Demographic Transition in Sub-Saharan Africa

2019 ◽  
pp. 99-114 ◽  
Author(s):  
Sergey Ivanov
Keyword(s):  
Family Planning ◽  
Reproductive Behavior ◽  
Demographic Transition ◽  
Formal Education ◽  
Child Survival ◽  
Sub Saharan Africa ◽  
Scientific Debate ◽  
Fertility Reduction ◽  
Small Family Size ◽  
Sub Saharan

The demographic transition is a global phenomenon but sub-Saharan Africa is several decades late. The quantitative characteristics of the region are well known, but they are insufficient to explain the lags even though sub-Saharan Africa is rightly taken as a synonym of a least developed region. The author revisits – within the African context – the concept of fundamental restructuring of reproductive behavior in response to improvements in child survival. Improved survival makes the outcome of reproductive behavior predictable and therefore makes rational family planning. Family planning assumes the form of insurance and replacement strategies, which have different fertility outcomes. In sub-Saharan Africa the threshold of saturation of child survival beyond which fertility starts to decline appear to be higher than elsewhere. Besides, as fertility does not respond automatically to improved survival, there are no rigid proportions that would have determined fertility outcome of a given decline of child mortality. Instead, there are always universal socioeconomic mechanisms that translate improvements in child survival into fertility reduction and these mechanisms function in tend in culture- or country-specific ways. Education is the main translator: its universal valuation coupled with substantive price tag leads to quantity–quality conflict; the opportunity cost of working time lost to childrearing is higher among better educated women; formal education is the most effective and the most durable instrument of diffusion of the modern way of life, which necessarily includes small family size. African nets of values and mechanisms of their transmission weaken these channels. The demographics of Africa operate with billions, and they are so specific that they often carry cognitive rejection. The demographics are scary; by itself this is a sufficient reason for denial. In addition, there is a longstanding political and intellectual tradition to deny or minimize the differences that separate Africa from other regions. Finally, apart from a narrow circle of scholars who concentrate on the issues of population growth and development, there is an overwhelming alignment with anti-malthusianism which is considered as a presumption rather than outcome of scientific debate. In fact, specific features of population reproduction in Africa, its enormous demographic potential coupled with economic stagnation should move to the forefront of research and quest for appropriate policy responses.

scholarly journals Generating and capitalizing on the demographic dividend potential in sub-Saharan Africa: a conceptual framework from a systematic literature review

2020 ◽  
Vol 4 ◽  
pp. 145
Author(s):  
Carolina Cardona ◽  
Jean Christophe Rusatira ◽  
Xiaomeng Cheng ◽  
Claire Silberg ◽  
Ian Salas ◽  
...  
Keyword(s):  
Labor Market ◽  
Family Planning ◽  
Child Health ◽  
Literature Review ◽  
Demographic Transition ◽  
Sub Saharan Africa ◽  
Demographic Dividend ◽  
African Countries ◽  
Sub Saharan ◽  
And Child Health

Background: Africa will double its population by 2050 and more than half will be below age 25. The continent has a unique opportunity to boost its socioeconomic welfare. This systematic literature review aims to develop a conceptual framework that identifies policies and programs that have provided a favorable environment for generating and harnessing a demographic dividend. This framework can facilitate sub-Saharan African countries’ understanding of needed actions to accelerate their demographic transition and capitalize on their demographic dividend potential. Methods: The search strategy was structured around three concepts: economic development, fertility, and sub-Saharan Africa. Databases used included PubMed and EconLit. An inductive approach was employed to expand the reference base further. Data were extracted using literature records following a checklist of items to include when reporting a systematic review suggested in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Results: The final review consisted of 78 peer-reviewed articles, ten reports from the gray literature, and one book. Data were categorized according to relevant demographic dividend typology: pre-dividend and early-dividend. The results from the literature review were synthesized into a framework consisting of five sectors for pre-dividend countries, namely 1) Governance and Economic Institutions, 2) Family Planning, 3) Maternal and Child Health, 4) Education, and 5) Women's Empowerment. An additional sector, 6) Labor Market, is added for early-dividend countries. These sectors must work together to attain a demographic dividend. Conclusions: A country's demographic transition stage must guide policy and programs. Most sub-Saharan African countries have prioritized job creation and employment for youth, yet their efforts to secure a productive labor market require preliminary and complementary investments in governance, family planning, maternal and child health, education, and women’s empowerment. Creating a favorable policy environment for generating and capitalizing on a demographic dividend can support their stated goals for development.

scholarly journals Promoting Scale-Up Across a Global Project Platform: Lessons from the Evidence to Action Project

2021 ◽  
Author(s):  
Laura Ghiron ◽  
Eric Ramirez-Ferrero ◽  
Rita Badiani ◽  
Regina Benevides ◽  
Alexis Ntabona ◽  
...  
Keyword(s):  
Family Planning ◽  
Scale Up ◽  
Scaling Up ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Country Level ◽  
Look Ahead ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Multi Stakeholder

AbstractThe USAID-funded flagship family planning service delivery project named Evidence to Action (E2A) worked from 2011 to 2021 to improve family planning and reproductive health for women and girls across seventeen nations in sub-Saharan Africa using a “scaling-up mindset.” The paper discusses three key lessons emerging from the project’s experience with applying ExpandNet’s systematic approach to scale up. The methodology uses ExpandNet/WHO’s scaling-up framework and guidance tools to design and implement pilot or demonstration projects in ways that look ahead to their future scale-up; develop a scaling-up strategy with local stakeholders; and then strategically manage the scaling-up process. The paper describes how a scaling-up mindset was engendered, first within the project’s technical team in Washington and then how they subsequently sought to build capacity at the country level to support scale-up work throughout E2A’s portfolio of activities. The project worked with local multi-stakeholder resource teams, often led by government officials, to equip them to lead the scale-up of family planning and health system strengthening interventions. Examples from project experience in the Democratic Republic of the Congo, Kenya, Nigeria, and Uganda illustrating key concepts are discussed. E2A also established a community of practice on systematic approaches to scale up as a platform for sharing learning across a variety of technical agencies engaged in scale-up work and to create learning opportunities for interacting with thought leaders around critical scale-up issues.

scholarly journals The impact of antenatal care on under‐five mortality in Ethiopia: a difference‐in‐differences analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samuel Oduse ◽  
Temesgen Zewotir ◽  
Delia North
Keyword(s):  
Antenatal Care ◽  
Child Survival ◽  
First Trimester ◽  
Sub Saharan Africa ◽  
P Value ◽  
Difference In Differences ◽  
Under Five ◽  
Care Services ◽  
Sub Saharan ◽  
The Impact

Abstract Background Sub-Saharan Africa, as opposed to other regions, has the highest under-five mortality rates yet makes the least improvement in reducing under-five mortality. Despite the decline, Ethiopia is among the top ten countries contributing the most to global under-five mortalities. This article examines the impact of the number of antenatal care and the timing of first antenatal care on child health outcomes. We specifically investigated if the utilization of antenatal care services positively affects the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14–49 who had antenatal care visits at different times before delivery. Results The study revealed 1 481 cases of reported under-five mortality. 99.0% of that under-five mortality cases are women who had less than eight antenatal care visits, while only 1% of that is by women who had eight or more antenatal care visits. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 45.2% (CI = 19.2–71.3%, P-value < 0.001) while the timing of first antenatal care within the first trimester decreases the likelihood of under-five mortality by 10% (CI = 5.7–15.6%, P-value < 0.001). Conclusions To achieve a significant reduction in the under-five mortality rate, Intervention programs that encourages more antenatal care visits should be considered. This will improve child survival and help in attaining Sustainable Development Goal targets.

scholarly journals Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Martin K. Mutua ◽  
Yohannes D. Wado ◽  
Monica Malata ◽  
Caroline W. Kabiru ◽  
Elsie Akwara ◽  
...  
Keyword(s):  
Family Planning ◽  
West Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Rate Of Change ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sexually Active ◽  
Sub Saharan ◽  
Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

Focus Group Methods for Formative Research in Child Survival: An Ivoirian Example

1988 ◽  
Vol 8 (4) ◽  
pp. 297-316 ◽  
Author(s):  
Deborah Glik ◽  
Andrew Gordon ◽  
William Ward ◽  
Kale Kouame ◽  
Mahbi Guessan
Keyword(s):  
Focus Group ◽  
Program Planning ◽  
Child Survival ◽  
Sub Saharan Africa ◽  
Focus Group Interviews ◽  
Education Planning ◽  
Group Methods ◽  
Interview Methods ◽  
Sub Saharan ◽  
Group Interviews

The study reported here represents the ongoing development of focus group interview methods in support of health education planning for child survival programs in the CCCD project in Sub-Saharan Africa. Using illustrative examples from a field experience in Cote d'Ivoire, methods that enhance the usefulness and validity of focus group interviews for health program planning are discussed.

The changing value of children among the Kikuyu of Central Province, Kenya

Africa ◽  
1996 ◽  
Vol 66 (3) ◽  
pp. 411-436 ◽  
Author(s):  
Neil Price
Keyword(s):  
Family Planning ◽  
Social Institutions ◽  
Sub Saharan Africa ◽  
High Fertility ◽  
Central Province ◽  
Economic Insecurity ◽  
Family Planning Services ◽  
Value Of Children ◽  
Sub Saharan ◽  
Demand For Children

Within demography, high fertility in sub-Saharan Africa was considered until recently to reflect a demand for children firmly rooted in indigenous social institutions, which were resistant to external forces of change. On the basis of findings from recent Demographic and Health Surveys, Caldwell et al. (1992) suggest that many of the institutional supports for high fertility in sub-Saharan Africa—such as lineage-based descent systems, polygyny, bridewealth, extended kinship structures, child fostering, and communal land tenure—are being eroded. This article considers changes in the value of children among the Kikuyu of Central Province, Kenya, and the extent to which the social institutions which have traditionally supported high fertility have persisted. Fieldwork undertaken in two ethnically homogenous communities, one rural and one peri-urban, reveals significant variation in the fertility motives and value of children in the two communities. In the rural community many of the indigenous social supports for high fertility, although modified, cohere. In the context of economic insecurity and lack of access to land (especially for women without sons), manipulation of customary kinship and marriage practices (supported by the persistence of many indigenous religious beliefs and ideologies about fertility) has become strategically important for realising fertility desires. There is, however, unmet demand for modern contraception, due largely to lack of access to and the poor quality of family planning services. In contrast, in the peri-urban community, where access to family planning services is relatively good, there has been effective legitimation of fertility regulation and the use of modern contraception is widespread. There is markedly less economic insecurity: wage labour opportunities are available, and some women have successfully challenged male control over land. Consequently, there is reduced demand for children, although a number of the indigenous cultural supports for high : fertility retain residual importance.

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