Does Contraceptive Use Always Lead to Lower Fertility? The Case of Malawi

Aparna Jain, Population Council
John Ross, Futures Group International
Erin McGinn, Futures Group International
Jay Gribble, Futures Group International

Increases in CPR have not translated into expected declines in Malawi’s TFR. CPR increased from 13% in 1992 to 46% in 2010, accompanied by a modest TFR decline of 6.7 to 5.7 rather than 4.4 according to international CPR/TFR correlations. Using three Malawi DHS surveys, we applied the Proximate Determinants Model to estimate TFRs. The estimated and observed TFR values differed less than half a child: estimated was lower than observed by 1/3 of a child in 2000, the TFRs were the same at 6.0 in 2004, and estimated was again lower at 5.2 compared to observed 5.7 in 2010. Between 2000 and 2004, a decline in postpartum insusceptibility offset by a small increase in contraceptive use yielded the same TFR in 2004. By 2010, contraceptive use rose substantially with no change in postpartum insusceptibility that produced the difference of a half child in 2010. Non-model determinants are discussed.