Fertility levels, trends, and differentials in sub-Saharan Africa in the 1980s and 1990s

Stud Fam Plann. 1998 Mar;29(1):1-22.

Abstract

This study presents an assessment of fertility trends in 23 countries of sub-Saharan Africa. It examines trends and differentials in proximate determinants and fertility preferences. Findings from the Demographic and Health Surveys for these countries over a period of 15 years show that desired family size has decreased significantly. Two-thirds of the countries examined show evidence of fertility decline, a particularly rapid decline in the cases of Kenya and Zimbabwe. Areas with higher education for women and lower child mortality experienced larger reductions in fertility and desired family size. Contraceptive use far exceeds other proximate determinants in explaining these changes. The striking regularity in fertility reduction across all ages indicates that contraception is practiced mostly for birth spacing and that contraceptive methods have gained wide acceptance among younger cohorts. Good prospects are seen for further intensification of fertility declines in East Africa and urban West Africa. However, low levels of education and high child mortality make rapid changes unlikely in rural West Africa.

PIP: This study examined fertility decline and its determinants in 23 countries in sub-Saharan Africa. Demographic and Health Surveys (DHS) during 1986-95, provided the data for analysis. A map of total fertility rates (TFR) showed a clear pattern of lower fertility in southern Africa, and transitional fertility in East Africa, especially Kenya and Rwanda. Fertility decline is less dramatic in West Africa. Central Africa has surprisingly low fertility. Fertility decline is confined to 3 groups according to the TFR data. Group A countries have a relatively advanced fertility transition and include Botswana, Ghana, Kenya, Namibia, and Zimbabwe. Group B countries include Cameroon, Cote d'Ivoire, Madagascar, Nigeria, Rwanda, Senegal, Tanzania, Togo, and Zambia. Group C countries, with the least decline, include Burkina Faso, Burundi, Liberia, Malawi, Mali, Niger, and Uganda. Age specific fertility did not vary much by group. Differences between the 3 groups were greatest at ages 40-44 years. Bongaarts model indicates that contraceptive use was the strongest determinant of fertility decline for all ages and between countries. Fertility differed between Groups A and C by 27%, between A and B by 17%, and between B and C by 13%. Contraceptive use varied by type of method and the strength of the family planning program. Age at marriage increased as fertility transition advanced. Postpartum factors were important explanatory factors for birth intervals. Education factors affected fertility preferences, contraceptive use, age at first marriage, postpartum amenorrhea and abstinence, and child survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara / epidemiology
  • Birth Rate / trends*
  • Developing Countries*
  • Family Characteristics
  • Family Planning Services / trends
  • Female
  • Fertility*
  • Forecasting
  • Humans
  • Infant, Newborn
  • Middle Aged
  • Population Control*
  • Pregnancy
  • Socioeconomic Factors