Ethiopia has seen a massive cut in its fertility rate, from an average of seven children per woman in the 1990s to 4.6 currently. But how has it managed this?

Experts say the country has made this turnaround because of a combination of factors.

“Women stay longer in school, the standard of living is increasing so people don’t want to have too many children and more importantly, family planning is becoming more popular,” explains Faustin Yao, the United Nation Population Fund (UNFPA) representative to Ethiopia.

The country’s economy is among the fastest growing in the world, and as the quality of life improves, people tend to have fewer children.

Muluwork Tesfaye, a nurse in Addis Ababa, says she could not afford to support a large family in the capital.

The mother of two grew up in a family of eight and her parents struggled to provide for them.

“My husband is the one who took me to college,” she says. “I wanted a better life for my children.”

In the capital, Addis Ababa, the fertility rate is estimated to be 1.7 – lower than the rate needed to keep the population steady.

More educated women and a higher cost of living often mean fertility rates are lower in urban areas.

Contraception

In Ethiopia, the availability of contraceptives has also played a big role.

“The increase in contraceptive use during 2000-2011 emerged as the single most important source for the recorded decline in TFR (Total Fertility Rate),” said a UNFPA report.

However, a quarter of all women who need contraceptives are still not able to get them.

Rural areas have also recorded a decline in the number of children per woman, albeit slower.

Ayenalem Daw, a mother of six living in Weyo Rafu Hargisa village about a four-hour-drive out of Addis Ababa, is in her late thirties.

She says if she had heard about family planning earlier, she would have had four children.

Women in her village hold regular meetings called “shene” to discuss contraception and other health issues.

“Things are changing now. I think my children will have only two babies each,” says Mrs Ayenalem.

Health extension workers also regularly provide health education in the villages, including information about contraception to those who need it.

The program entails home visits by government-employed community workers who engage families on a one-on-one basis.

The big leap in contraception use between 2000 and 2011 is largely attributed to health extension workers.

This was also helped by an increase in the number of girls going to school over the same period.

“We go to the churches and mosques to talk to people about family planning,” said one of the women in the village of Hunta, in the Oromiya region.

While it is known that the major religions in Ethiopia – Orthodox and Muslims – do not openly approve of family planning, the health workers said religious leaders were generally supportive of their work.

Ethiopia is among nine African countries whose rate of population growth is declining.

Continue reading on BBC News
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