Childbearing and the Impact of HIV: The South African Experience

Abstract

A demographic transition of falling birth and death rates has been widely observed across much of Europe and the Western world in parallel with economic development. Yet there is conflicting evidence surrounding the much anticipated African transition (Zaba and Gregson 1998). In response to regional economic and political development, a limited number of sub-Saharan countries have observed declining birth rates in the past 20 years. Increased urbanization, improved education, health services, higher prevalence of contraceptives and access to reproductive health care has led to a swift reduction in fertility rates in Zimbabwe, Botswana, Nigeria, Kenya and South Africa (Kalipeni 1995). This effect is most pronounced in South Africa, where fertility rates of 2.4 births per woman in 2009 were exactly half those in 1980 and are now the lowest in sub-Saharan Africa (The World Bank 2008).