Fertility decline in developing countries does not depend on economic growth but follows contraceptive use

Many politicians, the public, and some scientists still think that economic development is a major cause of reduced birth rates in developing countries. We tested this belief empirically in a recently published long-term study of many countries (1970-2014). We found no relationships between fertility and economic growth, but a strong association with modern contraception: birth rates in developing countries declined linearly with increasing contraceptive use. This suggests adequate funding for family planning is important to lower birth rates in countries with unsustainably high fertility.

By Frank Götmark & Malte Andersson

There are few studies of what politicians and the public in the West think about high birth rates in developing countries. Many of TOP’s readers are probably aware that declining birth rates in these countries are related to family planning programs and increased education of women. But our impression is that politicians, and the public, have quite different views.

The long-standing quote that development is the best contraceptive comes from Karan Singh, speaking as an Indian delegate at the UN’s World Population Conference in Bucharest in 1974. On Google today, you get 15 million hits for these words. For instance, the title of a newspaper article from India last year reads “Development best contraceptive, says national health survey report”. It dealt with income levels and contraceptive use. Another example comes from Germany. In response to population growth in Western Asia and Africa and immigration to Europe in 2015-16, Angela Merkel visited African leaders in October 2016. What is needed in Africa, she emphasized, is “real economic development”. Globally, development is strongly associated with economic growth; governments are happy when they can report to citizens and voters that “we can look forward to future economic growth”.

In a survey in Sweden last year, TOP investigated the public’s views about birth rates in developing countries. We asked, “Which factor do you think is most important for falling birth rates in developing countries?”. Respondents could suggest one factor only. The most common was “better economy” (25% of respondents), followed by increased education (19%) and contraception (10%).


Empirical evaluation

In a recently published long-term study of changes in fertility rates in developing countries, our aim was to test whether decreasing total fertility rate (TFR) is associated with rising economy. We related changes in TFR between 1970 and 2014 to changes in gross domestic product (GDP) and household consumption per capita, using graphical analysis. In addition, we analyzed changes in TFR and contraceptive prevalence rate, for which historical data also were available (see the open-access paper for details about datasets and methods). Below, we first summarize the results for TFR versus GDP per capita, where in total 110 countries were included in the analysis.


TFR and GDP per capita

The graph below shows that in four country groups at different levels of economic development, TFR declined on average by about 1.5–2.5 child per woman during the first 30 years (1970–1999). This large decrease took place although GDP per capita remained almost constant in developing countries in three groups, at Very low, Low and Intermediate GDP levels. In the Relatively high GDP country group, results depended strongly on two outliers, the rich oil states Qatar and Kuwait. When they are included (dashed line), mean GDP per capita declined markedly 1970–1984 during the global oil crises, and so did TFR.

GDP per capita in the Very low group remained low over the entire period 1970–2014 (see graph). Yet its mean TFR declined from 6.8 to 4.8. TFR declined greatly also in the Low and Intermediate groups 1970–1999, although GDP per capita stayed almost constant. On the other hand, 2000–2014 when GDP per capita increased in these two groups, there were only modest declines in TFR. This was so also in the Relatively high group. Most of its TFR decline took place 1970–1999, as in the other three groups.

These results show that TFR declined strongly in spite of little change in GDP per capita 1970–1999. In all four groups, TFR declined markedly even during periods when GDP per capita decreased. Moreover, when GDP increased markedly, 2000–2014, there was only modest decline in TFR. Economic growth (in GDP per capita) therefore was not a major cause of the great reductions in TFR that occurred among developing countries 1970–2014.


TFR and consumption per capita

We next related TFR to changes in household consumption per capita. Fewer countries were available in this analysis, so we used three country groups instead of four: Very low/low, Intermediate, and Relatively high consumption. For the first two groups, results were similar to those in the analysis of GDP: TFR declined although consumption stayed almost constant. In the Relatively high group, however, TFR declined with increasing consumption – or one could state the reverse: consumption increased as TFR declined. See Figure 3 in the online version, here.


TFR and contraceptive prevalence

Finally, we related TFR to changes in contraceptive prevalence rate (CPR), also in this case using three country groups. As the graph below shows, falling fertility is consistently associated with increasing contraceptive use 1970–2015. In all three country groups, TFR declined almost linearly with increasing CPR.

Was the increasing use of modern contraception a consequence of a better economy? To test this possibility, we plotted CPR in relation to GDP. The graph below shows that CPR increased largely independently of GDP 1970–1999. When CPR rose strongly during that period, GDP per capita even declined in the Very low/low group, and it increased only modestly in the two other country groups. Increasing use of modern contraceptives therefore was not mainly a consequence of economic growth. Whether this was so also after 1999, when GDP as well as contraceptive use increased, is not clear from our analysis.


Interpretation and conclusion

At the level of country groups, our results show that economic growth does not explain the fertility drop that took place between 1970 and 2014, particularly for the period 1970–1999 when fertility fell the most in poor countries. Instead, fertility decline tended to precede economic growth, which can increase as a consequence of lowered fertility: a so-called demographic dividend, according to many demographers. Economic growth can be enhanced when the working part of the population increases relative to the part outside working age. But in the long run GDP growth, like population growth, needs to be restricted for a sustainable future.

The clear linear relationship between fertility and contraception in all country groups is encouraging. Increased contraceptive use was an important part of international family planning programs 1965-1995. Family planning and modern contraception received attention through global media and ‘soap operas’ on radio and TV, which also contributed to declining fertility in many developing countries (see Manon Parry, Broadcasting Birth Control, and the Population Media Center). But contraceptive prevalence is still low, around 20%, in many countries in Sub-Saharan Africa and other areas where fertility remains high. Making contraceptives available and encouraging their use, through education and changes in family-size norms, should therefore be a high priority.

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18 thoughts on “Fertility decline in developing countries does not depend on economic growth but follows contraceptive use

  1. Interesting study but one that might shed some additional light would be how a depression affects TFR. When a local board member of ZPG we learned, in the U.S. the TFR was the lowest ever during the world wide depression in the 30’s. It makes sense as in the natural world when animals are near starvation their ability to conceive drops. Also, people who are poor and destitute would not want to have more kids as they would be an additional burden.

  2. The simple answer, but not simple or even possible to implement, is making contraception freely available to every woman capable of giving birth.

      1. True. But women wear the consequences of child rearing and are more committed to contraception.

  3. A very important report. Advocates of economic growth advocate growth as a panacea for all our problems, when in reality it either causes or exacerbates many of them, particularly our environmental unsustainability.

    1. This months ‘Atlantic’ brought that fable to light. In “The Eureka Theory of History is Wrong” It was stated:”…the progressives have become too focused on what are essentially negative prescriptions for improving the world, including an emphasis on preservation and sacrifice (“reduce, reuse, recycle”) over growth (“build, build, build”). At the extremes, this ascetic style leads to calls for permanent declines in modern living standards, a philosophy known as “degrowthism.” I wrote the organization a strong letter of protest and, after 20++ years of being a member, quit that institution. It also became clear to me the “Big Lie” is not so much about trump and his enablers but from those who push a certain ideology that got us to this point. It is an ideology created by people who ascribe to a baser instinct of greed and power. People who are unwilling to see where their ideology has taken to the dysfunctional, violent and destructive world we now live. A world where the climate is changing for the worse and thousands of species are going extinct. Soon one of those species will include us.

  4. More “humans can fix this” fantasies. Good luck with those – you will need it.
    At humanity’s current rate of consumption of Natural Resources, lowering population simply increases that rate, or at least maintains it – because it tends to increase the deadly GDP and improve the general standard of living (i.e. it increases consumption). The authors do acknowledge this, in their Conclusion – “… fertility decline tended to precede economic growth, which can increase as a consequence of lowered fertility: a so-called demographic dividend, according to many demographers. Economic growth can be enhanced when the working part of the population increases relative to the part outside working age. But in the long run GDP growth, like population growth, needs to be restricted for a sustainable future.”
    I accept that population de-growth can and often does precede “Development” – but isn’t that out of the frying-pan into the fire? It sounds as if population de-growth might actually fuel Development or rather Overdevelopment – though it is not the aim of this study to explore this and it is only mentioned at the end (“fertility decline tended to precede economic growth”).
    Aren’t we in a classic double bind? Ecologists insist on labelling it a “predicament” – apparently, this words means there is no way out, though I am not sure non-ecologists would make this subtle distinction between crisis and predicament. The great William Rees uses “predicament” a lot – for instance a 2017 article entitled “The Human Ecological Predicament: Wages of Self-Delusion”, and other ecologists have followed suit.
    Rees’s insistence on De-Growth is considered “extreme” – but it is not really very extreme viewed from an even darker green perspective. It still advocates “Steady State” rather than “De-Growth” – and it still allows for some Growth for developing Nations. I don’t know if Rees has changed his mind since 2017 – but he ought to have, because it is obvious that every Nation is now Overdeveloped, and there is no longer any such thing as Developing and Developed Nations. All are Overdeveloped – most to the point of no return. Only a vertiginous drop in both population AND consumption is of any use – and no-one is going to propose that humans somehow engineer this cataclysm (even if humans could). Instead, anyone who has understood this has simply retreated into the wilderness and is keeping their fingers crossed.

    1. Thank you for the link and comment. I would agree any country that has exceeded it’s carrying capacity is no longer a developing country. Perhaps those extreme progressives who feel we need to do all we can to help the ‘poor’ people of the world need to understand helping a relatively few will do little to help the conditions of those countries (and will actually exacerbate them). There is a group, NumbersUSA, that has a TED talk about how our help is of little significance: https://youtu.be/LPjzfGChGlE

  5. Thank you for sharing your interesting research. It does appear that the U N’s almost exclusive focus on “economic development” is due to their following a political agenda, to transfer wealth from the rich North to the poor South, rather than applying the hard won lessons learned from the mistakes and accomplishments of the rich North over the past 250 years.

    Nevertheless the experience of Western Europe and of the “Asian tigers” (Japan, Taiwan, South Korea, Singapore) of TFR falling below 2.1 replacement level suggests that economic development is one of the preconditions for falling birth rates. However China’s falling birth rate was a result of that authoritarian government’s “One Child” fiat, in anticipation of the demographic dividend prophesied by Deng Zhou Ping, which has in fact been realised. While the economic migration of women of child bearing age from Eastern Europe to Western Europe, since the enlargement of the E U, has led to falling birth rates in their homelands.

    It is not economic development per se, but a number of inter-related socio-economic drivers that alter reproductive behaviour. For example adult migration from an overpopulated countryside, where 6 year old children are economically active collecting water, herding goats, etc., to cities in search of employment, where the cost of living is higher and often requires the wages of both husband and wife; where couples are exposed to greater opportunities for female emancipation, education, employment and birth control advice; where childhood dependency and costs can continue through their off-springs’ secondary education into their early twenties at university; all these militate against having too many off-spring.

    Apart from the exponential increase in the human population during my lifetime, from 2.5bn in 1950 to 8bn today and 11.2bn forecast by 2100, what is most significant is the dramatic fall in Infant Mortality. During the previous 10,000 years, premature death due to warfare, famines and diseases, and particularly the death of the most vulnerable, in child birth or early years, restricted the growth of the populations across Eurasia to 500,000 by 1300 and 1bn by 1800. Throughout the 1950s and 60s, after Independence from the European colonial powers, the new political elites, in Asia, Africa and elsewhere, systematically “robbed their own people blind” of their nations’ natural resources, with the consequence that there was almost no GDP per capita growth in developing countries through the first period 1970 – 1999, shown in the graph “Change over time in TFR and GDP levels”.

    Despite this, the graph demonstrates that TFR fell from 6.8 to 4.8, 6.6 to 4.4, 5.7 to 4.5 and 4.9 to 2.9 in the four different country groups. Can this fall in the TFR not be explained by the decline in mortality, and in particular Infant Mortality, due to the application of European medical science to combat tropical diseases and generally improve health care globally after World War Two.

    Assuming that the optimum family size to help on the family’s agricultural holding and, in due course, support their parents in old age, was 4+ children, but one expected >40% of their children to die in infancy, it made sense to give birth to 6+ children, in order to allow for “Spares”. Once the fear of high rates of Infant Mortality became a thing of the past, as a result of defeating malaria, beri beri, hepatitis, etc., families could reduce the number of their planned off-spring, even though their financial prospects have not improved.

    Finally, although economic development, whether actual or simply aspirational, is one of the pre-conditions for deciding to reduce TFR to close to 2.1, contraception is simply a mechanism for achieving that result. Thomas Malthus identifies several mechanisms, apart from contraception, for reducing birth rates. Delaying marriage, often beyond a woman’s fertile years, is increasingly common in the rich North, while child brides, often as young as 14 years of age, continue to be commonplace in the poor South. His other recommendation is celibacy, which need not mean living the ascetic life of a Cistercian monk. It could be a reduction in promiscuity, through active enforcement of religious laws as happens in some societies, or it could be the encouragement of homosexuality, as is the fashion in the rich North, or its tacit acceptance for sexual relief in parts of the poor South.

    1. Interesting comments, Hugh Cornwell. Decreased child mortality is most likely involved in the decline of TFR in the developing countries that we analysed. In fact, the “theory of demographic transition” postulates that mortality decline shall precede fertility decline. And child mortality is still comparatively high in Sub-Saharan Africa, where TFR is highest. More work is needed to study the factors involved in TFR change, but for policy, modern contraception is clearly important, and has been so in the international family planning programs historically. In addition, population growth increases the spread of diseases (https://overpopulation-project.com/growing-populations-increase-the-risk-of-pandemics/) and the future of human mortality rates is uncertain.

      1. One big problem in areas with high infant mortality rates is that in those countries the birth rate is also high in order to compensate for the mortality rate. As modern medicine comes into those countries which help lower the mortality rate, the culture still promotes lots of kids. Also, in some African countries the culture of Polygamy is practiced which increased the fertility rate. A group, EngenderHealth tries to educate men on the dangers of this practice.

  6. Good. Supports that aid for prevention techniques more important for the future of earth than other support.

  7. “My statement that ‘development is the best contraceptive’ became widely known and oft quoted. 20 years later I am inclined to reverse this, and my position now is that ‘contraception is the best development’.”
    Karan Singh, Indian statesman. 1992

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