Fertility levels in South Africa falling
Izelle Theunissen, MRC News
The level of fertility among South African women is decreasing - with women
having fewer children and spacing them further apart.
The level of fertility of South African women has declined by about half
between 1970 and 1996 to 3,2 children per woman nationally and 3,5 children per
woman in the African community. In addition, the median interval between births
per woman has almost doubled, from 30 months to around 50 months.
These are the findings of a secondary analysis of the 1996 Census and the
1998 Demographic and Health Survey, performed by the MRC's Burden of Disease
Research Unit.
Typically African, uniquely South African
The transition from high to low fertility has followed a pattern similar to
that observed in other African countries, with women in all age groups having
fewer children. This is in contrast to the fertility transition in Europe, where
the fertility decline was accounted for largely by falling fertility in older
age groups.
But the pattern is also uniquely South African in that the median time
between births has nearly doubled. Nowhere else in sub-Saharan Africa are
similarly long birth intervals found, while the current fertility patterns of
South African women of childbearing age indicate that these intervals may
lengthen still further.
Adolescent fertility was found to be very high. One-sixth of the more than
2600 children born to African women in the 36 months preceding the survey were
to women aged less than 20 at the time of the birth. This high adolescent
fertility, coupled with the long birth intervals, shows that the majority of
women don't use contraception before the birth of their first child, only
starting their use afterwards.
This has important implications for South African family planning and
reproductive health strategies. These need to shift towards promoting safe sex
and making barrier methods of contraception (such as condoms) acceptable to
young people before the birth of their first child, which would limit the spread
of HIV/AIDS. Currently the emphasis is on providing contraception to women only
after their first birth.
Impact of HIV/AIDS
The spread of the HIV epidemic is expected to further accelerate the decline
in South African fertility. Women infected by HIV have lower fertility because
of secondary sterility and fetal loss brought on by the disease and its
associated infections. Also HIV mortality and morbidity is greatest among women
in their mid-30s, thus reducing the number of children born.
In addition, long birth intervals increase the mean age of childbearing,
thereby reducing the number of children borne by a woman by the time she reaches
her mid-30s. This is illustrated by a Department of Health report into maternal
mortality, where 82 out of 565 maternal deaths in 1998 were due to AIDS. Of
these women, more than 87% had had fewer than 3 deliveries.
Historical factors
The decline in South African fertility has followed an unusually long
trajectory, even by the standards of developing countries. A decline in
fertility in the country was apparent by the late 1960s, several decades ahead
of the start of the fertility decline in some other southern African countries.
While fertility is still lower in South Africa than in other countries in the
region, many of these countries have shown faster rates of decline than that
observed in South Africa.
The earlier onset of fertility decline is attributable to the South African
population being more urbanised and better educated than in other countries in
the region, while modern contraceptive methods were made available from the
early 1970s. However, the introduction of a family planning programme in 1974
did little to hasten the decline in fertility. This is held to be more a
reflection of the structural constraints on African women under apartheid, than
of a lack of desire on their side to limit their fertility.
The freeing up of South African society in more recent years has contributed
to an acceleration in the pace of the fertility decline in South Africa.
This article courtesy of the MRC News: www.mrc.ac.za
For more information, please contact Dr Tom Moultrie at tel.: (021) 650-2475 or
e-mail tmoultri@commerce.uct.ac.za
This article is based on a Technical Report (Trends in South African fertility
between 1970 and 1998 --An analysis of the 1996 Census and the 1998 Demographic
and Health Survey. Moultrie TA and Timaeus IM. January 2002. ISBN
1-919809-17-1). This Report can be obtained on the MRC website at http://www.mrc.ac.za/researchreports/reports.htm
or by contacting Ms Elize de Kock at tel.: (021) 938-0327.
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