Can Family Planning Programs Affect High Desired Family Size in Sub-Saharan Africa?

John Bongaarts, Population Council

Fertility levels in sub-Saharan Africa are on average double those in Latin America and Asia. One contributing factor is that governments in sub-Saharan Africa have generally devoted low priority to family planning programs. But even if unwanted fertility could be reduced by implementing such programs, the high desired family size prevailing in this continent represents an obstacle to fertility decline. This study examines the potential role of family planning programs in reducing preferences for large families. Two kinds of evidence support such an effect: 1) A cross-sectional regression analysis of country variation in desired family size finds a significant effect for program effort after controlling for socioeconomic indicators; 2) Paired case studies of countries with similar levels of development document lower wanted and unwanted fertility when well-organized programs exist. A concluding section discusses possible mechanisms for this program impact, including the lower cost of contraception and the role of media campaigns.