Hospital in a tent

Youth Family Planning Policy Scorecard: Measuring Commitment to Effective Policy and Program Interventions

The Youth Family Planning Policy Scorecard evaluates the favorability of 28 current national policy and program environments for youth access to sexual and reproductive health services.

The March 2022 edition of PRB’s Youth Family Planning Policy Scorecard evaluates the favorability of 28 current national policy and program environments for youth access to sexual and reproductive health services. The Scorecard allows users to quickly assess the extent to which a country’s policy environment enables and supports youth access to and use of family planning through the promotion of evidence-based practices. Users can explore the digital interface and self-select countries to compile their own Scorecard!


Governments around the world are increasingly creating policies to formalize the rights of adolescents and young people to access sexual and reproductive health services. Despite growing commitment from decisionmakers, many barriers remain for young people who want to use contraception. A limited evidence base has hampered systematic assessment and mapping of the key policies and programs that govern young people’s ability to access family planning information, services, and commodities. Governments and their partners lack clear guidance on which interventions will ensure that their commitments to expanding family planning use among young people are realized. Similarly, efforts by civil society to monitor the state of policy environments for youth family planning are needed to understand how countries are addressing these needs and identify areas for improvement.

To address this evidence gap, PRB conducted research and analysis to identify the most effective policies and program interventions to promote uptake of contraception among youth, defined as people between ages 15 and 24. This research has been compiled into the Youth Family Planning Policy Scorecard to evaluate and compare the favorability of current national policy and program environments.

Based on a review of existing evidence and expert consultations, the following indicators were selected as evidence-based interventions for inclusion in the Scorecard:

  • Policy barriers related to consent (parental, spousal, or service provider); age; and marital status.
  • Policies supporting access to a full range of family planning methods.
  • Policies related to comprehensive sexuality education.
  • Policies supporting/inhibiting youth-friendly family planning service provision.
  • Policies related to an enabling social environment for youth family planning services.

The Scorecard can be used by governments, donors, and advocates to evaluate a country’s youth family planning policy environment, set policy priorities, guide future commitments, and compare policy environments across countries.

The March 2022 edition of the Scorecard includes data for 28 countries: Bangladesh, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Haiti, India, Kenya, Madagascar, Malawi, Mali, Mauritania, Nepal, Niger, Nigeria, the Philippines, Senegal, Sindh (Pakistan), Tanzania, Togo, Uganda, and Zambia.


PRB launched the March 2022 Edition of the Youth Family Planning Policy Scorecard on March 9 and March 10 through a webinar delivered in French and English. The webinar shares new country policy analyses and digital platform features. It also features guest speakers who share their experiences using the Scorecard to advance policy change.


Webinar: Using the Youth Family Planning Policy Scorecard to Advance Policy Change Video thumbnail

Webinar: Using the Youth Family Planning Policy Scorecard to Advance Policy Change

Webinar: Using the Youth Family Planning Policy Scorecard to Advance Policy Change

The Youth Family Planning Policy Scorecard allows for a quick assessment of the extent to which a country’s policy environment enables and supports youth access to and use of FP, can be used by governments, donors, and advocates to evaluate the inclusion of evidence-based interventions and policy language and set policy priorities and guide future commitments.

This webinar shares new updates and functions from the March 2022 edition of the Scorecard, and features guest speakers from Bridge Connect Initiative Africa and SERAC-Bangladesh sharing their experiences using the Scorecard to advance policy change.

Webinaire: Tableau de bord des politiques de planification familiale pour les jeunes Video thumbnail

Webinaire: Tableau de bord des politiques de planification familiale pour les jeunes

Webinaire: Tableau de bord des politiques de planification familiale pour les jeunes

Le Tableau de bord de la politique de planification familiale pour les jeunes est conçu pour permettre une appréciation rapide de la mesure dans laquelle l’environnement politique d’un pays permet et soutient l’accès des jeunes à la PF et son utilisation, en encourageant des pratiques fondées sur des données probantes. Le Tableau de bord peut être utilisé pour évaluer l’inclusion des interventions fondées sur des données probantes et les politiques avérées efficaces pour réduire les obstacles et/ou améliorer l’accès des jeunes à la contraception dans les pays. Au cours du webinaire, nous partagerons les nouvelles analyses et fonctionnalités du Tableau de bord et comment il a été utilisé pour motiver des changements de politiques.


Population's Role in the Current Food Crisis: Focus on East Africa

The prices of agricultural commodities, including staples of many African diets, have risen sharply over the last several years. The sharpest rises have been within the past six months. Since 2005, the prices of maize and wheat have doubled, and the price of rice has now reached unprecedented levels (see Table 1). According to the World Bank, the Food and Agricultural Organization of the United Nations, and the United States Department of Agriculture, rising prices are likely to persist through 2015.1

Table 1
Agricultural Commodity Prices ($US/metric ton),
2005 to the Second Quarter, 2008

Cereals 2005 2006 2007 1st Quarter 2008 2nd Quarter 2008
Wheat 152 192 255 411 347
Maize 98 122 163 220 259
Rice 288 304 332 516 953

Source: International Monetary Fund (IMF), “Table 3. Actual Market Prices for Non-Fuel
and Fuel Commodities, 2005-2008,” IMF Primary Commodities Prices (, accessed Aug. 12, 2008).

The factors leading to increased prices and the resultant food crisis are diverse and complex. Most factors, however, can be thought of as having impacts on the supply of food and/or the demand for food. The supply of food may be affected by land and water constraints, underinvestment in rural infrastructure and agriculture, lack of access to fertilizer and irrigation, trade policies, and weather disruptions. Factors that affect the demand for food include rising energy prices and conversion of croplands to biofuel production, population growth, globalization of food markets, and changing diets.2 The current food crisis is, in the simplest terms, a result of rapid growth in food demand in conjunction with a decline in the growth of food supply.

A number of recent reports have implicated population growth as one of the main contributors to increasing food demand.3 There has not, however, been a comprehensive examination of how population factors (size, growth, distribution, and composition) may affect both the supply and demand for staple food. This article will explore select aspects of the population-food crisis relationship, including several that are not typically discussed, and provide examples from East Africa, which has been particularly hard-hit by the food crisis.

East Africa and Food Security

East Africa, which includes Burundi, Eritrea, Ethiopia, Kenya, Rwanda, Somalia, Tanzania, and Uganda, imports fertilizers and food and contains some of the poorest countries in the world. Periodic drought, dependence on rain-fed agriculture, low agricultural productivity, and frequent conflict undermine local food production, contribute to food insecurity, and create greater dependence on food aid. For example, the December 2007 post-election conflict in Kenya disrupted production and trade and displaced farmers and laborers, which caused the normally food-secure regions of Central and Western Kenya to become food insecure. The conflict resulted in a post-harvest loss of 300,000 metric tons of maize.4 While East Africa is not as dependent on food imports (such as rice) as West Africa, this combination of factors makes most countries in East Africa especially vulnerable to higher global food prices. Recent research in nine developing countries found that higher prices of staple food commodities were associated with a significant increase in poverty.5 This increasing poverty and food security have led to an immediate need for food aid in several East African countries. Unfortunately, however, food aid volumes are near a 50-year low and the higher food prices mean that money dedicated to food aid simply doesn’t provide as much food as in the past.6
One might expect higher food prices to benefit rural farmers and lead to higher incomes and increased production, but in East Africa this isn’t necessarily the case. It is difficult for small farmers to increase production in response to higher prices for several reasons, including: lack of available land, inadequate irrigation, rising fertilizer prices, inability to get insurance and loans, and reluctance to risk investment with no guaranteed return. In fact, despite the higher prices of the foods they are producing, farmers in some parts of East Africa have actually planted less this year.7

In recent history, East Africa has been one of the most food-insecure regions in the world. Food security, which is defined as “when all people at all times have both physical and economic access to sufficient food to meet their dietary needs for a productive and healthy life,”8 is a broad and complex measure. It is usually studied through three dimensions: food availability, food access, and biological utilization/absorption of food.9 For East Africa’s poor, who typically spend 50 percent to 70 percent of their budgets on food, higher food prices lead to reduced food consumption as well as a less nutritious diet.10 Projections from the Famine Early Warning Systems Network (FEWS-NET) indicate that the severity of food insecurity will increase in parts of East Africa, especially Somalia, eastern Ethiopia, and northern Kenya, in the third quarter of 2008.11


Population and the Current Food Crisis

The majority of recent reports on the food crisis focus principally on population growth and an increasing demand for food. Population growth, however, is one of several demographic factors likely contributing to the current food crisis. Urbanization, the growth of the middle class and associated changes in consumption patterns, migration and wage employment, large family size, and HIV/AIDS are all contributing factors as well.

Population growth has been the most discussed demographic dimension of the food crisis because of its very direct impact on the growth in food demand. Last year the world population grew by 1.2 percent and it is expected to reach 7 billion in 2012 and 9.3 billion in 2050. Demand for food is projected to double by 2030 and 20 percent of that increase is attributed to population growth.12 Neither population growth nor food production are evenly distributed across the globe. For example, the total fertility rate (TFR), a measure of the average number of children a woman will have over her lifetime, in East Africa in 2007 was 5.5 compared to the world average of 2.7 (see Table 2). Rural fertility is particularly high and stagnant in most countries, such as Uganda, Burundi, and Ethiopia, and when combined with lowering mortality, is resulting in rapid population growth. The current East African population of approximately 300 million is projected to increase to 438 million by 2025 and to 650 million by 2050.

Table 2
2008 Population, Total Fertility Rates, and Projected 2050
Population in East African Countries

2008 Population (millions) Total Fertility Rate (TFR) 2025 Projected Population (millions)
World 6,705 2.7 8,000
East Africa 301 5.4 440
Ethiopia 79.1 5.3 110.5
Tanzania 40.2 5.3 58.2
Kenya 38.0 4.9 51.3
Uganda 29.2 6.7 56.4
Rwanda 9.6 6.0 14.6
Somalia 9.0 6.7 14.3
Burundi 8.9 6.8 15.0
Eritrea 5.0 5.3 7.7

Note: Regional total includes other East African countries. The total fertility rate measures the average number of lifetime births a woman would have given current birth rates.
Source: Carl Haub and Mary Mederios Kent, 2008 World Population Data Sheet.

In the past, technological improvements in agriculture allowed food production to comfortably exceed population growth, resulting in declining food prices. This pattern of declining food prices, however, has recently reversed and there is growing concern among policymakers and researchers as to whether the previous progress will continue.13

The relationship between population growth and food security is not limited to increased demand for food. Population growth can also have an impact on the food supply and access. In many areas population growth has been associated with land fragmentation and resettlement schemes in fragile environments that directly affect food production.14 Specifically, land fragmentation contributes to inefficient and destructive farming practices and increased cultivation of marginal land, which often reduces food production. Because of population growth and land distribution policies, the average farm size in Ethiopia fell from 1.2 hectares to 0.8 hectares during the 1990s.15


Migration for Wage Opportunities

In many countries a large share of rural income is earned by rural residents who migrate temporarily to places where they can find jobs. Research in East Africa has shown that rural households are increasingly dependent on wage labor not only as a coping strategy during hunger seasons, but also as a routine livelihood strategy to meet their food needs. In Kenya, wage labor now accounts for more than 50 percent of rural households’ income.16 The diversification of rural income is generally driven by social, cultural, and economic change, but population pressure and land fragmentation also play a role. As landholdings become too small to support households, and with excess family labor available, adolescent and young adult family members often migrate to supplement their farming livelihood with wage employment.17

This increased dependence on wage employment may have mixed effects on food security. First, households may suffer from rising staple food prices if employment opportunities are reduced by energy, fertilizer, transportation costs, and the inability of employers to secure loans.18 Second, household food production may decrease as adults migrate for employment and education opportunities and spend less time laboring on the farm. Finally, wage employment may actually improve food security in regions where household farming yields vary greatly from year to year and are highly vulnerable to drought. For these households, wage employment may serve as a risk mitigation strategy against crop failures.

The Growing Middle Class and Changes in Consumption

Media reports have also focused on the growing incomes of households in China and India, which account for almost 40 percent of the world’s population, and have had strong economic growth rates. Based on this trend, the world’s middle class will grow substantially. The World Bank estimated that by 2030 “fully 1.2 billion people in developing countries—15 percent of the world population—will belong to the global middle class, up from 400 million in 2005.”19

Rising incomes are often accompanied by changing food preferences. There is a greater emphasis on the consumption of meats, fruits, and vegetables and a move away from traditional staples. Thus, global trends are characterized by not only a growing demand for more food but also for different types of food. The growing demand for meat leads to a disproportionate increase in demand for grain and protein feed needed to produce meat. Producing one pound of beef requires seven pounds of corn feed.20

The growth of the middle class and economic growth in developing countries have also increased global energy demand. Rising petroleum use in developing countries has contributed to rising oil prices, which have affected food production in two ways. First, rising fuel prices have increased the cost of fertilizers, fuel, and pesticides used in agriculture. This has caused the prices of agricultural products to increase, and in certain places caused output to decrease. Second, the rising oil prices have increased the demand and production of biofuels as substitutes for oil. The increased demand for and production of corn, which is converted to ethanol, has diverted croplands away from food production and has contributed directly to the rising prices of corn and other staples.21


Urbanization and Its Effect on Food Demand and Supply

The world is becoming increasingly urban, and by the end of 2008, more than half of the world’s population will be living in urban areas. Future population growth is expected to occur almost exclusively in urban areas. By 2030, the world’s urban population is expected to reach 4.9 billion, while the rural population is expected to decrease by 28 million.22 Furthermore, the pace of urbanization will grow the fastest in regions that currently have low levels of urbanization, such as in East Africa. Consequently, these regions will have a growing nonagricultural population that relies on purchased food and is susceptible to increases in food prices. In Mozambique, for example, urban residents purchase 83 percent of their food, while rural residents purchase only 30 percent.23

Table 3
Urbanization Levels and Projected Urban Population in East Africa

% Urban 2008 Growth Rates, 2005–2010 Ratio of Urban to Rural Growth Rates % Urban 2030 Projection
Urban Rural



Note: Somalia is not included due to low reliability of estimates.
Sources: Carl Haub and Mary Mederios Kent, 2008 World Population Data Sheet; UN Population Division,
World Population Prospects: The 2006 Revision; and UN Population Division, World Urbanization
Prospects: The 2007 Revision
(, accessed July 31, 2008).

Urbanization, like income growth, is associated with increased consumption of meats, fruits, and vegetables. In East Africa, while the middle classes are growing in cities like Nairobi and Addis Ababa, there is little evidence so far that the urban poor, who are the majority, are changing their food preferences to the higher-priced products.

Urbanization is also often associated with decreases in food supply due to a loss of agricultural land and dietary diversification. The expansion of urban space tends to affect farm lands because many cities and towns are located in rich agricultural lands. A compounding factor is that urban growth is increasingly land-intensive. Urban space grows faster than urban populations, evident as urban sprawl. Cities and their growing populations also increasingly compete with the agricultural sector for scarce water resources, resulting in less water for irrigation. For example, in Tanzania, rapidly growing demand for water for domestic and industrial activities in the towns of Arusha and Moshi has led to the damming of large rivers to ensure urban water supply.24 Decreases in the water available for agriculture will further inhibit the ability of farmers to increase food production.


The spread of HIV/AIDS is also undermining food security in sub-Saharan Africa, including the East African countries of Kenya, Tanzania, and Uganda.25 HIV/AIDS reduces agriculture production through a number of factors, creating both immediate and cumulative impacts. HIV/AIDS affects people in their prime working ages, 15 to 49; in Kenya, Uganda, and Tanzania, more than 5 percent of the working-age population is infected. Furthermore, subsistence agriculture relies heavily on human labor, particularly women’s labor. Therefore, in regions with high HIV/AIDS prevalence like southern Africa, where subsistence agriculture is the norm, HIV/AIDS-related illness and deaths reduce the agricultural labor force, resulting in less land being farmed, reduced yields, and less intensive crops being grown. In Kenya, a study found that the death of an adult female household member resulted in fewer grain crops grown, while the death of an adult male resulted in decreased production of cash crops such as sugar and coffee.26

HIV/AIDS may also exacerbate poverty. Household income may fall if the infected individual was a wage earner, and expenses may increase because of new health care costs. The redistribution of money for medicine and funeral expenses by afflicted households reduces the income available for food and investments to improve agricultural production. Food production is also threatened by the loss of agricultural knowledge when infected individuals die. The food crisis is also likely to exacerbate the impact of HIV/AIDS as infected individuals, who have heightened nutritional needs, find it more difficult to purchase foods.


Several population factors play an important role in the increasing and changing nature of the demand for food, while also constricting supply and access to food. Population’s role is often neither direct nor simple, and its impacts can vary at the local and global level. Nonetheless, many demographic trends that affect food supply and demand, especially rapid population growth, urbanization, population density of the rural poor, and migration for employment, are projected to continue. In the absence of significant policy reforms and technological change, these demographic factors will likely continue to affect food security in coming decades. East Africa in particular is likely to face many population-related food security challenges. Policies aimed at the current food crisis or at achieving the United Nations’ Millennium Development Goal on hunger—by 2015, to reduce by half the proportion of people who suffer from hunger—must not ignore the complex role of population.


  1. World Bank, “Rising Food Prices: Policy Options and World Bank Response” (April 2008).
  2. Joachim Von Braun et al., “High Food Prices: The What, Who, and How of Proposed Policy Actions” IFRPI Policy Brief (May 2008).
  3. Von Braun et al., “High Food Prices”; Lee Hudson Teslik, “Backgrounder: Food Prices,”The New York Times, June 30, 2008; and UN Economic and Social Council, Issues Note for Special Meeting of the Economic and Social Council on Global Food Crisis (2008), accessed online at, on Aug. 6, 2008.
  4. “Kenya Food Security Outlook: April to September 2008,” accessed online at, on July 8, 2008.
  5. Maros Ivanic and Will Martin, “Implications of Higher Global Food Prices for Poverty in Low-Income Countries,” World Bank Policy Research Working Paper 4594 (2008).
  6. Javier Blas, “Food Aid Declines to Near 50-Year Low,” Financial Times, June 9, 2008.
  7. “The New Face of Hunger,”The Economist, April 17, 2008.
  8. U.S. Agency for International Development (USAID), “Food Aid and Food Security: USAID Policy Paper” (1995), accessed online at, on Aug. 5, 2008.
  9. Food availability is achieved when sufficient quantities of food are consistently available to all individuals within a country. Such food can be supplied through household production, other domestic output, commercial imports, or food assistance. Food access is ensured when households and all individuals within them have adequate resources to obtain appropriate foods for a nutritious diet. Access depends on income available to the household, on the distribution of income within the household, and on the price of food. Food utilization is the proper biological use of food, requiring a diet providing sufficient energy and essential nutrients, potable water, and adequate sanitation. Effective food utilization depends in large measure on knowledge within the household of food storage and processing techniques, basic principles of nutrition and proper child care,” USAID, “Food Aid and Food Security.”
  10. Von Braun et al., “High Food Prices.”
  11. A map showing the most severe food insecure regions in East Africa can be viewed at the Famine Early Warning Systems Network (FEWS-NET) website.
  12. United Nations Population Fund (UNFPA), Statement of the UNFPA on the Global Food Crisis, Population and Development (2008), accessed online at, on July 7, 2008.
  13. Food and Agriculture Organization (FAO), “Population Aspects in the Reduction of Hunger,” paper presented at the Seminar on Relevance of Population Aspects for Achievements of Millennium Development Goals, New York, Nov. 17-19, 2004.
  14. Nafis Sadik, “Population Growth and the Food Crisis,” Food, Nutrition, and Agriculture 1 (1991).
  15. “The New Face of Hunger,” The Economist, April 17, 2008.
  16. Thomas Reardon, “Using Evidence of Household Income Diversification to Inform Study of the Rural Nonfarm Labor Market in Africa,” World Development 25, no. 5.
  17. Reardon, “Using Evidence of Household Income Diversification.”
  18. “On the Basis of Need: Global Food Prices and Rural Realities,” FEG Consulting, May 2008.
  19. Richard Newfarmer et al., Global Economic Prospects: Managing the Next Wave of Globalization (Washington, DC: The International Bank for Reconstruction and Development/The World Bank, 2007): xvi, accessed online at, on July 31, 2008.
  20. Ephraim Leibtag, “Corn Prices Near Record High, But What About Food Costs?” Amber Waves (February 2008).
  21. Ronal Trostle, Global Agricultural Supply and Demand: Factors Contributing to the Recent Increase in Food Commodity Prices/WRS-0801 (Washington, DC: U.S. Dept. of Agriculture, Economic Research Service, 2008).
  22. George Martine et al., State of World Population 2007: Unleashing the Potential of Urban Growth (New York: UNFPA, 2007).
  23. Gina Kennedy, “Food Security in the Context of Urban Sub-Saharan Africa,” Internet Paper for Food Security Theme in FoodAfrica Internet Forum, March-April 2003, accessed online at, on Aug. 5, 2008.
  24. Milline J. Mbonile, “Population, Migration, and Water Conflicts in the Pangani River Basin, Tanzania,” Environmental Change and Security Program Report Issue 12 (2006-2007).
  25. FEWS, “Tanzania Food Security Framework: Underlying Factors” and “Kenya Food Security Framework: Underlying Factors,” accessed online at , on July 7, 2008.
  26. Lori M. Hunter, “Understanding How HIV/AIDS, Agricultural Systems, and Food Security Are Linked,” accessed online at, on July 31, 2008.