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Social Dynamics of Adolescent Fertility in Sub-Saharan Africa (1993)

Chapter: 2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY

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Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

2
Levels and Trends in Adolescent Fertility

Measures of schooling, marriage, fertility, and contraceptive use are basic to the study of adolescent fertility. Taking data on such factors from the 11 sub-Saharan African countries for which recent Demographic and Health Survey (DHS) data are available, this chapter provides a broad overview of current levels of, and recent changes in, adolescent fertility.1 Subsequent chapters add more detail as related topics emerge.

LEVELS OF EDUCATION, SEXUAL EXPERIENCE, MARRIAGE, FERTILITY, AND CONTRACEPTIVE USE AMONG ADOLESCENTS

Beginning with current levels, Table 2-1 presents a summary of basic cross-national DHS data on educational attainment, sexual activity, marriage, and fertility among African women aged 15 to 19. The first three columns display information on education. Total school enrollments in sub-Saharan Africa rose at an average annual rate of 7.1 percent between 1960 and 1980 and of 4.6 percent between 1980 and 1983 (World Bank,

1  

Note that four of these countries also participated in the World Fertility Survey (WFS). A recent analysis of age at marriage and age at first birth that utilized both WFS and DHS data reports findings that are quite similar to ours (Westoff, 1992).

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-1 Education, Sexual Activity, Marriage, and Fertility Among Women Aged 15–19, Selected Sub-Saharan African Countries: Percentage of Women Except as Noted

 

Education

Fertility

Country and Year of Survey

Primary

Secondary and Higher

Sexually Experienced

Ever Married

At Least One Birth

Currently Pregnant

Birth Rate 15–19 (per thousand)a

Births to Group as Percentage of all Birthsa

Botswana, 1988

95

38

66

6

23

5

127

19

Burundi, 1987

26

1

9

7

3

3

52

5

Ghana, 1988

81

7

50

24

19

4

130

13

Kenya, 1988/1989

95

21

46

20

21

4

153

16

Liberia, 1986

63

22

82

36

37

8

188

20

Mali, 1987

24

0

76

75

44

6

209

17

Nigeria, 1990

67

34

55

39

23

5

144

16

Senegal, 1986

32

14

b

44

26

4

161

18

Togo, 1988

63

16

64

27

21

5

129

15

Uganda, 1988/1989

79

12

62

41

30

7

186

20

Zimbabwe, 1988/1989

98

50

32

20

16

4

103

15

a Based on births in the four years before the survey.

b Unmarried Senegalese women were not asked about sexual experience.

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

1988). The expansion of education of young women was particularly rapid. Yet as the table shows, there is enormous variation across the region in levels of primary and secondary schooling among young women. In Kenya, Zimbabwe, and Botswana, 95 percent of women aged 15–19 had attended at least primary school, compared with fewer than one-third in Burundi, Mali, and Senegal. In Burundi and Mali, no more than 1 percent had attended secondary school.

In most countries, the DHS also asked women their age at first sexual intercourse. As Table 2-1 indicates, a large percentage of 15-to 19-year-old women are already sexually experienced, although again there is considerable variation across countries, from over 80 percent in Liberia to under 10 percent in Burundi. While the mean age at first marriage remains relatively low overall, in some countries a large proportion of young women appear to be sexually active before they marry. In Liberia, 36 percent of women aged 15–19 had married, but 82 percent of women in that age range acknowledged sexual experience. For countries like Liberia and Botswana, the age when a woman first marries may be an unreliable indicator of entry into regular sexual activity and exposure to the risk of pregnancy.2 For countries like Burundi and Mali, however, age at first marriage appears to be a highly accurate indicator of entry into sexual experience. Only 1 or 2 percent of women in these countries reported engaging in sex before marriage.

Because women in many countries marry so early and report early sexual experience, high rates of fertility among adolescents are not surprising. In

2  

Botswana appears to be an extreme case: Only 6 percent of women aged 15–19 report having ever been married as of 1988, whereas 66 percent report being sexually experienced. These estimates, however, are significantly different than those from an independent survey, the Contraceptive Prevalence Survey (CPS), conducted four years earlier, in 1984. The CPS reports a much higher proportion of women married. What should we make of this finding? Has there been an unexpected change in the pattern of marriage in Botswana over the period 1984–1988? The answer is, probably not.

The DHS data are quite comparable to Botswana census data from 1971 and 1981 (van de Walle, 1993). In 1981, only 7 percent of women aged 15–19 in Botswana had ever been in a union; down from 13 percent in 1971. Almost certainly, the reason that the 1984 CPS and the DHS and census are so different is because the CPS asked women additional probes concerning women's marital status and their "partners."

Although we see no reason to exclude the Botswana results on adolescents' marital status, we are by no means claiming that these results—or those from any other country—are accurate. Quite the contrary: Almost any attempt to categorize unions as married or unmarried quickly runs into trouble in many African countries, because of the fluidity and ambiguity surrounding unions. Hence, there is no reason why the problems that the Botswana DHS encountered in trying to define marriage should be considered unique. Had other countries conducted a second independent survey, they might have found a similar tendency for more unions to be classified as marriage.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

10 of the 11 countries listed, at least one in five women aged 15–19 had already had at least one child or was pregnant with her first child at the time of the survey. In those 10 countries the fertility rate ranged from 127 to 209 births per 1,000 women in their age group. Moreover, a large portion of all children are born to 15-to 19-year-olds. In Liberia, Mali, and Uganda, for example, these women accounted for around a fifth of all births in the four years preceding the survey dates.

Physiological readiness to conceive a child obviously influences when childbearing begins. According to Gyepi-Garbrah (1985a), age at menarche has declined more than one year since the early 1960s in Nigeria, and Adadevoh et al. (1989) indicate a similar decline in Ghana between 1946 and 1976. (See also Worthman and Whiting, 1987, for Kenya.) A question on age at first menstruation was included in the DHS only in Botswana, Burundi, and Senegal. (As with all survey data based on respondents' recall of events in the distant past, these data must be treated with caution.) The data from Burundi and Senegal do not reveal any decline in age at menarche over time, but in Botswana the reported age dropped from 16.2 years among women aged 40–49 to 15.3 years among 20- to 29-year-olds.

Table 2-2 focuses on another important aspect of the changing social context of fertility and reproduction in Africa: the rapidly rising knowledge and use of modern contraception. Women are almost certainly underreporting their knowledge and use of modern contraception (see, for example, Bleek, 1987). Still, the data show relatively high levels of knowledge among the youngest women, but far lower levels of usage. Among women of 15 to 19, reported knowledge of modern contraception, as well as of local sources for it, varies widely across the region. In Botswana, Kenya, and Zimbabwe, more than 75 percent of adolescents reported knowing about modern contraception, compared with only 29 percent in Mali. Not surprisingly, the young women who are most knowledgeable about contraceptives are those living in urban areas or in households with a radio or television, or those who have more education (calculations not shown). Knowledge of a source where modern contraceptives can be acquired manifests similar variations.

Although many young women know about contraception and some know where is can be acquired, they do not necessarily use it. Table 2-2 shows that with the exception of Botswana and Zimbabwe, few young women report ever using modern contraception, and very few were using it at the time of the survey. In Botswana and Zimbabwe one in five adolescents was using a modern method of contraception, primarily the pill. Elsewhere, 5 percent or fewer were using a modern contraceptive.

The reported lack of use of contraception, compared with the rest of the world, appears to reflect young women's strong desires to begin having children as soon as possible after marriage. Table 2-3 lends support to this thesis. It shows that in eight of the ten countries for which the comparison

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-2 Knowledge and Use of Contraception Among Women Aged 15–19, Selected Sub-Saharan African Countries: Percentage of Group

 

Knowledge About Contraception

Ever Use

Current Use

Country

Traditional Onlya

Modernb

Source of Modern

Traditional Only

Modern

Traditional Only

Modern

Botswana

0

94

93

2

37

1

21

Burundi

3

40

36

14

4

5

2

Ghana

2

57

48

13

12

9

3

Kenya

4

76

73

20

9

10

4

Liberia

1

63

63

4

13

1

5

Mali

13

29

21

18

4

8

2

Nigeria

1

39

29

4

4

4

2

Senegal

20

59

58

11

1

5

1

Togo

4

74

70

19

8

14

3

Uganda

5

68

62

16

6

2

2

Zimbabwe

1

88

80

8

3

4

22

a Traditional methods include abstinence, rhythm, withdrawal, and the use of ritual charms or potions.

b Modern methods include pills, IUDs, injectables, condoms, vaginal methods, and male and female sterilization.

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-3 Current Use of Contraception Among Sexually Experienced Women Aged 15–19 by Marital Status, Selected Sub-Saharan African Countries: Percentage of Group

 

Modern Methoda

Traditional Method Onlyb

Country

Currently Married

Never Married

Currently Married

Never Married

Botswana

15

22

3

1

Burundi

1

c

4

c

Ghana

2

3

3

15

Kenya

6

2

7

12

Liberia

2

7

0

3

Mali

1

c

8

c

Nigeria

1

11

1

23

Senegal

1

d

9

d

Togo

2

7

3

17

Uganda

1

3

1

5

Zimbabwe

27

14

1

7

a Modern methods include pills, IUDs, injectables, condoms, vaginal methods, and male and female sterilization.

b Traditional methods include abstinence, rhythm, withdrawal, and the use of ritual charms or potions.

c Fewer than 25 cases.

d Unmarried Senegalese women were not asked about sexual experience.

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

can be made, a greater proportion of sexually experienced, never-married women than of married women use both traditional and modern contraception. The absolute percentages are not large; but they are remarkable inasmuch as social and economic barriers make it difficult for adolescents in general, and particularly unmarried ones, to obtain modern contraceptives. Another surprise is that large numbers of sexually active, unmarried adolescent women in Ghana, Kenya, Nigeria, and Togo are using traditional methods of contraception instead of modern methods. One explanation for this anomaly may be that many countries, trying to discourage promiscuity, heavily restrict the use of modern contraceptives by unmarried women. Another explanation may be that women who have barely begun their childbearing careers fear impairment of fertility from the potent drugs that they know Western contraceptives contain (for some evidence for this hypothesis from The Gambia, see Bledsoe et al., 1993).

In Chapter 1, we highlight two distinct configurations of adolescent fertility. The first comprises women who marry and give birth at extremely young ages, often in rural areas, away from adequate medical care. The

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-4 Urban-Rural Differences in Education, Marriage, and Fertility, Women Aged 15–19: Percentage of Group Except as Noted

 

No Education

Ever Married

Birth Ratea

Country

Urban

Rural

Urban

Rural

Urban

Rural

Botswana

2

7

7

6

115

134

Burundi

21b

76

18b

6

130b

48

Ghana

14

22

20

28

91

153

Kenya

5

5

30

18

130

159

Liberia

25

48

29

43

173

202

Mali

43

90

74

76

172

224

Nigeria

16

41

22

45

91

164

Senegal

41

91

20

63

98

212

Togo

18

51

11

39

72

169

Uganda

12

22

32

42

139

194

Zimbabwe

2

3

12

24

83

113

a Based on data from the four years before the survey.

b Fewer than 50 cases.

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

second configuration consists of unmarried adolescents, often schoolgirls, living in urban areas whose pregnancies provoke condemnation. These women may be expelled from school, be forced into premature marriages, or face difficulty obtaining appropriate medical care. Table 2-4 highlights the differences in education, and in the timing of marriage and fertility, between urban and rural women. The table shows that in most countries, rural 15-to 19-year-old women are less likely than urban women to have attended school, but more likely to be married and to have given birth. In 10 of the 11 countries, the birth rate of women aged 15–19 is higher in rural areas than in urban areas.

But although Table 2-4 provides broad support for the urban-rural differences advanced in the two configurations, it dispels any conviction that the two configurations form two neat, mutually exclusive groups. In Mali, for example, nearly three quarters of urban women aged 15–19 have already married, a fact that undermines the assumption that only rural women marry at exceptionally young ages. Nor do urban women always surpass rural women in school achievement. In Zimbabwe over 95 percent of women living in rural areas have attended at least primary school.

Just as there are important differences in adolescent fertility between urban and rural areas, there are often large regional differences within countries. Nigeria is the most salient example. The most populous country in sub-Saharan Africa, Nigeria has over 350 ethnic groups and vastly different geographic and economic zones. Table 2-5 shows enormous differences in

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-5 Regional Differences in Education, Marriage, Contraceptive Use, and Fertility of Women Aged 15–19 in Nigeria, 1990: Percentage of Group Except as Noted

 

Northeast

Northwest

Southeast

Southwest

Total

Education

No education

66

66

10

4

29

Primary

25

17

47

26

30

Secondary or more

9

17

44

69

41

Marriage

Ever married

74

70

21

9

36

Contraceptive Use

Any method of contraception

4

3

8

15

9

Modern method

3

3

4

8

5

Fertility

Birth rate (per thousand)

224

194

106

74

146

At least one birth

40

41

14

8

22

Pregnant with first child

11

6

3

2

5

Sample size

352

308

570

381

1,612

 

SOURCE: Nigeria Demographic and Health Survey Standard Recode File, weighted data.

education, marriage, contraceptive use, and fertility across the four principal regions. The Northeast and the Southwest represent the extremes. In the Northeast 66 percent of women aged 15–19 have never been to school, 74 percent are already married, and 51 percent are either already mothers or pregnant with their first child. In the Southwest, the other end of the spectrum, only 4 percent of young women have never been to school, only 9 percent have ever been married, and only 10 percent are mothers or are now pregnant with their first child.

TRENDS IN EDUCATION, MARRIAGE, AND FERTILITY AMONG ADOLESCENTS

How have educational attainment, marriage patterns, and fertility rates changed over time? The rest of the tables in this chapter document major trends in these variables for the 11 countries for which DHS data are now available. They reveal trends by comparing the adolescent experiences of each cohort of women between 20 and 39 years of age. Because the experiences of women who are currently 15 to 19 years old are incomplete, figures from this group are not included. Instead we use the reports of women aged 20–24 as a guide to the experiences of women who most recently

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

finished their teen years. Similarly, the percentage of women aged 30–34 will indicate the behavior of adolescents 10 to 15 years ago, and so on. We cannot, however, compare the knowledge and use of contraceptives in their youth of women now in middle age. These data were not collected in the DHS because middle-aged women cannot be expected to remember accurately how much they may have known about contraception or practiced it many years earlier.

We have ignored the responses of women over 40 for several reasons. First, these data rely on long periods of recall and are generally unreliable. In reconstructing birth histories, older women are prone to omit births that occurred long ago, especially if the child subsequently died. Furthermore, they tend to move forward the timing of the births so that they appear to have occurred more recently than was actually the case (Potter, 1977). Finally, because marriage in Africa is better viewed as a process rather than an event, we suspect that older women, more so than younger ones, may underreport premarital births because the unions 2 into which these children were born would have had more time to mature into recognized marriages.

Education

Formal education for women, particularly secondary education, is widely correlated with low female fertility and low child mortality in sub-Saharan Africa (Feachem et al., 1991; Cohen, 1993). Accordingly, trends in education likely have important bearing on adolescent fertility and its concomitants. Moving from the oldest five-year age group to the youngest in Table 2–6, we see that female schooling has increased over time in every country. However, the degrees of change vary widely. In some countries, a revolution in women's schooling has occurred over the past generation; others have seen only small changes. In secondary education, Zimbabwe has experienced the sharpest increase. Just 14 percent of the oldest women we studied, those from 35 to 39 years of age, attended secondary school, compared with 51 percent among women of 20 to 24. The rise in secondary school attainment is also substantial in Botswana, Kenya, Liberia, and Nigeria, especially in Ondo State in southwest Nigeria (data not shown). Several other countries have had less pronounced but still noticeable increases. Only in Burundi and Mali have fewer than 10 percent of the youngest women attended secondary school.

Marriage

In a recent analysis of the World Fertility Surveys (WFS) and the Demographic and Health Surveys, van de Walle (1993) found only limited evidence of a recent trend toward later age at first marriage. To the extent

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-6 Percentage of All Women Aged 20 and Older, by Highest Level of School Attended

 

Age at Time of Survey

Country and Educational Level

20–24

25–29

30–34

35–39

Botswana

 

 

 

 

Primary

49

46

45

53

Secondary+

36

25

20

12

Burundi

 

 

 

 

Primary

19

18

14

14

Secondary+

3

3

3

1

Ghana

 

 

 

 

Primary

60

53

53

43

Secondary+

10

11

7

5

Kenya

 

 

 

 

Primary

56

54

46

48

Secondary+

35

28

17

10

Liberia

 

 

 

 

Primary

21

12

10

6

Secondary+

31

20

16

10

Mali

 

 

 

 

Primary

16

17

14

6

Secondary+

2

2

2

1

Nigeria

 

 

 

 

Primary

27

24

22

20

Secondary+

31

22

8

7

Senegal

 

 

 

 

Primary

18

15

13

9

Secondary+

11

9

8

6

Togo

 

 

 

 

Primary

37

24

23

24

Secondary+

18

19

9

5

Uganda

 

 

 

 

Primary

56

52

48

38

Secondary+

14

10

9

9

Zimbabwe

 

 

 

 

Primary

42

62

65

69

Secondary+

51

20

17

14

 

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

that we can rely on data about marital status, as categorized in DHS, Table 2-7 shows that changes in reported ages at marriage have occurred more recently, and have been less dramatic, than changes in schooling. (We take conjugal unions, as the DHS did, to include both women reporting they were married and those reporting they were living with a man but not married.) In most countries, there was little difference in the proportion

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-7 Percentage of All Respondents Aged 20 and Older Who Married Before Age 20, Selected Sub-Saharan African Countries

 

Age at Time of Survey

Country

20–24

25–29

30–34

35–39

Botswana

19

30

32

34

Burundi

44

57

58

54

Ghana

63

66

72

72

Kenya

52

65

68

71

Liberia

64

69

71

69

Mali

92

90

93

92

Nigeria

68

69

76

70

Senegal

70

76

79

85

Togo

63

69

71

66

Uganda

73

74

79

80

Zimbabwe

53

66

70

62

 

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

who had married before age 20 between women in their thirties and those in their forties at the time of the survey. But among women in their early twenties, the proportion reporting teenage marriages is lower almost everywhere. The changes have been greatest in Botswana, Kenya, and Zimbabwe. Changes are smaller but visible in all other countries except Mali. In all countries separate calculations indicate that marriage before age 20 is less common among those with more education. This finding suggests that education is largely incompatible with marriage.

We must be cautious in interpreting these DHS data on trends in age at marriage. As Chapter 3 explains, marriage in Africa is often less a discrete event than a process that develops over an extended period of time. Van de Walle (1993) highlights the difficulty in establishing the exact date a marriage begins, arguing that the apparent trend toward later age at first marriage could be exaggerated. Because conjugal relationships often develop gradually, a woman whose union endures may retrospectively report being married earlier than she would have if she had been asked at the time. Because first unions usually begin in the late teens, this response pattern would tend to exaggerate the distinctness of the women who currently form the youngest cohort.

Unlike retrospective DHS questions, census questions ask only current status. To supplement and check the DHS information, Table 2-8 examines trends in adolescent marriage for women aged 15–19 in sub-Saharan African countries by comparing census data for two points in time, whenever such data are available. In other cases, we were forced to use a less reliable

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-8 Percentage of Women Aged 15–19 Who Were Ever Married, Selected African Countries, 1950–1985

 

 

 

Date and Source of Datab

Subregion and Countrya

First Census or Survey

Second Census or Survey

Average per Annum (percentage points)

First Census or Survey

Second Census or Survey

Eastern Africa

Burundi

19

7

-1.6

1979 C

1987 S

Kenya

45

29

-0.9

1962 C

1979 C

Mozambique

35

52

0.6

1950 C

1980 C

Rwanda

18

13

-0.4

1970 C

1983 S

Tanzania

52

38

-1.3c

1967 C

1978 C

Zambia

42

32

0.9

1969 C

1980 C

Middle Africa

Central African

Republic

58

47

-0.7

1959 S

1975 C

Congo

58

26

-1.4

1960 S

1984 C

Southern Africa

Botswana

14

7

-0.6

1971 C

1981 C

Lesotho

22

26

0.4

1966 C

1977 C

South Africa

9

6

-0.1

1951 C

1980 C

Western Africa

Benin

67

46

-1.0

1961 S

1982 S

Ghana

54

32

-2.0

1960 S

1971 S

Liberia

57

42

-1.2

1962 C

1974 C

Mali

79

75

-0.1

1960 S

1987 C

Senegal

63

55

-0.4

1960 S

1978 S

Togo

53

41

-1.0

1958 C

1970 C

NOTE: Includes only countries for which observations were available for at least two points in time.

a For several countries, data were not available before 1970.

b C or S next to the date indicates whether the data are from a census or a survey.

c Data for mainland only.

SOURCE: United Nations (1990:65).

check on consistency: comparing census results with survey results (see van de Walle, 1993).

Despite problems of comparability between the sources, this table, like the DHS results, suggests that before 1970, the proportions of women aged 15–19 who were ever married at the time of the survey or census were quite high throughout the subcontinent. Only in Burundi, Rwanda, Botswana, and South Africa did fewer than 20 percent of women marry that young.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

Fifty percent or more of adolescents were already married in Tanzania, Central African Republic, Congo, Benin, Ghana, Liberia, Mali, Senegal, and Togo. Western African countries generally had the highest proportions. In the 1970s and 1980s, increases in the reported ages at marriage could be detected in some countries. Mali still had a high proportion of adolescent marriages (75 percent), and three countries (Mozambique, Zambia, and Lesotho) recorded increases in the proportion of adolescent marriages. But most countries show declines in the proportions. These are most marked in Burundi, Tanzania, Congo, Benin, Ghana, and Liberia. If we can rely on the evidence presented in these last two tables, then, it indeed appears that the age at marriage has increased in many countries.

Fertility

Have these recent changes in schooling and marriage patterns affected the prevalence of teenage fertility? Three issues are important to the analysis that follows. One concerns childbearing itself. Because of the widespread trend toward more schooling and somewhat older ages at marriage, we might expect to find a decline in teenage childbearing. Table 2-9 shows such a change in six of the eleven countries, when fertility before age 20 for women aged 20–29 is compared with that for women of 30–39. The largest declines appear in Burundi, Kenya, and Zimbabwe. In two countries, Liberia

TABLE 2-9 Percentage of All Respondents Aged 20 and Older Who Have Given Birth Before Age 20, Selected Sub-Saharan African Countries

 

Age at Time of Survey

Country

20–24

25–29

30–34

35–39

Botswana

55

61

60

57

Burundi

27

37

36

38

Ghana

51

50

58

56

Kenya

58

67

70

67

Liberia

64

62

55

52

Mali

67

61

64

59

Nigeria

54

54

57

4

Senegal

59

61

60

61

Togo

56

58

64

55

Uganda

68

68

72

73

Zimbabwe

49

58

59

53

 

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

and Mali, teenage births increased, but the trend is erratic; moreover, for Liberia the quality of the data on birth history is poor (Arnold, 1990).

Trends in adolescent fertility do not necessarily indicate trends in conceptions. The DHS, however, asked only about children ever born. It avoided questions about abortions on the grounds that most women are reluctant to reveal this information and their answers would be unreliable. In Chapter 7, we discuss evidence from hospital records and other studies that suggest a rising incidence of abortions in Africa, especially in urban areas.

Aside from childbearing and abortion, the other standard topic in studies of adolescent fertility is premarital births. Declines in some populations across cohorts in proportions of both reported marriages and births to teens do not necessarily mean declines in premarital births. Have they, too, declined? The fluid nature of marriage in much of Africa makes it more complicated to sort out the sequencing of marriages and births. With these reservations, we use cross-sectional data to calculate two separate measures. The first measure we examine is the percentage of women who had a premarital birth by age 20 across various cohorts (see Table 2-10). Because dating the start of a marriage is difficult, for these calculations, we define a birth as premarital if it occurred one year before the reported age at first marriage. Using this criterion, we find only slight increases in women who give birth premaritally over the last 10 to 15 years.

Our second measure is the ratio of premarital births to all births to women under 20. Table 2-11 shows that in Botswana and Kenya, the percentages of all births to adolescents that occur before marriage have increased sharply. Modest increases in premarital births occurred in Liberia, Uganda, and Zimbabwe. In a third group of countries (Burundi, Ghana, Mali, Nigeria, Senegal, and Togo) premarital births rose little, if at all. Taken together, Tables 2-10 and 2-11 show slight increases in four countries in proportions of women giving birth premaritally, and more noticeable increases in five of the eleven DHS countries in proportions of premarital births.

These observed rises in proportions of premarital births are roughly paralleled by rises in ages at first marriage and in education. Whereas trying to calculate the extent of premarital sexual activity would be quite problematic, we assume that because young women who are attending school remain unmarried for a longer period, they are at risk of premarital sexual activity for a longer period of time. At the same time, the fact that women appear to be entering marriage at older ages implies that sexual activity among teenage women has probably not increased at all; indeed, it may well have declined in most countries. Still, the proportion of adolescents who have sexual intercourse before they marry probably has increased (Meekers, 1991); that is, younger women are less likely than older ones to have had

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-10 Percentage of Women Aged 20–49 Who Had a Premarital Birth by Age 20, Selected Sub-Saharan African Countries

 

Age at Time of Survey

Country

20–24

25–29

30–34

35–39

Botswana

43

41

40

34

Burundi

2

0

1

1

Ghana

5

4

5

4

Kenya

20

18

17

13

Liberia

21

14

12

12

Mali

7

5

6

9

Nigeria

3

4

5

4

Senegal

6

6

5

4

Togo

9

7

10

10

Uganda

11

11

10

8

Zimbabwe

9

9

8

8

NOTE: Women who have given birth but never married and ever-married women who have given birth before marriage are counted as having had a premarital birth. Women who first gave birth after marriage, women who are married but have never given birth, and women who have neither married nor given birth are counted as not having had a premarital birth. Premarital births are defined as beginning one year before the date of first marriage reported in the DHS.

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

sex by age 15; but they are more likely to have had sex before marrying. In Ethiopia, a survey on sexual activity among urban youths reported that, even among unmarried women who reported that they were sexually experienced, 53 percent of women aged 15–19 and 44 percent of women aged 20–24 were not sexually active in the month prior to the survey (Manpower and Employment Department, 1991). And, in Banjul, The Gambia, the mean coital frequency in the past month among women aged 14–24 was 2.4 times for married women and 1.9 times for single women (Gambia Family Planning Association, 1988). Finally, a recent study on age at first sexual activity concluded that ''the trend in age at first sexual intercourse across cohorts [in African countries with DHS data] tends either to the flat or to show a slight increase'' (Blanc and Rutenberg, 1990:67).

Although the analysis so far has focused on differences among countries, we stress that countries differ internally as well, especially with respect to premarital births. Table 2-12 highlights some striking differences between urban and rural areas in the prevalence of premarital births. In

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-11 Premarital Births as a Percentage of All Births to Women Under Age 20, Selected Sub-Saharan African Countries

 

Age at Time of Survey

Country

20–24

25–29

30–34

35–39

Botswana

77

62

61

57

Burundi

6

1

5

1

Ghana

9

6

8

6

Kenya

27

21

16

14

Liberia

28

18

18

18

Mali

7

5

8

14

Nigeria

6

7

9

8

Senegal

8

8

7

6

Togo

14

10

11

13

Uganda

13

13

1

8

Zimbabwe

14

12

9

13

 

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

TABLE 2-12 Premarital Births as a Percentage of All Births to Women Under Age 20, by Current Place of Residence, Selected Sub-Saharan African Countries

 

Age at Time of Survey

 

20–29

30–39

Country

Urban

Rural

Urban

Rural

Botswana

72

68

60

61

Burundi

9

2

8

4

Ghana

7

8

5

9

Kenya

30

22

18

16

Liberia

32

15

24

13

Mali

6

6

4

9

Nigeria

8

4

5

7

Senegal

12

6

10

5

Togo

17

10

17

9

Uganda

23

12

22

10

Zimbabwe

15

12

15

7

 

SOURCE: Demographic and Health Surveys Standard Recode Files, weighted data.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

nine of the eleven countries, the proportion of premarital births to women now aged 20–29 was higher in urban areas than in rural areas. Furthermore, the proportion of premarital births rose over the decade in nine of the eleven urban areas, although in two countries the change was less than 2 percentage points. Furthermore, three countries, Botswana, Kenya, and Liberia, show big increases in both urban and rural areas.

PUTTING THE INDICATORS TOGETHER

The data and calculations we have reported here have shown substantial variation among countries in education, marriage, and early childbearing. No common pattern emerges. However, on the basis of the changes in the proportions of births that are premarital (Table 2-11), Table 2-13 identifies three groups of countries, each of which manifests broadly similar patterns of change over a decade, as evidenced by the difference in the results between women now aged 30–39 and women aged 20–29. We base the typology on trends in premarital births because such births indicate, however roughly, the changing social conditions under which entry into childbearing is occurring.

  • Group 1: Botswana and Kenya have experienced (1) marked rises in proportions of births to young women that are premarital by our definition, (2) dramatic increases in the proportions of women who have attended secondary school, and (3) indications of increasing age at marriage.

  • Group 2: Liberia, Uganda, and Zimbabwe show changes similar to those of Group 1, though generally not as marked.

  • Group 3: In Burundi, Ghana, Mali, Nigeria, Senegal, and Togo premarital adolescent childbearing has increased little, if at all, and only Nigeria and Togo have experienced marked increases in female education.

Charts for three countries—Kenya, Uganda, and Mali—are used to illustrate the relationships among the three principal variables for each group in turn.

Group 1

Figure 2-1 displays trends for Kenya in three indicators: percentage of women who married before age 20, attended secondary school, and had a first birth a year or more before their first conjugal union. The figure shows a clear increase in secondary school enrollment, accompanied by an increase in the proportion never married under age 20 and an increase in the proportion of women having premarital births. Botswana is distinctive among the 11 DHS countries because of its consistently low proportions of women marrying before age 20 and high proportions of premarital births to this group.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

TABLE 2-13 Recent Changes in Education, Marriage, and Fertility, DHS Countries in Africa: Percentage Point Change Between Proportion of Women Aged 30-39 and of Women Aged 20–29

 

Premarital Births

Group

Secondary Education

Teenage Marriage

Teenage Fertility

Percentage of Women Having Given Birth Before Age 20

Births as Percentage of All Births to Women Under Age 20

1 Botswana

+++

 

+

++

Kenya

+++

-

+

++

2 Liberia

+++

-

++

+

++

Uganda

+

-

-

+

+

Zimbabwe

+++

-

-

 

+

3 Burundi

 

-

-

 

 

Ghana

+

-

 

 

Mali

 

 

+

 

 

Nigeria

+++

-

 

 

 

Senegal

+

 

 

 

Togo

++

-

-

NOTE: The following key applies: +++/— increase/decrease of more than 12 percentage points between groups, ++/— increase/decrease of 8–12 percentage points between groups; +/— increase/decrease of 2–7 percentage points between groups.

SOURCES: See Tables 2.6, 2.7, 2.9, 2.10, and 2.11.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

FIGURE 2-1  Trends in education, marriage, and fertility,  selected sub-Saharan African countries.

The patterns for Group 1, then, are those of more schooling, delayed marriage, and higher proportions of premarital births. We stress once again that teenagers are not necessarily having more children; Kenya, in fact, has had a major decline in the proportion of first births before age 20 (see Table 2-9). But, among the births that do occur to adolescents, more are occurring outside of marriage. If there is a problem here, it arises not necessarily from increasing fertility; rather, it appears to stem from what society regards as mistimed births. (Chapters 3 and 4, however, provide some crucial qualifications for this generalization.)

The patterns manifested in Group 1 will sound familiar to contemporary Americans. Contrary to popular belief, the heart of the "teenage pregnancy problem" in the United States is not a rise in the number of births to teenagers. Indeed, American teenagers bear proportionally fewer children now than they did in the 1950s (Hayes, 1987). Because Americans in the 1950s married at earlier ages than they do now, most teenage births occurred to married couples. Consequently, these births were not considered a social problem. Today, although a smaller proportion of teenagers give birth to children, these teenage mothers are much less likely to be married

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

because of the rise in the average age of marriage and a decline in the stigma of bearing a child out of wedlock (Cherlin, 1988). Paradoxically, then, teenage childbearing has come to be seen as a social problem in the United States over a period in which rates of childbearing among adolescents have actually declined. In Africa, as well, teenage childbearing is coming to be defined as a problem only as the age at marriage is rising and overall fertility rates among young women are declining. Certainly, we are not suggesting that the Botswana and Kenya cases are like the American case in all respects. Still, some of the same forces may be operating both in the United States and in Africa.

Group 2

Countries in Group 2, represented in Figure 2-1 by Uganda, show patterns similar to those in Group 1. In two of the three countries in this group, Zimbabwe and Liberia, the proportion of women who attended secondary school expanded rapidly. With respect to age at marriage and especially premarital births, the trends are less pronounced. The proportion marrying in the teen years has declined somewhat, and the proportion of respondents who have had a premarital birth rose moderately. For Group 2, then, the changes are less marked than those in Group 1 countries, but the analogy with the United States still may be useful.

Group 3

The data from the remaining six countries do not suggest the emergence of the kind of adolescent fertility pattern experienced in the United States—or even in Kenya or Senegal. The proportion of premarital births changed little, a stability paralleled, on the whole, for most of the other indicators except education. In Mali teenage marriage remains extremely common, secondary schooling is still negligible, and the very low proportion of women having premarital births shows no clear trend. This pattern of socially approved early marriage and childbearing is by no means restricted to rural areas. In urban Mali, DHS data show that 70 percent of women in each cohort had been married by age 17, and close to 40 percent had given birth by that age.

Including Nigeria in this group—or in any group—is problematic, given its large, heterogeneous population. Nonetheless, the aggregate data show a substantial increase in secondary schooling and some decline in teenage marriage, but little change in the proportion of women having premarital births, a figure which was already low. These patterns reveal an important lesson: Increases in schooling are not necessarily associated with more premarital births.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×

CONCLUSION

The diverse paths that these countries have taken manifest enormous variability in patterns of formation of marital unions and childbearing by teenagers. Nevertheless, there are some broad similarities. In most countries, enrollment in secondary school increased and age at marriage rose. The figures presented here suggest that these changes have created a longer period during which adolescent girls are sexually mature yet unmarried and pursuing education, an activity their societies consider incompatible with motherhood. More important, in most countries we observe a rise in the proportion of births occurring before a woman's first marital union, especially in urban areas. In some countries these increases were small; elsewhere they were substantial. Although the African and Western situations differ in key respects, these premarital births could be as great a problem for African girls as they are for girls in the United States.

Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 16
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 17
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 18
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 19
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 20
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 21
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 22
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 23
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 24
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 25
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 26
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 27
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 28
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 29
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 30
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 31
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 32
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 33
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 34
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 35
Suggested Citation:"2 LEVELS AND TRENDS IN ADOLESCENT FERTILITY." National Research Council. 1993. Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. Washington, DC: The National Academies Press. doi: 10.17226/2220.
×
Page 36
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This examination of changes in adolescent fertility emphasizes the changing social context within which adolescent childbearing takes place.

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