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  • Erin Rogers (a1) (a2) and Rob Stephenson (a3) (a2)

Targeting reductions in fertility remains a key development goal, as too-high fertility hampers the economic and health prosperity of low- and middle-income countries. However, critical to the success of gaining reductions in fertility is the ability to understand the factors that are shaping fertility, and to understand the factors that are acting to keep fertility levels high. To contribute to this understanding, this study applied the Bongaarts (2015) adjusted proximate determinants of fertility model to 33 low- and middle-income countries using data collected from the Demographic and Health Survey (DHS) programme between 2000 and 2016. Results from the analysis indicate that there has been a universal decrease in the duration of breast-feeding and postpartum abstinence, which has contributed to stalling and increasing fertility rates in countries of Central Africa. In other regions of the world, such as Southern Africa, Latin America & Caribbean and Asia, increased contraceptive use and increased age at marriage, or sexual debut, has been able to offset this, leading to substantial decreases in fertility rates. These findings should serve as a guide to where additional development policy and programmatic attention should focus to reduce too-high fertility in resource-poor settings.

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Ahmed S., Li Q., Liu L. & Tsui A. O. (2012) Maternal deaths averted by contraceptive use: an analysis of 172 countries. The Lancet 380(9837), 111125.
Bloom D. E., Canning D., Fink G. & Finlay J. E. (2009) Fertility, female labor force participation, and the demographic dividend. Journal of Economic Growth 14(2), 79101.
Bloom D. E., Canning D. & Sevilla J. (2003) Demographic Dividend: A New Perspective on the Economic Consequences of Population Change. RAND Corporation.
Bloom D. E. & Finlay J. E. (2009) Demographic Change and Economic Growth in Asia. Asian Economic Policy Review 4(1), 4564.
Bongaarts J. (1978) A framework for analyzing the proximate determinants of fertility. Population and Development Review 4(1), 105132.
Bongaarts J. (2015) Modeling the fertility impact of the proximate determinants: time for a tune-up. Demographic Research 33(1), 535560.
Bongaarts J. & Casterline J. (2012) Fertility transition: is sub-Saharan Africa different? Population and Development Review 8(38), 153168.
Bongaarts J. & Potter R. (1983) Fertility, Biology, and Behavior: An Analysis of the Proximate Determinants. Academic Press.
Canning D., Raja S. & Yazbeck A. S. (eds) (2015) Africa’s Demographic Transition: Dividend or Disaster? World Bank Publications.
Davis K. & Blake J. (1956) Social structure and fertility: an analtyic framework. Economic Development and Cultural Change 4(3), 211235.
Family Planning 2020 (2017a) Commitments. URL: from (accessed 15th June 2017).
Family Planning 2020 (2017b) Global Data. URL: (accessed 15th June 2017).
Gribble J. N. & Bremner J. (2012) Achieving a Demographic Dividend. Population Bulletin 67(2), 116.
Hertrich V. (2017) Trends in age at marriage and the onset of fertility transition in sub-Saharan Africa. Population and Development Review 43(S1), 112137.
ICF International (2013) Demographic and Health Surveys Methodology. Measure DHS, Calverton, MD.
Laplante B., Castro-Martín T., Fostik A. L. & Martín C. (2016) The contributions of childbearing within marriage and within consensual union to fertility in Latin America, 1980–2010. Demographic Research 34(29), 827844.
Louie K. S., Chong E., Tsereteli T., Avagyan G., Vardanyan S. & Winikoff B. (2015) The introduction of first trimester medical abortion in Armenia. Reproductive Health Matters Supplement 44, 5666.
Lozano R., Wang H., Foreman K. J., Rajaratnam J. K., Naghavi M., Marcus J. R. et al. (2010) Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. The Lancet 378(9797), 11391165.
Sedgh G., Singh S., Shah I. H., Hman E., Henshaw S. K. & Bankole A. (2012) Induced abortion: incidence and trends worldwide from 1995 to 2008. The Lancet 379(9816), 625632.
Starbird E., Norton M. & Marcus R. (2016) Investing in family planning: key to achieving the sustainable development goals. Global Health: Science and Practice 4(2), 191210.
Stover J. (1998) Revising the proximate determinants of fertility framework: what have we learned in the past 20 years? Studies in Family Planning 29(3), 255267.
United Nations. (2015) Sustainable Development Goals. URL:
Westoff C. F. (2008) A new approach to estimating abortion rates. DHS Analytical Studies No. 13.
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Journal of Biosocial Science
  • ISSN: 0021-9320
  • EISSN: 1469-7599
  • URL: /core/journals/journal-of-biosocial-science
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