Contraceptive Use as a Determinant of Fertility Decline: Why Is Sub-Saharan Africa Different?

Aisha Dasgupta, UK Foreign Commonwealth and Development Office
Vladimira Kantorova, United Nations

Using the latest datasets published by the United Nations Population Division, in this paper we provide insights into the role of contraceptive use on fertility. We first present a global perspective of trends in fertility and contraceptive use, then draw on case studies within sub-Saharan Africa to examine how the relationship between contraception and fertility is mediated by other factors. Although there is an inverse relationship between contraceptive use and the total fertility rate, at every level of contraceptive use countries in Africa tend to have higher fertility compared to other regions. The other mediating factors include method-mix efficacy, abortion, inconsistent use of contraception, contraception for spacing versus limiting, sexual activity among married and unmarried, and proportions of women that are married. Attention is drawn to Malawi, Ghana, Namibia, and Burkina Faso.