As demographers and politicians say the country’s population growth continues to outpace resources, the Egyptian government has committed 100 million Egyptian pounds (Dh20.5 million) this week to bolster the Two is Enough family planning programme.
The Middle East’s most populous country will be home to an estimated 99 million people by the end of the year and at current levels of 3.2 children per woman, it would hit 128 million by 2030.
But last July, the Health Ministry set a target to slow population growth to 2.4 children per woman and keep it to 112 million by 2030. If they manage the 2.4 rate, it would keep the population largely stable with only a small annual rise.
The country's booming numbers – the population has nearly doubled since 1985 – is straining resources and there are concerns that the growth, coupled with the effects of climate change, could cripple basic services in the next decade and beyond.
If the population hits 128 million, the United Nations estimates Egypt will need 377,000 more doctors and 1.09 million more teachers to hit targets of one per 1,000 people. The country will also need tens of thousands more jobs a year. The increased population, as well as issues around climate change, will put a strain on food production and water resources.
“The issue of population growth represents a real threat to the efforts exerted by the state to implement economic and social reforms, which by themselves show positive indicators of an improvement of the economic situation,” Prime Minister Sherif Ismail said at a conference held with the Social Solidarity Ministry last week.
But even the government’s supporters harbour doubts about the ability of the economic reform package to deliver a quality of life to its nearly 96 million citizens as the population surges.
"The government needs to expand this plan to deal with the increase in population because it is eating up the positive economic reforms," said MP Mahmoud Shaalan from Beheira, between Cairo and Alexandria, where the birth rate remains at 3.5 children per woman.
While Egypt's unemployment rate fell from 11.3 per cent in the first quarter of last year to 10.6 per cent in the same period this year, the country still needs to create jobs for nearly 800,000 people entering the workforce each year.
"The [Two is Enough] project will be implemented through 100 civil society organisations as part of the national strategy to limit population growth," Social Solidarity Minister Ghada Wali said on Monday when more detail of the campaign was released. However, the full cost of the plan has not been made public.
“We aim to raise awareness of the benefits of small families among women,” Mrs Wali said. She explained that the programme would initially target about 1.15 million women enrolled in the ministry’s Takaful programme, which provides maternal and child healthcare services, plus cash support to the country’s poorest families.
The first phase of the information and contraceptive service effort will be rolled out in the 10 governorates with birth rates between 3.7 and 4.6 children per mother.
The Ministry of Solidarity and Health said the plan goes beyond an information campaign to provide technical supervision for family planning clinics and the operation of medical convoys to remote areas.
“It’s not easy to speak about this subject in Upper Egypt,” said Sanaa Atta Mahmoud, a 24-year-old tour guide in Luxor. “Families freak out when a bride doesn’t get pregnant in the first year of marriage. And then they ask when the next baby is coming within a year of giving birth to a first child.”
Ms Mahmoud, who is engaged to be married this year, said she and her fiance need a plan to “keep it a secret from our families that we don’t want kids for the first couple of years and that we don’t think we can afford to raise more than two kids”.
While the couple's respective families might be disappointed, Egypt's President Abdul Fatah El Sisi would probably be pleased with their choice.
“You want to ensure education is provided to all? Fix the population problem. You want to guarantee job opportunities? Fix the population problem. You want medical services? Fix the population problem,” Mr Sisi said at a youth forum held in Alexandria last June.
Egyptian feminist leaders said that while the Two is Enough campaign shows a renewed energy to address the population question, there are gaps in the government’s policy that need to be addressed.
“It’s about time that we talk to people about resources or, more accurately, the lack of resources,” said Nada Nashat, an attorney at the Cairo-based Centre for Egyptian Women’s Legal Assistance. “But this programme is insufficient because we are talking about limiting the number of children without addressing the core of the culture.”
Ms Nashat thinks changing attitudes about family size and making a dent in the birth rate will require a more comprehensive and radical approach.
“The campaign needs to reach beyond 10 governorates, young men need to be included in education efforts, and abortion needs to be a legitimate and legal option for women in addition to contraception,” she said.
But Aleksandar Bodiroza, the UN's Population Fund representative in Egypt, said he believes the Two is Enough campaign in an essential step to getting the country's birth rates in line with its resources.
“You can find references to the golden age of family planning in Egypt and the [Mubarak] government back then managed to reduce fertility rates from 5.8 [children per mother] to 3 – an extraordinary success.”
These efforts were cut short after Egypt's 2011 uprising ousted the longtime ruler.
“When the ideology changed [under Mohammed Morsi and] young people became parents more quickly because they were promoting big families.”
In the years of upheaval between Mr Mubarak’s departure and Mr Sisi’s current initiative, family planning projects were not prioritised and the birth rate started to creep up again.
The Middle East as a whole has been the fastest-growing area of the world over the past century and although most states have had successes in cutting birth rates, many still outpace levels in the West or the Far East.
The UNFPA representative said that the government of Mr Ismail's increased financial commitment to family planning is essential for Egypt to renew a policy of economic growth and along with a vision of environmental sustainability.
“These new elements are really encouraging, the government has put family planning and sexual reproductive health back on the table,” Mr Bodiroza said.