Unmet Need and Fertility Decline: A Comparative Perspective on Prospects in Sub-Saharan Africa

Unmet need for family planning refers to a situation where women want to delay the birth of their next child or to stop childbearing altogether, but are not using any method of contraception. It is important because reducing unmet need reduces the risk of unintended and unwanted pregnancies and births. Reducing unmet need, has greatly contributed to current declines in fertility. However, sub-Saharan Africa is the only major region where fertility is still substantially high in almost every country. High fertility rates jeopardize maternal survival. Multiple pregnancies place a woman at risk multiple times. Furthermore, high fertility rates place increased pressure on weak health systems.This article provides a comparative and historical analysis of the association between unmet need for family planning and fertility across four regions: Asia, Africa, and Latin America and the Caribbean. It is a part of a special series on Unmet Need for Family Planning published in the Population Council’s journal Studies in Family Planning.The analysis was based on data from four types of surveys from 1974 to present: Demographic and Health Surveys (DHSs), World Fertility Surveys (WFSs), the Reproductive Health Surveys (RHSs) and the Pan-Arab Surveys (PAP). Key findings included:

• Fertility is closely linked to unmet need for family planning in Latin America and the Caribbean, Asia and North Africa. This means that in these regions, as unmet need for family planning decreases, so does fertility.
• In sub-Saharan Africa, the picture is very different. Fertility does not seem to be closely related to unmet need.

The article proposes two possible explanations for these regional differences:1)      Problems in the measurement of data collected from the surveys in sub-Saharan Africa.2)      Different characteristics of fertility decline in sub-Saharan Africa compared to other regions, particularly the different conditions in the sub-Saharan Africa region at the start of the fertility decline such as the desire for large family sizes.To read the article, click here. To read other articles in the series, click here.Casterline, J. B., & El-Zeini, L. O. (2014). Unmet need and fertility decline: A comparative perspective on prospects in sub-Saharan Africa. Studies in Family Planning, 45(2), 227–245.