Fertility transition in subnational areas of sub-Saharan Africa: Where do they stand and what has contributed most to the transition?

Abstract

Stylized models of fertility transition predict that fertility declines first in urban areas and then in rural areas. Although capital cities are assumed to be at the forefront of a country's fertility transition, they have not been widely studied in sub-Saharan Africa. In addition, fertility transition in other urban and rural areas has also been understudied. Using 148 Demographic and Health Surveys, we first calculate fertility rates to determine at which stage each of the three subnational areas in 33 countries is in the fertility transition. We then estimate the fertility-inhibiting effect of the proximate determinants of fertility to analyze what has contributed most to the transition. Our results confirm that capital cities lead fertility transition, as they tend to be one phase further in the transition than other urban areas and two phases further than rural areas. We find that the subnational areas that have made the most rapid progress in the transition are those with a sharp increase in the fertility-inhibiting effect of contraception; however, contraceptive use remains low. Although the inhibiting effect of contraception increases as the fertility transition progresses, the greatest inhibiting effect is that of postpartum infecundability, which is a common feature for virtually all subnational areas, even at the most advanced stages of the transition. In the context of stalled fertility in sub-Saharan Africa, reducing the duration of postpartum infecundability without offsetting it with an increase in contraceptive use leaves open the possibility of further fertility stalls or longer-lasting current stalls.