Publications Summary

Document Type
Analytical Studies
Publication Topic(s)
Family Planning, Fertility and Fertility Preferences
Benin, Botswana, Burkina Faso, Burundi, Cameroon, Chad, Comoros, Cote d'Ivoire, Eritrea, Ethiopia, Gabon, Ghana, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Namibia, Niger, Rwanda, Senegal, South Africa, Sudan, Tanzania, Togo, Uganda, Zambia, Zimbabwe
Recommended Citation
Westoff, Charles F. and Akinrinola Bankole. 2001. The Contraception – Fertility Link in Sub-Saharan Africa and in Other Developing Countries. DHS Analytical Studies No. 4. Calverton, Maryland, USA: ORC Macro.
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Publication Date
June 2001
Publication ID


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The focus of this analysis is to explain why the correlation between contraceptive prevalence and the fertility rate has been so much lower in sub-Saharan Africa than in other parts of the developing world. We have disaggregated the data from 59 DHS surveys into 451regions of these countries—200 from sub-Saharan Africa and 251 from other countries. This approach not only increases the potential for statistical analysis but also increases the social and cultural homogeneity of the populations. The results of the regional analyses are quite consistent with those at the national level; both approaches clearly show a much lower association between the level of contraceptive practice and the total fertility rate in sub-Saharan Africa. A variety of explanations were statistically evaluated. The most important consideration appears to be the fact that the populations in sub-Saharan Africa were clearly at the beginning of their fertility transition and were being compared with Asian and Latin American populations at much more advanced stages of the transition. By comparing the correlation for the same regions that were surveyed more than once, we are able to discern a clear trend in sub-Saharan Africa toward a higher correlation over time. The implication of this trend is that the association will eventually be the same in sub-Saharan Africa as elsewhere.


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