Advancing Sexual and Reproductive Health and Rights
 
International Family Planning Perspectives
Volume 34, Number 3, September 2008
DIGEST

Fertility Declines Have Stalled in Many Countries in Sub-Saharan Africa

During the past four decades, the total fertility rate (TFR) in the developing world has fallen by about half, from around six births per woman to about three. However, a new analysis suggests that in much of Sub-Saharan Africa, the transition from high to low fertility has stalled.1 In two-thirds of countries in the region, there was no meaningful change in the TFR during the interval between the two most recent Demographic and Health Surveys. In contrast, fertility has continued to decline in Latin America, Asia and North Africa.

The study used data from 40 developing countries for which multiple Demographic and Health Surveys have been conducted since 1991. The key measures of interest were the TFR in the three years before a given survey, and the absolute rate of fertility decline per year between surveys. On average, the most recent survey for the 40 countries (22 in Sub-Saharan Africa, 11 in Asia and North Africa and seven in Latin America) was conducted in 2003, and the previous survey in 1997. For 29 of the countries, data from three surveys were available; on average, these surveys were conducted in 1992, 1998 and 2004. The former Soviet republics were omitted from the study because of their "unique demographic and political history," and Eritrea because the results of its 1999 survey were affected by the country's war with Ethiopia. In addition, surveys conducted in 1999 in the Dominican Republic and Nigeria were omitted because of a small sample size and underreporting of events, respectively; however, surveys conducted in other years were used for those countries.

In countries with three surveys, the TFR in Sub-Saharan Africa was 2.0–2.5 births per woman higher throughout the study period than it was in Latin America or in Asia/North Africa. Fertility declined in all three regions, both between the first and second surveys and between the second and third surveys. However, the rate of decrease slowed considerably in Sub-Saharan Africa, from 0.07 births per woman per year during the first intersurvey interval to 0.02 during the second interval. In six of the 16 countries in Sub-Saharan Africa, fertility actually increased during the second interval. In contrast, the rate of decline in the TFR was fairly steady in Latin America (0.08 during the first interval and 0.07 during the second) and in Asia and North Africa (0.08 and 0.010, respectively), and no individual country in these regions showed an increase in fertility during the second interval. Overall, in 17 of the 29 countries, the decline in the TFR achieved during the first interval either slowed or reversed during the second interval.

Another analysis, which used the entire sample of 40 countries, examined whether there had been a statistically significant decline in fertility between the most recent two surveys. In Sub-Saharan Africa, only seven of the 22 countries (32%) showed such a decline. In contrast, nearly all of the countries in the other two regions had declines in fertility—10 of 11 in Asia and North Africa, and six of seven in Latin America.

Almost all of the 40 countries could be considered to be in transition from high fertility to low (replacement level) fertility; the exceptions were Vietnam—where the fertility rate (1.9) has fallen below replacement level—and Chad, Guinea and Mali, where contraceptive use is so low (<10%) that they have not yet begun the fertility transition. Of the remaining 36 countries, 14 (39%) did not show a statistically significant decline in fertility between the last two surveys, indicating a stall in the fertility transition. Twelve of the countries with stalls were in Sub-Saharan Africa. Although such stalls are uncommon, they need not be permanent: Nine of the countries with three surveys had such stalls during the first intersurvey interval, and all but one had a decline during the subsequent interval.

The researcher posits that several factors may have played a role in the recent fertility stalls in Sub-Saharan Africa. For example, fertility tends to decrease when countries experience economic growth and declining mortality; in Sub-Saharan Africa, however, the economy stopped growing during most of the 1990s, while mortality increased because of the AIDS epidemic. Moreover, in many African countries, funding and promotion of family planning programs have declined in the past decade. "If the recent slow pace of fertility transition persists," the researcher notes, "this trend will likely have adverse effects on the region's prospects for social and economic development, food security, and the sustainability of natural resources."—P. Doskoch

REFERENCE

1. Bongaarts J, Fertility transitions in developing countries: progress or stagnation, Studies in Family Planning, 2008, 39(2):105–110.