At CGD, we’ve had a longstanding interest in population and development, and we’ve thought carefully about some of these issues. Earlier this year, we released a working paper with Kate McQueston on the causes and consequences of adolescent fertility in the developing world. After conducting a systematic review of existing empirical literature and analyzing the results, our findings challenged the conventional wisdom about fertility behavior. Contraceptive access programs sometimes increased on contraceptive use, but results varied from study to study; even the strongest results, while statistically significant, showed a relationship of relatively limited magnitude, and a highly questionable connection to actual fertility rates. What’s more, we found that adolescent fertility was more the consequence than cause of negative socioeconomic outcomes, particularly school dropout. Surprised? This finding holds equally true in rich countries: teen moms are not poor “because they have babies. They have babies because [they are] poor.” While we should be careful to overgeneralize, or to conflate adolescents with women more generally, this does suggest that the proximate causes of fertility – sexual activity and contraceptive use – may mask the deeper forces driving fertility behavior, at least among girls.What does this mean for donors as they make good on their pledges of support to family planning? There are a couple of takeaways. First, have limited expectations. Increasing contraceptive access and uptake may not, on its own, be sufficient to change fertility trends. Nor will it, on its own, be sufficient to empower women who are otherwise oppressed, disenfranchised, or abused; indeed, it is unlikely to reach them at all. Second, think about the big picture. What are the barriers to family planning in the first place? Lack of financial resources? Geographic remoteness? Few opportunities for women outside the home, such that having more children is the most rewarding option? Of these barriers, which are donors prepared to address, and with which strategies? A greater supply of contraception may help, but empirical studies show that conditional cash transfers or scholarships to encourage school continuation or return may be even more effective, both at lowering fertility rates and increasing women’s empowerment. In this era of shrinking global health budgets, I urge donors to remember that while contraceptive access is necessary for women’s rights, health and empowerment, it is not, on its own, sufficient to achieve any of those goals.
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.