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Fertility Preferences and Contraceptive Change in Low- and Middle-Income Countries

Mobolaji Ibitoye, The Ohio State University
John B. Casterline, Ohio State University
Chenyao Zhang, The Ohio State University

The past five decades have witnessed an enormous increase in the use of modern contraception on the part of reproductive-age women in most low- and middle-income countries. We examine the extent to which this increase can be attributed to changes in fertility preferences versus improved implementation of fertility preferences. This distinction is at the heart of intense debates about the returns on investments in family planning services. We analyze national survey data from five major survey programs: WFS, DHS, RHS, PAP (Pan-Arab), and MICS. We perform regression decompositions of change between successive surveys in 58 countries (95 decompositions in total, making use of 153 surveys). The striking outcome is that on average more than 90% of the change in contraception use can be attributed to increase in contraception within categories of fertility preferences, that is, improved implementation of fertility preferences. This constitutes a powerful empirical refutation of the view that contraceptive change has been driven mainly by reductions in demand for children. We show that this outcome is not surprising given that the distribution of in-union women according to fertility preferences has changed surprisingly slowly in these countries over the historical period considered.

Keywords: Family planning and contraception, Fertility and childbirth

See paper.

  Presented in Session 117. Global and Macro-level analysis of Contraceptive use Data