Does child survival make for smaller family sizes?

Hans Rosling (1948–2017), physician and epidemiologist, famously upturned assumptions widely held by the public and by the development community — assumptions that, thanks to US President Donald Trump, are back in the spotlight. A recurring theme of Rosling’s was that family sizes have been shrinking even though child survival rates have improved.

Rosling’s global statistics on total fertility rate and infant mortality rate do not indicate causality, neither are they necessarily correlated. Although such a correlation holds for Asia, it does not in Africa. The infant mortality rate in Niger, for example, has fallen by two-thirds since the 1980s but the country’s total fertility rate has risen slightly, leading to a predicted population explosion from 20 million in 2015 to 72 million by 2050.

The researchers make the case that lack of family counseling or reduced family counseling results in increased abortions.

According to the results of the UN 2015 Revision of world population, the world population reached 7.3 billion as of mid- 2015, implying that the world has added approximately one billion people in the span of the last twelve years. Sixty per cent of the global population lives in Asia (4.4 billion), 16 per cent in Africa (1.2 billion), 10 per cent in Europe (738 million), 9 per cent in Latin America and the Caribbean (634 million), and the remaining 5 per cent in Northern America (358 million) and Oceania (39 million). China (1.4 billion) and India (1.3 billion) remain the two largest countries of the world, both with more than 1 billion people, representing 19 and 18 per cent of the world’s population, respectively.

The Millennium Development Goals was to reduce the under-five mortality rate by two thirds between 1990 and 2015. While the MDG Target will not be achieved globally by the end of 2015, progress in reducing under-five mortality has been very significant and wide-reaching in recent years. Between 2000-2005 and 2010-2015, under-five mortality has decreased by more than 20 per cent in 156 countries, with widespread reductions of 20 per cent or more recorded in Africa (42 out of 57 countries), Asia (43 out of 51 countries), Europe (39 out of 40 countries), Latin America and the Caribbean (24 out of 38 countries), and Oceania (8 out of 13 countries). Between 2000-2005 and 2010-2015, under-five mortality fell by more than 30 per cent in 86 countries, of which 13 countries saw a decline of more than 50 per cent.

Globally, total fertility is expected to fall from 2.5 children per woman in 2010-2015 to 2.25 in 2045-2050 and to 2.0 in 2095-2100 according to the medium-variant projection. However, in Europe and Northern America, total fertility is projected to increase between 2010-2015 and 2045-2050 from 1.6 to 1.8 children per woman in Europe and from 1.86 to 1.9 children per
woman in Northern America. In Africa, Asia, Latin America and the Caribbean, and Oceania fertility is expected to fall between 2010-2015 and 2045-2050, with the largest reductions projected to occur in Africa. Thus, in all major areas of the world, fertility levels are projected to converge to a level at or just below the replacement level by 2095-2100.

In recent years, fertility has declined in virtually all major areas of the world. In Africa, where fertility levels are the highest of any major area, total fertility has fallen from 4.9 children per woman in 2005-2010 to 4.7 children per woman in 2010-2015. Fertility levels have also fallen in Asia and Oceania over the same period, from 2.3 to 2.2 children per woman in Asia and from 2.5 to 2.4 children per woman in Oceania. Recent fertility declines have been slightly larger in Latin America and the Caribbean where fertility has fallen from 2.3 to 2.15 and in Northern America where fertility has fallen from 2.0 in 2005-2010 to 1.86 in 2010-2015. Europe is the only major area that was an exception to this trend. In recent years, total fertility in Europe has increased slightly from 1.55 children per woman in 2005-2010 to 1.6 children per woman in 2010-2015.