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The effect of contraception on fertility: Is sub-Saharan Africa different?

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  • John Bongaarts

    (Population Council)

Abstract

Background: Cross-sectional analyses of the relationship between contraceptive prevalence and the total fertility rate of developing countries show the expected strong negative correlation. However, this correlation is much weaker in Sub-Saharan Africa than in the developing world as a whole. Objective: This paper aims to explain the unexpected weak effect of contraceptive use on fertility in sub-Sharan African countries by using different regression models to obtain unbiased effects. Methods: Using DHS survey data from 40 developing countries, the analysis consists of three steps: 1) examine the conventional cross-sectional TFR-CPR relationship by region at the time of the latest available surveys, 2) remove known technical flaws in the comparisons of fertility and contraceptive prevalence and 3) analyze multiple observations of TFR and CPR per country using pooled OLS and fixed effect regressions. Results: The conventional cross-sectional analyses produce biased results in part because technical factors, in particular post-partum overlap, create a downward bias in the effect of prevalence on fertility in sub-Saharan Africa. In addition, and more importantly, the cross-sectional regression OLS parameters have a bias due to confounding country fixed effects. Technical adjustments and the use of fixed effect models remove these biases. Conclusions: A rise in contraceptive prevalence among fecund women has the same average effect on fertility in sub-Saharan Africa as in other regions of the developing world. Contribution: This study solves a long-standing demographic puzzle and reassures policymakers and family planning program managers.

Suggested Citation

  • John Bongaarts, 2017. "The effect of contraception on fertility: Is sub-Saharan Africa different?," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 37(6), pages 129-146.
    • Handle: RePEc:dem:demres:v:37:y:2017:i:6
    DOI: 10.4054/DemRes.2017.37.6
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    1. John Bongaarts, 2015. "Modeling the fertility impact of the proximate determinants: Time for a tune-up," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 33(19), pages 535-560.
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    Cited by:

    1. Daphne H. Liu & Adrian E. Raftery, 2020. "How Do Education and Family Planning Accelerate Fertility Decline?," Population and Development Review, The Population Council, Inc., vol. 46(3), pages 409-441, September.
    2. Pedzisai Ndagurwa & Clifford Odimegwu, 2019. "Decomposition of Zimbabwe’s stalled fertility change: a two-sex approach to estimating education and employment effects," Journal of Population Research, Springer, vol. 36(1), pages 35-63, March.
    3. Pascaline Dupas & Seema Jayachandran & Adriana Lleras-Muney & Pauline Rossi, 2024. "The Negligible Effect of Free Contraception on Fertility: Experimental Evidence from Burkina Faso," NBER Working Papers 32427, National Bureau of Economic Research, Inc.
    4. David A. Sánchez-Páez & José Antonio Ortega, 2018. "Adolescent contraceptive use and its effects on fertility," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 38(45), pages 1359-1388.
    5. Bruno D. Schoumaker & David A. Sánchez‐Páez, 2024. "Disruptions in Educational Progress and Fertility Dynamics by Educational Level: Unraveling the Link between Education and Fertility Stalls in Sub‐Saharan Africa," Population and Development Review, The Population Council, Inc., vol. 50(1), pages 59-85, March.

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    More about this item

    Keywords

    fertility; contraceptive use; sub-Saharan Africa; fixed effects; regression;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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