BACKGROUND
Continued rapid population growth in sub-Saharan Africa is driven predominantly by high fertility. Contraceptive use was a key determinant of past fertility transitions. An analysis of this relationship in sub-Saharan Africa can yield a better understanding of the region’s prospects for fertility decline.

METHODS
Using global estimates and projections, we describe trends in contraceptive use and fertility and analyse the relationship between the two. Timing, pace, and level parameters derived from Bayesian hierarchical models of historic contraceptive and fertility transitions are used to investigate how the experience of sub-Saharan Africa may be distinctive.

RESULTS
Fertility in sub-Saharan Africa fell from 6.4 births per woman in 1990 to 4.6 in 2020, the highest among regions today. Contraceptive use among married/in-union women in sub-Saharan Africa increased from 13% to 33% over the same period, and remains the region with lowest use. At all levels of contraceptive use, countries of sub-Saharan Africa tend towards higher fertility compared to other regions. Transitions in contraceptive use and fertility have occurred later in sub-Saharan Africa, and have been slower in Middle and Western Africa (but not Eastern and Southern Africa), compared to the experience of Asia, Latin America, and the Caribbean.



中文翻译：

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避孕药具使用和生育转变：撒哈拉以南非洲的独特经历（作者：Aisha Dasgupta、Mark Wheldon、Vladimíra Kantorová、Philipp Ueffing）

背景
撒哈拉以南非洲人口持续快速增长主要是由高生育率驱动的。避孕药具的使用是过去生育转变的关键决定因素。分析撒哈拉以南非洲的这种关系可以更好地了解该地区生育率下降的前景。

方法
使用全球估计和预测，我们描述了避孕药具使用和生育率的趋势，并分析了两者之间的关系。从历史避孕和生育转变的贝叶斯层次模型中得出的时间、速度和水平参数被用来研究撒哈拉以南非洲的经历如何与众不同。

结果
撒哈拉以南非洲的生育率从 1990 年的每名妇女生育 6.4 胎下降到 2020 年的 4.6 胎，是当今地区最高的。同期，撒哈拉以南非洲已婚/同居妇女的避孕使用率从 13% 增加到 33%，仍然是使用率最低的地区。在避孕药具使用的各个层面，与其他地区相比，撒哈拉以南非洲国家的生育率往往更高。与亚洲、拉丁美洲和加勒比地区的经历相比，撒哈拉以南非洲的避孕使用和生育率的转变发生得较晚，并且在中非和西非（但不是东非和南部非洲）更慢。