The stall in the fertility transition in Kenya

The fertility rate had been declining and contraceptive prevalence had been increasing for a quarter of a century. This unexpected interruption of an established trend is the focus of this inquiry. The stall or reversal of the fertility decline is seen throughout the country but is particularly evident among the least educated women while those with a secondary or higher education still show a modest decline in childbearing. The stall in contraceptive prevalence is seen mainly among younger women and among those with less education. The use of oral contraceptives, the IUD, and sterilization declined over the preceding decade while the use of injectables increased. A finding of particular interest is that while use of contraception among all women remained constant between 1998 and 2003, the expected increase did occur among sexually active women, regardless of marital status. There was a decline in the proportion of women who had sex in the four weeks preceding the survey. This trend has also been seen in other countries in southern and eastern Africa (but not in West Africa) and may be related to the higher prevalence of HIV/AIDS in that region. Another factor underlying the stall in the increase in contraceptive prevalence and the decrease in fertility is the observed decline in the proportion of women who want no more children, a marked departure from the steady increase in this variable since 1977. This recent change is seen in urban and rural areas, in all provinces and ethnic groups, and among women with less than a secondary education. A similar change is seen among men. HIV/AIDS may have a role in the reversal of reproductive preferences in Kenya because it has contributed to the increase in child mortality. Women who have experienced the death of a young child are more likely than other women to want another child. Although the analysis has identified the demographic dynamics of the stall in the fertility transition in Kenya, a full explanation is lacking. Shortages of contraceptive supplies have probably played some role but this does not explain the increase in the proportion of women who want more children. (Author abstract)