Fertility Stalls in sub-Saharan Africa: Where, Who, Why?

Fertility transition in sub-Saharan Africa has been different than in other low- and middle-income countries. Slowdowns, halts and reversals in fertility decline have been observed over the last 20 years. So far, studies have focused on fertility trends at the national level and the potential causes remain unclear. We use more than 130 Demographic and Health Surveys from 33 sub-Saharan African countries to examine fertility trends at the subnational level and to identify the potential causes that have led to fertility plateaus. We reconstruct fertility trends from the 1980s by pooling birth histories. Then, we smooth the trends using restricted cubic splines and use decomposition methods to analyze if changes in fertility trends are due to changes in fertility by place of residence or to changes in population composition. Stylized models of fertility transition predict that fertility decline occurs first in urban areas and then diffuses to rural areas. Likewise, theory shows that as the transition progresses, the demand for children decreases due to higher levels of education and welfare. However, on the one hand, our results show that fertility is stalled mainly in capital cities in sub-Saharan Africa at rates well above replacement level. On the other hand, our results show that stalled fertility among the most educated women and of wanted fertility, as the demand for children remains at high levels, explain fertility stalls at the national level. Finally, we found a clear correlation between the countries most affected by the HIV pandemic and fertility stalls.