toward stagnation that has characterized mid-twentieth century Egyptian economic history? Alternatively, has the timely exploitation of opportunities in foreign capital and labor markets simply postponed the day of reckoning with the Egyptian economy's underlying employment problem?

To assist in answering these questions we have used a computable general equilibrium model. This model is used for the purpose of comparative statics. The computations describe the influence of exogenous and policy parameters on the growth path. The calculations do not represent projections of what will happen to particular variables over time. This model was constructed around a 1976 social accounting matrix for Egypt. The matrix provides a twelve sector interindustry breakdown of the economy. The model was developed and previously used for other purposes. 1/ We have changed the specification somewhat to focus more sharply on labor market issues. In particular, labor demand has been disaggregated into three skill categories. 2/ For most sectors there are separate two-level production functions for public and private enterprises. At the first level value-added depends on inputs of aggregate labor, capital and, in agricultural activities, land. At the second level aggregate labor is ,produced, with inputs of three types of labor--white- collar, blue-collar and unskilled--along a constant elasticity of substitution (CES) production function. From this production structure incomes are generated through returns to labor, capital and land and distributed to their owners.

A typical solution sequence goes as follows: initial production levels and factor returns (wages, profits, and rents) are assumed. From these we compute value-added, incomes and sectoral levels of consumption

1/ For an extensive discussion of the model, see R. S. Eckaus, F.D. McCarthy, and A. Mohie-Eldin, "Multisectoral General Equilibrium Models for Egypt," Working paper No. 233, Department of Economics, Massachusetts Institute of Technology, March 1979.

2/ See the Appendix to this chapter for a more detailed discussion of specification issues. - 173 - demand. The latter, along with other exogenous components of final demand (investment, government, exports, stock changes and remittances) determine a new level of output. The procedure is repeated (this time keeping factor returns as they were) until equilibrium is reached between savings and investment or, in other words, until

X = AX + C(X) + G + E + S + I is satisfied.

Next, factor demands are computed (for the equilibrium output) and then matched with supplies of factors. Factor returns are adjusted to equil- ibrate the two. The equilibrium factor returns are then reintroduced in the first stage and the process again repeated until equilibrium is achieved in both the savings-investment equation and in the factor markets.

Precisely how the model is closed, by which we mean the specification of which factors will be constrained, is important for our purposes since it determines which factor returns will move to equate supply and demand. Not constraining a factor implies an infinite elasticity of supply and a fixed nominal rate of return. Our decision to constrain the supply of unskilled and blue-collar labor is based on revisionist views of rural surplus labor and on the implications of recent wage trends. Our decision not to constrain the supply of white collar labor is based on our knowledge of public sector employment policies and other evidence of overstaffing. 1/

The Base Run

We use the model to elucidate the implications for labor market conditions of alternative assumptions regarding the growth of the domestic labor force, on the one hand, and of the various categories of final demand, which in the model are exogenous variables, on the other, with 1976 as the base year. Figure 5.2 schematizes the aggregate supply side alternatives. In the 1960s the domestic labor force grew at about the same rate as the total labor force which, because of the age structure of the population and the changes in participation rates increased more rapidly than Egypt's population. Between 1970 and 1976, the rate of growth of the domestic labor force fell below that of the total labor force as a consequence of emigration. The difference between the high and low projections for the ten-year period depend on alternative assumptions principally regarding the rate of emig.ration,but also on trends in participation rates and in the size of the military.

1/ Capital is constrained in all sectors other than agriculture, where it is assumed for the most part to be traditional in nature and easily reproducible, and in services, which includes the Suez Canal and tourism, because of the difficulty of defining the concept there. Total land use in agriculture is constrained. - 174 -

Figure 5.2: AGGREGATESUPPLY SIDE ALTERNATIVES

-4i

0.~~~~~~~~3 a.El I I

1960 1965 1970 1975-76 1980 1985

Note: See text discussion. Growth rates are shown at annual percentage rate. - 175 -

There are also two alternativesets of projectionsfor various categories of exogenousdemand. With the exception of government expenditure, which is explainedbelow, the projected growth rates are all relativelyhigh in one set and low in the other. The high set was taken from the Egyptian five-year plan; the other set was based on estimatesmade by the World Bank.

The base run of the model serves as our referencepoint for all subsequent runs. Given our focus on labor market balance and wage trends it is the most optimistic of alternativesas it combines the low set of projections of domestic labor force growth, assuming therefore continuationof high rates of emigration,with high rates of growth of the exogenousdemand categories. Table 5.11 presents the values on the labor supply and demand variables included in the base run. _/

Since it is assumed that the key exogenousvariables continue the trends of the mid 1970s, the results of the base run should not come as a surprise. With slow labor force growth and rapid growth of aggregatedemand, inability to absorb increments to the labor force is not Egypt's problem. On the contrary, even assuming percent increases per annum in labor productivity, there is some doubt whether the supply of labor is adequate to satisfy the growing demand. Table 5.12 indicates the real output and price increases given by the model for various sectors over a five-yearperiod. 2/ Production levels, led by constructionand transport and communications,rise rapidly as do prices. Table 5.13 presents the increasesin demand for manual labor in those sectors where the increasesare forecast to be largest; Table 5.14 presents the largest sectoral wage increases. Substantialincreases in real wages are forecast for all manual workers. The real wages of white collar labor do not rise because its supply is unconstrained,but the forecastsof increaseddemand relative to supply suggest a marked decline in overstaffing, assuming of course mobility of labor from positionswhere productivityis low to positionswhere better use can be made of their skills.

1/ We have assumed a one year lag in all sectors in the transformationof investment into operating capital. We thus assumed that capital stocks grow at the rate that will produce by the end of the five year period an increase equal to the accumulatedinvestment for four years plus unused capacity. (Unusedcapacity, estimated at 18.1% in industryand 8% in the remainingnonagricultural sectors, is assumed to decline to zero over the period). The distributionof investmentacross sectors was based on the allocationsindicated by the 1976-1982 plan.

2/ Results are also available for ten years. Since they do not add much to the discussion they are not presentedhere. - 176 -

Table 5.11: VALUES ON THE LABOR SUPPLY AND DEMANDVARIABLES INCLUDED IN THE BASE RUN

Base Run Growth Rates (X)

Exogenous Variables 8.9

Investment 3.0

Stocks and Inventories 4.0

Government Expenditures 4.0

Exports 5.9

Remittances 11.3 White- Collar---- Lao 3. White Collar Labor 3.13

Blue Collar Labor 3.22

Unskilled Labor 0.98 ______

Labor Productivity 2.0

Crop Acreage 1.5

Note: See text discussion. - 177 -

Table 5.12: BASE RUN COMMODITYPRICES AND OUTPUT

CATEGORY FItlAL OUTPUT INITIA' OUTPUT CHA'.SE PRICES 1981 1976 Z 1976-1.0

StapleFood 577.572021 455.00000 26.938389 1.423631 Non-StapleFood 1803.54810 1268.00000 42.629974 1.371503 Cotton 308.748535 235.00000 31.382339 1.412630 OtherAgriculture 654.43S477 464.00000 41.042770 1.490759 FoodProcessing Irnh. 2053.97241 1522.00000 34.952179 1.362055 TextileIndustry 1140.25049 835.00000 28.841858 1.971658

Other Industries 1903.03979 1392.00000 36.712616 1.738003 Construction 970.034473 636.00000 52.528992 1.831759 CrudeOil and Products 815.603154 509.00000 33.925797 2.030257 Transportand Ccmm. 943.497559 577.00000 63.517751 1.883786

Housing 185.333572 142.00000 30.516536 2.353616 OtherServices 4266.14052 3118.0C000 35.8229°3 1.563701

Note: See text discussion. - 178 -

Table 5.13: INCREASES IN DEMANDFOR MANUALLABOR IN VARIOUS SECTORS, EGYPT, 1976-1981

(Base Run Levels and Precent changes)

(in 0,000)

Sectors Blue Collar Unskilled

EHousing 5.9490 7.9016 ( 1%) (147%)

Construction 4.4489 12.1994 (25%) (206%)

Textiles 3.5797 11.8281 (24%) (11%)

Other Industry 2.4388 7.6192 (12%) (.5%)

Table 5.14: WAGE INCREASES IN THREE SECTORS

(Percent changes)

Sectors Blue Collar Wages UnskilledWages

Constructionand Housing (144%) C 81%)

Agriculture ( 79%) ( 81%)

Industry (Sectors6, 7, 9) (115%) (123%)

Note: See text discussion. - 179 -

Variants 1 and la: Increased Labor SupplY

In Variant 1 the impact of a decline in the rate of emigration is assessed. Reduced growth of demand for foreign workers is a likely consequence of the slowing of development expenditure by Egypt's oil exporting neighbors. Only the labor supply assumptions are altered, as follows:

Rates of Growth

(%) Variant 1 Base Run

White-collar 3.82 3.13

Blue-collar 3.91 3.22

Unskilled 1.67 0.98

The growth rates of the exogenous categories of final demand are left as they were in the base run. Overall, the changes imply a 46 percent increase in the rate of growth of the domestic labor force. At the end of the five year period the projected labor force is roughly 3 percent greater than in the base run, a not inconsiderable difference, given the size of the Egyptian labor force in 1976.

The directions of the movements of output, prices and wages in response to this outward shift of the labor supply curve are predictable. Output is higher than in the base run, the labor constraint on production having been relaxed, and the rate of inflation is reduced, as are wage increases. What are notable are the magnitudes of these changes. They are much less than might be expected given such a difference in the rate of growth of the labor force. Substantial real wage increases are forecast, despite a substantial decline in emigration. This suggests that the Egyptian labor market may be less vulnerable than has been supposed to changes in the economic or political conditions of its neighbors.

Variant 1 took account only of the direct effect of a reduction of emigration. As we have noted, the flow of Egyptians has had a substantial impact, through remittances, on the demand side of the economy as well. The roughly one million Egyptians working abroad remitted approximately $2.2 billion in 1979. This compares with total exports of $5 billion and petroleum exports, the largest commodity group, of $1.7 billion. In the base run remittances are presumed to grow at 11.3 percent per annum. In Variant la they grow at 4 percent per annum. This reduction is the only demand side change, indeed the only distinction between the base run and Variant la. While increasing the domestic supply of labor increased output, decreasing remittances reduced increases in output. The latter change outweighs the former. The effects of reduced growth of remittances and increased labor supply on prices and wages are, however, the same. The declines are again quite moderate, reinforcing the impression that a quite significant decline in rates of emigration and an associated slowing of the flow of remittances will not jeopardize the rising trend of real wages for manual workers in Egypt. Of course the consequences of a large scale repatriation of Egyptian workers would be quite another matter. - 180 -

Variant 2: Increased Labor Supply and Decreased Aggregate Demand

In Variant 2, we substitute more pessimistic growth rates for the various exogenous categories of aggregate demand as follows: Rates of Growth (%) Variant 2 Base Run Investment 3.5 8.9 Exports 3.0 5.9 Stock changes 2.0 3.0 Remittances 7.5 11.3 Government 6.5 4.0

The biggest change is in investment growth. These rates are combined with the projections of more rapid growth of the labor force.

Table 5.15 presents the forecast output and price changes in various sectors. The decrease in aggregate demand has had a marked deflationary impact: output growth is significantly lower than in any of the other runs and prices actually decline. By comparison with the other runs, a markedly higher proportion of labor is absorbed in agriculture. Real wages decline. This run suggests that Egypt's economic policymakers cannot afford to be complacent regarding the economy's ability to absorb in productive employment the large increments to the labor force. Given the likelihood of slower rates of emigration, slower than planned rates of growth of aggregate demand, which historical and other country comparisons suggest are still quite high, would reverse the upward trend in real wages of the mid 1970s.

Variant 2 contains another warning. At first, the run was attempted with 4 percent increases in government spending, the same rate of increase as in the base run. But the resulting growth of aggregate demand was so slow that the model could not achieve equilibrium. It was necessary to increase government spending as a means of decreasing deflationary pressures. This outcome suggests that if investment, exports and remittances do not fulfill optimistic targets the government will be under pressure to take up the slack. The implication for the labor market is a further accumulation of surplus labor in the public sector and a reduced likelihood of disconti- nuing the employment guarantees for upper-level school leavers. - 181 -

Table 5.15: VARIANT2, COMMODITYPRICES AND OUTPUT

CATEGORY FINALOUTPUT INJITIALOUTPUT CHAtIGE PRICES 1981 1976 % 1976-1.0

StapleFood 520.878418 455.00000 14.478765 0.957545 Non-StapleFood 1425.49780 1268.00000 12.420959 0.961°32

Cotton 272.491699 235.00000 15.953914 0.955453

Other Agriculture 526.365967 464.00000 13.440934 0.962297

Food ProcessingInd. 1673.55420 1522.00000 9.057567 0.976553

TextileIndusLry 1034.96021 805.00000 16.944541 0.952523

Other Industries 1653.85083 1392.00000 18.811111- 0.992172

Construction 759.635498 635.00000 19.439529 0.790s42 CrudeOil & Products 731.954590 609.00300 20.139575 0.783281

Transport& Comm. 790.718994 577.00000 37.039673 0.785997

Housing 213.443100 142.00000 50.312027 0.740577

Other Services 3898.55786 3118.00000 25.033905 0.811557

Note: See text discussion. - 182 -

Conclusions

The paper reviews the evidence underlying assertions that Egypt suffers from a tendency for increases in labor supply to outstrip the growth of labor demand, and from the adverse impacts on earnings and the distribution of income that such a tendency implies. The Egyptian labor force is growing rapidly (2.1% p.a. on average between 1970 and 1976). The labor force is growing even faster; mission projections suggest that the population between the ages of 15 and 60 will grow over the 80s at an average annual rate of 2.6%, while since 1970 labor force participation rates appear to have been rising. Land is scarce, and with regard to employment, the agricultural sector may have reached its absorptive capacity. Thus, nonagricultural sectors must bear most of the burden of absorbing the increments to the labor force. In manufacturing, construction and transport, however, labor productivity has increased, i.e., employment has grown much slower than output, for example from 1971 to 1976, in manufacturing the growth of output was 8.2% while employment grew at 3.1%, and in transport the rate of growth of output was double that of employment. Despite rapid growth of output, these sectors have employed a relatively small proportion of labor force increment over the past four decades. Only in services has the growth of employment matched the growth of output; this sector has absorbed around 27% of the increase of the labor force and has markedly increased its share of total employment. At least in the government segment of the service sector there is 1ittle doubt that rapid employment expansion has been associated with the accumulation of "surplus labor"; workers, in this instance white collar workers, earn wages well in excess of their productivity. Wage trends provide perhaps the most telling evidence in support of the contention that Egypt is faced with a serious employment problem. Real earnings of unskilled workers fluctuated between 1940 and the early 1970s but ended up at roughly the same level where they began. Secular stagnation, or even a decline of wages, is just what is predicted when labor demand is unable to outpace the growth of labor supply.

Nevertheless, since the early 1970s, evidence contrary to the pessimistic assertions regarding Egypt's employment problem has been accu- mulating. Open unemployment has been declining, wages of manual workers in agriculture and construction have been rising; between 1974 and 1977 average wages rose 52% in agriculture and 62% in construction, while consumer prices rose 32.7%. In some manual occupations there are growing numbers of unskilled vacancies and attempts to substitute capital for labor are apparent in construction and elsewhere. Labor exports and capital imports provide an explanation for the marked tightening of the Egyptian labor market. Egyptians have been obtaining employment in the nearby oil producing countries in unprecedented numbers; by 1979 around I million Egyptians were estimated to be working abroad. As a consequence, the rate of growth of the domestic labor force has been sharply diminished, from over 3% p.a. to around 2%. Simul- taneously, increases in aid flows to Egypt, combined with large scale worker remittances from abroad, have resulted in a surge in investment, output and labor demand. For example between 1975-77 gross domestic produce at constant factor cost grew at an average of 9.3% p.a., compared to 2.7% in 1974. - 183 -

Has Egypt-s employmentproblem been solved? Or will the underlying tendencies for growth of labor supply to outstrip demand reassert themselves? Our results caution against undue optimism in answering these questions. The labor market may be able to adjust quite easily to a substantialreduction in emigration if aggregate demand trends are sustained. Indeed, an increase in the domestic labor force may, in the short run, alleviate inflationarypres- sures, without adverse effects on wages. Taking acccount of moderate declines in the flow of remittancesdoes not alter this assessment. It is, of course, difficult to determine just how sensitive the labor market is to changes in trends in aggregatedemand. Our results, however, do suggest that even moderate declines in export and investmentgrowth could rather quickly reverse the wage and unemploymenttrends of the 1970s. It is not for us to assess the likelihood of a slowing of growth of exogenousdemand. What is clear is that as long as Egypt's population continues to grow rapidly, extraordinarygrowth of demand aggregateswill be required to avoid yet another period of wage stagnationor decline. - 184 -

CHAPTERV

LABORFORCE GROWTH,EMPLOYMENT, AND

EARNINGSIN EGYPT: 1966-1986

ANNEX VA

TABULARSUPPLEMENT I.61. V Al: ECYPTIA ARA8S 8Y SEX. rPtLOYMINT STA7USAND ECONHI0CACTIVITY, 1960 AND 1976

(p ...... 6 yea.O ad Int-

p() e-oeMI. A.etFlt, S r.yo*V .*1S ell lve0 P.1d BIe,... - Jetd P*.11v Wo-k.r. DU U... td W.o.k.-r Iet t7hO______1 ___ IS601976 t 1960 1 Y L90 076 16 t 1960 1976 2 7 2 1960 1, 1976

S Alg,S., For-tr7 H 424,718 75.7 680,014 80.5 1,101,554 64.9 1,170.455 59.2 1,433,'P7 41.2 2,351,057 38.9 1,163,444 91.9 509,954 90.8 10,541 49.9 721 27.2 58.9 6.133.604 4,712.201 50.0 b1.S &*i.hlg 1 9 S .8817 75.2 9,424 67.1 12,733 24.8 12,980 25.6 85,276 25.23 82,519 14.5 163,833 92.4 50,128 90.4 682 27.3 69 9.2 46.9 271 341 155 120 22.5 T 433,535 75.7 689,438 80.3 1,114,287 63.8 1,185,435 58.4 1,518.623 39.8 2,433,576 36.8 1,325,277 92.0 560,062 90.8 11,223 *7.9 790 23.2 57.9 *,40192.5 4,867,321 48.1

64a6 S Quuly4. H 81 .014 151 .018 267 .015 548 .02 20,19S .5S 29,718 .49 151 .012 234 .42 26 .12 5 .lU .29 20.7;3 30.656 .33 1 - 4 .034 7 .046 2 .005 49 .Ot 91 ,027 .1,222 .21 23 .013 32 .057 2 .079 . - .02 122 1.310 .19 a85 .014 158 .018 269 .015 597 .029 20,209 .532 30,940 .46 174 .012 266 .043 28 .118 5 .146 .27 20,845 31.966 .32

1 s 80e.t.r1f n 217.67 4.97 39,144 4.63 85,722 5.05 153,125 7.75 534,852 15.3 1,066,653 17.6 25,181 1.99 10.881 1.98 5,130 2.4 538 20.3 9.6 67,.752 1.270.341 13.5 1 514 4.38 770 5.48 5,113 9.9 11,733 23.1 14,852 4.3 75,411 13.26 3.939 2.2 973 1.6 82 3.3 93 12.2 4.2 24.509 80,9JD 12.9 1 28.381 4.96 39.914 4.6 90,835 5.2 166,050 8.13 549.704 14.4 1.142,064 15.2 29.120 2.02 11,804 1.9 5,212 2.2 631 10.5 9.2 703'2 S 1,359.271 13.6

4 Ce.tr,.-tioa H 7,728 1.37 11.593 1.37 20,404 1.2 69,727 5.53 125,342 3.62 278,3DO 4.6 3,172 .25 2.367 .42 249 1.17 111 4.2 2.2 156.U95 3e2.096 35. 9 6 .05 35 .269 26 .05 239 .47 447 .13 6,320 1.11 103 .059 103 .18 2 .079 1 .13 .10 584 6.695 .97 S 7,734 1.32 11,628 1.35 20,430 1.169 69,66 3.45 125,789 3.3 284,6zO 4.3 3,275 .23 2,470 .40 251 1.06 312 2.2 2.1 157,479 ?68.796 3.6

5 82t.ttl y, G 6 _ 36,072 1.05 57,086 .95 - . . .51 36072 57,0S6 .61 8*1a0, & S0at I *..Ltar * 277 .08 4.595 .80 - _ _ .05 277 * SA5 .64 S.17-8 I 36,349 .95 61.681 .93 - * - - .46 36.141 bl.653 .60

0 Cr_ . 8 62,667 11.22 86,924 10.3 329,454 19.4 407,154 20.6 155,862 4.68 291,555 4.03 43.478 3.4 10,981 3.38 667 3.1 65 2.4 8.4 592.346 605,p67 S.5 1 1,292 19.9 2 383 16.9 23,307 45.4 19,024 39.04 7.603 2.25 24.933 6.4 56400 3.1 1.382 2.49 26 1.03 9 1.18 6.5 37.611 48.5S1 7.0 T 64.149 11.21 893507 10.4 352,761 20.2 426,978 21.06 163,485 4.25 316,486 4.79 468,878 3.3 20,363 3.3 693 2.93 74 2.2 8.3 629,9r6 0S5 1,2 6.6

7 fra.p-pt. Itorag. H 4.80 6,76 .80 27,661 1.63 70,895 53.5 215.225 6.192 581,802 6.327 5,81 .46 2.971 .53 320 1.1 33 1.2 3.6 253.971 662,460 S.9 S, 04...e.8. Y 13 .11 21 .1 60 .07 220 43 2,70 5 .68. 15.4719 3.72 i12 .065 100 .18 1 .059 1 .13 .43 2.4- 15,822 2.5 S 4,986 .85 6,782 .79 27,701 1.58 71,113 3.50 217.510 5.70 397 281 6.02 5,996 .42 3,071 .29 221 1.35 36 .99 3.6 256.6 677,1 *.7

a 88-...8 H 31,729 5.6 17,725 2.1 126.350 7.5 91,319 4.6 923.847 26.5 1,487,069 24.6 22.213 6.161 .76 5.871 10.3 296 10.9 15.9 I,IOS.OI; 1.601.370 67.8 T 1.050 0.9 322 .23 9,761 19.1 1, 63 3.3 224,069 66.5 340,417 59.7 3,315 256 .46 1.609 67.3 23 6.1 *1.5 259.6o- 3.701 49.6 S 32,779 5,7 18,047 2.1 136,111 7.6 93,002 6.6 1,147,916 30.1 1,828,286 27.7 25,528 6,617 .72 5,560 3.5 319 22.2 17.7 1,347,B9. 1.14,7071 19.5

8 et0,ltti8 x8t N 511 .09 1,751 .21 3,507 .20 12,974 .65 29,543 .86 88,896 1.47 1,375 .093 11,661 2.07 303 0.43 800 33.2 .50 35,441 .IC1.4 1.2 Adq6t.911y D7 crI.4 * 10 .is 1,086 7.7 230 .644 4 038 7.95 1,534 .45 17,624 3.09 203 .12 2.475 4.4 17 .67 556 73.0 .35 2,07: 25 701 ".7 T 529 .092 2,837 .33 3,737 .214 17.012 .83 31,479 .82 106,520 1.6 1,378 .096 14,13D 2.29 320 1.3 1,439 42.2 .49 37,043 141,945 1.6

C8. T... 36 561 384 646,063 1.694,919 1,976.195 3,474,710 6.032.934 1,263,695 541,212 21,107 2,649 7,014,811 *,*17.053 7 11.704 14,068 51,212 10,764 336.454 569,520 175,931 25,399 2.501 756 577,80: 690,687 T 572,088 56 ,111 1,740,131 2,6.961 3.811,164 6,602,654 1,659,626 616,011 23.609 3,682 7,.52,612 10,107,550

1 189*1t.60t Ce..l 1860. 1976.

Vio Table V A2: EMPLOYMENT STATUS BY SEX A4D ECONOMIC ACTIVlTY, EGYPT, 1960 AiuD 1976 (Index Numbers 1960 = 100)

Unpaid Other Self Paid Family Unpaid Economic Activity Sex Employers Employed Employees Workers Workers Total 1960 1976 1960 1976 1960 1976 1960 1976 1960 1976 1960 1976

Agric., Forestry, Hunting,Fishing M 100 160.1 100 106.2 100 164.0 100 43.8 100 6.8 100 114.0 F 100 106.8 100 101.9 100 .98 100 30.8 100 10.1 100 57.z T 100 159.0 100 106.1 100 160.2 100 42.3 100 7.03 100 110.5

Mining & Quarrying M 100 186.4 100 205.2 100 147.1 100 155.0 100 19.2 100 147.9 F 100 175.0 100 245.0 100 134.3 100 139.1 100 - 100 1,073.7 T 100 185.8 100 222.0 100 132 4 100 152.8 100 17.8 100 153.3

Manufacturing M 100 140.5 100 178.6 100 199.4 100 43.2 100 10.4 100 187.2 F 100 169.8 100 229.5 100 507.7 100 23.4 100 113.4 100 362.9 T 100 140.6 100 181.5 100 207.7 100 40.5 100 12.1 100 193.3

Construction M 100 150.0 100 341.7 100 222.0 100 74.6 100 44.5 100 230.8 1 F 100 583.0 100 919.0 100 1,413.0 100 98.1 100 50.0 100 1,146.9 H T 100 150.3 100 342.5 100 226.3 100 75.4 100 44.6 100 234.1 O 0N Electricity, Gas, M - - 100 158.3 - - 100 158.3 Water & Sanitary F - - 100 1,658.8 - - 100 1,658.8 Services T - - 100 169.7 - - 100 169.7

Commerce M 100 138.3 100 123.6 100 187.0 100 42.7 100 9.7 100 135.8 F 100 185.8 100 85.0 100 327.9 100 25.5 100 34.6 100 129.0 T 100 139.2 100 121.0 100 193.6 100 41.6 100 10.6 100 135.4

Transport,Storage M 100 138.5 100 256.3 100 177.4 100 50.5 100 10.3 100 182.1 & Communications F 100 161.5 100 550.0 100 67].5 100 86.9 100 100.U 100 639.5 T 100 138.5 100 256.7 100 182.6 100 51.2 100 10.6 100 186.5

Services M 100 55.8 100 72.3 100 161.1 100 18.7 100 7.6 100 144.5 F 100 30.6 luu 1y.2 1uu 1l.9 luu 7.7 10u .i.4 luU 14Z.0 T 100 55.1 100 68.3 100 159.2 100 17.3 100 5.7 100 144.2

ActivitiesNot M 100 342.0 100 369.9 100 296.8 100 99.2 100 285.7 100 327.7 Adequately F 100 6,033.0 100 1755.0 100 1,148.0 100 1,219.2 100 3,282.0 100 1,287.0 Described T 100 536.3 100 455.2 100 338.3 100 1,025.9 100 449.3 100 379.0

Grand Total M 100 150.6 100 116.6 100 173.6 100 44.4 100 12.5 100 134.2 F 100 120.0 100 99.1 100 169.3 100 31.4 100 30.1 100 119.5 T 100 149.9 100 116.1 100 173.2 100 42.8 100 14.4 100 133.1

Source: PopulationCensus 1960, 1976. - 187 -

Table V A3: AGRICULTURALPOPULATION PER SQ. KM. CROP AREA, SELECTED COUNTRIES, 1975

Agricultural Crop Area Agricultural Est. Growth Esc. GrcwLjb Area 1975 1975 Population/ Rate ag. Rate Crop sq. km. crop area 1970-1975 Area 1970- ('000 sq. km.) ('000 sq. kw.) area 1975 X p.a. 1975

Rurundi 169 126 256 0.7 0.9 Rwanda 152 92 421 -0.1 5.5

Hauritius 11 11 263 0.2 0.2

Egypt 286 286 687 0.1 0.1 Lebanon 36 55 136 1.3 1.4

Ba;igladesih 1,011 951 660 0.8 0.9 India 17,975 16,720 244 0.3 0.2 Nepal 400 200 586 0.1 0.2 Pakistan 2,445 1,945 204 0.1 0.1 !r £ Lan!a 242 198 384 0.0 0.0

'ictlna 1,044 557 574 1.0 2.0 Indolnesia 2,848 1,860 458 0.3 0.5

Korea,Rep. 243 242 641 0.7 0.7 i'hilippilles 856 790 278 1.8 2.5 hLaiIland 1,689 1,658 197 3.7 3.7

E1 Salvador 132 65 342 1.2 0.9 llaiti 151 86 373 1.0 1.2 Dominican Republic 246 100 302 1.0 0.6 Buatbidos 4 3 119 0.0 0.0 Ja:.iica 48 26 106 -0.4 0.8 Trinidad 17 16 106 3.0 ).I

Japan 600 557 289 -0.1 -0.6 IdL'herlands 208 84 107 -1.0 -0.6

Source: LoUNdUs:: FA0, Prodtuccion Yearbook, Vol 30, 1976 Projections of Agricultural Population: FA0, based on UN Mfedium Variant Projections. Table V A4: URBANIZATION PATTERNS IN EGYPT AND IN A SAMPLE OF OTHER LESS DEVELOPED COUNTRIES, 1975-20UU

Per capita Size ot population (in '00Os) Percentage of Compound urban Compounu rural GNP level 1975 2000 urban population growth rate growtn rate Country in 1972 US$ Urban Rural Urban Rural 1975 2000 1970-75 1995-2000 1970-75 1995-20OU

Argentina 1,290 20,293 5,091 29,288 3,573 79.9 89.1 2.19 1.11 -2.46 -1.06 Colombia 400 15,938 9,952 40,115 11,349 61.6 78.0 5.24 2.96 2.58 0.13 Algaria 430 8,432 8,455 27,205 11,199 49.9 70.8 6.78 3.85 1.52 0.94 1 Egypt 240 17,822 19,546 42,716 23,726 47.7 64.3 4.20 3.24 1.15 0.49 cO Korea 310 16,074 17,875 36,019 15,979 47.4 69.3 6.66 2.26 -1.36 -0.68 Ivory Coast 340 994 3,891 3,7.8 5,83; 20.4 38.7 7.02 4.46 1.51 1.54 Nigeria 130 11,419 51,511 40,953 94,008 18.2 30.3 4.67 5.10 2.07 2.36 Kenya 170 1,483 11,625 6,458 24,743 11.3 20.7 6.48 5.61 3.38 2.b3 India 110 132,367 488,742 354,872 748,834 21.3 32.2 3.62 3.92 2.09 1.27 Indonesia 90 26,232 110,284 78,433 171,519 19.2 31.4 4.54 4.01 2.32 1.29

Sources: UN Urban-Rural Projections from 1950-2000 (October 1974), medium tempo with medium variant; World Bank Atlas (1974). Rep. in G. Beier et al. (1976). - 189 -

Table V AS: EMPLOYHENTIN SERVICES, EGYPT, 1959-1965

(in thousands)

Sectors 1959/60 19C'0/61 1961/62 1262/63 1963/63 1964/65

Education Public 176.0 184.0 189.3 202.5 208.0 240.0 Private 15.0 16.0 14.7 9.0 1.0 16.0 Total 191i0 200.0 204.0 211.5 226.0 256.0

'lealth Public 32.0 43.3 49.6 75.3 79.0 79.8 Private 12.0 15.0 17.0 10.0 11.0 6.2 Total 44.0 58.3 66.6 85.3 90.0 86.0

Soci.iland Religious Public 18.0 21.6 22.-1 18.0 22.2' 24.1 Private 5.0 7.0 6.9 9.5 9.4 9.0 Total 23.0 28.6 29.0 27.5 31.6 33.1

Sectirityand Judges Public 160.0 164.0 166.0 164.9 170.3 169.3 I'rivate 13.0 14.0 13.5 14.5 14.0 15.0 Total 173.0 178.0 17r.5 179.4 184.3 184.3 t.,tuLUraland Recreation P_.blic 2.0 3.9 3.0 6.8 9.8 11.3 Private 14.3 13.9 16.0 19.0 14.0 15.0 Total 16.7 17.8 19.0 25.8 23.8 26.5

Governmental Organi.k-itions 71.0 90.0 93.0 103.0 145.0 180.5

Pcrsonal Scrvices 548.5 578.5 543.5 546.0 543.7 540.1

1,066.8 1,151.2 1,134.6 1,178.5 1,244.9 1,306.5

Source: Follow-Up Re!ports oz the. tMlnistryof Plair.inn,, cited in N. A. `anyil and l1. t1. lari.ft: LcborAb.,;tjricn 1:1 the Egyptt-.i: L op. cit., TCable 50. Table V A6: EDUCATIONALEXPANSION, EGYPT, 1951-1971

Number of pupils 1950/51 1960/61 1970/71 Percentage Annual compound enrolled in each increase growth rates educationalstage (-°08s) (O000s) ('000s) (1950/51-1970/71) %

1. Primary 1,310 2,663 3,741 185.6 5.4 (2,627)

2. General preparatory 349 254 849 143.3 4.5 (300) (852)

3. Secondary

3.1 General 92 132 298 223.9 6.1 (136)

3.2 Vocational 43 67 272 532.6 9.7 0 (75) (271)

4. Higher Education /1 34 108 212 532.5 9.6

/1 Data include students enrolled in Al-Azhar Universityand higher education institutes.

Sources: The data for 1950/51 and 1960/61 are from J.S. Szyliowicz,Education and Modernization in the Middle East (CornellUniversity Press, 1973), Appendix 3, p. 462. The data for 1970/71 are from StatisticalIndicators for U.A.R. (Cairo: July 1971).

Figures in parenthesesare CAPMAS figures given elsewhere in the report. Tabl. V A7: EGYrPAN ARABSBY nelLo0mENT STATUS,SEX A4D EDUCATIONALSTATUS (Persons 10 yrs. & over)

Certificato Below Intermediate /1 Employment Status Sax Illiterate Literat- Intermediate Certificate Hi_l_ - Not Stated T32 1960 1977 1960 1976 1960 197 i 1960 1976 1960 1976 1960 1976 19bi'6

Eloyers M 346,521 586,112 183,970 221,059 9,499 4,500 9,320 9,616 5,751 6,543 623 6,148 555.6S4 833,978 F 10,686 10,439 730 2,604 66 103 106 * 275 94 256 11 186 11b93 13,8@3 T 357,207 596,551 184,700 223,663 9,565 4,603 9,426 9,891 5,845 6,799 634 6,334 567,J7 647,41

Self Employed N 1,183,530 1,225,672 466,030 670,951 11,864 14,508 10,192 12,064 5,707 2,813 2,203 15,1S9 1,679,526 1,9;1,197 F 47,312 30,013 3,134 17,516 215 438 176 449 78 99 132 653 51,347J i T 1,230,842 1,255,685 469,164 688,467 12,079 14,946 10,368 12,513 5,785 2,912 2,335 15,842 1,730,572 1, i- ,35

Paid 1Epoloyeas M 1,973,807 2,934,466 977,969 1,535,457 101,240 172,364 230,352 537,258 98,824 361,364 11,270 53,707 3,393,442 5,59-,116 P 225,676 166,213 19,366 42,316 6,153 22,995 41,515 191,260 10,650 91,910 5,523 4,176 308,83 5iS jc T 2,199,483 3,100,679 997,315 1,577,773 107,393 195,359 271,867 728,518 109,474 453,274 16,793 57,883 3,70! 325 6,113,."

Unpaid Fmily Workcrs N 775,358 336,572 282,525 36,331. 6,965 59 5,500 - 157 - 7,099 9,209 1,077,604 382,172 F 112,526 30,934 . 8,649 1,484 51 3 66 - 9 - 1,782 958 123.183 33 00 T 887,884 367,506 291,176 37,616 7,116 8S 5,966 * 1.8 0,61 10.187 l,41333787 4"s,"

Other Unpaid Workers I 13,162 1,171 5,569 660 270 6 94 - 81 - 146 26 19,322 1,361 7 1,660 163 321 154 41 5 28 - 16 - 34 3 _, 94 39- *1 t 14,822 1,334 5,890 814 311 11 122 - 91 - 180 29 21,-16 2,1J

LneMloyed H 55,348 18,720 43,046 7,559 4,826 937 22,995 2,684 4,384 2,31 5 c 789 iil,l23 33,Oa,;. F 21,344 3,085 4,606 400 903 118 4,896 868 1,021 560 193 277 32,963 5,308 T 76,687 21,805 47,652 7,959 5,729 1,055 27,891 3,552 5,405 2,875 722 1,066 16, 086 38,312

Labor Force m 4,347,721 5,102,713 1,959,89 2,472,018 134,664 192,374 218,453 561,622 114,907 373,035 21,870 85,068 6,856,701 8,786.630 1+2+3+4+5+6 F 419,204 240.847 36,806 64,474 7,529 23,662 46,787 192,852 11,862 92.825 7,675 6,253 529,863 e20,g13 T 4,766,925 5,343,560 1,995,895 2,536,492 142,193 216,036 325,240 754,474 126,766 465,860 29,545 91,321 7,386,564 9,-07,743

Lhable to Work 91 13Z,015 265,769 29,880 85,746 2,619 2,738 4,307 19,240 1,760 10,366 4,103 10,936 174.684 394 7ls ? 298,703 622,132 4,958 20,510 403 1,427 979 3,289 36 642 4,038 23,256 309.117 c 1,254 T 430,718 887,901 34,838 106,256 3,022 4,165 5,286 22,529 1,796 11,008 8,141 34,192 483,601 1,Co6,051

Not SeekingWork N 557,092 197,307 814,793 1.188,425 60,092 672,785 303,574 363,973 7,416 18,331 32,577 51,321 1,775,544 2,.92,142 F 6,804,515 8,492,106 1,011,961 1,595,085 91,477 433,042 146,665 234,812 3,973 31,452 63,400 211,333 8,121 971 IG,97,630 T 7,361,607 8,689,413 1,826,754 2,783,510 151,569 1,105,827 450,239 598,785 11,389 49,783 95,977 262,654 9,897,535 13,-S9,672

Not Stated N 3,224 55,357 2,179 34,511 266 4,782 409 10,861 83 4,024 894 21,528 7,057 *31,S83 F 1,776 592 333 274 16 167 20 438 5 372 496 211 2,6-6 2,054 T 5,000 55,949 2,512 34,785 782 4,949 429 11,299 88 4,396 1,390 21,739 9,703 ;33,117

Total y 5,040,052 5,621,146 2,805,941 3,780,700 197,641 872,679 586,743 955,696 124,165 405,756 59,444 168,853 8 813 ,Q6 11,S30 7 7,524,198 9,355,677 1,054,058 1,680,343 99,425 458,298 194,451 431,391 15,876 125,291 75,609 241,053 89ro:17 12,292,85 4 T 12,564,250 14,976,823 3,859,999 5,461,043 292,066 1,330,977 781,194 1,387,087 140,041 531,047 133,053 409,906 17,777,603 2 ,c96,"3

/L University first degre, postgraduace diploma, m"tere degree and doctorate.

: PepatUea Ce_mm 19.8, 11. Table V A8: EMPLOTMENTSTATUS BY EDUCATIONALDEVELOPMENT, FGYPT, 1960 and 1976 (Row Percentnees)

Certificate Category Illiterate Literate Below Inter. Intermediate High Not stated 1960 1976 1960 1976 1960 1976 1960 1976 1960 1976 1960 1976 k;nployere h 62.3 70.2 33.1 26.5 1.70 0.54 1.67 1.1 1.0 0.78 0.11 0.74 Y 91.4 75.3 6.2 18.7 0.56 0.74 0.90 1.99 0.80 1.85 0.94 1.34 T 62.9 7U.4 32.5 26.4 1.7. 0.54 1.67 1.2 1.0 0.80 0.11 0.74

Self Ewployed h± 70.5 63.1 27.7 34.5 0.70 0.74 0.60 0.62 0.34 0.15 0.13 0.78 F 92.7 61.0 6.1 35.6 0.42 0.89 0.34 0.91 0.15 0.20 0.26 1.3 T 71.1 63.1 27.1 34.5 0.69 0.75 0.60 0.62 0.33 0.15 0.13 0.79

Paia Emp. tn 58.2 52.5 28.8 27.4 2.98 3.1 6.79 9.6 2.9 6.5 0.32 0.96 r 73.1 32.0 6.2 8.1 2.0 4.4 13.4 36.9 3.4 17.7 1.8 0.80 T 59.4 50.7 26.9 25.8 2.9 3.2 7.3 11.9 2.9 7.4 0.45 0.95

Unpaid F'amily h 71.9 88.1 26.2 9.5 0.64 0.01 0.51 - 0.15 - 0.66 2.4 F 91.3 92.6 7.0 4.4 0.01 0.01 0.01 - 0.01 - 1.4 2.8 T 73.9 88.4 24.2 9.1 0.60 0.01 0.46 - 0.01 - 0.73 2.4

Other unpaid ti 68.1 62.8 28.8 35.4 1.4 0.32 0.48 - 0.41 - 0.75 1.4 F 79.2 50.2 15.3 47.3 1.95 1.05 1.3 - 0.76 - 1.6 0.9 T 69.2 60.9 27.5 37.2 1.45 0.50 0.56 - 0.42 - 0.84 1.3

Unemployed 1i 42.2 56.7 32.8 22.9 3.7 2.8 17.5 8.1 3.3 7.0 0.40 2.4 F 64.7 58.1 13.9 7.5 2.7 2.2 14.8 16.3 3.1 10.5 0.58 5.2 T 46.7 56.9 29.0 20.7 3.5 2.7 16.9 9.2 3.3 7.5 0.44 2.8

Labor force h 63.4 58.0 28.5 28.1 1.96 2.2 4.1 6.4 1.6 4.2 0.32 0.96 F 79.1 38.7 6.9 1U.3 1.04 3.8 8.8 31.1 2.2 14.9 1.4 1.0 T 64.5 56.7 27.0 26.9 1.9 2.2 4.4 8.0 1.7 4.95 0.40 0.97

Unable to work ,I 5.5 67.3 17.1 21.7 1.5 0.69 2.5 4.8 1.0 2.6 2.3 2.7 F 9b.6 92.7 1.6 3.1 0.13 0.21 0.32 0.49 S.01 3.9 1.3 i.4 T 89.0 83.3 7.2 9.9 0.62 0.39 1.1 2.1 0.37 1.0 1.7 3.2

Not beeki%4 work Ni 31.3 7.9 45.8 47.7 3.4 26.9 17.1 14.6 0.42 0.73 1.87 2.1 F 83.8 77.2 12.4 14.5 1.1 3.9 1.8 2.1 0.05 0.28 0.78 1.9 T 74.4 64.4 18.4 20.6 1.5 4.5 8.2 0.12 0.37 0.97 1.9 hot stated hi 45.6 42.2 30.9 26.3 3.76 3.6 5.8 8.2 1.2 3.1 12.6 16.4 F 66.7 28.8 12.5 13.3 0.60 8.1 0.75 21.3 0.19 18.1 18.7 10.2 T 51.5 42.0 25.9 26.1 8.01 3.7 4.4 8.5 0.91 3.3 14.4 16.3

Total ti 57.2 47.6 31.8 32.0 2.2 7.3 6.6 8.1 1.4 3.4 0.67 1.4 F 83.9 7b.1 11.7 13.6 1.1 3.7 2.2 3.5 0.18 1.0 0.84 1.9 T 70.6 62.1 21.7 22.6 1.6 5.5 4.1 5.7 9.78 2.2 0.76 1.7

Sou,rce: Population Censwu 1960, 1976. * 193 -

Table V A9: TRENDS IN GDP AND ITS SUBAGGREGATES,EGYPT, 1974-1979 (percent)

1974 1975 1976 1977 1978 1979

A. Annual Growth Rates:

CDP at Constant Factor Cost 2.7 10.5 10.2 7.3 8.2 8.6

(a) Commodity Sectors 0.1 9.4 7.2 6.3 7.3 6.9 (b) Distribution Sectors 8.5 20.8 21.8 8.9 13.8 12.0 (c) Service Sectors 4.1 7.2 8.8 8.4 5.6 9.4

B. Ratios:

Investment/tOP 18.1 26.2 23.9 24.6 26.4 23.2

Gross National Savings/GNP /1 2.3 5.4 12.8 16.6 18.8 14.7

Cross Domestic Savings/GNP /I 1.9 4.8 10.0 13.9 13.4 7.3

/1 Until 1979, foreign savingswere seriously understatedbecause the foreign resousrcegap was converted at the overvalued official exchange rate. The appropriateexchange rate to avoid such understatementwould have been a weighted average of the official and parallel market exchange rates. With the un'ficationof the exchange rate in.January 1979, the modest nature of the contributionfrom domestic savings and the importance of workers' remittances in national savings has become evident.

Source: Ministry of Planning and World Bank Estimates. - lOl -

Chapter V

LABOR FORCE GROWTH AND EARNINGS IN EGYPT: 1966-1986

APPENDIX A: THE MODEL AND THE DATA

I. INTRODUCTION

The model in this paper follows closely a computable general equilibrium model built by The Cairo University/M.I.T. Technology Adaptation Program. Since the details of the model are available in Eckaus, McCarthy and Mohie-El Din (1979) 1/ (henceforth E.C.M.), we will limit ourselves in this first section to outlining the general features of the model and its mechanism without going into the details of its structural equations. The structural equations that differentiate our model from the E.C.M. model are presented here.

Table Al presents the basic equations of the E.C.M. model in very stylized form. Its mechanisms are fairly straightforward. Output is determined in the material balance equations (e.q. [1]). This in turn determines the level of value added and factor demands. Value added, in turn, determines incomes, consumption, and government tax revenue (equations [2], [3], [4] and [5]). Output prices are cost-determined in e.q. [5] with consumption in turn determined by value added and all other terms in equation [1] determined exogenously. A new level of output is established. A savings investment balance will determine equilibrium output. Corresponding to this output are factor demands. These are matched with factor constraints to determined factor returns. These in turn feed back into output prices (via P v in equation [5]) leading to new incomes, consumptions, factor i demands, etc. General equilibrium is obtained when the savings investment balance holds and factor markets clear simultaneously. Figure Al presents a flow-chart of the model. Details are left to E.C.M. (1979).

Before we move to present our model a few basic features of the E.C.M. model -- many of which will carry over into our discussion -- are worth mentioning. The value added "production functions" are Cobb-Douglas functions with their implications of fixed factor shares and unit elasticities of substitution. This feature will be changed in the model presented in this chapter as explained below. Money does not enter the model explicitly. Government deficit (determined endogenously) is presumably financed by money creation. No money demand equations are specified. The inflation rate is endogenous, i.e. the price determination equations are not homogeneous of 0 degree in nominal values.

1/ References cited will be journal style at the end of this appendix. - 195 -

Table Al: BASIC EQUATIONOF THE E.C.M. MODEL

Material Balance

X - AX + C + C + E + I us (l)

Value Added

V = P(K, L, X) (2)

Incomes

12 ; 2 pVij ( - t.) + S i , . . , 12

(3)

Consump tion 6 C. Z C: (Y) i = 1, . . 12 (4)

Price Determination

Price of Value' Added P g r) 12 Price of output p + i jiPj + t P. + P*mi (5)

Government Expenditures & Revenue

pC itPi tjivi

ij - 196 - Table Al (continued)

Foreign Trade

12 Exports = ZEPiE i

Imports = z P* m.x f Z mC (7)

Factor Market Constraints

D Z L (W/P) = L ii

z K (r/P) K (8)

The model has 12 sectors built around an input-outputmatrix. Consumers are divided into six groups by size distributionof income and sector (three for the urban sector and three for the rural sector.) Factors are Capital,

Land, and Labor. Production is for most sectors divided between private sector, production and public sector production. - 197 -

Figure Al: FLOWCHARTOF THE MODEL

Initial Output Guess x

Value Added

Initial Factor Returns Pries~ Guess W, r o .

ancmes

Consumption

r Final Demand i |C + G + E + I I AS| X)

_} R Factolr| Fato Excess DemnandsReun % - 198 -

As a consequence of this lack of homogeneity, the savings investment balance is attained through forced savings imposed in part through factor returns. Foreign savings is determined endogenously; since real exports are fixed, it is implicitly assumed that the nominal exchange rate (for exports only) will move to keep them constant.

With this brief exposition of the E.C.M. model we outline below the differences between this model and ours.

II. FACTOR SUBSTITUTION IN A GENERAL EQUILIBRIUM FRAMEWORK

To project labor demand for various skill levels a basic reformula- tion of the value added production function is necessary. In this section we present the production functions introduced and their implications for income determination and factor demands.

The Production Fynction

As in the E.C.M. model, our model is built around a twelve sector input-output matrix and its production functions are assumed to be with fixed coefficients in value added and intermediates:

X. = vV.+ La.. X. + m.X. (II-l)

i.e. value added is a fixed proportion of output along with domestic and imported intermediates.

Real value added is "produced" according to a two level C.E.S. production function (as opposed to a Cobb-Douglas in the E.C.M. model), i.e.

L -xi k x-i T -xi -l/Xi tlI-2) V.{ L_ + .K. + a. T. (I-2 31 I 1 1 1 1 1

where Li = a labor aggregate (explained below) in i

K = capital stock in i i

T, land in i ,-ev

Xw ' where ai is the elasticity of factor substitution in

value added.

L, ki, BT a distribution parameters - 199 -

correspondingto this production function is a cost function that will determine the "price" of value added.

pi [bi W.LOjJ + bkiR(lU1) + bT z(loY)j i (II-3) where Wi is the unit cost of the labor aggregate input (defined below) in i.

Ri the rental rate on capital in i

Z. the rental rate on land in i 1

These two functionsprovide the first level of the C.E.S. functions for value added. The second level appears with the production of the labor aggregate Li. It is assumed that only a labor aggregate enters the production function for value added. This aggregate is "produced" by combining -- in a C.E.S. production function -- three types of labor -- skilled, blue collar, and unskilled.

thus: a[.Y

with:

Ii£ ' skilled labor in i

Zi2 ' blue collar labor in i

ti3 = unskilled labor in i

1-0 Y pi= where ai is the elasticity of substitution between the 1 2. i various labor inputs

Y yI Y = are distributioncoefficients - 200 -

Again corresponding to this "production function" a cost function will determine the cost of the labor aggregate Wi i.e:

1 (lat 2 li) 3 l a l-2 W~~~m[4I(w) I) 13j 11- Wi [Si( )li + gi w21 gi 3i ] (II-5)

The cost of this labor aggregate Wi will enter the cost function in (II-3) to determine the price of value added Pi. - 201 -

Factor Demands

Coupled with these cost equations,factor demand equationsare derived along neoclassicallines:

CY R -a K -Bi 1Ii I i v X ) i ~ik t v~ vX Pi i - 1, . . , 12 V [ - V T -cr aiZP i * (11-6-A) i iT ±±i Pi

R.-y [-3 B -]*vX (II-6-B) ji

j- 1, 2, 3 i 1 12 - 202 -

III. MODEL CLOSURE

As is clear from the nature of computable general equilibrium models of the E.C.M. type, the closure of the model will markedly affect the results of the comparative macro-statics performed. By closure we mean the specification of which factors will be constrained in the model since this choice will determine which nominal factor returns will move to equate supply and demand. The homogeneity of the model rules out any unemployment in the constrained factors. On the other hand, not constraining a factor implies a fixed nominal return to it, and therefore, if prices go up, a decreased real return. In this model, after various experiments, we settled on the following constraints.

i) Unskilled Labor: In view of observed recent increases in real wages, we decided to constrain the supply of unskilled labor. Perfect labor mobility is assumed between the agricultural sectors and the nonindustrial sectors, (construction, housing, transportation, services). The industrial sectors (textiles, intermediate and capital goods industries and oil production) are constrained separately with perfect labor mobility among them. Wage differentials among sectors (within each of the two groups above) are kept fixed. This is to represent institutional barriers to wage equalization via labor mobility that the model cannot handle. Note that the differential between the two groups of unskilled workers (agricultural/nonindustrial and industrial) can vary.

ii) For blue collar workers, we chose to constrain their supply in the agricultural and the food processing sectors (with full mobility and fixed wage differentials). A separate constraint was imposed for the industrial sectors (defined above) and one for services and transportation. In view of the important role migration has played in the availability of labor for the construction and housing sectors 1/, we chose to isolate their blue collar workers by assuming no mobility between the rest of the economy and these two sectors.

iii) White Collar Workers -- The 1961/62 nationalization and employment drive led to an overstaffing of firms with white collar workers. 2/ This-- along with the education policy of Egypt, stressing academic and university training--led us not to constrain white collar employment in activities where the public sector predominates (all of the industrial sectors, transport, communication, and services). This lack of a supply constraint does pose a problem in terms of the political economy of Egypt. Most white collar workers will remain with a fixed nominal wage and thus (as the model results show) a decreasing real wage. However, given that white collar workers constitute a sizable portion of the politically vocal strata, such a decrease in their real

1/ See Choucri, Eckaus and Mohie-Eldin (1978).

2/ See R. Mabro and S. Radwan: The Industrialization of Egypt: 1939-1979, Clarendon Press, Oxford, 1976. - 203 - wage seems dubious. Some experiments can be performed to capture this point. Regarding other sectors, we constrain white collar workers in agriculture (again with free mobility and fixed wage differentials). Finally, following the argument for blue collar workers, construction and housing have their labor supplies constrained separately.

iv) Capital -- capital has proven to be the most difficult factor to pin down since data for capital stocks and capacity utilization are very poor in Egypt. 1/ We have therefore assumed that there is no constraint on capital in agriculture, it being of a rather traditional nature and easily reproducible.

In the rest of the economy evidence suggests that there was unuti- lized capacity until around 1973. We therefore proceeded as follows. Using educated guesses for capital-output ratios, we computed capital in use in the 12 sectors (along with base year profit rates), and assumed unused capacity to be 18.1% in industry and 8.0% in the remaining nonagricultural sectors 2/ (these somewhat low figures take into account the drive for increased production after 1973 and presumably the increase in capacity used). We then constrained the capital stock in the public sector portion of all non-agricultural sectors, with fixed profit differentials and full mobility (which in the context of the public sector seems plausible).

As for the service sector, we chose not to constrain its capital since the concept of capital in that sector (which includes the Suez Canal and tourism) is not well defined.

v) Land -- we have normalized the base year rent on land at unity and therefore land is measured in normalized units. It represents cropped acreage (as opposed to actual acreage) since crop rotation constraints have not been taken into consideration. We thus impose only a constraint on total land use in agriculture.

IV. DATA BASE

1 - Labor

Obviously the extension of the model to a more detailed picture of the Egyptian economy requires expanding its data base. These data collected from various sources (discussed below) did not match our twelve sector classification (see Table Al). The sectors in which the data on employment by skills, capital (when available) and wages by skill are classified are listed on the left-hand side of Table A2 (below). Now based on the E.C.M. twelve sector aggregation (for details see E.C.M. [1979]) the mapping from the nine

1/ See Mabro and Radwan, (1976).

2/ See Mabro and Radwan, (1976). - 204 -

Table A2: MAPPING FROM NINE TO TWELVE SECTORS

Official Classification Model Classification

Agriculture Staple Food Non-Staple Food Cotton Other Agriculture

Manufacturing Food Processing Textile Industry Other Industry (.8)

Gas and Electricity Other Industry (.2)

Construction Construction Housing (.7)

Mining Crude Oil and Products

Transportation and Communication Transportation and Communication

Trading Finance Services Services Housing (.3) - 205 - sectors of official publicationsinto our twelve sectors is shown in Table A2. This mapping is based on labor value added weights (since it is going to be used to distribute employmentamong sectors). The numbers in parentheses indicate that some of our twelve sectors drew their labor from more than one of the (officialpublication) left-hand sectors in the proportionsshown. 1/

This first mapping provided us with employmentby sector for our twelve sectors. Next a skill proportionsmatrix 2/ was used to break down total employment by sector into employment by skill level (skilled, blue collar and unskilled) by sector. Finally, the breakdown of employment by skill and by sector into private sector employmentand government sector employment was done according to the respective shares in total labor value. The resulting final distributionof labor is shown in Table A3.

1/ The data on total employmentby sector was taken from "AL TAWAZOFFWAL OJOUR for 1975" published by CAPMAS.

2/ Provided in an unpublished document of the World Bank. - 206 -

Table A3A:

THE BASE PERIOD EMPLOYMENT MATRIX PRIVATE SECTOR IN 0,000 UNITS

Sector White Collar Blue Collar Unskilled

Staple Food 1.159685 1.632348 71.327423

Non-Staple Food 2.459472 3.462008 152.154388

Cotton 0.831700 1.170799 51.996399

Other Agriculture 1.782300 2.508599 110.176193

Food Processing Industry 0.126670 2.284715 8.418262

Textile Industry 0.159477 2.885838 10.633100

Other Industry 0.302428 2.175154 7.577731

Construction 2.211554 3.541041 3.979243

Crude Oil and Products 0.089849 0.134120 0.665247

Transportation and Communication 0.308776 1.188485 1.133301

Housing 2.698134 5.873165 3.196939

Other Services 19.041611 75.777512 14.072956 - 207 -

Table A3B:

THE BASE PERIOD EMPLOYMENTMATRIX GOVERNMENTSECTOR IN 0,000 UNITS

Sector White Collar Blue Collar Unskilled

Staple Food 0.117614 0.165551 7.233969

Non-Staple Food 0.208928 0.294091 12.925243

Cotton 0.0 0.0 0.0

Other Agriculture 0.0 0.0 0.0

Food Processing Industry 0.51730 0.935984 3.448731

Textile Industry 0.367723 6.654156 24.517792

Other Industry 1.186272 8.532043 29.723648

Construction 5.560145 8.902656 10.004355

Crude Oil and Products 0.376951 0.562680 2.790952

Transportation and Communication 4.645824 17.881912 17.051590

Housing 0.060564 0.131834 0.071761

Other Services 37.851471 150.632690 27.974625 - 208 -

REFERENCES

Abdel-Fadil, M. "Development, Income Distribution and Social Change in Rural Egypt (1952-1970)." Cambridge University Press (Cambridge 1975).

Beer, G., A. Church, M. Cohan and B.M. Renaud. "The Task Ahead for the Cities of the Developing Countries." World Development, 4 (May 1976).

Berry, A. and R.H. Sabot. "Labor Market Performance in Developing Countries: A Survey." World Development, 6 (1978).

CAPMAS, Arab Republic of Egypt, Central Agency for Public Mobilization and Statistics, General Population and Housing Census, 1937, 1947, 1960, 1966, 1976 (Cairo).

CAPMAS, Arab Republic of Egypt, Central Agency for Public Mobilization and Statistics, Labour Force Sample Survey (Cairo, various years).

Choucri, N., R. Eckaus and A. Mohie-Eldine. "Employment and Emigration in the Construction Sector: Critical Factors in Egyptian Development." CU/MIT Technology Adaptations Program (Cairo 1978).

Eckaus, R.S., F.D. McCarthy and A. Mohie-El Din. "Multisectoral General Equilibrium Models for Egypt." Working Paper No. 233, MIT Economics Department (March 1979).

FAO. Production Yearbook (1976).

Hansen, B. "Employment and Wages in Rural Egypt." AER 59 (1969).

Mabro, R. "The Egyptian Economy 1952-72." Clarendon Press (Oxford 1974).

and S. Radwan "The Industrialization of Egypt: 1939-1976" Clarendon Press (Oxford 1976).

Mohie-El Din, Amr. "Rural Employment Problems in Egypt: Questions to be Answered." Faculty of Economics and Political Science, Cairo University (September 1979).

Mongi, M.A. and M.N. Hamafi. "Labour Absorption in the Egyptian Economy." Institute of Economic Planning, (Cairo 1973) mimeo.

Statistical Indicators for U.A.R. (Cairo 1971).

Szyliowicz, J.S. "Education and Modernization in the Middle East." Cornell University Press (1973). - 209 -

SOME ISSUES IN POPULATION AND HUMAN RESOURCE DEVELOPMENT IN EGYPT

CHAPTER VI

POPULATION AND FOOD 1/

SUMMARY

The implications of population growth for food requirements and probable food deficits and consequent food imports are extremely important in the Egyptian context. The relationship between food needs and population growth in Egypt is fairly unique because of several factors: (1) Egypt currently has a very high level of caloric consumption per capita; (2) there is, however, a very low level of animal protein in the Egyptian diet; (3) there is currently full utilization of all arable land and there is a high cost to, and long-time lag in, bringing new land into production; (4) a very large proportion of Egypt s food supply is currently being imported at a cost of $2 billion a year and an even larger cost results from the program of food subsidies.

To analyze the effects of population growth on food requirements and food deficits, alternative assumptions were made with respect to future trends in yields, future increases in arable land and alternative assumptions about the level of future protein intake.

The various estimates of food deficits are somewhat difficult to summarize concisely. What is very clear is that a wide variety of possibilities are open to Egypt. The size of the food deficit is most dependent on what happens to increases in yield and what happens to consumption levels. The effects of population are substantial within any set of consumption-yield assumptions. These can be summarized as follows:

(1) With constant yield, it would take 3.3 million feddans, a 30 percent in cropped area to feed the additional population that would result from the fastest rather than the slowest feasible rate of population growth.

(2) With increasing yields and constant consumption levels alternative population growth rates make the difference between an increase or a decrease in the food deficit from 1976 levels if land is held constant.

(3) If land and yields are increased at the maximum rates assumed here and consumption remains constant, then it is possible to achieve self sufficiency if population grows at the slowest rates, but if it grows faster deficits will continue to the year 2000.

1/ This chapter was prepared by Susan H. Cochrane. - 210 -

If consumption of animal protein increases from its current low level to a level comparable to that of the average South American country, and if Egypt continues to produce meat domestically rather than to import it, the implications for food deficits are even less optimistic than those described above:

(1) The food deficit will be above 1976 levels under all assumptions.

(2) The food deficit will continue to increase every year until 2000 unless yields increase at the rate of 2 percent annually, land increases at the rate of 128,000 feddans annually and population grows at its slowest rate.

(3) If attempts are made to increase the consumption of animal protein by domestic production to the level currently consumed in Latin America, then the land required by the year 2000 will be 40 percent greater than if levels of consumption of animal protein remain constant.

(4) As in the conclusions about constant consumption levels, we find that differences in food requirement between high and low population growth can cancel out gains made from increasing land availability by the year 2000 if yields do not increase.

The above analysis actually underestimates the effect of population growth on food deficits because we have assumed in all cases that fertility rates fell at least 1 percent per year. If fertility were to remain constant, the potential food deficits would be substantially larger than any shown above since constant fertility would imply a population of 64 million in the year 2000. This would be as opposed to a level of 63 million that would result from the fastest population growth rate assumed above, or to the 54 million which would result from the slowest rate assumed above.

The discussion that follows begins by analyzing individually the four interlocking factors that uniquely influence the relationship between food needs and Egyptian population growth. The implications of that interre- lationship until the year 2000 are then examined under varying assumptions (supported by a technical note in an appendix). The analysis thus covers: the current situation, projected overall food needs, Egypt's ability to produce food requirements, alternative population projects, the roles of new lands and of increasing yields, and increasing consumption levels. - 211 -

INTRODUCTION

The well-being of the Egyptian population and labor force discussed in preceding chapters clearly depends on adequate food intakes. But in most years since 1940 food production in Egypt has grown more slowly than population. Given the government's committment to maintain consumption levels, increased food imports have been inevitable. By 1978 food and commodity imports had reached $2 billion, up from $1.8 billion in 1977 and $1.4 billion in 1976. Indeed, in 1978 40 percent of Egypt's grain supply was imported, as was 72 percent of its wheat and wheat flour. 1/ One of the major problems of population growth in Egypt is the amount of food that will be needed to maintain current consumption standards; any attempt to increase the consumption standards--particularly the consumption of animal protein--from its current low levels will be made much more difficult by population growth. The implication of population growth for food needs and food deficits under various assumptions about production increases will be explored in this paper.

The relationship between food needs and population growth in Egypt is fairly unique because of the interlocking combination of several factors: (1) the current very high level of caloric intake per capita; (2) the low level of animal protein in the diet; (3) the scarcity of available arable land and the long time lag and high cost of bringing new land into production; and (4) the high proportion of food currently being imported.

These four points will now be discussed individually and then their implications for the population-food relationship will be explored.

1/ U.S. Department of Agriculture, "Egypt: Agricultural Situation Report- 1978" p.15 [References are listed at the end of this chapter]. - 212 -

Table 6.1: FOOD CONSUMPTION PER CAPITA, EGYPT 1948/50-1978

Grams of Proteins Calories Protein Grams Per Day from % Protein Year Per Day Per Day Animal Sources From Animal

1948/50 1/ 2360 69.3 12.1 17.5 1951/53 1/ 2340 67.7 10.6 15.7 1954/56 17 2470 71.5 12.1 16.9 1957/59 1/ 2530 73.5 11.8 16.1 1960/62 1/ 2700 78.7 12.1 15.4 1963/65 1/ 2880 83.8 12.3 14.7

1972/73 2/ 3/ 2744 74.8 10.5 14 1976 2/ 3424 95.0 12.9 14 1977 2/ 3442 94.0 12.5 13 1978 2/ 3503 94.8 13.3 14.0

1/ FAO Production Yearbook 1968, cited in Economic Bulletin of National Bank of Egypt, 1969, vol. XXII, no. 4.

2/ Food Balance Sheets from Production Economics Research Division, Research Institute for Agricultural Economics, Ministry of Agriculture.

3/ In the Basic Economic Report a figure of 2552 calories per capita is given for 1972/73. Although the Ministry of Agriculture is cited as the source of this figure, the exact source is not cited (vol.3, p.4 8). - 213 -

Table 6.2: DAILY PER CAPITA CALORIE SUPPLY, COUNTRY GROUPINGS,1977

As percentage As percentage Total of requirement Total of requirement 1977 1977 1977 1977

Low-incomecountries 2,052w 91 w 67 Malaysia 2,610 117 68 Jamaica 2,660 119 1 Kampuchea, Dem. 1,926 78 69 Lebanon 2,495 101 2 Bangladesh 1,812 78 70 Korea, Rep. of 2,785 119 3 Lao PDR 2,082 94 71 Turkey 2,907 115 5 Ethiopia 1,754 75 72 Algeria 2,372 99 6 Mali ~~~~~~2,11790 74 Panama 2,341 101 7 Nepal 2,002 91 75 Taiwan 2,805 120 8 SoMalia 2,033 88 76 Chile 2,656 109 10 Chad 1762 74 77 South Africa 2,831 116 10 ChaM 1,762 74 78 Costa Rica 2,550 114 11Mozambique 1,906 81 79 Brazil 2,562 107 I" Burmia 2,286 106 1,, Upper Volta 1,875 7 80 Uruguay 3,036 114 14 Viet Nam ~~~~1,801 79 81 Argentina 3,347 126 15 India 2,021 91 82 Portugal 3,076 126 1617 SrwLandaMlalawi 2,0662,6 98083 84 TrinidadYugoslaviaand Tobago 2,6943,445 111136 18 Sri Lanka 2,126 9685 Venezuela 2,435 99 19 Guin~ 1,943 8486 Hong Kong 2,883 126 20 Sierra Leone 2,150 93 87 Greece 3,400 136 21 Zaire 2271 104 88 Singapore 3,074 134 22 Niger 2,219 93 89 Spain 3,149 128 23 Benin ~~~~~2,24998 90 Israel 3,141 122 24 Pakistan 2,281 99 lhdustrializedcountries 3,377w 131w 25 Tanzania 2,063 89 ______26 Afghanistan 2,695 110 91 Ireland 3,541 141 27 Central African Rep. 2,242 99 92 Italy 3,428 136 28 Madagascar 2,486 115 93 New Zealand 3,345 127 29 Haiti 2,100 93 94 United Kingdom 3,336 132 30 Mauritania 1,976 86 95 Finland 3,100 114 31 Lesotho 2,245 99 96 Austria 3,535 134 32 Uganda 2,110 91 97 Japan 2,949 126 33 Angola 2,133 91 98 Australia 3,428 129 34 Sudan 2,184 93 99 France 3,434 136 35 Togo 2,069 90 100 Netherlands 3,338 124 36 Kenya 2,032 88 101 Belgium 3,583 136 37 Senegal 2,261 95 102 Canada 3,374 127 38 Indonesia 2,272 105 103 Norway 3,175 118 104 Germany,Fed. Rep. 3,381 127 Middle-incomecountries 2,590w 108w 105 United States 3,576 135 39 Egypt 2,760 lt 109 106 Denmark 3,418 127 40 Ghana 1,983 86 107 Sweden 3,221 120 41 Yemen, PDR 1,945 81 108 Switzerland 3,485 130 42 Cameroon 2,069 89 Capital-surplus 43 Liberia 2,404 104 oil exporters 2,963w 115w 44 Honduras 2,015 89 45 Zambia 2,002 87 109 Iraq 2,134 89 46 Zimbabwe 2,576 108 110 Iran 3,138 130 47 Thailand 1,929 105 111 Libya 2,985 126 48 Bolivia 1,974 83 112 Saudi Arabia 2,624 88 49 Philippines 2,189 97 113 Kuwait 50 Yemen Arab Rep. 2,192 91 51 Congo, People's Rep. 2,284 103 Centrallyplanned 52 Nigeria 1,951 83 economies 2,752w 114w 53 Papua New Guinea 2,268 85 114 China 2,467 105 54 El Salvador 2,051 90 115 Korea, Dem, Rep. 2,837 121 55 Morocco 2,534 105 116 Albania 2,730 113 56 Peru 2,274 97 117 Cuba 2,720 118 57 Ivory Coast 2,517 105 118 Mongolia 2,523 104 58 Nicaragua 2,446 109 119 Romania 3,444 130 59 Colombia 2,364 102 120 Bulgaria 3,611 144 60 Paraguay 2,824 122 121 Hungary 3,521 134 61 Ecuador 2,104 92 122 Poland 3,656 140 62 Dominican Rep. 2,094 93 123 USSR 3,460 135 63 Guatemala 2,156 98 124 Czechoslovakia 3,340 139 64 Syrian Arab Rep. 2,684 108 125 German Dem. Rep. 3,641 139 65 Tunisia 2,674 112 66 Jordan 2,107 62

Source: World Development Report, 1980, World Bank, August 1980, Table 22. 1/ Ministry of Agriculture figures for Egypt in 1977 give daily caloric consumptionof 3,442. - 214 -

THE CURRENT SITUATION

Egypt's very high level of caloric intake is illustratedin Table 6.1 which gives data for several years between 1948/50 and 1977. 1/ These figures can be compared with those on caloric consumptionin a number of other countries. Table 6.2 shows that Egypt has higher caloric intake per capita than the average for middle income countries and it is the lowest income country in that group. 2/ Table 6.2 shows that in fact Egypt had a daily level of caloric consumptionin 1977 of 2,760, equal to the average consumptionof industrializedcountries in 1974.

Despite current high levels of caloric intake one cannot, for two main reasons, assume that current food supplies are completelyadequate. First, meat consumptionis low and the proportion of protein from animal sources has actually been declining over the entire period since 1950 for which data are shown in Table 6.1. 3/ Second, although a recent survey showed less than 1 percent of the children surveyed suffered from acute third degree malnutrition,chronic malnutritionas measured by low height per age was 20 percent in Lower Egypt and 25 percent in Upper Egypt. There was also a higher incidence of malnutritionin the rural than the urban areas. 4/ While such malnutritionis not a simple function of total food production and results from both distributionof food and poor sanitation resulting in high instancesof diarrhea disease, these data do suggest that Egypt does not have much leeway in which to allow food consumptionper capita to decrease as populationgrows.

Before examining the production levels needed to supply the caloric requirementsof the projected population growth to the year 2000, it is necessary to examine the current levels of domestic production and imports of the major foods. Table 6.3 gives a detailed food balance sheet for selected

1/ The figure of the Department of Agriculture in Table 6.1 seems to be an underestimatesince it is based on a population size of 38,200,000 rather than the 1976 census estimate of 36,965,000.

2/ The Bank's World DevelopmentReport, 1980 gives a figure of 2,760 which is below the Ministry of Agriculturefigures for both 72/73 and 76. No source is given in the Report.

3/ The Basic Needs Report hypothesizedthat the apparent reduction in meat consumptionmay be due to an increase in non-officialor illegal slaugh- tering that is not captured in the AgriculturalStatistics (p. 21).

4/ World Bank, Meeting Basic Needs in Egypt, September 26, 1979, p. 32. Table 6.3: FOOD CONSUMPTION PER CAPITA, DOMESTIC AND IMPORTED, EGYPT, 1972/73, 1976, 1978

Per Capita Per Capita Per Capita Per Capita Domestic Production Net Imports Calorie Intake Protein Intake (_rams) Calories Imported Protein Imported 1972/73 1976 1978 1972/73 1976 1978 1972/73 1976 1978 1972/73 1976 1978 1972173 1976 1978 1972/73 1976 1978

Cereal Wheat 1,616 1,997 1,815 1,144 2,258 3,001 620 932 925 20.7 31.2 30.9 257 495 576 8.6 16.6 19.3 Wheat flour - - - 171 404 960 49 111 245 1.4 3.3 8.2 49 111 245 1.4 3.3 8.2 Bran 326 514 546 - - - 29 43 44 1.1 1.7 1.8 - Barley 107 121 122 -2 -3 3 4 5 5 0.1 0.2 0.2 . - - _ _ _ Maize 2,417 2,781 2,724 68 459 730 595 746 744 15.4 19.3 19.2 16 106 157 0.4 2.7 4.3 Millet 831 775 648 - - - 183 163 127 5.4 4.9 3.8 - - - _ _ _ Paddy 2,507 2,422 2,272 -396 -305 -210 371 367 335 6.9 6.8 6.2 -70 -53 -31 -1.3 -1.0 -0.6 Total Cereal 1,851 2,367 2,425 51.0 67.4 69.1 252 659 947 9.1 21.6 31.2

Starch 739 1,057 936 -71 -128 -71 28 37 33 0.5 0.8 0.6 -2.5 -4.4 -2.3 -0.1 -0.1 -0.1 rJ Sugar and syrup 8,657 8,892 9,266 -22 126 317 221 251 284 0.3 0.2 0.2 -6.6 35.0 85.0 - - - Pulses, nuts, seeds 523 392 376 6 145 67 114 120 88 6.8 6.8 5.1 -4.2 32.0 13.0 -0.2 1.7 0.7 Fresh vegetables 4,034 5,062 5,593 -145 -148 -168 65 79 79 4.1 4.8 4.9 -3.9 -3.5 -3.5 -0.2 -0.1 -0.2 Fruits 2,960 3,695 3,467 -238 -217 -156 92 100 89 1.6 1.7 1.5 -5.6 -3.0 -0.3 -0.1 -0.1 -0.1 Vegetable oils 205 286 329 151 252 301 182 254 283 - 0.1 0.1 69.0 108.0 57.3 - 0.1 0.1 Total 702 841 856 13.3 14.4 12.4 46.2 164.1 149.0 -0.6 1.5 0.4

Animal Meat 401 425 437 22 44 57 46 52 53 4.3 4.8 4.7 3.4 4.9 6.0 0.2 0.4 0.6 Fish 105 125 110 4 55 58 5 10 9 0.7 1.1 1.1 0.2 4.7 5.0 0.0 0.4 0.5 Milk 1,666 1,748 1,801 22 720 914 116 152 153 5.0 6.8 7.0 1.2 35.0 43.1 0.1 1.8 2.2 Eggs 58 63 75 - - - 6 6 7 0.5 0.5 0.5 ------Total Animal 173 220 222 10.5 12.8 13.3 4.8 44.6 54.1 0.3 2.6 3.3

Total All Categories 2,726 3,424 3,503 74.8 95.0 94.8 303 868 1,150 8.8 25.7 34.9

Source: Food Balance Sheets, produced by the Ministry of Agriculture, Government of Egypt. - 216 - years in the 1970s. Cereals provide two-thirds of the calories 1/ and more than two-thirds of the protein. No other category of food provides even 10 percent of the calorie intake. Vegetable oils, and starches, make a lesser contribution than do cereals. If all animal sources of food are combined, they constitute the fourth major source of calories and the second major source of protein.

From Table 6.3 we can determine the amount of calories and protein imported in recent years. 2/ The amount and proportion of calories and protein per capita imported in recent years have been increasing. The proportion of calories imported rose from 11 percent in 1972/73 to 23 percent in 1977 while the proportion of protein imported has increased from 12 to 37 percent.

The most important imported foods are wheat and wheat flour which, together, represented 821 calories per capita per day in 1978, or 23 percent of the calorie intake and 29 percent of the protein intake. Maize and vegetable oils were the second most important sources of imported calories. In addition, 25 percent of the proteins from animal sources were imported. Overall, therefore, without food imports Egyptian food consumption would have been 2,556 calories in 1976 and 2,353 in 1978. This would still be slightly above what is estimated as the required levels of caloric consumption, if food were equally distributed. 3/

The increase in food consumption and food imports have resulted from two factors, population growth and the government commitment to subsi- dized food which has led to increases in consumption levels. For the whole period 1960 to 1976, 51 percent of the increase in food consumption resulted from increases in population, 35 percent from increases in caloric consumption per capita and 14 percent from an interaction of the two. The food imports, however, show a somewhat different picture which is more difficult to document precisely. The increase in imports has occurred primarily in the period since the opening up of the Egyptian economy in 1973. In the period 1973-1976 average per capita consumption of calories rose by 698 calories or 25.6

1/ During the 1950s and early 1960s cereals contributed over 70 percent of the calorie intake. For 1972/73, cereals provided 67 percent of food requirements, but for 1977 the figure was back to 70 percent.

2/ These calculations were made from the individual items of consumption rather than by broad categories. In addition, figures reflect net imports. Therefore, they cannot be calculated directly from the material in Table 6.3.

3/ For a detailed discussion of food imports in Egypt see World Bank, Arab Republic, Economic Management in a Period of Transition, Vol. III Productive Sectors, Report No. 1815 EGT pp. 50-51. - 217 - percent. This compareswith an increase over the entire 1960 to 1976 period of 724 calories. Thus the major increase in caloric consumptionper capita has occurred in the brief period since 1973. Therefore, the relative importance of population growth and consumptionlevels in increasing food consumptionand food imports depends on the time period selected. The short run increase in food imports has been the result primarily of consumptionlevels, but the long term increase in food consumptionhas been primarily a result of population growth. 1/

In the following section we shall first project the food needs of the Egyptian populationassuming constant per capita consumptionlevels, and then introduce the assumption of increasedanimal protein. Egypt's ability to meet these food needs will then be estimated by using alternativeassumptions about land availabilityand yields.

PROJECTED FOOD NEEDS

To project food needs requires assumptionsabout the consumption per capita of various crops and the size of the population in each year. For this report two different assumptionsare made about consumptionlevels. The first assumption is that per capita consumptionof each crop and food type remains constant at the 1976 level. The second assumption is that while overall caloric consumptionremains constant, the consumptionof animal protein increasesfrom the low level of 12.5 grams per capita per day to 30 grams per capita per day in 2000. Given the high cost of meat production in Egypt these two assumptionshave very different impacts on the difficultythat Egypt will have in meeting food needs. This point will be discussed later in the chapter.

Three different populationprojections will be used eventually, but initiallywe shall use the followingmedium projectionof population growth to get a basic projection of food requirements.

Population Year (Millions)

1980 39.9 1985 44.6 1990 49.4 1995 54.1 2000 58.9

1/ If one looks at consumption of animal proteins rather than calories, the picture is somewhat different. Consumptionof animal proteins increasedvery little between 1960 and 1976 (12.3 grams per day versus 12.9). In the recent period the animal protein has increasedfrom 10.5 in 1972/73 to 12.9 in 1976. This implies that only with the opening up of the economy was Egypt able to reverse a trend in decreasing consumption of animal protein in the period 1963/65 to 1972/73. - 218 -

This projected population growth is fairly modest and is based on the assumption that the net reproductionrate 1/ reaches 1.0 in the year 2015, and on a 2 percent annual decline in the total fertility rate. Alterna- tive population projections will be used to calculate food needs later in the report.

The projected need for various categories of food based on these assumptions is shown in Table 6.4. The modest nature of these projected needs can be shown by comparing these projections of certain food types with those prepared by the Ministry of Planning for 1980, as shown below:

Food Needs 1980 ('000 metric tons)

Ministry Our of Item Estimates Planning Col. 2/Col. 1

Wheat 4,754 5,843 1.23 Wheat Flour 439 897 2.04 Maize 3,515 4,438 1.26 Rice (Paddy) 2,277 1,643 .72 Meat & Chicken 514 628 1.22

Source: Table 6.4 and Table 10.13 from World Bank Report No. 1815, EGT., vol. III.

Only for rice consumption do our figures exceed those estimated by the Minis- try of Planning. The reason for the difference in estimates is unclear since the assumptions underlying the Ministry figures were not explained. The differences probably reflect higher consumption levels and population grow.h assumed by the Ministry. In 1985, for example, the Ministry estimates a population of 44.6 million while our figures show 46.8 million.

1/ The net reproduction rate is the number of daughters a woman would have, under prevailing fertility and mortality patterns, who would survive to the mean age of childbearing. A net reproduction rate of 1.0 is, of course, the level at which childbearing women, on the average, have enough daughters to replace themselves in the population, buit no more, i.e., replacement level fertility. - 219 -

Table 6.4: PROJECTED FOOD NEEDS USING MEDIUM POPULATION PROJECTION AND CONSTANT CONSUMPTION LEVELS, EGYPT, 1976-2000

Per Capita Total ('000 metric tons) 1976* 1976 1980 1985 1990 1995 2000

Wheat 0.119 4,390 4,754 5,313 5,875 6,439 6,999 Wheat flour 0.011 404 439 491 543 595 647 Bran 0.014 514 559 625 691 758 823 Barley 0.003 118 120 134 148 162 176 Maize 0.088 3,240 3,515 3,929 4,344 4,762 5,176 Millet 0.021 775 839 938 1,037 1,136 1,235 Paddy 0.057 2,116 2,277 2,545 2,814 3,084 3,353

Starch 0.025 929 999 1,116 1,234 1,353 1,470

Sugars 0.244 9,018 9,747 10,894 12,046 13,203 14,351

Pulses, nuts and seeds 0.015 555 599 670 741 812 882

Vegetables 0.133 4,914 5,313 5,938 6,566 7,197 7,823

Fruits 0.094 3,478 3,755 4,197 4,641 5,086 5,529

Vegetable oils 0.015 538 599 670 741 812 882

Meat & Chicken 0.013 469 519 580 642 703 765 Fish 0.005 180 200 223 247 271 294 Milk 0.067 720 2,677 2,991 3,308 3,625 3,941 Eggs 0.002 63 80 89 99 108 118

Source: Mission estimates. * Calculated from the 1976 Food Balance Sheet. - 220 -

EGYPT'S ABILITY TO PRODUCE FOOD REQUIREMENTS

To calculate the implications of population growth for food deficits in Egypt it is necessary to examine not only consumption levels, but also the ability to produce food under various assumptions. There are many ways in which one could estimate food deficits. The one we have selected is fairly straight forward. The first thing that must be done is to convert the food requirements into a common unit so that we can discuss total requirements rather than crop specific requirements. The common unit we have chosen to use is land. This unit was selected for two reasons: (1) it is easy to convert crop requirements into land requirements by using various assumptions about yields and (2) it seems highly likely that the most binding constraints on agriculture in Egypt may be arable land. 1/ Therefore, we shall convert the food needs into a measure of land needed to grow all food needs given first constant yields and later increasing yields.

The major advantage of the technique we will be using here is its simplicity. The major limitation is that it does not represent in any sense an economic optimal solution to the food problem. That is, it only projects the land need to meet consumption needs under the current production techniques within Egypt or uniform increases in yields across all crops. It may well be that the current situation is far from optimal. This appears to be the case with respect to animal production (see Cuddihy, 1980).

It appears that given the high cost of meat production due to a scarcity of pasture, it would be more efficient to produce crops in which Egypt is more efficient, export the surplus, and use the proceeds to import meat. To a large extent this "optimal" solution is currently prevented because a large portion of the animal population is needed for agricultural production. Therefore although neither the current situation or the technique used here reflect the best possible solution to the food problem, it will take some time for a better solution to come about. In a later section of this chapter we will separately sketch out the implications of population growth for the animal requirements.

1/ A report for the Egyptian Master Water Plan (Kutcher, 1980) finds that the supply of irrigation water could become an additional constraint on agricultural growth in the medium term if full land reclamation plans are realized. If this does occur, optional adjustments would call for allowing part of the new lands to lie uncultivated, rather than divert supplies away from the existing, more productive old lands. Because the analysis in this chapter does not consider this potential additional constraint, we may in fact be underestimating future food deficits. - 221 -

Table 6.5: AREA CROPPED, EGYPT, 1950-1975

Crop 1950-54 1955-59 1960-64 1965-69 1970-74 1975 1/

Wheat 1,571 1,501 1,387 1,268 1,302 1,357

Barley 122 135 128 110 81 100

Maize 1,746 1,850 1,727 1,510 1,593 1,830

Sorghum 438 451 469 507 493 489 2/

Rice 505 641 791 1,028 1,093 1,480

Sugarcane 96 ill 122 145 197 220

Vegetables (onion & other vegetables) 338 491 591 751 794 955 2/

Pulses (Fenugreek, peanuts, lentils, sesame, beans) 467 512 588 493 447 318 2/

Orchards 94 114 147 208 255 385

Clover 2,184 2,362 2,444 2,630 2,801 2,812

Cotton 1,765 1,791 1,751 1,694 1,551 1,326

Flax 8 14 27 30 33 2/

Others 78 104 147 163 215 -

Total Cropped Area 9,412 10,077 10,319 10,537 10,855 10,832 3/

1/ 1978 FAO Production Yearbook.

2/ One season-s production missing.

3/ Nearest estimate.

Source: Constructed from El Tobgy, 1976, Table 13. - 222 -

Although Egypt has done a remarkable job of feeding its population it has had to do so increasinglyby reliance on imports. The reason for this dependence is the very limited ability to increase domestic food production in the short or medium run. Arable land is very fully employed at present with an average of 1.94 crops per year grown on each feddan of cultivated land. While cropped area has increased by 15 percent between 1950-54 and 1975, most of this increase resulted from an increase in cropping intensity on existing land that resulted from the increasedwater availabilityfollowing the completion of the Aswan High Dam. 1/ Since the end of the 1960s, however, the total cropped area has increasedby only 3 percent. (This is the increase for the entire period 1965-69 to 1975.) The area under various crops are shown in Table 6.5.

The actual area cultivated is about half the area cropped, since multiple cropping is so widespread. The 1961 agriculturalcensus estimated the cultivatedarea as 5,974,000 feddans. While no more recent agricultural census has been taken estimatesof area cultivatedhave been made by El Tobgy. 2/ These are shown below:

1970 1971 1972 1973 1974

(in thousands feddans)

Estimate 1 (Winter) 5,665 5,653 5,684 5,713 5,732 Estimate 2 (Summer) 5,712 5,674 5,714 5,744 5,812

For the five-yearperiod 1970-1974 the average is 5,689,000 feddans for the first estimation technique and 5,730,000 for the second. Both of these are below the estimate of area in 1961. The reason for this is that cultivated land has been encroached on for building at a rate of about 40,000 feddans annually.3/ To some extent this has been offset by the reclamationof new land, but these figures are difficult to come by.

The potential for further increases in cultivatedarea (through increasedarable land or increased intensity of land use) will be discussed in a later section of the chapter. But on the basis of recent data dramatic increaseswill require a substantialintensification of efforts at reclamation. These reclaimed lands, however, cannot be quickly brought into production even under the best of circumstances,while full productivityon new land cannot be

1/ El Tobgy, p. 46.

2/ These are estimatedby summing the land under various crops. The calculation can be made from either the winter or summer crops, but since not all land is under cultivationin both seasons, the estimatesvary slightly depending on which season is used for the estimate. El Tobgy, pp. 44.

3/ El Tobgy, p. 43. - 223 - expected before 10 to 15 years after they have been brought under cultivation. Therefore, as a first approximation, it seems legitimate to assume that land area will not expand in the next 20 years to any appreciative extent. (This assumption will be altered later in our discussion.)

To judge the impact of population growth on food needs we will compare the land needed to grow sufficient food to maintain existing levels of food consumption per capita in each cereal grain, animal protein and other good groups. Assuming the middle population growth assumption, the metric tons of food needed until 2000 were as shown in Table 6.4.

To calculate the land required to grow these amounts of food is fairly simple for field crops, if one assumes constant yield: one must simply divide the metric tons needed by the yield per feddan. The yield figures for this purpose were those for the average of the 1970-1974 period as shown in El Tobgy. 1/ Obtaining land area requirements for milk, meat and eggs is far more complex and is explained in the technical note contained in Appendix VI A. Fruit crops from orchards should probably also get different treatment from field crops since yield is an important function of the age of the orchard and many new orchards have not yet reached full production. A technique identical to field crops was, however, used for simplicity. Several minor food sources were neglected in this calculation. Wheat flour and bran are indirect products of wheat production, but most wheat flour is imported and the bran is a pure by-product that does not reduce other wheat availability. In addition, fish is not a land using food product, so has been deleted from our calculation. Altogether, these sources of food represented 3.5 percent of calories and 4.6 percent of protein (6 percent and 8 percent including bran). Therefore, our estimates will represent a slight underestimate of food needs.

The land needed to obtain self-sufficiency in food in 1976 and for the projected period to 2000 are shown in Table 6.7. The figure of 14,523,000 feddans for 1976 is substantially above the total area cropped in 1975 which is approximately 10,800,000 feddans. It should be stressed that this figure of 14.5 million feddans is an underestimate to the extent that some food items were not included in estimating land needs, and that no nonfood crops such as flax were included in food needs. Cotton was included, however, because of its use for producing animal feed in the form of cotton seed. Imports of food in 1976 released 1,763,000 feddans from wheat production, 297,000 from maize, 380,000 from vegetable oils and at least 1,062,000 from animal production. This totals at least 3.5 million feddans which bring the total figure down to 11 million, which was approximately the actual cultivated area for 1976. A small amount of land was devoted to various exports other than cotton. 2/ So the comparison of our projected land needs with those cultivated in 1976 indicates that the technique based on 1970-1974 yields, and the very circui- tous calculation of area needed is arithmetically correct.

1/ The yield figures in Table 6.6 will be altered at a later point in our discussion to develop an alternative set of land requirements based on different assumptions about productivity growth.

2/ Net food exports in 1976 required approximately .2 million feddans. - 224 -

Table 6.6: ESTIMATION OF CROP YIELDS, EGYPT, 1970-74

Area Production (1,000 fed.) (1,000 tons) Yield (tons/fed.) 1970-74 1970-74 1970-74

Wheat 1,302 1,716 1.318 Maize 1,593 2,460 1.544 Rice 1,095 2,432 2.221 Sorghum 493 847 1.718 Barley 81 90 1.111

Legumes Beans 283 280 0.989 Lentils 64 50.1 0.783 Fenugreek 27.8 20.2 0.727 Chickpeas 8.2 6.1 0.744 Lupines 8.9 5.7 0.640

Oil Crops Sesame 37.1 19.9 0.536 Groundnuts 34.5 30.4 0.881 Sunflower 23 16.1 0.7 Soybeans 3.7 1.6 0.42

Clover 2,819 50,531 17.925 Cotton (lint) 1,551 492 0.317 Cotton (seed) 1,551 865 0.558 Flax (straw) 32.5 81 2.492 Flax (seed) 32.5 16 0.492 Sugarcane 197 7,300 37.0 Potatoes 86 620 7.209 Onions 73.5 552 7.510 Tomatoes 259 1,600 6.178 Other melons 20 196 9.800 Water melons 97 1,031 10.629 Other vegetables 299 2,100 7.023 Total fruit 255 1,716 6.729 Citrus 145.6 860 5.907 Grapes 35 153 4.371 Mangoes 24 71 2.958 Bananas 11 99 9.000

Source: Figures for 1970-74, El Tobgy, 1976. - 225 -

Table 6.7: LAND AREA NEEDED FOR VARIOUS CROPS ASSUMING MEDIUM POPULATIONPROJECTION, EGYPT, 1970-2000

Area 1/ Actual Projected Crop 1970-74 1976 1976 1980 1985 1990 1995 2000 (in thousand feddans)

Cereal Wheat Wheat flour 1,302 1,396 3,331 3,607 4,031 4,458 4,885 5,310 Bran Barley 81 - 106 108 121 133 146 158 Maize 1,593 1,490 2,098 2,277 2,545 2,813 3,084 3,352 Millet 493 446 451 488 546 604 661 719 Paddy 1,093 1,074 953 1,025 1,146 1,267 1,389 1,510

Starch 86 128 129 138 155 171 188 204 Sugars 197 242 244 263 294 325 357 388 Pulses, nuts, seeds 453.5 299 2/ 611 659 737 815 893 970 Vegetables 631.5 832 3/ 730 789 882 975 1,069 1,162 Fruits 372 313 4/ 440 475 531 587 643 699 Vegetable oils 26.7 - 811 903 1,010 1,117 1,224 1,330

Crops needed for animal feed Clover 2,801 - 2,805 3,274 3,659 4,046 4,435 4,820 Other cereals - - 613 751 884 929 1,017 1,106 Cottonseed cake 1,551 1,084 1,201 1,267 1,416 1,566 1,717 1,866 Other & missing 173 3,894 Total Cropped 6/10,855 11,198/e 14,523 16,024 17,957 19,806 21,708 23,594

1/ See Table 6.5. 2/ Only beans and groundnuts. 3/ Includes water melons and other melons. 4/ Excludes water melons and other melons. 5/ Total figure obtained from the Ministry of Agriculture. 6/ For actual figures the crops listed do not necessarilyadd to total area in 1976 since complete data were not available for 1976 from the FAO yearbook. - 226 -

Another way of comparing the 1976 projected "no import" figure with the actual 1976 production is by using aggregate figures. As mentioned earlier, 25 percent of the calories and 27 percent of the proteins were imported in 1976. Therefore, imports replaced between 3.6 and 3.9 million feddans from domestic food production which gives actual estimated food production for 1976 as being between 10.9 and 10.6 million feddans. These figures are close to the total cultivated areas in 1976 leaving a small amount for export of foods and nonfood crops other than cotton.

To estimate the impact of population growth on food, one can either examine Table 6.4 which shows the volume of food needed in each year to maintain current levels of consumption, or one can examine the land requirements in Table 6.7. In 1980, 16 million feddans will be needed to grow projected food needs. This is 1.5 million feddans more than would have been needed for self-sufficiency in 1976, and 4.8 million feddans above what was actually cultivated in 1976 when an equivalent of between 3.5-3.9 million feddans worth of food was imported. An additional 1.5 million feddans would therefore have to be added through new productivity of existing land, through new land, or by imports. This is more than the area that was planted in wheat in 1976. If all wheat production ceased in Egypt, most of the needed 1.5 million feddans would be released and imports of wheat would have to increase from the 2,419,000 metric tons of 1977 to 4,754,000 in 1980, an approximate doubling in a 3-year period. This is, of course, an unlikely scenario 1/, but it represents the magnitude of the problem that will be faced in the very short run. Between 1980 and 1985 an additional 1.9 million feddans of production will be needed. This is larger than the area devoted to any crop except clover which covered 2.819 million feddans in 1970-74. Table 6.8 summarizes the area shortages under this set of assumptions. This can be used as a proxy for food imports.

By the year 1995, 21.7 million feddans would be needed--about twice the cropped area in 1976--and Egypt would at current levels of consumption and yields, have to import at least 50 percent of its food supply. These scenarios are, of course, exaggerated because they have so far ignored the possibilities of increasing yields or increasing area under cultivation. Each of these possibilities will be discussed below, but first we shall look at the effect of alternative rates of population growth.

1/ A serious side effect of such a scenario would be the loss of wheat straw for animal feed, and other important uses of straw. - 227 -

ALTERNATIVE POPULATION PROJECTIONS

The population projection used in our first estimate assumed a 2 percent annual decline in fertility and an increase in the life expectancy at birth for females from 58.21 in 1980 to 64.06 in the year 2000. For males the increase is from 54.74 to 60.24.

It may well be that fertility will fall faster or slower than this. Therefore, two alternative projections have been used. In the projection labled P1 we assume that fertility falls at a rate of 1 percent a year. For projection P3 fertility is assumed to fall at 3 percent a year. The increases in life expectancy are the same in all three projections.

Table 6.8: CROPPED AREA NEEDED AND AVAILABLE WITH CONSTANT CONSUMPTIONLEVELS, CONSTANT LAND AREA AND CONSTANT YIELDS AND A MEDIUM POPULATION PROJECTION EGYPT, 1980-2000

1980 1985 1990 1995 2000

Land Needed 16,024 17,957 19,806 21,708 23,594 ('000 feddans)

Area Available 11,000 11,000 11,000 11,000 11,000 ('000 feddans)

Land Deficit 5,024 6,957 8,806 10,708 12,594 ('000 feddans)

Ratio of Land Needed to Land available 1.46 1.63 1.80 1.97 2.14

Source: Mission estimates. - 228 -

Table 6.9: LAND NEEDED UNDER ALTERNATIVE ASSUMPTIONS WITH CONSTANT PER CAPITA FOOD INTAKE EGYPT, 1980-2000

Alternative Assumptions 1980 1985 1990 1995 2000

A. Constant Yield

Population 1 - 18,099 20,331 22,777 25,409

Population 2 16,024 17,957 19,806 21,708 23,594

Population 3 - 17,833 19,350 20,767 22,015

B. 2% Annual Increase in Yield

Population 1 - 15,090 15,322 15,516 15,646

Population 2 14,780 14,972 14,927 14,788 14,529

Population 3 - 14,860 14,583 14,147 13,556 - 229 -

BE AVAILA1LE UNDER LApe D NA) IE ofOULD O T aI U E 8. ALSUMMONSPCPOUNLATXIN YXELD AND LAMDINCREASE is ASMPINSC SUMPVXONLEVELs HELD CON:STANr,)

KE IELD AREA AVAILABLE

14 - Constant Constant= 1I million feddarns 2000 Onstant Increaseof 2.5 million feddansby year ncreasing Colnstant 11Imillion feddarns 13 ... by 2%per Increaseof 2.5 million feddlansby year 200 Year

122

11 ~~~~~~~~~~~~~~~~~~~~~~~~~~3

_-= . 1

t0 + >,lw - 230 -

Panel A of Table 6.9 summarizes the land needed under these three population projections. Under the fastest population growth assumption Egypt will need to import half its food by 1990, while under the slowest growth this situation is not reached until after 2000. The top three lines of Figure 6.1 graph the difference between level of land needed and the land available in 1976 for alternative population projections. Of course, the assumptions of constant land area and constant yield are extreme. Therefore, alternative projections have been developed assuming increasing area of cultivation and increasing yields.

NEW LANDS

Between 1952/53 and 1974/75, 912,000 feddans were reclaimed. 1/ Most of that total was added in the ten-year period between 1960/61 and 1969/70 after the completion of the Aswan High Dam. This would give an estimated 800,000 added feddans per decade if that pace could be maintained. It should be noted, however, that this new land is not all net addition due to an estimated loss of 40,000 feddans a year to building. Therefore, an optimistic assumption would be that a net annual increase of 40,000 feddans could be sustained (400,000 per decade). If this could be double cropped on the average, 80,000 feddans of cultivated area could be added a year. It should be stressed that this is a very optimistic assumption. It is estimated that the new lands brought into production since the High Dam will contribute 5 percent to agricultural output by 1980 2/, but that the increase in land needed between 1976 and 1980 alone is 10 percent. The strategy of bringing new land into production is extremely costly--estimated at between LE600 and LEl,000 per feddan in 1975, and probably much more expensive now. 3/ In addition, the gestation period for bringing new land into production is quite long. "Instead of the 3 to 5 years initially planned, the reclamation authorities have experienced a period of about 15 years of capital absorption before earning enough to even cover operating expenses." 4/ Therefore, it would seem that at least for the next 20 years, it is unlikely that the reclamation of new lands will be able to contribute substantially to the increased food needs arising from population growth.

1/ El Tobgy estimates that this represents 724,000 feddans of net area.

2/ Bank Report No. 1815 EGT, vol. III, pp. 46-47.

3/ It is extremely difficult to get seasonal estimates of the cost of bringing a new feddan into production. U.S. Department of Agriculture estimates for the mid 1970's were between LE 350-400 for capital cost, but this did not include the operating losses on the land incurred until the land covers current cost (U.S. Department of Agriculture, 1976, p. 37). Recent Bank estimates for land reclamation projects in West Beheira and West Nuboriya range from LE 1800 to LE 5600 depending on the type of project. These costs are substantially above those for 1976 even allowing for inflation. 4/ Ibid, p. 47 - 231-

a substantially faster rate of increase than that achieved in the recent past. It represents an increase of 104,000 feddans a year between 1976 and 2000, while the previous rate has been 80,000 which, net of losses of land, was 40,000 by El Tobgy's estimation. To determine the effect of such a target if it were achieved, still assuming a loss of 40,000 feddans a year, one could estimate a 64,000 addition to cropped area per year. Extreme optimism would also assume that this could be double cropped to give an additional 128,000 feddans of cropped area per year. This would yield an increase in cropped area by 2,000 of 3.3 million feddans. Even this extremely optimistic assumption still implies very substantial food deficits, as shown by the second set of curves in Figure 6.1. While new land substantially reduce the deficit, it will continue to rise from its current level. These figures clearly show the tremendous impact of population growth. The difference between the highest and lowest population gruwth rates is sufficient to wipe out all the gains from the additional lands before the year 2000. (This is shown by the crossing of the two projections on Figure 6.1.) With the highest population growth and new land the deficit will be larger than the deficit with the slowest population growth and no new land.

INCREASING YIELDS

Egypt's yields per feddan in field crops are among the highest in the world. El Tobgy reports that, in 1971, Egypt had the highest yields in the world in long stable cotton, rice, sorghum, broadbean, lentils. It was second in cotton and sugarcane, third in peanuts, fourth in onions, and sixth in wheat and maize. In wheat and maize, however, the only countries exceeding Egypt are those with a cooler climate which is more suitable to the crops (i.e., that found in Northern Europe and North America). 1/

During the period from 1950 to 1976 yields have increased substantially, as is shown in Table 6.10. Yields for the crops shown have had average annual rates of growth between 0.40 and 3.60. But the period covered has been a remarkable one due to the completion of the High Dam, the development and adoption of new varieties of cotton and rice, and consolidation of fragmented small holdings within the cooperative system. Whether these rates of increase can be maintained or not in the future is uncertain. Soil deple- tion and inadequate drainage causing salinity 2/ are both problems which may

1/ There is evidence that in 1978, while the yields have continued to increase, Egypt fell behind in its position relative to other countries. It became 19th in world yield in wheat, 80th in maize and 7th in rice. FAO Yearbook,vol. 32.

21 The Basic Economic Report estimated that 70 percent of the old lands have been adverselyaffected by poor drainage. - 232 -

Table 6.10: YIELDS OF FIELD CROPS IN TONS/HA, AND AS INDEX NUMBERS, EGYPT, 1950-1976

Crop 1950-54 1955-59 1960-64 1965-69 1970-74 1974-76

Wheat Yield 1.996 2.321 2.582 2.560 3.138 3.356 Index 100 116 129 128 157 168

Maize Yield 2.136 2.090 2.513 3.576 3.776 3.618 Index 100 98 118 167 172 169

Rice Yield 3.802 5.039 5.310 5.017 5.287 5.261 Index 100 133 140 132 140 138

Sorghum Yield 2.820 3.033 3.413 4.006 4.092 3.856 Index 100 107 121 142 145 137

Barley Yield 2.057 2.328 2.634 2.414 2.642 2.785 Index 100 113 128 117 129 135

Cotton (lint) Yield 0.501 0.523 0.602 0.671 0.756 0.702 2/ Index 100 104 120 134 151 140

Broadbeans Yield 1.631 1.605 1.837 2.037 2.361 2.309 Index 100 99 113 125 145 142

Lentils Yield 1.527 1.436 1.489 1.444 1.862 1.500 Index 100 94 98 95 122 98

Sesame Yield 0.812 0.870 0.970 0.994 1.274 1.238 Index 100 107 119 122 157 152

Groundnuts Yield 1.812 2.019 2.078 2.039 2.094 1.976 Index 100 111 115 113 116 109

Sugarcane Yield 82.100 89.800 92.100 92.500 88.200 81.473 Index 100 109 112 113 108 99

Onion Yield 17.000 15.900 16.500 17.400 19.398 27.211 2/ (winter crop) Index 100 94 97 102 114 160

1/ Using area from seed.cotton. 2/ Winter plus summer crop.

Sources: 1950-1974, El Tobgy, Table 49. 1974-1976, calculated from FAO Year Book. - 233 - increasingly limit productivity and may be extremely expensive to correct, but there are projects underway to provide improved drainage for almost all of Egypt.

The stagnation of yields after rapid increases in the 1950-54 to 1974-76 period are illustrated in Table 6.10. As the table indicates, only in the cases of wheat, barley and onions did yields increase between the early and mid-1970s (last two columns). In the case of all other crops the yields fell. Therefore, given recent and past trends it is difficult to hypothesize reasonable increases in yield, although certain sources of increases in yield have been identified. Improved drainage and increased livestock management are two of the obvious sources of yield increases.

In general, while improved drainage affects crops differently an estimate of 20-30 percent increases in yield where drainage is improved seems reasonable. El Tobgy has estimated that a complete rebuilding of the drainage system would cost LE320 million (1976 estimate). A number of large scale drainage projects are already underway.

Livestock production suffers from a number of constraints at present due in part to the need for livestock draft power for farm production. El Tobgy's recommendations include selective breeding of buffaloes to increase milk yield 1/ and hasten maturation, and fattening of male buffalo calves prior to slaughter. There also now exists increased potential for improved breeds of cattle. Lastly, given the greater efficiency of poultry for con- verting grain to meat and the possibilities for large scale poultry production, El Tobgy has suggested shifts in consumption from beef to poultry. Of course, given the scarcity of pasture, it may be that the most efficient way to obtain animal protein is though imports.

What these potentials imply for improved yields is difficult to determine. World Bank projections of yield suggest that a 2 percent increase in yield is the maximum sustainable increase. 2/ This is approximately the level of yield increase over the 1950-54 to 1970-74 period.

In Panel B of Table 6.9, the 2 percent increase in yield is combined with the three assumptions on population growth. In Figure 6.1 the food deficit is plotted (blue lines) using the assumption of constant land. The food deficit remains constant with the medium rate of population growth, increases with faster population growth and drops with the lowest level of population growth.

The most optimistic set of assumptions are those illustrated by the bottom lines in Figure 6.1. This illustrates what would occur if land and

1/ In the past breeding has been selective for work capacity, but with increased mechanization this will be less necessary.

2/ World Bank, Report 1815 EGT op. cit. p. 54. - 234 - yield both increase at the maximum rate. Under all these population assumptions, the deficit in land decreases, but it is only if fertility falls at the most rapid rate that self sufficiency is obtained by the year 2000.

INCREASING CONSUMPTION LEVELS

The achievement of self-sufficiency in food by the year 2000 is only possible under the most optimistic assumptions about increasing production and the most conservative assumptions about increasing consumption. As stressed above self-sufficiency in food may not be the most efficient way to deal with food needs. The difficulty in obtaining self-sufficiency in food is even clearer when we examine the implications of increasing the consumption of animal protein. All the preceding analysis is based on the assumption of constant per capita consumption of calories and proteins. Given the very low levels of consumption from animal sources, however, it is to be expected that an increased level of animal protein would be a high priority for increasing welfare. Therefore, we have revised the previous estimates to include such an objective. We have assumed that in the 24 years from 1976 to 2000 Egypt will move from a level of consumption of animal protein of 12.5 grams per day (the average level of Africa as a whole) to 30 grams per day, the average level of South America in 1976. Increasing protein intake is also associated with an increase in calories of approximately 290 calories a day. This would result in an overall daily calorie consumption of 3,730 by the year 2000. An adjustment was made to reduce calories to the original level while increasing protein.

Table 6.11 illustrates the amount of land needed to increase animal protein for the medium population projection under assumptions of constant and increasing yields and compares this with the land need under the same population-yield assumptions and constant consumption.

This analysis shows that even under the most optimistic assumptions on population growth, yields and land availability the size of the food deficit will increase if consumption levels of protein rise as assumed. Under the worse assumption Egypt will be unable to produce even one-third of its food needs by the year 2000.

Figure 6.2 shows that, for constant yield, after 1990, the slowest population growth with constant land generates a smaller food deficit than that with the most rapid increase in population and maximum increases in land. When yields increase (the lower position of Figure 6.2), the deficits for maximum population growth with increased land equal that for the slowest population growth and constant land in a bit after the year 2000. - 235 -

The effect of increasingprotein consumptionon land needed is best illustratedby comparing land need under constant and increasingconsump- tion. The data for such a comparisonare contained in Table 6.12. The top portion of that table shows land needed under the two consumptionlevels for medium population projection 1/ and constant yields. The bottom portion of the table shows the differencein land needed under the two consumption assumptions with increaisngyield. Under both sets of assumptionsthe land needed by 2000 is over 40 percent higher under the assumptionof constant animal consumption. The amount of land needed to increase animal consumption, however, is much higher if yields are constant than if they increase; 10 million additional feddans versus 6 million additional feddans. If land is used to produce high yield products for export and import meat, the land requirementwould be much less, but it is impossibleto calculatethe land requirementunder a meat import scheme because one would need to make assumptions about the relative prices in future years of crops to be imported and exported. Very rough calculationsusing 1980 prices indicates that one feddan planted in rice could pay for the import of more meat than could be grown on a feddan. Such simple calculationsignore many of the complexitiesof the need for animals in agricultureand the suitabilityof land in various uses. The analysis above, however, illustrateshow difficult it will be to meet the increasing food needs of the Egyptian populationespecially if consumption levels are to increase.

1/ The differencesbetween consumptionlevels are larger if rapid population growth is assumed and smaller if slow growth is assumed. - 236 -

Table 6.11: LAND NEEDED UNDER VARIOUS ASSUMPTIONS FOR INCREASING LEVELS OF PROTEIN CONSUMPTION EGYPT, 1980-2000

Alternative Assumptions 1980 1985 1990 1995 2000

Panel A Constant Yield

Population 1 17,144 20,968 25,304 30,331 36,063

Population 2 - 20,803 24,650 28,907 33,487

Population 3 - 20,659 24,083 27,654 31,426

Panel B Increasing Yield

Population 1 15,813 17,482 19,070 20,622 22,207

Population 2 - 17,344 18,577 19,692 20,621

Population 3 - 17,224 18,150 18,839 19,352 - 237 -

FIGURtE6.2 LAND NEEDEDIN EXCESSOF WHATWOULD BE AVAILABLEUNER ALTERNATIVEPOPULATION, YIELD AND LAND INCREASE ASSU4PTIONSCPROTEIN CONSUMPTION FROM ANIMALS PR CAPITA INCREASINGFROM 12.5 GRAMSIN 1976 TO 38 GRAMSIN 208 KEEPINGCALORIES CONTANT) 2B- KEY YIELD AREA AVAILABLE Constant Constant = 11 miilion feddans -2- - Constant Increaseof 2.5 million feddans by year 2000 24 - Increasing Constant = 11 million feddans by 29o per- Increase of 2.5 million feddans by year 200 year 2 221 L A/ N

D / / E/ F

N t4-

L 12 /7

F .. 2 E D3

N ... - ~~~~~~~~~~~~~~~~~~~~-......

-~~~~ ~ ~ ...... 3...

.~~~~~~~~~~~~~~

198 1986 19619E 88

YEAR - 238 -

Table 6.12: LAND NEEDED FOR MEDIUM POPULATION GROWTH WITH CONSTANT CONSUMPTION LEVELS AND INCREASING CONSUMPTION OF ANIMAL PROTEIN, EGYPT 1980-2000

Assumption 1980 1985 1990 1995 2000

Constant Yields

1. Land needed for constant consumption levels ('000 feddans) 16,024 17,957 19,806 21,708 23,594

2. Land needed for increasing consumption ('000 feddans) 17,144 20,803 24,650 28,907 33,487

3. Additional land needed for increasing consumption of animal protein ('000 feddans) 1,120 2,846 4,844 7,199 9,893

Increasing Yields

4. Land needed for constant consumption levels ('000 feddans) 14,780 14,972 14,927 14,788 14,529

5. Land needed for increasing consumption ('000 feddans) 15,813 17,344 18,577 19,692 20,621

6. Additional land needed for increasing consumption of animal protein ('000 feddans) 1,033 2,372 3,650 4,904 6,092 - 239 -

CONCLUSIONS

The various estimates of food deficits are somewhat difficult to summarize concisely. What is very clear is that a wide variety of possibilities are open to Egypt. The size of the food deficit is most dependent on what happens to increases in yield and what happens to consumption levels. The effects of population are substantial within any set of consumption-yield assumptions for constant consumption levels. These can be summarized as follows:

(1) With constant yield it would take 3.3 million feddans, a 30 percent increase in cropped area to feed the additional population that would result from the fastest rather than the slowest feasible rate of population growth.

(2) With increasing yields and constant consumption levels, alternative population growth rates make the difference between an increase or a decrease in the food deficit from 1976 levels if land is held constant.

(1) The food deficit will be above 1976 levels under all assumptions.

(2) The food deficit will continue to increase every year until 2000 unless yields increase at 2 percent annually, land increases at 128,000 feddans annually and population grows at its slowest rate. In this case, the deficit begins to decrease after 1995 but is still 1.7 million feddans above the 1976 deficit in the year 2000.

(3) Increasing the consumption of animal protein raises the land required by over 40 percent whether yields increase or remain constant, but changes in yield of course make an enormous difference in the absolute rather than the relative magnitude of the food deficit. - 240 -

(4) As in the conclusionsabout constant consumptionlevels, we find that differencesin food requirementbetween high and low population growth can cancel out gains made from increasing land availability by the year 2000 if yields do not increase.

This analysis,of course, representsa simple projectionof assumptions about populationgrowth, food consumption,yield and land availability. It does not attempt to explain how Egypt might best adjust to the pressures in agriculture,but it does indicate that these pressureswill be substantial.

The above analysis actually underestimatesthe effect of population growth on food deficits because we have assumed in all cases that fertility rates fell at least 1 percent per year. If fertilitywere to remain constant, the potential food deficits would be substantiallylarger than any shown above since constant fertilitywould imply a populationof 64 million in the year 2000 as opposed to a level of 63 million that would results from the fastest populationgrowth rate assumed above, or the 54 million which would result from the slowest rate assumed. It may also underestimatethe deficits involved if some factor other than land, such as water, is a more binding constraint. The overall effect of these calculationsis to pose momentous questionsfor the Egyptian economy: Can exports increase sufficiently to pay for food imports? How useful is expansion of land area as a policy compared with efforts to reduce populationgrowth?

While this report has not addressed the issue of export expansion, it has examined the issue of land expansionand fertility reduction. Both of these are long term projects and to obtain food balance both are needed. At the margin, however, it appears that female education is underfundedas a long term solution to the issue of populationgrowth relative to land expansionwhich has proven to be both slow and expensive. - 241 -

REFERENCES

Cuddihy, William. "AgriculturalPrice Management in Egypt," World Bank Staff Working Paper No. 388, 1980.

El Tobgy, H.A. ContemporaryEgyptian Agriculture,Cairo, 1976.

Food AgricultureOrganization. 1978 FAO ProductionYearbook, vol. 32, Rome, 1979.

Food AgricultureOrganization. 1968 FAO ProductionYearbook, vol. 22, Rome, 1969.

Kutcher, Gary P. "Master Plan for Water ResourcesDevelopment and Use: The Agro Economic Model," Technical Report No. 16, UNDP-EGY/730/24, May 1980.

Ministry of Agriculture. Food Balance Sheet. Production Economic Research Division,Research Institutefor AgriculturalEconomics. Cairo, Egypt.

National Bank of Egypt. EconomicBulletin, 1969. Vol. XXII, No. 4.

United States Departmentof Agriculture. Egypt: AgriculturalSituation, Report - 1978. American Embassy, Cairo, 1977.

______,Egypt: Major Constraintsto IncreasingAgricultural Productivity. Foreign AgriculturalEconomic Report No. 120, Washington,D.C., June 1976.

World Bank. "Arab Republic of Egypt: Economic Management in a Period of Transition. Report No. 1815-EGT (May 1978).

World Bank. "Meeting Basic Needs in Egypt." September 26, 1979.

World Bank. World DevelopmentReport, 1980. - 242 -

APPENDIX VIA

CALCULATIONOF INPUTS: A TECHNICAL NOTE

Calculationof the land inputs required for production of meat, milk and eggs was based on some very rigid production assumptionsnone of which are likely to hold in the long run. These assumptionswill be relaxed when alternativeyield assumptions are introduced. Most of the data used for this and other sections of this report come from El Tobgy-s book on Egyptian agriculture.1/

DATA TO BE USED

Table 6A.1: we have calculated the relationshipbetween meat, milk and egg productionand the stock of animals and poultry. This is based on production data from the Food Balance Sheets 1972/73 and animal stock data from El Tobgy for the closest year. Implicit in this calculationis the assumption that the ratio of work animals and meat animalswill be maintained, as well as the meat production per slaughteredanimal.

Table 6A.2: starch equivalent (SE) needs and digestible protein (DP) needs per animal and per poultry. These are estimated by dividing total poultry nutritionalneeds in 1970 as calculated by El Tobgy by the poultry population in 1970-73. For animals the animal population is first weighted by a scale given on page 181 of El Tobgy and the weighted total of animals is divided into the nutritionalrequirements in El Tobgy. These numbers are:

SE DP

Animals 1.11 0.15

Poultry 0.28 0.005

These need to be adjusted for the shortfall of these requirementsin 1970 (36 percent shortfallin starch and 69 percent in protein).

1/ H. A. El Tobgy, ContemporaryEgyptian Agriculture (Cairo - 1976). - 243 -

ASSUMPTIONS FOR CALCULATING ANIMAL NEEDS

1. Protein from each animal source in 1976 will remain constant on a per capita basis.

2. The relationship between the production of meat, eggs and milk to stocks of farm animals and poultry will remain constant.

3. In the case of meat and milk the amount of animals needed in any year may differ. Since the same stock is used to produce both items, we shall specify the animal needs as the larger of the two stocks needed. The same applies for poultry and eggs.

4. It is assumed that animal feed comes primarily from clover (70 percent starch and 85 percent protein). Straw, grains and cottonseed cake are calculated on the bases of Table 62 in El Tobgy. But straw will not be added to total good requirements unless their use in animal production exceeds that which would result as natural by-products of wheat production.

The first step is to calculate the number of animals and poultry needed in each year assuming that 1976 per capita consumption levels of meat, milk and eggs remain constant. These calculations are shown in Table 6A.l. The meat requirements are then divided by the ratio of meat production to animal stock (or milk production per stock) which prevailed in 1973 as shown in Table 6A.I.

Since the cattle required for meat and for milk may differ, the largest animal requirement will be used in our calculation. This problem arises primarily because different proportions of milk and meat are imported. Cattle requirements for constant milk consumption in 1980 without imports would be 4,236,000, while for meat production the total is only 3,224,000. This difference arises because 54 percent of cow milk is currently imported, but only 27 percent of beef and veal.

From Table 6A.3 a weighted sum of animals is calculated and an unweighted sum of poultry is calculated. These figures are then multiplied by the animal starch and protein requirements given above. These figures are then further multiplied by a factor representing the 1970 shortfall of actual animal food from the hypothetical food needs (36 percent shortfall for starch and 6 percent for protein). This procedure indicates a requirement of 6,055,000 units of starch equivalent in 1980 and 1,234,000 of disposable protein in 1980. These figures need to be converted into crop needs. This is done in the bottom half of Table 6A.4.

This conversion is based on the proportion that each crop contributed to starch and protein animal (cattle and poultry) consumption in 1970 (0.70 and 0.85 respectively for clover) and the amount required to produce a unit of starch and protein respectively. The figures needed for these calculations are taken from Table 62 of El Tobgy. The total production needed is given in Table 6A.5. - 244 -

To calculateland required to grow the inputs for animal feed several techniqueswere used. For clover,yield figureswere easily available as shown in Table 6.6 of the text of the main chapter. For straw, land use needs were not calculatedsince straw is a byproduct of wheat productionand straw needs seem to be much below wheat grain needs for food. Cereal grains were calculatedusing a weighted average of yields of the major grains plus beans and lentils. Cottonseedcake was approximatedusing the yields on cotton seed of .56 per unit of lint cotton. - 245 -

Table 6A.1: ANIMAL PROTEIN YIELD: PRODUCTIONAND ANIMAL STOCKS EGYPT, 1972/73

1972/3 1/ 1973 2/ Animal Meat produced Stock of Animals Productionof meat per stock Type metric tons per animal (1) (2) (3)

Cattle 120 2,127 0.056 Buffaloes 125 2,135 0.059 Sheep 32 1,994 0.016 Goats 16 1,264 0.013 Swine 1 14 0.071 Camels 5 113 0.044 Horses 32 Mules 5 Donkeys 1,400

Poultry Meat produced 1/ Stock of Animals 3/

Poultry and rabbits 102 37,167 0.0027

Milk Production4/ Stock Milk per stock

Cattle 591.2 2,127 0.278 Buffaloes 1,042.5 2,135 0.488 Sheep 17.0 1,994 0.009 Goats 6.3 1,264 0.005

Eggs 54.4 4/ 37,167 3/ 0.0015

1/ 1972/73Food Balance Sheets 2/ Table 56, El Tobgy 3/ Table 57, _/ Table 60, - 246 -

Table 6A.2: STARCH EQUIVALENT AND DIGESTIBLE PROTEIN NEEDS FOR ANIMALS AND POULTRY

1970 Animal No. Equivalent weight Equivalent animals

Cattle 2,115 0.8 1,692 Buffaloes 2,009 1.0 2,009 Sheep 2,006 0.1 201 Goats 1,155 0.1 116 Swine 15 0.2 3 Camels 127 1.1 1,397 Horses 35 1.0 35 Mules 6 1.0 6 Donkeys 1,362 0.8 1,362

Total weighted animals 6,821

Poultry 1970-73

Chicken 25,000 Turkeys 665 Ducks 3,075 Geese 2, 529 Pigeons 3,814 Rabbits 2,084 37,167

S 7,539 = 1.11 per animal 6,821 DP 15,024 =- .1 per animal 37,161 0.15 S 1,057 = 0.028 per poultry 37,167

DP 102 = .0 per animal 37,167 = 0.005

Note: S = starch; DP = digestible protein. - 247 -

Table 6A.3: EXAMPLE OF CALCULATION OF 1980 ANIMAL NEEDS

Meat Type Meet Needs Projected 1980 Available Meat Meat Stock Animal supply .76 per capita need needs Equivalent (10 tons) 76 (10 tons) (10 tons) ('000) (1) (2) (3) (4) (5)

Cattle 165 0.0045 179 3,198 2,559 Buffaloes 130 0.0035 141 2,392 2,392 Sheep 35 0.0016 38 2,375 237 Goats 17 0.0005 19 1,460 142 Swine 2 0.0001 2 31 6 Camels 5 0.0001 5 123 136

Poultry 115 0.003 125 46,236 46,236

Milk

Cows 1,345 0.0365 1,460 5,252 4,202 Buffaloes 1,116 0.0303 1,211 2,483 2,483 Sheep Goats 7 0.0002 8 1,520 152

Eggs 63 0.0017 68 45,953 45,593

Weighted Total Animal Need 1980 ('000)

Cattle 4,202 Buffaloes 2,483 Sheep 237 Goats 152 Swine 6 Camels 136

Total 7,216

Total Poultry Needs 1980 = 46,236 - 248 -

Table 6A.4: FOOD REQUIREMENTSFOR MEAT, MILK AND EGG PRODUCTION,1980

Starch equivalentfor 1980 (Animals)

7,216 x 1.11 x 0.64 = 5,126

Disposableprotein for 1980 (Animals)

7,216 x 0.15 x 0.84 = 1,017

Starch equivalent for 1980 (Poultry)

46,236 x 0.028 x 0.64 = 829

Disposableprotein for 1980 (Poultry)

46,236 x 0.005 x 0.94 = 217

Total starch equivalent = 6,055

Total disposableprotein = 1,234

Crop needs to achieve starch equivalentand disposableprotein for 1980

(S x 0.70 x 46,772/3,378 = 58,687 Clover need ( (D x 0.85 x 46,772/930 = 52,752

Straw need (S__ x 0.12 x 2,843/654 = 3,159

(S x 0.12 x 414/324 = 928 Cereal need ( (Bran, grain, pulses (DP x 0.06 x 414/27 = 1,135

(S x 0.06 x 611/314 = 707 Cottonseed ( cake (DP x 0.10 x 611/110 = 685 - 249 -

Table 6A.5: PRODUCTIONREQUIRED TO PRODUCEMILK, MEATAND EGGS

(Needs 1976 to 2010)

Predicted

1970-74 1976 1980 1985 1990 1995 2000

Clover (1) 50,531 50,276 58,687 65,592 72,526 79,494 86,407

Cereals (2) 982 1,135 1,336 1,403 1,537 1,671

Cottonseed 865 670 707 790 874 958 1,041 cake (3) (cotton production)