1. Male dominance – father decides how large family will be Poverty – parents see children as an asset – free labour, insurance for old age. Government policy - tax incentives to boost the birth rate as the population is ageing / declining e.g. Russia INCREAS E Religion – may discourage use of contraception FACTORS AFFECTING BIRTH RATEStage 2 Stage 3 Stage 4 Stage 5 If family planning advice available. DECREASE Government policy e.g. One child policy in China from 1979 Affluence – children seen as a ‘financial burden’ – a long term cost reducing access to luxuries Confidence – child will survive - good medical services Education of women - understands health issues, has a career, delayed marriage, plans family

2. Countries with an ageing population tend to have rising death rates - as you get older you are more likely to die. The UK (10/1000) has a higher death rate than India (8/1000). Famine, plagues, disease wars. INCREAS E Lack of clean water / bad sanitation Poor nutrition Malaria and HIV – malaria 1 million deaths a year in Africa. FACTORS AFFECTING DEATH RATEStage 2 Stage 3 Stage 4 Stage 5 DECREASE Access to primary health care – immunisation (e.g. Polio) and education, access to treatment – even in rural areas .