Africa's Stalled Fertility Transition: Causes, Cures, and Consequences?

“Sub-Saharan Africa’s young people are in effect the global labor force of the future,” said Jack Goldstone at the Wilson Center on October 15. “Whether they are productive, how large that cohort turns out to be, whether they find work or not, is going to have a bearing, I think, on all of us.”

With nearly 200 million of the world’s 15 to 24 year olds – the bulk of the largest youth cohort the world has ever seen – many sub-Saharan Africa nations appear poised to achieve a “demographic dividend.” But the reality is most are still far off, said Goldstone, a professor of public policy at George Mason University and Wilson Center fellow.

In order to achieve the demographic dividend, a term first coined during the 1990s,population growth must decline significantly. This shift creates a “youth bulge” of more working age young adults than either children or seniors and the elderly.

While some sub-Saharan African countries like Kenya and Ghana have begun a transition towards such an age structure, many others have experienced persistently high fertility rates, guaranteeing significant future growth and making it unlikely they will experience lower dependency ratios anytime soon.

Goldstone spoke alongside Jeffrey Jordan, president and CEO of Population Reference Bureau, and Paul Lubeck of Johns Hopkins University School of Advanced International Studies on the potential causes and consequences of stalled fertility transitions in Africa and what it could mean for economic, environmental, and health outcomes. They cautioned that not all countries are the same, but highlighted the over-arching importance of women’s empowerment and good governance in accelerating demographic transitions and easing the impact of continued rapid growth.

A Stalled Transition

Since the 1950s, the global total fertility rate has plummeted from five children per woman to well under three, but this statistic masks significant regional variances, said Jordan. Sub-Saharan Africa has experienced a slight decline, but far less than what has been seen elsewhere. In fact, with total fertility rates hovering between four and six, some countries have seen no decline at all, and a few have experienced increases, said Goldstone.

Consequently, instead of nearing a dividend, many sub-Saharan countries have instead found themselves stuck on one side of a demographic divide, said Jordan. As health care improves and mortality rates begin to drop but fertility rates remain high, countries are on track to see massive population booms in the decades ahead.

Niger and the Netherlands, for example, have populations nearly identical in size (17 million), said Jordan. But total fertility in Niger hovers between 6.0 and 7.0, while it is 1.7 in the Netherlands. Consequently, there are 845,000 annual births in Niger, but only 176,000 in the Netherlands, and while the Netherlands’ population is expected remain roughly the same in size over the next few decades, Niger’s population is projected to skyrocket, possibly quadrupling by 2050 depending on whether fertility rates decline and how quickly.

Similarly, Nigeria and Uganda’s populations could more than triple and quadruple, respectively, said Goldstone, and “a lot of that is just baked in in the very large number of young women entering child bearing age in next few decades.”

Although policymakers have focused largely on the services – education, skills training, and health care – needed to create promising, productive futures for today’s youth, it won’t be enough if overall growth remains rapid, said Jordan. “If you’re in a situation where you have a stalled fertility transition, by definition you’ve eliminated the possibility or hope to achieve a dividend,” since the number of dependents that today’s youth will have to care for as adults will remain high.

New Challenges for Health Systems

As populations increase, health systems may become overburdened – not only with the number of patients, but the type.

When birth rates slow and life expectancies improve, health systems typically shift from dealing mainly with mortality to morbidity and disability, said Jordan. But countries that have yet to undergo a demographic transition face a double disease burden: they still have to deal with the high rates of communicable diseases that accompany high fertility and infant/maternal mortality, but as more people – overwhelmingly adolescents – adopt Westernized diets and alcohol and tobacco consumption, they become hotspots of non-communicable diseases as well.

In Madagascar, Mauritania, and Namibia, more than 30 percent of boys between 13 and 15 use tobacco, said Jordan, and those rates are expected to rise significantly. Already, 80 percent of global deaths from cardiovascular disease, diabetes, and chronic respiratory illnesses occur in low- and middle-income countries, whose health care systems have rarely seen those diseases and are ill-equipped to handle them on such a scale, he said.

By 2030, non-communicable diseases will be the leading cause of death in sub-Saharan Africa, lead to severe losses in productivity, and sap vital financing from the education and economic sectors, said Jordan.

Nigeria: A Convergence of Crises

Rapid growth can also affect political stability. By 2040, states today deemed “fragile” – many of which are in sub-Saharan Africa – will gain nearly 1 billion people, while stable states are unlikely to see substantial growth.

In Nigeria, Africa’s most-populous country with perhaps the highest capacity for industrialization, “the lack of decline of fertility is essentially creating a demographic-ecological crisis,” said Lubeck. “It’s not just the increase of people; it’s the stress on the environment.”

Livestock and agricultural lands are strained by population growth and climate impacts like drought and rising temperatures; economic inequality is rampant; and there has been a systematic failure on various levels of government to enable young people to build futures for themselves, said Lubeck.

This breakdown has helped fuel recruitment for Boko Haram, the radical Islamist group that has attacked government offices, the military, schools, and civilians in the north. Islamist leaders staged a “generational revolt” against both the ineffective national government and the young Boko – inauthentic, educated, “Western” Muslims – who have disproportionately benefited from it, he said.

The northern Sharia states are also those with the highest fertility rates – as high as 8.5, compared to rates around 4.5 in the south. The UN recently projected that 1 in 5 people added to the planet this century will be Nigerian.

“Nigeria matters,” said Lubeck. “Its scale is very significant, and if it breaks up it’ll be chaos.”

Economic Growth Not Enough

Economists have long held to the notion that “the best contraceptive is economic growth,” said Goldstone – that increases in employment, urbanization, and income levels lead to lower fertility levels. But in many sub-Saharan African countries, these factors are not having the significant impact on fertility that they did in Asia and Latin America.

In economies driven by extractive industries, like Nigeria’s, increases in income have been uneven. In others, most of the new employment opportunities have been concentrated in service sectors in cities, excluding substantial rural portions of the population (around 70 percent or more in many countries), said Goldstone. Additionally, those that do obtain a service job often work outside the formal economy and have unstable wages.

Exceptionally high desired family size is also a key factor, said Jordan and Goldstone. Strong extended family networks, which help women raise large numbers of children, may in part explain this, said Goldstone, but identifying a set of universal cultural roots that drive large family sizes across Africa is virtually impossible.

“Africa is a continent, it’s not a country, but I’d even offer that Africa is not a series of countries,” said Jordan. The national borders drawn during European colonial rule have little to do with cultural, ethnic, and linguistic boundaries.

Invest in Girls and Women

Regardless of differences, the panelists agreed that the most powerful step for sub-Saharan African countries to take in addressing their demographic challenges is improving the status of women, particularly young girls.

Mitigating short-term challenges by bolstering governance, law and order, and skills training, is clearly important in order to stably engage the massive group of young people already on the brink of adulthood, said Goldstone. But policymakers should take a “two-pronged” approach and also make long-term investments in health, education, and the futures of young women and girls.

In many countries where fertility is highest, the right of women to make sexual and reproductive health decisions for themselves is not recognized as central to development. They’re often unable to complete their education, and are expected to marry and give birth at an early age. Across the northern Nigerian states, Lubeck explained, only 3 percent of women use contraception of any kind, and 76 percent have never attended school.

Expanding enrollment of young girls in secondary education, said Goldstone and Lubeck, would delay the average age of marriage, one of the best predictors of age of sexual activity in conservative societies. It will also enable women to secure the information and financial assets needed to access contraception and enter the workforce. Over time, it could lower fertility rates and improve economic stability.

“Female education is critically important,” said Goldstone. “There’s a huge impact in the effect of secondary education that kicks in after about 2040 and makes all the differences in the world in the second half of the century.”

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Sources: African Economic Outlook, PSI, Population Reference Bureau, National Geographic, The World Bank.

Drafted by Sarah Meyerhoff, edited by Schuyler Null.