Linking Fertility Preferences and Unintended Birth Outcomes to Fertility Stalls in Sub-Saharan Africa

Although fertility in sub-Saharan Africa has decreased since the 1980s, it remains at high levels mainly due to the desire for large families, low levels of contraceptive use, and high unmet need for family planning. Even more, since the early 2000s slowdowns, halts and reversals in fertility decline have been observed in many countries. Our goal is to analyze whether fertility preferences and unmet need for contraceptives have contributed to the reversals and halts in fertility decline, specifically in those countries where strong evidence of fertility stalls has been found. We use information on 110,173 births from 27 DHS surveys collected in Cameroon, Congo, Kenya, Namibia, Zambia and Zimbabwe. We compare changes in fertility rates with trends in unmet need for family planning and contraceptive failure. We also decompose total fertility rates and age-specific fertility rates by fertility planning status, i.e., planned, mistimed, and unwanted. Finally, we propose some scenarios on unmet need levels to estimate fertility rates and examine whether any changes may have altered fertility trends and thus reversed the periods of stalled fertility. Our findings suggest that, since demand for children remains at high levels, fertility plateaus are mainly driven by wanted fertility, especially planned fertility. Reductions in unmet need for family planning could lead to lower fertility levels and, under certain circumstances, it is possible to prevent the emergence of fertility stalls. The scenarios show that not only access to contraceptives is important, but also their correct use