The role of the proximate determinants and ideal family size on fertility stalls in capital cities of sub-Saharan Africa

Background: Fertility in sub-Saharan Africa has stalled since the early 2000s. Studies to determine when and where the stalls are have mainly focused at the national level. Little is known about fertility stagnations in the capital cities and the reasons behind them. Data and methods: We use 116 DHS surveys from 30 sub-Saharan countries. Focusing only on the capital cities, we aim to find associations between fertility stalls periods and the proximate determinants of fertility and ideal family size. We propose scenarios to simulate the potential effect of changes in the determinants of fertility. Results: The proximate determinants of fertility and ideal family size are highly correlated with periods of fertility stalls. On average, increases of 10% in sexual exposure or contraception indexes would lead to the rise of TFR in 0.40 and 0.44, respectively. The same increase in postpartum insusceptibility would add 0.26 to TFR. One child more in the desired family size would increase TFR in 0.24. Discussion: Sexual activity is positively correlated to fertility stalls. Also, meeting contraceptive needs would have helped to avoid periods of fertility stagnation or, at least, to reduce their intensity. Moreover, the decreased length of postpartum insusceptibility has contributed to plateauing. There is a correlation between the invariance of the ideal family size over time and periods of non-decreasing fertility