Adolescent Fertility Is Lower than Expected in Rural Areas: Results from 10 African HDSS.

The adolescent birth rate (ABR) is an important indicator of maternal health, adolescent sexual health, and gender equity; it remains high in sub-Saharan Africa. While Demographic and Health Surveys (DHS) are the main source of ABR estimates, Health and Demographic Surveillance Systems (HDSS) also produce ABRs. Studies are lacking, however, to assess the ease of access and accuracy of HDSS ABR measures. In this paper, we use birth and exposure data from 10 HDSS in six African countries to compute local ABRs and compare these rates to DHS regional rates where the HDSS sites are located, standardizing by education and place of residence. In rural HDSS sites, the ABR measure is on average 44 percent lower than the DHS measure, after controlling for education and place of residence. Strong temporary migration of childless young women out of rural areas and different capacities in capturing temporarily absent women in the DHS and HDSS could explain this discrepancy. Further comparisons based on more strictly similar populations and measures seem warranted.

Stalls in Fertility Transitions in sub-Saharan Africa: Revisiting the Evidence.

Stalls in fertility decline were first identified in Ghana and Kenya in the early 2000s, and since then as many as 20 African countries have been classified in the "stall" category at some point. The countries and time periods in which they occurred are not well established, however, and whether stalls in sub-Saharan Africa are pervasive or not remains an open question. This article identifies where and when fertility stalls have occurred in sub-Saharan Africa. I combine a variety of data sources and methods to identify cases of fertility stalls strongly supported by the data. I find unambiguous support for stalls in two countries (Namibia and Zimbabwe), very strong support in three additional countries (Congo, Kenya, and Zambia), and fairly strong support in Cameroon, in the early 2000s. Stalls are possible in seven cases in six other countries (Côte d'Ivoire, Gabon, Madagascar, Nigeria, South Africa, and Tanzania), where evidence is moderate. Fertility stalls in sub-Saharan Africa are thus not widespread, but they are not exceptional either. Further research on the causes of these stalls is key to a better understanding of the future paths of fertility in sub-Saharan Africa.