Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend POLICY BRIEF OCTOBER 2022 POLICY BRIEF Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend Sameh El-Saharty, Amr Elshalakani, Nahla Zeitoun, Bridget Crumpton, Amira Kazem, Cornelia Jesse, and Souraya El-Assiouty OCTOBER 2022 This Policy Brief is based on: El-Saharty, Sameh, Amr Elshalakani, Nahla Zeitoun, Bridget Crumpton, Amira Kazem, Cornelia Jesse, and Souraya El-Assiouty. 2022. “Policy and Strategic Priorities in Making the Choice”. In El-Saharty, Sameh, Heba Nassar, Sherine Shawky, Amr Elshalakani, Mariam Hamza, Yi Zhang and Nahla Zeitoun, eds., 2022. Achieving the Demographic Dividend in Egypt: Choice, not Destiny. 2022. Washington, DC. The World Bank. © 2022 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 This work is a product of the staff of The World Bank with external contributions. 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CONTENTS Egypt’s population challenge 01 Reaping the demographic dividend 01 Increasing the CPR 02 Reducing school dropouts 05 Increasing female labor force participation 06 Delaying age of marriage 07 Leveraging social protection programs 07 Improving governance of the population program 08 Ensuring a broad-based socioeconomic development policy 10 Creating productive jobs 10 Investing in and leveraging human capital 11 Enhancing financial inclusion and entrepreneurship 12 Sustaining macroeconomic stability and 12 ensuring policy predictability The way forward: a time frame 12 References 14 Egypt’s population challenge Egypt’s population program began in the early 1970s and was very successful in bringing down the country’s total fertility rate (TFR), the mean number of children a woman would have by age 50. Key investments in reproductive health and family planning (FP), as well as women’s empowerment, contributed to an impressive decline in the country’s TFR from 4.5 to 3.0 between 1988 and 2008. However, by 2014, the TFR decline had reversed (Figure 1). This reversal was not only alarming but has been seen in only a handful of countries worldwide. FIGURE 1 Total fertility rate for women ages 15–49, Egypt, 1988–2014 Total fertility Source: MOHP, El-Zanaty and Associates, and ICF International 2015. Note: The Demographic and Health Survey was not conducted in 2011. Egypt’s population will continue to grow in the foreseeable future. According to the United Nations (UN) Population Division population projections, Egypt’s population will grow to 120.8 million in 2030 and will have a TFR of 2.9, all things remaining equal. However, the first phase1 of the demographic dividend can be realized if the TFR declines from an estimated 3.1 in 2020 to the fertility replacement level of 2.1 by 2030, or shortly thereafter, with a total population of only 117.3 million. A TFR decline of one child per decade is possible—Egypt itself achieved it in the 1980s and 1990s along with several other countries. The actual outcome will greatly depend on how the government implements policies to slow population growth and create productive jobs. Reaping the demographic dividend For Egypt to reap its demographic dividend, we propose six policy and strategic priorities that—if well implemented—should yield the greatest reduction in fertility. The six priorities are: increasing the con- traceptive prevalence rate (CPR)—the central priority; reducing school dropouts; increasing the female labor force participation rate (LFPR); delaying age of marriage; leveraging social protection programs; and improving the governance of the population program. (See Table 2 toward end of document.) These would achieve the first phase of the demographic dividend, but it is transitory and can only be sus- tained into the second phase through four broad-based socioeconomic development imperatives: creating productive jobs; investing in and leveraging human capital; enhancing financial inclusion and entrepre- neurship; and sustaining macroeconomic stability and ensuring policy predictability. (See Table 2.) 1 The first phase is a direct and immediate consequence of the growth of the 2 The second phase may arise if changes in age structure create space for size of the labor force relative to the cohort of children—that is, when the age higher savings and lead to increasing investments in human and physical dependency ratio falls and the share of the working-age population rises as capital, which can further enhance labor productivity (Birdsall, Kelley, and more people are able to produce at the most productive stages of their lives. Sinding 2004), leading to increased investments and per capita GDP. 1 Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend 1 Increasing the CPR Figure 2 presents strong evidence on the inverse correlation between the CPR and TFR in 86 countries. Egypt is above the trendline, largely reflecting the underperformance of its FP program. According to the latest Demographic and Health Survey (DHS) of 2014, Egypt’s CPR was only 58.5 percent (MOHP, El- Zanaty and Associates, and ICF International 2015). However, a recent survey estimated that the CPR had reached 62.6 percent in 2018 (Krafft, Assaad, and Keo 2019). The centerpiece for reducing fertility and curbing population growth is aiming to expand FP coverage to reach a CPR of 75 percent within the next decade, which would bring the TFR down to roughly 2.3—near replacement level. This would require addressing two primary challenges: meeting the unmet need and reducing contraceptive discontinuation. The Evidence: Impact of CPR increase The Republic of Korea started an FP program in the 1960s and 1970s, which was responsible for one-third of the total reduction in fertility during its imple- mentation period (Whang 1981). TOTAL FERTILITY RATE FIGURE 2 The CPR and TFR showed a strong inverse correlation between 1985 and 2019 Upper middle income Lower middle income Low income High income Egypt (lower middle income) Source: Authors’ calculations based on DHS data from 86 countries. CONTRACEPTIVE PREVALENCE RATE (%) Egypt’s unmet need for contraception has been consistently higher than the average for other countries at the same CPR (Figure 3). Using the Egypt DHS 2014, unmet need for currently married women is 12.6 percent and the share of unsatisfied demand for FP is 17.7 percent, which means that these high levels may not just be related to the FP program but also to social norms. The Evidence: Effect of Reducing Unmet Need for FP The Copenhagen Consensus Center concluded that every $1 invested in meet- ing the unmet need for contraceptives yields an average of $120 in accrued annual benefits and $60–100 in long-term benefits from putting countries on a path toward a demographic dividend and economic growth (FP2020 undated). Policy Brief 2 FIGURE 3 UNMET NEED FOR CONTRACEPTION The CPR and TFR showed a strong inverse correlation between 1985 and 2019 Upper middle income Lower middle income Low income Egypt (lower middle income) Source: Authors’ calculations based on DHS data from 86 countries. CONTRACEPTIVE PREVALENCE RATE (%) Reasons for contraceptive discontinuation include side effects, myths, contraceptive failure, or the service environment, including service quality and availability of a sufficient choice of methods (FP2020 and Population Council 2015). Based on the Egypt DHS 2014, the most common reasons for discontinuation were related to fear of side effects and health concerns. Increasing the CPR and overcoming these two primary challenges would require the government to undertake the following seven strategies. Expanding the To address the shortage of female service providers and lack of services capacity of the in remote and rural areas, the base of providers needs to be expanded to MOHP to provide include female nurses and task-shifting some services, such as providing FP services injectables or subdermal implants, as well as through mobile clinics and teams. Further, FP should be integrated into other health services so that all encounters with public providers may be used to educate women (and their husbands) about FP. The Evidence: Impact of using community health workers A review of impact found that provision of pills and condoms by community health workers in a community increased contraception uptake by 56 percent, which increased to 70 percent when the provision of injectables was added to the other methods (Weinberger et al. 2019). 3 Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend Integrating FP into Integrating FP services into the postpartum care provided during childbirth postpartum care and up to 12 months after delivery is the best time when women are in in- creased contact with the health system. Improved quality of intrauterine de- vices (IUDs) and implants, and their safer insertions, make getting an immedi- ate postpartum IUD simpler and easier. General and district hospitals of the MOHP should expand the base for providing postpartum FP services through their Ob/Gyn departments. Finally, because more than 55 percent of all births are outside the public sector–administered facilities, postpartum FP services and consultations must be offered to mothers in private facilities. The Evidence: Impact of postpartum FP A review of impact shows that facility-based immediate postpartum FP has the highest odds ratio of 2.03 out of 14 interventions, followed by community-based postpartum FP (1.96) (Weinberger et al. 2019). Expanding FP FP clinics and services need to be expanded to all hospitals and clinics services in the of the Health Insurance Organization, General Authority of Healthcare, public sector Curative Care Organization, Teaching Hospital Organization, and other public sector provider institutions. Engaging non- Engaging nongovernmental organizations (NGOs) was one of the factors public-sector that contributed to increasing access and coverage of FP services in Egypt providers in the late 1980s and early 1990s. Similarly, engaging the private sector, particularly pharmacies, can also increase access to oral contraceptive pills, including those for emergency contraception, and injectables, especially for underserved populations (HIPs 2013). Improving the Between the 2008 and 2014 Egypt DHS, use of IUDs declined as the supply chain proportion of women using the contraceptive pill or injectables increased, and quality of which may point to fundamental changes in FP access, particularly for IUD methods insertion. Further, robust supply chains that eliminate stock-outs and engage multiple manufacturers to ensure high-quality, low-cost contraceptive products are critical for uptake and continuation (HIPs 2012). Expanding the New contraceptive technologies have been developed to satisfy the diverse method mix in the preferences of women and their partners and to overcome the challenges public and private of providing some methods in low-resource settings. A key intervention is to sector remove the MOHP monopoly for distributing some FP methods and allowing their official statutory pricing for subsequent use through community pharmacies. One immediate action is allowing the private sector to import and distribute subdermal implants and allowing private doctors to insert them, a practice currently confined to the MOHP. The Evidence: Effect of method mix increase The addition of one new method to the available method mix would increase con- traceptive prevalence by as much as 8 percentage points (Ross and Stover 2013). Policy Brief 4 Generating An expanded method mix can only reach its full potential with continued demand demand from users. Satisfied contraceptive users who speak to others about their experience are also highly effective in generating demand for FP (Belaid et al. 2016). In Egypt, when change in norms and ideas occurred in one village, similar shifts took place in neighboring villages, whether fertility increased or decreased (Weeks 2004). The Evidence: Effect of mass media A synthesis of several studies found that those exposed to mass media were 25 percent to 2 times more likely to use modern contraception than those not exposed (HIPs 2017). 2 Reducing school dropouts Increasing girls’ enrollment and their completion of upper-secondary education is an internationally proven strategy that Egypt can use to address fertility challenges through the following interventions. Increasing girls’ Enrollment is near universal at primary level and the net enrollment rate was re- enrollment cently 97.60 percent at lower-secondary level and 76.59 percent at upper-sec- ondary level—75.87 percent girls and 77.26 percent boys (MOETE 2020). Ac- celerating expansion of girls’ enrollment at secondary level requires continued policy attention on investment to expand the supply of schooling at secondary level, and ensuring, for example, that schools are accessible and safe. The Evidence: Effect of girls’ education In Brazil, improvements in schooling of girls accounted for about 70 percent of the fertility decline observed in the country during the 1960s and 1970s (Lam and Duryea 1999). In Turkey, the extension of compulsory schooling from five to eight years in 1997, led to the decline of the proportion of married women from 15.2 to 10.0 percent and of the share of adolescent girls who had given birth from 6.2 to 3.5 percent (Kirdar, Tayfur, and Koç 2009). Reducing girls’ Once enrolled in school, the priority is to keep girls enrolled. Dropouts in dropouts Egypt increase sharply at upper-secondary level than lower-secondary level and are 4.7 percentage points higher for girls: 17.3 percent against 12.6 percent, and 15 percent overall (El-Laithy 2021). International evidence also demonstrates the value added of strategies to keep girls in school, especially at the upper-secondary level. Among these are: girls’ clubs to promote girls’ empowerment, life skills, awareness of sexual reproductive health and gender issues in a safe, peer, or mentoring environment (UKAID 2018). Prioritizing edu- International evidence shows that programs in education on sexual and repro- cation on sexual and ductive health play a vital and multifaceted role in providing accurate infor- reproductive health mation, dispelling myths and misinformation, reinforcing values and positive attitudes, and strengthening decision-making and communication skills. 5 Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend 3 Increasing female labor force participation Increasing the female labor force participation rate (LFPR) in Egypt is critical, particularly among urban, educated women, as this group had the greatest increase in desired fertility after 2005. Women’s partici- pation has not increased, despite improvements in education attainment and the relatively large share of women with a university degree, which calls for a comprehensive approach in the following areas. Improving women’s Egypt’s female enrollment in higher education—though increasing in recent employability years—needs to shift toward disciplines offering higher employment rates for women and from humanities and into science, technology, engineering, and mathematics disciplines or other more labor market–relevant programs. The Evidence: Female employment It was estimated that if female employment rates were to match male employ- ment rates in Egypt, this would result in an increase of 34 percent in the GDP (Booz and Company 2012). Providing support A growing body of research shows that affordable childcare is important for services that facilitate lifting the female LFPR. As household chores—particularly care for family female employment members—mostly fall on women’s shoulders, better policies to support the care economy would no doubt boost the female LFPR. Creating an enabling Key policy directions include tackling stereotyping of female employees; and and conducive adopting targeted awareness and incentives packages for employers to re- environment for duce biased decision-making that either drives female candidates away, offers female employment them a lower benefits package, or hurts women’s promotion once in a job. Combating violence Women and girls face gender-based violence in public and private spheres, against women and and steps to overcome it include enforcing laws on violence against women girls and girls and sexual harassment in public spaces, including transport and work. Addressing the Changing attitudes and addressing gender stereotypes and social norms social norms and are integral for greater female LFPR. Unless gender-equality policy is values system translated into action, using a “behavioral lens” approach to benefit women and girls, these entrenched informal social norms will undermine policies to advance gender justice. Addressing Women on average get paid 34 percent less per hour than their male impediments in counterparts. Given this, a shrinking public sector, and a private sector the private sector with an increasing role in employment creation, the private sector must become more hospitable to women by addressing biases and enhancing inclusiveness and gender equality. Boosting women’s Twelve private-sector industries that hire women intensively or have the participation in potential to grow and employ more women are social care, education, promising new sectors human health, garments, computers and electronics, pharmaceuticals, financial services, travel agencies, business services, real estate, information and communications technology, and retail trade (World Bank 2018). Policy Brief 6 4 Delaying age of marriage In traditional societies, competition between the reproductive and productive roles of women is usually in favor of the former. Early marriage and early motherhood limit the chances and options open to women, and the vicious circle results in increasing fertility among women who too often take low-paid jobs and lack career prospects. Experience from other countries sheds light on the type of interventions to delay early marriage. Empowering Such interventions are aimed at empowering girls through sharing informa- girls tion, teaching life skills, vocational and livelihoods skills training, mentored learning spaces to facilitate the acquisition of core academic skills, and sup- port networks to enhance opportunities for continued schooling for girls. Engaging parents This is essential for creating an “enabling environment,” reducing the stigma and communities. associated with delaying marriage, and changing social norms to reduce the pressure to marry early. Improving formal This could be achieved by preparing, training, and supporting girls for schooling and education enrollment/re-enrollment in school (in addition to education reform so that opportunities for girls academic skills are aligned with labor market needs, creating an enabling environment for girls to stay in school). Enforcing laws In Egypt, although early marriage is prohibited by law, the practice is still and policies prevalent in rural areas, especially in Upper Egypt. It is imperative to enforce the existing child protection laws more rigorously and close any legal loopholes, which should be complemented by multisectoral interventions to raise awareness among decision-makers and local community leaders. 5 Leveraging social protection programs The Takaful and Karama (TKP) cash-transfer program should be leveraged to optimize the impact on fertility reduction and become a platform for “cash plus” interventions to impact other aspects of people’s lives, including factors that influence fertility, such as the ability to access health care and education and to alleviate poverty. The TKP database currently hosts over 8 million households (31 million individuals) who have applied to the program, of which 3.4 million households (12 million individuals) were found eligible and enrolled in the program. Seventy-five percent of the card holders are women and 67 percent of the cash is dedicated to Upper Egypt. In 2018, the government took the decision to have the TKP support up to two children only, which became effective as of January 2019, echoing a clear message that the government is promoting smaller families. The TKP program, “Forsa” (meaning opportunity), has a strong focus on women to help generate female employment and sustainable livelihoods that can encourage fertility reduction. Policy inventions targeted at lower-quintile households to incentivize demand for schooling and attendance have proven effective in Egypt. They should be reinforced and diversified through the TKP, which was found to be an effective mechanism for rewarding school attendance and health clinic visits. Other incentivizing options could include on-the-job training and adult literacy programs among others (El-Laithy 2021). 7 Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend 6 Improving governance of the population program In the past few decades, Egypt succeeded in curbing population growth only during 1986–93, when the government shouldered the burden of reducing population growth seriously, reflecting four concurrent factors (Dawood and Abdel Latif 2019): strong political will; a comprehensive population policy with quantitative objectives; a strong, independent, and stable institutional framework—the National Population Council—responsible for population; and the provision of financial resources from the government and donors. One key factor was the “authority and powers” of the National Population Council that mobilized government sectors and ministries as part of a coordinated national plan. Improving the governance of the national population program would require all these elements, as all the first five policy and strategic priorities require actions beyond the remit of one ministry. Thus for 2021 and beyond, the following four fundamental interventions are proposed. Establishing a The first intervention is to establish a “strong, independent, stable institutional strong institutional framework” (Dawood and Abdel Latif 2019) for the national population framework program: • It should comprise an existing national body headed by a ministerial-level official—the “Champion”—reporting, ideally, to the president or at least the prime minister and having a core team of key ministers. • This body would be the sole government entity responsible for preparing the coordinated national plan, coordinating across ministries and organizations, and monitoring performance indicators. • It should have a technical team or secretariat to prepare, for instance, background technical studies, and to conduct monitoring and evaluation. • In each governorate, local coordinating committees should be formed, reporting to the national body and made up of representatives from relevant ministries and public entities. • Implementation plans should be adequately funded via a budget for the national population program and an allocation for each governorate. Providing legal and Many of the proposed policy and strategic priorities require critical review of regulatory support current laws and regulations, to allow, for example, qualified health workers, such as nurses, to provide FP services, and to contract out FP services to the private sector. Developing The population program should consider the variations in the governorates’ differentiated “demographic profiles.” Table 1 presents the “high-priority” governorates subnational where, for example, the likelihood and concentration of live births are high, implementation but the associated “social determinants” vary widely from school dropouts plans to unemployment. Supply-side and demand-side interventions (including to address, respectively, high unmet need and discontinuation rates, and early marriage/conception and school dropouts) need to be crafted concurrently by the governorate based on local circumstances. Policy Brief 8 TABLE 1 Demographic profile of high-burden governorates Live births Marriage contract School dropout Unemployment Illiteracy Name Likelihood Conc. Likelihood Conc. Likelihood Conc. Likelihood Conc. Likelihood Sharqia U U G G G G F F/M G Menia U R/U G G G G F/M F/M G Assiut U R/U G G G G F F G Aswan U U G G G G F/M F/M G Alexandria R R G G G G M F/M G Giza R R G G G G F F G Qena R R G G G G F F G Sohag R/U R G G G G F F/M G Dakahlia U U G G G G F F G Gharbia U U G G G G M M G Beheira U U G G G G F F G Beni Suef U U G G G G F/M F/M G Source: Authors, based Note: Conc. = Concentration, G = Governorate level, U = Urban, R = Rural, F = Female, M = Male. on CAPMAS (2020) for live Red cells denote high rates (>95% confidence interval above national average) and/or distribution births, marriage contracts, exceeding population distribution by >1%. Green cells denote low rates. and unemployment; and on CAPMAS (2017) for school dropouts and illiteracy. Developing a national Issues of data generation and use impede FP planning and decision-making dashboard for the in Egypt, as most plans and studies use the latest DHS data, which is more population program than seven years old. A DHS or similar surveys or assessments to update the status of the key demographic indicators and assess progress is therefore imperative, and such surveys need to be conducted much more frequently, if policy makers and program managers are to take timely corrective measures. A “population dashboard” should therefore be established, with annual key performance indicators (KPIs) that can be collected in a timely manner and reported on a quarterly or even monthly basis. Only KPIs with a baseline measurement can be included, as it is impossible to improve what is not measured. Data from CAPMAS can constitute the backbone of the dashboard as these are routinely collected and do not require additional data collection tools. The annual KPIs established at national level should be translated to a subset of KPIs at governorate level, and should reflect each governorate’s demographic profile. Governorate implementation plans should be closely linked to their corresponding KPIs. The dashboard should be automated to provide near real-time data and flag any deviations from planned targets to enable timely corrective measures. 9 Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend Ensuring a broad-based socioeconomic development policy The six policy and strategic priorities discussed above can help the government in achieving the first phase of the demographic dividend through fertility decline, increased share of the working-age popu- lation, and increased worker productivity (Figure 4). To achieve the second phase of the demographic dividend, the government should undertake the following four policy imperatives. FIGURE 4 TOTAL DEPENDENCY RATIO First and second phases of the demographic dividend Source: Adapted from World Bank and IMF 2016. 1 Creating productive jobs Egypt is an “early-dividend” country, but the first phase arises only to the extent that the economy can create productive jobs to absorb the growing working-age population. Yet, during 2004–18, Egypt’s aggregate GDP growth averaged 4.5 percent, compared with 5.6 percent for the average for middle- income countries, and its GDP per capita 2.4 percent—2.0 percentage points lower than the average for middle-income countries (Alnashar, El-Ashmawy, and Youssef 2020). The underperforming GDP per capita growth reflects modest labor productivity growth and declining employment rates, which can be explained by weak labor productivity growth that averaged 1.9 percent compared with 4.6 percent for its peers and despite having the largest share of demographic change because of its growing young population (Figure 5). The pace of job creation has fallen below the growth in the size of the working-age population, which has in turn weighed on GDP per capita growth (Alnashar, El-Ashmawy, and Youssef 2020). Policy Brief 10 FIGURE 5 Decomposition of annual average growth in GDP per capita, Egypt and comparators, 2004–18 Productivity Employment rate Demographic change Source: Alnashar, El-Ashmawy, and Youssef 2020. An economic transformation is needed to increase productivity within sectors as well as the reallocation of labor (among other resources) toward more productive sectors so as to generate high-earning jobs at scale (McMillan et al. 2017). Further, getting the enabling environment right is equally critical to create attractive opportunities for domestic and foreign investment to enhance within-sector productivity growth and to support the movement of workers into higher-value-activities and sectors. This is in addition to resolving some of the impediments to private sector activity through reducing barriers to competition and easing regulations to access loans from commercial banks (Alnashar, El-Ashmawy, and Youssef 2020). Finally, there is a need to accelerate job creation, by ensuring that both the supply side (particularly human capital formation) and the demand side (job-intensive economic growth) of job creation are well-aligned to absorb the labor force across different income levels (Troiano 2015; World Bank 2013). These policies would also include the removal of barriers to the female LFPR, given persistent gender gaps in the labor market in Egypt. 2 Investing in and leveraging human capital In the coming decades, global trade flows are projected to continue shifting toward countries earlier in their demographic transition, possibly yielding substantial benefits for these countries. In pursuing their domestic agendas, countries can also arbitrage, and in the process leverage demographic change at the global level through cross-border capital flows and global trade (World Bank and IMF 2016). For Egypt, investments in developing the skills of its growing working-age population from the first phase of the demographic dividend in more productive industries and selected value-added services and products may lead to comparative advantages in trade, and in the returns earned by labor and capital. 11 Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend 3 Enhancing financial inclusion and entrepreneurship Financial inclusion, particularly for women, is a key enabler for poverty reduction and inclusive growth; and is critical to women’s economic empowerment and the ability to address the livelihood of their families. Financial inclusion and entrepreneurship are proven to be game changers for women, but this is subject to a conducive legal, regulatory, and business enabling environment. In Egypt, many women, especially poor and rural residents, remain outside the formal financial system, mainly due to lack of awareness of service providers and their weaker financial position. Intersecting with the gap in financial inclusion is the low level of entrepreneurship. Women’s full financial inclusion requires intertwined efforts at three levels: micro, focusing on enhan- cing women’s financial literacy and changing their attitudes toward banking; meso—where financial institutions and entities produce gender specific products—encouraging women to utilize these prod- ucts and services; and macro—where the legislative framework ensures non-discrimination in access to credit—changing prevailing social norms to support this shift. 4 Sustaining macroeconomic stability and ensuring policy predictability Early-dividend countries like Egypt need to lay the foundation for the second phase of the demograph- ic dividend, notably through consolidating the country’s public finances and enhancing government fiscal and debt management and transparency. Measures should include resuming fiscal consolida- tion after the COVID-19 pandemic is over, paving the way for the private sector to invest and expand; maintaining a market-determined and competitive exchange rate; and achieving low and stable infla- tion (Alnashar, El-Ashmawy, and Youssef 2020). These measures will help reduce fiscal risks and create the fiscal space to strengthen social protec- tion, reduce inequity, and invest in human capital—all necessary for economic transformation. The effects of successful policies in these areas can be mutually reinforcing, helping create a virtuous circle of sustained growth. The way forward: a time frame Given the scope and complexity of the six proposed policy and strategic priorities, and the four policy imperatives, the following time frame aims to ensure optimal sequencing of implementation; harmoniz- ation and complementarity across priorities; and expectations-setting about the implementation timeline and expected results from each intervention (Table 2). The President’s “Decent Life Initiative” and the “National Project for the “Development of the Egyptian Family” can be used as the platform to implement many of the proposed strategic priorities. In this way, Egypt will be on course to reap its long-delayed demographic dividend. Policy Brief 12 TABLE 2 Proposed time frame for six policy and strategic priorities and four policy imperatives Policy and Immediate Short–Medium Long-Term strategic priority (within 1 year) (1–3 years) (2–5 years) • Meeting unmet need • Expanding FP services in • Integrating FP services in post- the public sector partum care • Reducing contraceptive • Improving the supply chain and discontinuation Increasing the CPR quality of methods • Engaging non-public-sector • Expanding the capacity of the providers MOHP to provide FP services • Expanding the method mix in • Generating demand on FP use the public and private sector • Creating an enabling • Reducing girls’ dropouts Reducing school • Increasing girls’ enrollment, environment to incen- • Prioritizing education on sexual dropouts particularly at secondary level tivize girls’ retention in and reproductive health education • Combating violence against • Addressing the social women and girls norms and values Increasing female • Creating an enabling and • Providing support services that system labor force conducive environment for facilitate female employment • Boosting women’s participation female employment participation in promising • Addressing impediments in the new sectors private sector Delaying age of • Enforcing laws and policies • Improving formal schooling and marriage • Engaging parents and communities education opportunities for girls • Leveraging the TKP pro- Leveraging social • Boosting the “Two is Enough” • Expanding coverage of the TKP gram to address broader protection programs program” program issues (e.g., gender, violence) • Developing a national dash- • Establishing a strong institutional Improving the board for the population framework governance of the program • Developing differentiated subna- population program • Providing legal and regulatory tional implementation plans support Policy imperative Immediate (within 1 year) Short–Medium (1–3 years) Long-Term (2–5 years) Ensuring a broad- based socioeconomic policy • Increasing productivity • Identifying sectors for potential • Reallocating labor toward more within sectors value-added growth productive sectors Creating • Encouraging job • Easing regulations to access loans • Reducing barriers to competition productive jobs creation and formal hir- from commercial banks • Reducing the cost of establish- ing by private firms • Removing female LFPR barriers ing formal enterprises • Reskilling and upskilling the labor • Investing in early child Investing in and force to address the skills mismatch development • Enhancing labor leveraging human • Investing in technical and vocational • Improving learning outcomes market mobility capital education and training • Adopting quality standards in • Promoting healthy lifestyles production and service delivery • Easing regulations to access Enhancing financial • Enhancing women’s financial lit- loans from commercial banks • Ensuring non- inclusion and entre- eracy and changing their attitudes • Encouraging financial institu- discrimination in access preneurship toward banking tions to produce gender-specific to credit products • Improving the investment climate Sustaining macro- • Resuming fiscal consolidation plans for domestic and foreign invest- • Incentivizing domestic economic stability • Maintaining a market-determined ment in higher-value sectors savings and ensuring policy and competitive exchange rate • Enhancing government fiscal and • Facilitating access predictability • Achieving low and stable inflation debt management and transpar- to land ency 13 Policy and Strategic Priorities for Egypt to Reap its Demographic Dividend References Alnashar, Sara, Fatma El-Ashmawy, and Jala Youssef. 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