1. Home
  2. Vol 30, No 8 (2026)
  3. Lei

Urbanization, contraceptive uptake and childbearing patterns in selected African countries

Anqi Lei(1), Caoyuan Yang(2), Qi Li(3), Li Yang(4),


(1) Faculty of Law, Ningxia University, yinchuan, Ningxia,750021, China;Macao Polytechnic University，Macao, 999078, China
(2) Macao Polytechnic University Macao, 999078, China
(3) Faculty of Law, Ningxia University, yinchuan, Ningxia,750021, China; Ningxia Local Financial Administration Bureau, yinchuan, Ningxia, 750000, China
(4) Faculty of Law, Ningxia University, yinchuan, Ningxia,750021, China ; Institute of Agricultural Economics and Information Technology, Ningxia Academy of Agriculture and Forestry Sciences, yinchuan, Ningxia, 750021, China
Corresponding Author

Abstract


Using a qualitative interpretive descriptive–analytical approach, this study analysed harmonised secondary data from the World Bank World Development Indicators covering six countries between 2000 and 2024. Longitudinal trend assessment and cross-country comparisons were employed to examine urban population, modern contraceptive prevalence, and total fertility rates. The findings indicate sustained urban expansion across all countries, accompanied by gradual increases in contraceptive uptake and fertility decline. However, these patterns remain uneven across national contexts. Ghana and Sierra Leone combine relatively high urbanisation with stronger improvements in contraceptive prevalence and faster fertility decline. In contrast, Nigeria and Guinea maintain comparatively high fertility levels despite substantial urban growth and weaker contraceptive uptake. The Gambia and Liberia display intermediate trajectories characterised by moderate urbanisation, rising contraceptive use, and gradual fertility reduction. The results indicate that urbanisation alone does not generate uniform reproductive outcomes; rather, fertility transitions are mediated by contraceptive access and the effectiveness of urban health service. The study recommends integrating family planning into urban development strategies and strengthening reproductive health service delivery in rapidly expanding urban and peri-urban settlements to reduce persistent reproductive health inequalities

References


Rigolon A, Browning MHEM, Lee K , Shin S. Access to urban green space in cities of the Global South: A systematic literature review. Urban Science 2018; 2(3): 67. https://doi.org/10.3390/urbansci2030067

Joshi S, Bailey A , Datta A. On the move? Exploring constraints to accessing urban mobility infrastructures. Transport Policy 2021; 102: 61–74. https://doi.org/10.1016/j.tranpol.2020.11.005

Korah A , Wimberly MC. Smaller cities have large impacts on West Africa’s expanding urban system. Sustainable Cities and Society 2024; 106: 105381. https://doi.org/10.1016/j.scs.2024.105381

Titz A , Chiotha SS. Pathways for sustainable and inclusive cities in Southern and Eastern Africa through urban green infrastructure? Sustainability 2019; 11(10): 2729. https://doi.org/10.3390/su11102729

OECD , Sahel and West Africa Club. Urbanisation and conflicts in North and West Africa. Paris: OECD Publishing; 2023. https://doi.org/10.1787/3fc68183-en

Essien E , Jesse EE. Urban informality in Nigeria: A midsized city perspective. Environment, Development and Sustainability 2024. https://doi.org/10.1007/s10668-024-05647-6

Azuh DE, Osabohien R, Orbih M ,Godwin A. Public health expenditure and under-five mortality in Nigeria: An overview for policy intervention. Open Access Macedonian Journal of Medical Sciences 2020; 8(E): 353–362.

Gershon O, Akhigbemidu A , Osabohien R. Domestic resource mobilization and under-five mortality in Nigeria. Research in World Economy 2020; 11(3): 320–332. https://doi.org/10.5430/rwe.v11n3p320

Jakovljevic M, Liu Y, Cerda A, Simonyan M, Correia T, Mariita RM, Kumara AS, Garcia L, Krstic K, Osabohien R , Toan TK. The Global South political economy of health financing and spending landscape–history and presence. Journal of Medical Economics 2021; 24(Sup1): 25–33. https://doi.org/10.1080/13696998.2021.2007691

Aprilla RM, et al. Urban–rural disparities in modern contraceptive use in sub-Saharan Africa: Evidence from DHS. PLOS ONE 2021; 16(3): e0248414. https://doi.org/10.1371/journal.pone.0248414

Harpham T, Tetui M, Smith R, Okwaro F, Biney A, Helzner J, Duminy J, Parnell S , Ganle J. Urban family planning in sub-Saharan Africa: An illustration of the cross-sectoral challenges of urban health. Journal of Urban Health 2022; 99(6): 1044–1053. https://doi.org/10.1007/s11524-022-00649-z

Apostolopoulou E, et al. Infrastructure-led development and uneven urban outcomes in the Global South. World Development 2023; 168: 106178. https://doi.org/10.1016/j.worlddev.2023.106178

Himaz R. Challenges associated with the BRI: A review of recent economics literature. The Service Industries Journal 2021; 41(7–8): 512–526. https://doi.org/10.1080/02642069.2019.1584193

Sharifi A, Khavarian-Garmsir AR, Allam Z , Asadzadeh A. Progress and prospects in planning: A bibliometric review of literature in urban studies and regional and urban planning, 1956–2022. Progress in Planning 2023; 173: 100740. https://doi.org/10.1016/j.progress.2023.100740

Feng Y, Ahuru RR, Anser MK, Osabohien R, Ahmad M , Efegber AH. Household economic wealth management and antenatal care utilization among business women in the reproductive-age. African Journal of Reproductive Health 2021; 25(6): 143–154.

Sui Y, Ahuru RR, Huang K, Anser MK , Osabohien R. Household socioeconomic status and antenatal care utilization among women in the reproductive-age. Frontiers in Public Health 2022; 9: 724337. https://doi.org/10.3389/fpubh.2021.724337

Nasir MH, Anser MK, Ahuru RR, Osabohien R, Ebiaku KC ,Abbas S. A comparative study of the effect of health insurance on women’s use of health facility delivery: Evidence from demographic health survey in Benin Republic. African Journal of Reproductive Health 2022; 26(6): 104–115.

Xu Y, Peng MYP, Ahuru RR, Anser MK, Osabohien R , Aziz A. Individual and community-level factors associated with non-institutional delivery of women of childbearing-age in Nigeria. Humanities and Social Sciences Communications 2022; 9(1): 1–7. https://doi.org/10.1057/s41599-022-01168-7

Zhang X, Anser MK, Ahuru RR, Zhang Z, Peng MY, Osabohien R , Mirza M. Do predictors of health facility delivery among reproductive-age women differ by health insurance enrollment? A multilevel analysis of Nigeria’s data. Frontiers in Public Health 2022; 10: 797272.

Boadu I. Coverage and determinants of modern contraceptive use in sub-Saharan Africa: Further analysis of demographic and health surveys. Reproductive Health 2022; 19(1): 18. https://doi.org/10.1186/s12978-022-01332-x

Matthew OA, Osabohien R, Fagbeminiyi F , Fasina A. Greenhouse gas emissions and health outcomes in Nigeria: Empirical insight from autoregressive distributed lag technique. International Journal of Energy Economics and Policy 2018; 8(3): 43–50.

Urhie E, Afolabi A, Afolabi A, Matthew O, Osabohien R , Ewetan O. Economic growth, air pollution and health outcomes in Nigeria: A moderated mediation model. Cogent Social Sciences 2020; 6(1): 1719570. https://doi.org/10.1080/23311886.2020.1719570

Apostolopoulou E, Cheng H, Silver J , Wiig A. Cities on the new silk road: The global urban geographies of China’s Belt and Road Initiative. Urban Geography 2024; 45(6): 1095–1114. https://doi.org/10.1080/02723638.2023.2247283

Upadhyay UD, Gipson JD, Withers M, Lewis S, Ciaraldi EJ, Fraser A, Huchko MJ , Prata N. Women’s empowerment and fertility: A review of the literature. Social Science & Medicine 2014; 115: 111–120. https://doi.org/10.1016/j.socscimed.2014.06.014

World Bank. World Development Indicators. Washington DC: World Bank; 2024. https://databank.worldbank.org/source/world-development-indicators

UN DESA. World urbanization prospects: The 2018 revision. New York: United Nations; 2019. https://doi.org/10.18356/625fcb1f-en

Bongaarts J. Fertility transition in sub-Saharan Africa: The role of family planning. Population and Development Review 2017; 43(S1): 39–58. https://doi.org/10.1111/j.1728-4457.2017.00185.x

Dyson T. Population and development: The demographic transition. Oxford: Oxford University Press; 2010. https://doi.org/10.1093/acprof:oso/9780199562427.001.0001

Montgomery MR. Urban poverty and health in developing countries. Population and Development Review 2009; 35(1): 121–138. https://doi.org/10.1111/j.1728-4457.2009.00294.x

Starrs AM, Ezeh AC, Barker G, Basu A, Bertrand JT, Blum R, Coll-Seck AM, Grover A, Laski L, Roa M, Sathar ZA. Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher–Lancet Commission. The lancet. 2018;391(10140):2642-92

Ai W, Aderemi TA, Bassey R , Khalid AA. Out-of-pocket expenditure and maternal mortality nexus in China: Implications for the Sustainable Development Goal 3. African Journal of Reproductive Health 2023; 27(12): 94–100.

Li H, Zhang X, Ma F , Osabohien R. Out-of-pocket medical expenditures, remittances and health outcomes in China. African Journal of Reproductive Health 2024; 28(8): 122–132.

Osabohien R, Jaaffar AH, Akpa AF , Jakovljevic M. Mobile money, medical cost anxiety and welfare of individuals within the reproductive age in Malaysia. Humanities and Social Sciences Communications 2024. https://doi.org/10.1057/s41599-024-02767-2

Zhang C, Jing X, Wang Z , Chen H. Belt and Road Initiative and urban landscapes: Quantifying land use changes and development strategies in Minsk, Vientiane, and Djibouti. Land 2025; 14(4): 875. https://doi.org/10.3390/land14040875

Jia H, Han X, Aderemi TA, Ifekwem NE , Al-Faryan MAS. Out-of-pocket expenditure and human welfare in Nigeria: Evidence from a fully modified ordinary least squares regression. African Journal of Reproductive Health 2025; 29(2): 151–159.

Hu YL, Zhang YJ, Lv XY, Liu RL, Zhong ZH, Fu LJ, Bao MH, Geng LH, Xu HJ, Yu SM, Ding YB. Impact of Omicron variant infection on female fertility and laboratory outcomes: a self-controlled study. American Journal of Reproductive Immunology. 2024;92(5):e70012. https://doi.org/10.1111/aji.70012

Kang S, Jin S, Mao X, He B, Wu C. CD4+T , CD8+T cells in uterus exhibit both selective dysfunction and residency signatures. Journal of Immunology Research. 2024;2024(1):5582151. https://doi.org/10.1155/2024/5582151

Yang J, Yao YL, Lv XY, Geng LH, Wang Y, Adu-Gyamfi EA, Wang XJ, Qian Y, Chen MX, Zhong ZH, Li RY, Wan Q, Ding YB. The safety and efficacy of inactivated COVID-19 vaccination in couples undergoing assisted reproductive technology: a prospective cohort study. Vaccine. 2025; 45:126635. https://doi.org/10.1016/j.vaccine.2024.126635

Yang Z, Ping YQ, Wang MW, Zhang C, Zhou SH, Xi YT, Zhu KK, Ding W, Zhang QY, Song ZC, Zhao RJ. Identification, structure, and agonist design of an androgen membrane receptor. Cell. 2025;188(6):1589-604.

Ma W, Gu Z, Lin Q, Cao M, Zhong J, Li X, Li H, Lin Y, Lin H, Xu M, Liu J, Du L, Song G. Integrative genetic and multi-omics analysis reveals the interleukin-6 receptor's role in recurrent spontaneous abortion. Frontiers in Immunology.2025;16:1659251. https://doi.org/10.3389/fimmu.2025.1659251

Fei Z, Wang Y. Parental gender preferences and fertility ideals in China. Acta Psychologica. 2026; 264:106523. https://doi.org/10.1016/j.actpsy.2026.106523


Full Text: PDF

Article Metrics

Abstract View : 0 times
PDF Download : 0 times

Refbacks

  • There are currently no refbacks.