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Sub-Saharan Africa: The Challenge of High Fertility

Sub-Saharan Africa: The Challenge of High Fertility. John F. May Lead Population Specialist Africa Region, World Bank Washington, DC, July 16, 2008. Key demographic features. SSA annual rate of growth: 2.5% (it could even accelerate if mortality declines faster)

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Sub-Saharan Africa: The Challenge of High Fertility

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  1. Sub-Saharan Africa:The Challenge of High Fertility John F. MayLead Population Specialist Africa Region, World Bank Washington, DC, July 16, 2008

  2. Key demographic features • SSA annual rate of growth: 2.5% (it could even accelerate if mortality declines faster) • Total population could reach 1.8bn people by 2050 - from 800 million today - if fertility declines rapidly • TFR is above 5 today and needs to decrease to 2.5 in 2050 to match these projections • HIV/AIDS will not fundamentally change the demographic equation (except in Southern Africa) • 2 out of 3 people are under 25 (youth bulge)

  3. Rationale for intervention • Health rationale as highlighted in “Fertility Regulation Behaviors and Their Costs” • Reduce population pressure on land tenure and ecosystems • Human capital investments (e.g., education and health) and fiscal space

  4. Modifying the age structure (1)

  5. Modifying the age structure (2)

  6. Modifying the age structure (3) • Three key messages: • The bottom of the population pyramid needs to take a rectangular shape to facilitate the formation of human capital • Such a process will require the acceleration of the fertility transition • Fertility will need to drop to low levels to change the shape of the population pyramid

  7. Changing attitudes in SSA • Women do want services (large unmet needs) • Politicians, traditional & religious leaders, and civil society are more open to discuss Pop/RH issues However • Need for more proactive policies • Scarcity of real champions • Weakness of M&E framework

  8. What can be done? A few key interventions vs. scattered programs: • Stronger and more persistent advocacy • More consistent provision of family planning and reproductive health services • Breastfeeding programs • Contraceptive security plans • Female education and legal reform (e.g., age at marriage) • More involvement of men

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