Volume 37 - Article 6 | Pages 129–146 Editor's Choice

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

By John Bongaarts

Print this page  Facebook  Twitter


Date received:06 May 2017
Date published:18 Jul 2017
Word count:4065
Keywords:contraceptive use, fertility, fixed effects, regression, sub-Saharan Africa


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.

Author's Affiliation

John Bongaarts - Population Council, International [Email]

Other articles by the same author/authors in Demographic Research

» Extramarital fertility in low- and middle-income countries
Volume 47 - Article 3

» Modeling the fertility impact of the proximate determinants: Time for a tune-up
Volume 33 - Article 19

» Five period measures of longevity
Volume 13 - Article 21

Most recent similar articles in Demographic Research

» What has high fertility got to do with the low birth weight problem in Africa?
Volume 28 - Article 25    | Keywords: fertility, fixed effects, regression, sub-Saharan Africa

» Contraceptive use and fertility transitions: The distinctive experience of sub-Saharan Africa
Volume 46 - Article 4    | Keywords: contraceptive use, fertility, sub-Saharan Africa

» Further evidence of community education effects on fertility in sub-Saharan Africa
Volume 27 - Article 22    | Keywords: fertility, fixed effects, sub-Saharan Africa

» Fertility among better-off women in sub-Saharan Africa: Nearing late transition levels across the region
Volume 46 - Article 29    | Keywords: fertility, sub-Saharan Africa

» Accuracy of wives' proxy reports of husbands' fertility preferences in sub-Saharan Africa
Volume 46 - Article 17    | Keywords: fertility, sub-Saharan Africa


»Volume 37





Similar Articles



Jump to Article

Volume Page
Volume Article ID