Family planning in sub-Saharan Africa: progress or stagnation?

May 4, 2011 • Family Planning, Reproductive Health, Africa, Daily Email Recap

From the Bulletin of the World Health Organization.  See

Family Planning in Sub-Saharan Africa: Progress of Stagnation?

John G Cleland a, Robert P Ndugwa a & Eliya M Zulu b

a. Department for Population Studies, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, England.

b. African Institute for Development Policy, Nairobi, Kenya.

Correspondence to John G Cleland (e-mail:

(Submitted: 22 March 2010 – Revised version received: 22 October 2010 – Accepted: 02 November 2010 – Published online: 04 November 2010.)

Bulletin of the World Health Organization 2011;89:137-143. doi: 10.2471/BLT.10.077925


Fertility and future projected population growth are much higher in sub-Saharan Africa than in any other region of the world, and the decline in birth rates, which was already modest, has slowed even further over the past decade.13 Concern that uncontrolled population growth will hinder the attainment of development and health goals in Africa led to the present study, which rests on the assumption that fertility will decline only if the population at large adopts effective modern methods of contraception, as witnessed in other parts of the world.

The objective of this study is to review progress towards the uptake of modern contraception in Africa. We use as our framework Ansley Coale’s succinct summary of the preconditions for the European fertility transition, as amended by Lesthaeghe & Vanderhoeft.4,5 Fertility is not likely to decline at a fast sustained pace unless a large and growing number of couples is “ready, willing and able” to use modern contraception.

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