Traditional supports and contemporary disrupters of high fertility desires in sub-Saharan Africa: a scoping review

Abstract

Rationale The desired number of children is markedly higher in Sub-Saharan Africa (SSA) than in other major regions. Efforts to understand how and why these desires are generated and maintained have yielded a broad research literature. Yet there is no full picture of the range of contextual, cultural, and economic factors that support and disrupt high fertility desires. Objective This scoping review synthesizes thirty years of research on the determinants of fertility desires in SSA to better understand what factors underlie men and women’s stated fertility desires and how they weigh the costs and benefits of having (more) children. Method We identified and screened 9863 studies published from 1990 to 2021 from 18 social science, demographic, and health databases. We appraised determinants of fertility desires from 258 studies that met inclusion criteria according to their roles as traditional supports or contemporary disrupters of high fertility desires. Results We identified 31 determinants of high fertility desires, which we organized into six overarching themes: economy and costs; marriage; the influence of others; education and status; health and mortality; and demographic predictors. For each theme, we summarize ways in which the determinants both support and disrupt high fertility desires. We find that high fertility remains desirable in many regions of sub-Saharan Africa but contemporary disrupters, such as the economic situations and increases to family planning and education, cause individuals to decrease their desired fertility with such decreases often viewed as a temporary adjustment to temporary conditions. Most included studies were quantitative, cross-sectional, and based on survey data. Conclusion This review demonstrates how traditionally supportive and contemporary disruptive forces simultaneously influence fertility desires in sub-Saharan Africa. Future studies analyzing fertility desires in sub-Saharan Africa should be informed by the lived experiences of men and women in this region, with qualitative and longitudinal studies prioritized.

Determinants of fertility desire among reproductive age married/cohabiting women in Ethiopia; an analysis of PMA-ET 2021 data

“…However, differences in outcome variable measurement, study period, sample size, and categories of the outcome variable might be related to the study setting. Existing conditions, such as differences in sociocultural norms and expectations regarding family size, differences in economic conditions, government policies related to family planning, and disparities in access to contraception services and health care infrastructure, may also contribute to these differences [54][55][56].…”

Prevalence and factors associated with short birth interval in Kaya Municipality, North Central Burkina Faso: a multilevel Poisson regression modeling with a robust variance of a community survey

“…Furthermore, women in the rich and very rich quintiles may be better educated than those in the poorer groups. Given the strong link between education level and desire for children (negative association between formal schooling and desired fertility) [35,36], they could, therefore, space births better than poor women. However, a study in Ethiopia showed that poor households were less likely than wealthy households to have a short birth interval [37].…”

Adverse childhood experiences, emotional distress and dissatisfaction with motherhood among first-time mothers: Mediations and child differences

“…There is extensive discussion in traditional gender theories regarding the role that gender plays in decision-making and behavior across cultures and nationalities, particularly in Africa (Olatunji, 2013 ; Olonade et al, 2021 ). Patriarchal norms and gender roles perpetuated by patriarchal institutions favor male children (Sylvia, 1989 ; Church et al, 2023 ; Ibrahim et al, 2023 ). A high priority is given to continuing a family lineage through male children in Nigeria (Church et al, 2023 ).…”

“…Patriarchal norms and gender roles perpetuated by patriarchal institutions favor male children (Sylvia, 1989 ; Church et al, 2023 ; Ibrahim et al, 2023 ). A high priority is given to continuing a family lineage through male children in Nigeria (Church et al, 2023 ). Women have traditionally been assigned the role of household and caregiving (Ibrahim et al, 2023 ), while men have traditionally been assigned the role of breadwinner (Mensah, 2023 ).…”