The Relative Influence of Contraception, Abortion, and Postpartum Infecundability on Fertility Trends in 22 Sub-Saharan African Countries: 1986 and 2007

Amy Tsui, Johns Hopkins University
Supriya Madhavan, Johns Hopkins University
Ye-Mon Myint, Johns Hopkins University

We assess the relative influence of key proximate determinants of fertility using both the Bongaarts and Stover frameworks and data from 22 sub-Saharan African countries with at least two rounds of DHSs between 1986 and 2007. To calculate the different index values, we compile age-specific fertility, proportions sexually active, contraceptive use, duration of breastfeeding, proportion infecund, neonatal mortality and proportion childless from 67 surveys. The two proximate determinants suppressing potential fertility the most are postpartum infecundability and contraception. In 11 countries, abortion's influence appears to increase and contraception's to decrease, whether estimated by the Bongaarts or Stover model. Postpartum infecundability's influence persists over time in all countries, due to prolonged breastfeeding but possibly also due to continued practice of postpartum abstinence combined with discreet contraceptive injectable use. The time-varying influences of the proximate determinants suggest slow but steady fertility transitions from these joint contributions, particularly in the post-partum context.