Scholarlink

Background <p>Sub-Saharan Africa’s fertility transition has lagged behind other regions despite rapid urbanization. While most fertility studies in the region examined national trends, research on major urban areas remains limited. This study examines fertility transition patterns and the contribution of proximate determinants to fertility variations across major urban centers in Sub-Saharan Africa.</p> Methods <p>This analysis used Demographic and Health Survey (DHS) data from 19 cities with populations over 1&#xa0;million, classifying cities based on the Total Fertility Rate (TFR) into four fertility transition stages: post-transition (TFR &lt; 2.1), late-transition (TFR 2.1–2.99), lower mid-transition (TFR 3.0–3.99), and upper mid-transition (TFR 4.0-4.99). The Bongaarts’ proximate determinants model was used to assess how marriage, contraception, postpartum infecundability (PPI), and abortion influence fertility variations across transition stages, with decomposition analysis measuring their respective contributions to TFR differences.</p> Results <p>TFR varied widely, from 1.8 in Addis Ababa, below replacement level, to 4.8 in Bamako, the highest observed. Marriage rates are lowest in post-transition cities (34.3%) compared to 52–56% in the other stages. Contraceptive use is highest in post-transition at 50.1% and lower at 45.2%, 38.4%, and 21.3% in late-transition, lower mid-transition, and upper mid-transition cities, respectively. Marriage rates accounted for the largest portion of the TFR difference between post-transition and late-transition cities (38%), while contraceptive use explained only 2.8% of this gap. Together, marriage and contraceptive use account for 45–60% of the TFR difference between post-transition cities and those in the lower mid- and upper mid-transition stages. Between late-transition and lower/upper mid-transition cities, contraceptive use explains up to 32% of the TFR difference. Abortion has minimal influence, while PPI slightly offsets fertility differences across the transition groups.</p> Conclusion <p>Sub-Saharan African cities exhibit diverse fertility transitions with most in mid- or late-transition stages. Contraceptive use drives early fertility declines while marriage patterns sustain lower fertility in advanced stages, revealing how family planning services and evolving marital norms jointly shape the cities’ fertility transition. Accelerating fertility transitions in the cities require strengthening comprehensive family planning services with diverse contraceptive choices and developing targeted programs to shift social norms around marriage timing.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Fertility transition across major Sub-Saharan African cities: the role of proximate determinants

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月13日

查看全文
  • Yared Mekonnen,
  • Daniel Telake

摘要

Background

Sub-Saharan Africa’s fertility transition has lagged behind other regions despite rapid urbanization. While most fertility studies in the region examined national trends, research on major urban areas remains limited. This study examines fertility transition patterns and the contribution of proximate determinants to fertility variations across major urban centers in Sub-Saharan Africa.

Methods

This analysis used Demographic and Health Survey (DHS) data from 19 cities with populations over 1 million, classifying cities based on the Total Fertility Rate (TFR) into four fertility transition stages: post-transition (TFR < 2.1), late-transition (TFR 2.1–2.99), lower mid-transition (TFR 3.0–3.99), and upper mid-transition (TFR 4.0-4.99). The Bongaarts’ proximate determinants model was used to assess how marriage, contraception, postpartum infecundability (PPI), and abortion influence fertility variations across transition stages, with decomposition analysis measuring their respective contributions to TFR differences.

Results

TFR varied widely, from 1.8 in Addis Ababa, below replacement level, to 4.8 in Bamako, the highest observed. Marriage rates are lowest in post-transition cities (34.3%) compared to 52–56% in the other stages. Contraceptive use is highest in post-transition at 50.1% and lower at 45.2%, 38.4%, and 21.3% in late-transition, lower mid-transition, and upper mid-transition cities, respectively. Marriage rates accounted for the largest portion of the TFR difference between post-transition and late-transition cities (38%), while contraceptive use explained only 2.8% of this gap. Together, marriage and contraceptive use account for 45–60% of the TFR difference between post-transition cities and those in the lower mid- and upper mid-transition stages. Between late-transition and lower/upper mid-transition cities, contraceptive use explains up to 32% of the TFR difference. Abortion has minimal influence, while PPI slightly offsets fertility differences across the transition groups.

Conclusion

Sub-Saharan African cities exhibit diverse fertility transitions with most in mid- or late-transition stages. Contraceptive use drives early fertility declines while marriage patterns sustain lower fertility in advanced stages, revealing how family planning services and evolving marital norms jointly shape the cities’ fertility transition. Accelerating fertility transitions in the cities require strengthening comprehensive family planning services with diverse contraceptive choices and developing targeted programs to shift social norms around marriage timing.