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February 8, 2019

The Promise of a Fertility Transition in Sub-Saharan Africa

By Sara Rotenberg

The  United Nations Population Division estimates that the population of sub-Saharan Africa will quadruple by the end of the century. That is, the population will go from its mid-2018 level of 1.05 billion people to 4 billion people by 2100. While this estimate is contingent on the pace of the decrease of high fertility levels, this type of rapid population growth raises concerns about how countries might prepare and address the long-lasting and economic impacts of the rising demographic pressure. For example, with a population of 196 million people and a total fertility rate of 5.5 children per woman, Nigeria will more than double its population by mid-2050, according to the Population Reference Bureau, making it the third largest country in the world, after India and China.

While rapid population growth is a new challenge for policymakers in sub-Saharan Africa, other countries in South East Asia utilized proactive policies to mitigate rapid population growth in the 1970s. For example, the governments of Indonesia, Thailand, and Singapore are among others who sought to mitigate the population growth by disincentivizing large families. This resulted in a sharp fertility decline and changed the age structure, with more economically active adults and less young dependents. Eventually, these countries were able to capture a “demographic dividend”—an economic surplus triggered by the more favorable age structure of the population. Singapore, for instance, was able to invest this economic surplus into its development, which has helped it become the country it is today. However, this rapid fertility reduction also has its challenges. Today, Singapore struggles with one of the lowest fertility rates in the world and, consequently, a rapidly aging population.

This highlights the wide-reaching and long-lasting impacts of population growth, and the need for significant policy oversight and planning. While countries in Southeast Asia were able to mitigate rapid population growth and capture a demographic dividend because of strong policies that caused a rapid fertility decline, there are unique circumstances surrounding the fertility transition in sub-Saharan Africa. First, fertility rates have already started to fall in the region, but they have not declined rapidly enough to open the demographic window of opportunity needed to capture a demographic dividend. Furthermore, human rights policies and the acceptance of top-down approaches to family planning have changed since the period of rapid population growth in Southeast Asia, meaning that there is now an opportunity to implement novel, rights-based population policies to decrease high fertility levels and capture a demographic dividend. These types of population policies will have to target a wide range of issues, such as family planning; legal reform to increase the legal age of marriage; enhanced female education; and universal health coverage.

While these policies are promising to boost economic development, and promote sustainable population growth, gathering political support to implement these policies will be a challenge. It will require strong foresight and political commitment from policymakers, who must recognize that the benefits of these policies will not be immediate, but likely reaped over several decades. This reluctance, along with considerations of cultural, religious, and political acceptability of these policies make these policy levers hard to implement. Therefore, the promise of a fertility transition in sub-Saharan Africa is possible but would require significant commitment from policymakers to develop an acceptable rights-based approach to population policy.

Sara Rotenberg (NHS'20) is an undergraduate studying global health and health policy and a student fellow with the Global Health Initiative.