Do Family Planning Programs Influence Fertility Desires? A Multilevel Analysis of Sub-Saharan Africa

John B. Casterline, Ohio State University
Sarah Garver, Ohio State University

A fundamental issue entirely unresolved in the literature is whether increased availability of family planning services, and the increased contraceptive prevalence which often ensues, can themselves have a causal effect on fertility desires. That is, do family planning programs generate demand for limiting and spacing births? Social science theory supports such an effect, but empirical evidence is largely lacking. The question is especially salient for sub-Saharan Africa, where fertility is relatively high, demand for children is a major obstacle to decline, and there is renewed NGO and government commitment to family planning. This study uses DHS data for sub-Saharan Africa countries to conduct multilevel analysis in which fertility desires are modeled as a function of (i) Contraceptive prevalence (lagged) at the province level and (ii) Family Planning Effort (lagged) at the country level. Results have important implications for our understanding of contemporary fertility declines and for population policy.