UNconventional: A Point of View
Accelerating Fertility Transition in Sub-Saharan Africa
By Jacques Emina Be-Ofuriyua

Woman and Child figure from the Congo, courtesy of the National Museum of African Art at the Smithsonian Institution, Washington, D.C., USA.

Population generally contributes to economic development. But in the context of poverty and limited resources, high fertility can provoke health, economic and demographic problems, such as infant and child mortality, cases of infanticide, infant and child abandonment, inadequate education and unemployment. In most sub-Saharan countries, despite considerable efforts in the field of reproductive health, fertility remains at high levels (5 children per woman).

The process of fertility transition will probably be achieved over a longer period of time than initially anticipated, by 2010-2025. Nor will fertility decline occur at the same pace throughout. Thirteen countries, among them Burkina Faso, Chad and Guinea, have not begun the fertility transition; 22 are progressing through the incipient stage of transition; and in some countries, such as South Africa, Zimbabwe, Botswana, Kenya and Cape Verde, transition is advanced.

It is imperative to treat the question of fertility as a problem of human and social development and to: improve accessibility of the population to health services and modern contraception by the installation of such services in national territories; improve the effectiveness and efficiency of family-planning services by organizing home visits; explain and motivate the use of contraceptive methods, and provide contraception during prenatal consultations and pre-school consultations of children; involve the political, traditional and religious authorities in public awareness campaigns. In the majority of cases, pro-natalist attitudes are a heritage due to the traditional, religious standards and laws inherited from colonization; fight illiteracy, ignorance and poverty to improve health services and access to modern contraception; revise the laws on abortion to avoid unwanted births. For example, abortion can also be authorized for adolescents pregnancies and frequent pregnancies, with the same conditions (duration of the pregnancy, evidence of social or socio-economic instability).

Early marriage, low contraceptive prevalence (less than 25 per cent) and prohibition of abortion, except to save the life of the pregnant woman, explain this situation. Areas with incidence of early marriage have a high fertility, and those with late marriage have just started the transition. Transition is advanced in regions with high contraceptive prevalence (3 children per woman in southern Africa, with 47 per cent of contra-ceptive), with the exception of some large cities (Accra, Lomé, Yaoundé) where abortion could explain the fertility decline.

From the socio-economic point of view, education of women, health development and urbanization explain the fertility decline and its speed. In fact, education, especially of women, delays marriage and changes reproductive behaviour by providing knowledge about contraceptive use, increasing female participation in family decision-making and improving children’s health. In the same way, child survival affects reproductive behaviour by shortening birth intervals and altering parents’ perceptions about their children’s survival chances.

What should the United Nations and the African Governments do to speed up the decline in fertility in the region? They should lead the population to dissociate sexuality and marriage, because in several countries current fertility is higher than desired-this difference varies between 0.5 and 2 children per woman. In fact, certain researchers think that to reach 2.3 children per woman in eastern, middle and western Africa by the year 2050, and 2.1 children per woman in southern Africa, contraceptive use must encompass at least 70 per cent of the women in each subregion, about 80 per cent in the western subregion, and 90 per cent in the middle subregion. The annual rate of contraceptive prevalence must be about 1.5 per cent, whereas the current annual change is 0.4 per cent for middle and western Africa, and 1.1 per cent for eastern and southern Africa. Data on abortion are scarce because of very restrictive laws.

To conclude, there is no miracle solution for accelerating fertility transition in sub-Saharan Africa. National policies based on human development (education and health) are necessary to speed up the decline of fertility in the region.

Links:
Population and development in the United Nations system

Jacques Emina Be-Ofuriyua, of the Institute of Demography, Catholic University of Louvain, in Belgium, was among the young researchers invited by the United Nations to a workshop on "Prospects for Fertility Decline in High Fertility Countries" held last year.