The proximate determinants of fertility in tropical Africa: demographic and institutional change.

Acknowledging uneven estimate quality of the total fertility rate in sub-Saharan Africa this study examines trends in the levels of fertility and components of the proximate determinants including: lactation and lactational amenorrhea postpartum abstinence sterility and contraceptive use age at first marriage for both sexes husband-wife age differences polygyny widowhood divorce remarriage child fostering and nuptiality. Most recent available census and survey data from 57 regions over 16 countries showed no sign of fertility decline. In 11 cases an increase of at least 1 live birth was recorded compared to earlier studies. Record population growth rates equal to and greater than 3.5% in parts of Eastern and Southern Africa were tied to reduced child spacing. Low levels of polygyny lack of large age gaps between spouses and comparatively short postpartum abstinence are also more typical of these regions than in West African countries. Links between female literacy and contraceptive use and age at first marriage for women were identified. Policy recommendations include female education to increase contraceptive use and delayed marriage. Womens organizations and other existing communal networks should be employed to deliver primary health care and contraception.