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Fertility Transition: Middle East and North Africa
Fertility Transition: Middle East and North Africa John B Casterline, Institute for Population Research, The Ohio State University, Columbus, OH, USA Ó 2015 Elsevier Ltd. All rights reserved. This article is a revision of the previous edition article by H.M. Yousif, volume 8, 5588–5593, Ó 2001, Elsevier Ltd.
Abstract Fertility in the Middle East and North Africa declined by more than one-half in the period from 1960 to 2010, most rapidly in the two decades from the 1970s to the 1990s. At present seven of the 22 countries have fertility below replacement level (two births per woman), while the fertility rate exceeds three births per woman in six countries. Changes in marriage patterns have made an unusually large contribution to fertility decline in this region, roughly matching the contribution of improved birth control within marriage. Further decline will depend on future trends in marriage and the availability of the most effective methods of birth control (sterilization and induced abortion).
Introduction The 22 countries considered here stretch from Western Sahara on the Atlantic coast of Africa to Iran in western Asia. The countries, and their estimated population sizes in 2010, are shown in Table 1. Nineteen of the 22 countries are commonly regarded as Arab states, as indicated by their membership in the Arab League. Some of these Arab countries contain substantial subgroups that are non-Arab according to criteria such as past and present culture (including language), historical patterns of migration and marriage, and/or self-identification. These include Berber population in Morocco and Algeria, Kurdish population in Iraq (and in the non-Arab countries of Iran and Turkey as well), and Asian labor migrants in the Persian Gulf states. Three of the countries are non-Arab: Iran, Israel, and Turkey. Note that Israel contains a large Arab minority population, however. With the exception of Israel, the majority of the population in all countries of the Middle East and North Africa is Muslim, but there are large Christian minorities in Egypt and in most of the countries in West Asia.
Table 1 Listing of countries and estimated population size (in millions) in 2010 Country
Population
North Africa Algeria Egypt Libya Morocco Sudan Tunisia Western Sahara
37.1 78.1 6.0 31.6 35.6 10.6 0.5
Country
Population
West Asia Bahrain Iran Iraq Israel Jordan Kuwait Lebanon Oman Palestine Qatar Saudi Arabia Syria Turkey United Arab Emirates Yemen
1.2 74.5 31.0 7.4 6.5 3.0 4.3 2.8 4.0 1.8 27.2 21.5 72.1 8.4 22.8
Source: UN Population Division: World Population Prospects, 2012 Revision.
International Encyclopedia of the Social & Behavioral Sciences, 2nd edition, Volume 9
In 2010, the total population of these 22 countries was estimated as 488 million persons, with almost one-half (46%) in the three demographic giants: Egypt, Iran, and Turkey. A large fraction of the population in this set of countries resides along the Mediterranean Sea in northern Africa and western Asia. There are also substantial population concentrations in Morocco on the Atlantic Ocean, Iraq in the Mesopotamian River plain, Turkey on the Anatolian plateau and eastern mountains, Iran in the plateaus and mountains of southwest Asia, and Saudi Arabia with population along both the Persian Gulf and the Red Sea. Throughout this geographic expanse annual rainfall is relatively light, and this explains the concentration of population along seas and rivers. This climatic factor also helps account for the high level of urbanization as rural settlements engaged in intensive agriculture is feasible on a large scale in only a few locations (Atlantic coast of North Africa, Nile River Valley, Mesopotamia, and Anatolian plateau). Population dynamics in the Middle East and North Africa during the past century have been intertwined with political upheaval and uneven economic development (the discussion in this paragraph and the next draws on Courbage (1999), Fargues (1989), and Tabutin and Schoumaker (2005)). Most of the countries were subject to European imperial rule, either directly or through externally imposed local political regimes, beginning in the nineteenth century (Egypt) and continuing until a decade or so after World War II. The breakup of the Ottoman Empire at the end of World War I was especially consequential for the political history of Western Asia, with reverberations to the present (Iraq, Palestine, and Syria). The nationalism of the 1950s and 1960s resulted in generous social policies and programs in some countries (e.g., Egypt), with consequences for demographic behavior (fertility and migration). In the period since 2000, the region has experienced excessive civil strife – Iraq, Palestine, and Syria, with the strife in Palestine a continuation of conflict which began in the late 1940s. Note that the extreme civil strife in these countries spills over into neighboring countries, thereby affecting a large fraction of the population of the region (all three of the demographic giants have been directly affected by conflict in nearby countries). The period since 2010 has also witnessed historically significant internal political upheaval – the ‘Arab Spring’ – which began in Tunisia and has rippled through the region. The ultimate outcome of this upheaval is not yet
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known, in particular the longer-term political influence of Islamist parties whose programs often include explicit pro-natalist prescriptions about family life. As for economic development, the oil wealth of the Gulf States has had a profound impact on the entire region from the 1970s to the present. Non-oil-producing states have benefited from oil wealth via labor migration and tourism (i.e., holiday visits by Gulf State nationals). More generally, international migration is a dominant feature of the landscape throughout the region. This includes intra-regional labor migration to the Persian Gulf states and northward migration to western Europe, especially from the Maghreb countries in northern Africa (Morocco, Algeria, and Tunisia). The Middle East and North Africa have also participated in the global surge in formal schooling in recent decades. The high rates of women’s secondary and university schooling in post-1980 birth cohorts represent a sharp departure from the past, with implications for marriage and childbearing.
Fertility Decline to Date Overview The level of fertility in these 22 countries in the period from the early 1950s to the present is summarized in Table 2. In this table the measure of fertility is the total fertility rate (TFR), which is the sum of age-specific fertility rates for women of reproductive age during the specified historical period. The TFR can be viewed as the average number of births at the termination of a woman’s reproductive career, were this career characterized by childbearing at the rates observed during the historical period in question. That is, this is a lifetime total for a hypothetical (or ‘synthetic’) cohort, not an actual birth cohort of women (whose reproduction would extend over three historical decades). In the early 1950s, when the region had largely recovered from the severe disruption caused by World War II, almost one-half of the countries in the region had TFRs which exceeded seven births per woman, and only two countries (Israel at 4.3 and Lebanon at 5.7) had TFRs below six births per woman. The average for the region was roughly seven births per woman. With the exception of Israel and Lebanon (TFR ¼ 5.7), these can be regarded as pre-decline levels of fertility which had obtained, with slight variation, for many generations in the past. Available evidence indicates that predecline fertility in the Middle East and North Africa was higher than in other major regions, including other subregions of Asia, Table 2
Sub-Saharan Africa, and Latin America and the Caribbean (Casterline, 2011; Rashad, 2000). This coincides with other quantitative and qualitative evidence of the fundamental pronatalism of these societies in the past: relatively early and nearly universal marriage, short postpartum abstinence, and a high valuation placed on children and childbearing. Six decades later in 2010–14, 16 of the 22 countries have TFRs below three births per woman, and the average fertility for the region is less than three births per woman, a decline in the level of fertility from the early 1950s of more than one-half. It is also evident from Table 1 that in the majority of countries the decline was concentrated in the two decade period from the early 1970s to the early 1990s, although to be sure further substantial decline has occurred from the early 1990s to the present. From a comparative perspective, fertility decline in this region was late to start; in the early 1970s, only five countries had TFRs below six births per woman (Bahrain, Egypt, Israel, Lebanon, and Turkey), and only two of these (Israel and Lebanon) were below five births per woman. Among major regions, only Sub-Saharan Africa experienced later onset of fertility decline. Through the 1960s and 1970s (and even into the 1980s), the Arab region appeared to be very reluctant to join in the gathering international movement toward lower levels of fertility, a fact frequently commented upon in the demographic literature and in policy forums; see Obermeyer (1992). Once commenced, the declines proceeded rapidly – as summarized in Table 3. During the 1980s, when the pace of decline was most rapid, 11 of the 22 countries experienced a decline in their TFRs that exceeded 1.5 births per woman. Of the more populous countries, only Sudan and Yemen were not caught up in the rapid fertility decline in this period (indeed, Yemen’s TFR is thought to have increased from the early 1970s to the early 1990s). As of 2010–14, seven countries in the Middle East and North Africa have TFRs which are equal to or below replacement level of 2.1 births per woman; these countries are Bahrain, Iran, Lebanon, Qatar, Tunisia, Turkey, and United Arab Emirates. The low fertility in the Persian Gulf States (Bahrain, Qatar, and United Arab Emirates) is striking. At the other end of the spectrum, four countries retain TFRs above four births per woman; these countries are Iraq, Palestine, Sudan, and Yemen. Each of these countries has its own distinctive political and demographic history, but it is difficult to ignore the fact that three of the four (excepting Yemen) have experienced severe civil strife in recent decades. Political demography is more tangible in this region than most (Fargues, 2000; Khawaja, 2003).
Distribution of country-level TFR by historical period
TFR
1950–55
1970–75
1990–95
2010–14
> ¼ 7.0 6.0–6.9 5.0–5.9 4.0–4.9 3.0–3.9 2.2–2.9 < ¼ 2.1 Total
10 10 1 1 0 0 0 22
9 8 3 1 1 0 0 22
1 3 3 3 8 3 1 22
0 0 0 4 2 9 7 22
Source: UN Population Division: World Population Prospects, 2012 Revision.
Table 3
Rate of decline in TFR: births decline per decade
TFR
1960s
1970s
1980s
1990s
2000s
TFR increase 0.00–0.49 0.50–0.99 1.00–1.49 > ¼ 1.50 Total
8 6 5 3 0 22
3 2 8 8 1 22
0 2 4 5 11 22
1 1 7 7 6 22
3 8 10 0 1 22
Source: UN Population Division: World Population Prospects, 2012 Revision.
Fertility Transition: Middle East and North Africa
Figure 1
Fertility decline in populous North African countries. Source: UN Population Division.
Fertility Decline by Country There is considerable inter-country diversity in fertility decline – both the historical timing of onset and the pace of decline. This becomes clear from examining trajectories countryby-country. Fertility trends for 12 of the 22 countries are shown in Figures 1–3. The fertility declines in North Africa (Figure 1) have several interesting features. The declines in Algeria and Morocco were rapid, especially in Algeria which from the mid-1970s to mid-1990s experienced one of the fastest declines on record (four-birth decline in merely 20 years). By comparison, the declines in Egypt and Sudan have proceeded more slowly, especially in Sudan which after 1990 has among the highest levels of fertility in the region. A final intriguing feature of Figure 1 is the increase in fertility observed in both Algeria and Morocco in
Figure 2
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the period after 2000; in both countries, the estimate for the most recent period (2010–14) has risen to nearly three births per woman after declining to around 2.5 births per woman in the early 2000s. This recent increase has surprised demographers, who fully expected fertility in both countries to continue downward to replacement level or below, following the pathway of most countries once rapid and sustained decline is underway. The Algerian case has been examined in some detail by Ouadah-Bedidi and Vallin (2013), who conclude that the rise is principally due to a fall in the average age at first marriage. Note that fertility increase in both countries preceded the political upheaval of the Arab Spring. The same diversity is evident in the populous countries of West Asia. Iran experienced a spectacularly rapid fertility decline from the mid-1980s to the early 2000s, following a slight rise after the 1979 Revolution (the new government
Fertility decline in populous West Asian countries. Source: UN Population Division.
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Fertility Transition: Middle East and North Africa
Figure 3
Fertility decline in select countries. Source: UN Population Division.
was initially explicitly pro-natalist). Abbasi-Shavazi et al. (2009) provide a comprehensive demographic portrait of this exceptional decline. Less remarked on is the substantial and relatively rapid fertility decline in Saudi Arabia in the period since 1980. In the most recent period fertility is still well above replacement level (the TFR estimate for 2010–14 is 2.7), so it remains uncertain whether fertility in Saudi Arabia will continue downward to replacement level (as has occurred in Iran and Turkey; the latter via slow and steady decline from the early 1950s to the present) or settle at a level above replacement or even increase (as has occurred in Algeria and Morocco). Iraq has experienced slow decline since the late 1960s; the UN estimates notwithstanding, its fertility patterns during the past decade of extreme civil unrest are murky due to disruption of demographic data collection. Figure 3 shows four countries that are, in one respect or another, idiosyncratic. Israel has a majority Jewish population, and the majority of them are first- or second-generation emigrants from Europe or North America. Hence it is not surprising that Israel’s level of fertility was markedly lower than other countries in the region through the 1950s and 1960s. What is perhaps unexpected is the stability of Israel’s TFR at around three births per woman in the period from the 1980s to the present. This national-level TFR is an average of widely varying levels within the Israeli population, with subreplacement fertility among the more secular and European segments offset by high fertility among Orthodox Jews (Fargues, 2000). Fertility in Palestine, by contrast, was quite high throughout the period from the early 1950s to the 1990s, and although it declined substantially after 1990 it remains moderately high up to the present (TFR ¼ 4.0 in 2010–14) (Khawaja, 2003). Apart from Israel, Lebanon is usually regarded as the forerunner for fertility decline in this region, and its trajectory in Figure 3 supports this. In the most recent period Lebanon’s fertility is far below replacement (TFR ¼ 1.5 in 2010–14), uniquely low among countries in this region. Finally, Tunisia is also often labeled as a fertility decline forerunner (Rashad, 2000), and this is indeed the case by
comparison with its North African neighbors Algeria, Egypt, and Morocco (see Figure 1). But Tunisia’s decline seems neither early nor rapid by comparison with several countries in West Asia (Iran, Lebanon, and Turkey).
Explanation Demographic A search for explanations for fertility decline in the Middle East and North Africa begins with demographic analysis of the direct determinants of fertility, namely sexual exposure and active birth control. With regard to the former, because sexual activity in the region is confined to formal marital unions – probably less so than in the past but to a larger extent than in most other regions (Tabutin and Schoumaker, 2005) – the timing of first marriage and the ultimate proportion marrying have marked effects on fertility levels. Several analyses demonstrate convincingly that nuptiality change has made a substantial contribution to the fertility decline to date in this region (Rashad, 2000; Tabutin and Schoumaker, 2005). Considering the region as a whole, the nuptiality contribution has been on the order of one-half of the fertility decline, with the other one-half due to more effective birth control within marital unions. This breakdown varies across countries; in particular, the nuptiality contribution has been especially large in the Maghreb countries such as Algeria, Morocco, and Tunisia – where the nuptiality change has been most dramatic – and Lebanon as well, and the nuptiality contribution has been of lesser magnitude in Egypt, Iran, and Turkey. The most direct evidence of the nuptiality change underway are declines in the proportion of women of reproductive age – especially under age 30 – who have ever married. Many of these declines are relatively recent, and hence it is too soon to determine whether the predominant phenomenon is delayed entrance to first marriage or an increase in celibacy (Rashad and Osman, 2003). This is an important distinction, not
Fertility Transition: Middle East and North Africa
necessarily from a mechanistic standpoint (lost reproductive exposure) but rather because of the societal implications, which in turn may indirectly bear on fertility. One might posit that an increase in celibacy is the more revolutionary of the two. If meaningful fractions of women (e.g., 10% or greater) remain unmarried through the reproductive years, almost necessarily this must force an acceptance of primary roles for adult women other than motherhood. To the extent such acceptance occurs, this could affect the formulation of childbearing goals of women in marital unions. Recent demographic survey data show considerable crosscountry variation in marriage patterns (Casterline, 2011). If one considers, for example, the percentage of women married under age 30, the percentage of those ever married at ages 20–24 ranges from 15% in Tunisia to nearly 60% in Palestine and Yemen, while at ages 25–29 the percentages range from below 50% in Algeria, Tunisia, and Lebanon to above 80% in Egypt and Yemen. The difference in reproductive exposure between, say, Algeria (16% married at ages 20–24) and Egypt (54% married at ages 20–24) is enormous. These are the ages at which reproductive unions tend to be most fertile. Turning to the second major direct determinant of fertility, that is, active birth control, one of the noteworthy developments in the demography of this region in the period since 1960 has been the growing prevalence of contraception as a means of birth control (Tabutin and Schoumaker, 2005). The majority of women live in countries where at least onehalf of the currently married women are using contraception (Casterline, 2011). Pursuing this in more detail, one can distinguish contraceptive methods according to their efficacy in preventing pregnancy. This investigation reveals several distinctive features of this region. First, ineffective ‘traditional’ methods are relatively prevalent in some countries. More specifically, withdrawal is popular in western Asia (Jordan, Lebanon, Syria, and Turkey), as has been evident in all fertility surveys in this subregion since the 1960s. Secondly, small percentages of women are sterilized, with the exception of several Gulf states (Oman and United Arab Emirates) and Iran. This is not surprising, as a common view among Arabs (most of whom are Sunni) is that sterilization is contrary to Islam. This is popular opinion, and not a view actively propounded by Islamic scholars (although it is the case that sterilization is rare in most Islamic countries). Recourse to sterilization to terminate childbearing once a desired number has been achieved is, therefore, regarded as an unappealing solution in most subgroups in this region. That leaves the inter-uterine device (IUD) and the oral contraceptive as the effective methods of choice; both are highly effective when used diligently but subject to error and deliberate discontinuation. A further method of birth control is induced abortion. Induced abortion is legal under most circumstances in Israel, Tunisia, and Turkey, in limited circumstances (woman’s physical and mental health) in most countries in the region, and only if the woman’s life is endangered in a few countries (including Egypt and Iran) (United Nations Population Division, 2013b). Whatever the legal standing, there is a common assumption throughout these largely Islamic societies that induced abortion is contrary to Islam. There are no sound estimates of incidence (Tabutin and Schoumaker, 2005), but it can be assumed to be relatively low except in
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Iran, Lebanon, Tunisia, and Turkey. The incidence of induced abortion is probably highest for pregnancies of unmarried women, but these are also the most strenuously kept secret. In all likelihood, induced abortion has contributed less to fertility decline in the Middle East and North Africa than in other regions. Possibly increased demand for birth control will lead to far more reliance on induced abortion in the future; this possibility cannot be simply dismissed out of hand, especially given the increased availability of medical abortion (which can be procured from a pharmacy and administered privately at home). But to this point there is little indication that social norms against induced abortion are weakening, and, in the absence of concerted political efforts to legalize abortion, access to safe surgical abortion will remain difficult and costly.
Other Factors Scholars have attributed fertility decline in this region to the constellation of factors posited to cause fertility decline in other major regions in the period since 1950: dramatic improvements in child survival, higher levels of formal schooling (especially for women), income growth and growth of secondary and tertiary sectors of the economy, and the emergence of norms of family life incompatible with high fertility. Existing scholarship contains no rigorous assessments of the relative weight of these and other hypothesized explanatory factors, but a number of scholars have rendered judgments on the basis of quantitative investigation (e.g., Rashad, 2000; Tabutin and Schoumaker, 2005). From a comparative perspective, the causes of fertility decline in the Middle East and North Africa appear to be distinctive in several respects. First of all, adult women’s participation in the formal labor market was relatively low in the past and up to the present is low from a comparative standpoint. This would seem to diminish the likely force of opportunity costs of childbearing, that is, the financial cost to the household of women foregoing income-generating economic activity in order to bear and raise children. Second, the establishment of expansive social welfare policies and programs in many countries in the region in the 1950s and 1960s created an unusual context for fertility decline. These programs included guaranteed employment in the public sector for persons with formal schooling credentials and subsidization of fuel and food. Directly and indirectly, these diffused the household-level cost of bearing and raising children. Arguably it was the weakening of the social welfare state beginning in the 1980s, as it became unaffordable and/or as the neoliberal economic policy came to dominate, which stimulated fertility decline in this region (see Courbage (1994) for the case of Syria). There is dispute about the causal contribution to fertility decline of the provision of family planning services through public sector programs. Tunisia is often cited as an historically early demonstration of fertility reduction due in part to enhanced availability of good quality family planning services (Brown, 2007). Egypt has supported the largest and longest standing public-sector program in the region; Robinson and El-Zanaty (2006) give it much credit for the fertility decline to date, and Rashad and Eltigani (2005) somewhat less credit. From a demographic standpoint and as compared to other
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countries in the region, a larger fraction of the Egyptian decline has been due to change in marital fertility than to change in nuptiality, a fact supportive of a relatively larger contribution of its family planning program. The Iranian decline too has been driven disproportionately by decline in marital fertility, and hence it is natural to credit effective provision of family planning services at the community level throughout Iran beginning in the late 1980s. But Abbasi-Shavazi et al. (2009) place more explanatory weight on shifts in the demand for children due to economic aspirations running ahead of economic opportunities. And the fertility decline in a few countries occurred in the absence of an active public-sector family planning program; Algeria is a notable instance (Ouadah-Bedidi and Vallin, 2013). Three salient features of the demography of the Middle East and North Africa since the 1950s suggest a distinctive causal structure underlying its fertility decline. The first is the relatively large contribution to the fertility declines in most countries of postponement of entry to first marriage, that is, nuptiality change. This is evidence in support of the argument that increased formal schooling of women has been a decisive factor driving fertility decline. The second demographic feature is the relatively high rates of international migration. It is plausible that this has disrupted existing high-fertility regimes through multiple pathways, including transformation of household economics and economic aspirations, changes in intra-family power structure, and diffusion of new norms about family life. A third salient feature is the preexisting patriarchal character of the family system which directly and indirectly was strongly pro-natalist. Some scholars have argued that undermining this system was a prerequisite for fertility decline in these societies (Courbage and Todd, 2011; Fargues, 2005). For this reason, formal schooling of women may have assumed more importance as a cause of fertility in this region than elsewhere. Other factors noted above, including economic transformation and international migration, also may have served to weaken the patriarchal family system.
Prospects for Future Trends in Fertility As of 2010–14, seven of 22 countries in the Middle East and North Africa have sub-replacement fertility, while six of the 22 countries have a TFR in excess of three births per woman. What does the evidence in hand suggest about prospects for future fertility change? This might consist of fertility increase in countries with the lowest fertility, and fertility decline in countries where fertility is well above replacement level. Considering first the subset of countries with subreplacement fertility, there is only one country with fertility far below replacement (i.e., TFR less than 1.8): Lebanon with a TFR of 1.5. Outside the Middle East and North Africa, the period since 2000 has witnessed substantial rebound in fertility in some countries with sub-replacement fertility, especially in northern Europe (most notably Sweden and the United Kingdom). But the more common pattern in western Europe, southern Europe, and East Asia has been rather a modest increase from TFRs far below replacement level (United Nations Population Division, 2013a). One might posit that Lebanon will adhere most closely to the Mediterranean pattern
(Greece, Italy, and Spain) of sustained low fertility (although, to be sure, both Italy and Spain have recovered from TFRs well below 1.5). To this point – historical experience with fertility far below replacement is limited – there is no evidence that fertility below replacement level constitutes an unstable equilibrium. More consequential is the future of fertility in those countries with recent TFRs in excess of three births per woman. Five of these six countries are in western Asia (Jordan, Iraq, Palestine, Syria, and Yemen), and the sixth is Sudan. Data from demographic surveys provide some basis for assessing the potential for further decline. These surveys routinely gather information on fertility desires. Over the decades, controversy has surrounded the measurement and interpretation of such data. But given that fertility is highly purposive, fertility desires are likely to be informative about fertility trends in the shortterm, even recognizing the constraints which couples face in implementing their desires. Elsewhere (Casterline, 2011) the author has examined survey estimates of the level of unwanted fertility. These suggest that unwanted fertility is relatively common throughout the region – the fraction of unwanted births ranges between one-sixth (Lebanon) to one-third (Yemen) – and therefore fertility should decline further if women become more successful in avoiding unwanted births. At the same time, attitudinal data on fertility ideals makes clear that in most Middle East and North African countries younger cohorts of women (under age 30) continue to find families with three or more children appealing. Mean ideal number of children of 3.4 in Algeria, 3.1 in Lebanon, and 4.3 in Syria are especially striking, as each is substantially higher than the recent TFR. Almost no women choose zero or one child as their ideal. These and other attitudinal data are emphatic in documenting weak attachment to small-family ideals (i.e., two children or less) (Casterline, 2011). Other data reveal that most women recognize many advantages of stopping at two children and also perceive various costs of having three or more children. Even so, a large fraction of women – in some countries a plurality, even among the younger cohorts – desire to have three (or more) children. In short, while the attitudinal data reveal the prevalence of motivation in most countries to reduce fertility below existing levels, these data also provide no grounds for projecting that fertility will fall to two births per woman (or lower) in all countries in the region in the near future. The behavioral factors that bear directly on fertility (see Section Demographic above) can also be examined for indications of the potential for further decline in fertility. There are, first of all, patterns of union formation. It was noted above that nuptiality change has made a substantial contribution to fertility decline in this region; does potential remain for further nuptiality change which would further depress fertility? Casterline (2011) examines the evidence and concludes that nuptiality change in the future has the potential to cause substantially more fertility decline in the region, especially in Egypt (most populous country in the region and characterized by relatively early marriage) and also in Morocco, Syria, and Yemen. And further nuptiality change does indeed seem likely; nuptiality change in the region appears to be driven by the (perceived) unaffordability of marriage, itself a function of heightened expectations about the material resources one
Fertility Transition: Middle East and North Africa
must bring to marriage (including the wedding itself) simultaneous with declines in economic opportunities for young adults (Rashad and Osman, 2003). Both could ease – the increase in expectations and the decline in economic opportunity – but this seems unlikely, at least in the short run. The second behavioral factor which bears directly on fertility is active birth control. The heavy reliance on ineffective methods in some countries (see Section Demographic) leaves room for fertility reduction as a consequence of shifting the contraceptive method mix toward more effective methods. But the evident resistance to sterilization and induced abortion as a means of birth control, especially in the cluster of countries where fertility remains high, presents an obstacle to decline of fertility to two births per woman (or lower). An important unknown factor is whether medical induced abortion will become a common resolution of unintended pregnancies. Finally, fertility prospects in Israel and Palestine resist conventional demographic analysis because of the unique confluence of political and demographic dynamics. It is reasonable to posit fertility decline in both countries, but it is not difficult to envision inter- and intra-country political developments which generate pressure toward maintenance of fertility levels substantially above replacement level. Summing up this assessment of prospects for further decline in fertility, there are factors which facilitate and factors which hinder such further decline. Chief among the former is the potential for further nuptiality decline, and also the possibility of more recourse to medical abortion. Factors working against fertility decline include weak attachment to the two-child norm, and the fact that to this point neither sterilization nor surgical abortion are readily available as methods of birth control in those countries in the region which at present have fertility well above replacement level. Fertility rates at replacement level (or below) are almost never attained without heavy reliance on one or the other of these two methods of birth control.
See also: Children, Value of; Fertility Theory: Embodied-Capital Theory of Life History Evolution; Fertility Theory: Theory of Intergenerational Wealth Flows; Fertility Transition: Cultural Explanations; Fertility Transition: Cultural Explanations; Fertility Transition: Economic Explanations.
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Bibliography Abbasi-Shavazi, M., McDonald, P., Hosseini-Chavoshi, M., 2009. The Fertility Transition in Iran: Revolution and Reproduction. Springer, New York. Brown, G., 2007. Tunisia: the debut of family planning. In: Robinson, W., Ross, J. (Eds.), The Global Family Planning Revolution: Three Decades of Population Policies and Programs. the World Bank, Washington, pp. 59–70. Casterline, J., 2011. Fertility Prospects in the Arab World. Population Division Expert Paper No. 2011/6. United Nations, New York. Courbage, Y., 1994. Fertility transition in Syria: from implicit population policy to explicit economic crisis. International Family Planning Perspectives 20 (4), 142–146. Courbage, Y., 1999. Economic and political issues of fertility transition in the Arab worlddanswers and open questions. Population and Environment 20, 353–380. Courbage, Y., Todd, E., 2011. A Convergence of Civilizations: The Transformation of Muslim Societies around the World. Columbia University Press, New York. Fargues, P., 1989. The decline of Arab fertility. Population E 44 (1), 147–175. Fargues, P., 2000. Protracted national conflict and fertility change among Palestinians and Israelis. Population and Development Review 26 (3), 441–482. Fargues, P., 2005. Women in Arab societies: challenging the patriarchal system? Reproductive Health Matters 13 (25), 43–48. Khawaja, M., 2003. The fertility of Palestinian women in Gaza, the West Bank, Jordan and Lebanon. Population-E 58 (3), 273–302. Obermeyer, C., 1992. Islam, women and politics: the demography of Arab countries. Population and Development Review 18 (1), 33–66. Ouadah-Bedidi, Z., Vallin, J., 2013. Fertility and population policy in Algeria: discrepancies between planning and outcomes. Population and Development Review 38 (Suppl.), 179–196. Rashad, H., 2000. Demographic transition in Arab countries: a new perspective. Journal of Population Research 17 (1), 83–101. Rashad, H., Eltigani, E., 2005. Explaining fertility decline in Egypt. In: Jones, G., Karim, M. (Eds.), Islam, the State and Population. C. Hurst & Co., London, pp. 174–198. Rashad, H., Osman, M., 2003. Nuptiality in the Arab countries: changes and implications. In: Hopkins, N. (Ed.), The New Arab Family, Cairo Papers in Social Science. American University Press, Cairo, pp. 20–50. Robinson, W., El-Zanaty, F., 2006. The Demographic Revolution in Modern Egypt. Lexington Books, Lanham, MD. Tabutin, D., Schoumaker, B., 2005. The demography of the Arab world and the Middle East from the 1950s to the 2000s: a survey of changes and a statistical assessment. Population-E 60 (5–6), 505–616. United Nations Population Division, 2013a. World Population Prospects 2012. United Nations, New York. United Nations Population Division, 2013b. World Abortion Policies 2013. United Nations, New York.
Abstract Fertility in the Middle East and North Africa declined by more than one-half in the period from 1960 to 2010, most rapidly in the two decades from the 1970s to the 1990s. At present seven of the 22 countries have fertility below replacement level (two births per woman), while the fertility rate exceeds three births per woman in six countries. Changes in marriage patterns have made an unusually large contribution to fertility decline in this region, roughly matching the contribution of improved birth control within marriage. Further decline will depend on future trends in marriage and the availability of the most effective methods of birth control (sterilization and induced abortion).
Introduction The 22 countries considered here stretch from Western Sahara on the Atlantic coast of Africa to Iran in western Asia. The countries, and their estimated population sizes in 2010, are shown in Table 1. Nineteen of the 22 countries are commonly regarded as Arab states, as indicated by their membership in the Arab League. Some of these Arab countries contain substantial subgroups that are non-Arab according to criteria such as past and present culture (including language), historical patterns of migration and marriage, and/or self-identification. These include Berber population in Morocco and Algeria, Kurdish population in Iraq (and in the non-Arab countries of Iran and Turkey as well), and Asian labor migrants in the Persian Gulf states. Three of the countries are non-Arab: Iran, Israel, and Turkey. Note that Israel contains a large Arab minority population, however. With the exception of Israel, the majority of the population in all countries of the Middle East and North Africa is Muslim, but there are large Christian minorities in Egypt and in most of the countries in West Asia.
Table 1 Listing of countries and estimated population size (in millions) in 2010 Country
Population
North Africa Algeria Egypt Libya Morocco Sudan Tunisia Western Sahara
37.1 78.1 6.0 31.6 35.6 10.6 0.5
Country
Population
West Asia Bahrain Iran Iraq Israel Jordan Kuwait Lebanon Oman Palestine Qatar Saudi Arabia Syria Turkey United Arab Emirates Yemen
1.2 74.5 31.0 7.4 6.5 3.0 4.3 2.8 4.0 1.8 27.2 21.5 72.1 8.4 22.8
Source: UN Population Division: World Population Prospects, 2012 Revision.
International Encyclopedia of the Social & Behavioral Sciences, 2nd edition, Volume 9
In 2010, the total population of these 22 countries was estimated as 488 million persons, with almost one-half (46%) in the three demographic giants: Egypt, Iran, and Turkey. A large fraction of the population in this set of countries resides along the Mediterranean Sea in northern Africa and western Asia. There are also substantial population concentrations in Morocco on the Atlantic Ocean, Iraq in the Mesopotamian River plain, Turkey on the Anatolian plateau and eastern mountains, Iran in the plateaus and mountains of southwest Asia, and Saudi Arabia with population along both the Persian Gulf and the Red Sea. Throughout this geographic expanse annual rainfall is relatively light, and this explains the concentration of population along seas and rivers. This climatic factor also helps account for the high level of urbanization as rural settlements engaged in intensive agriculture is feasible on a large scale in only a few locations (Atlantic coast of North Africa, Nile River Valley, Mesopotamia, and Anatolian plateau). Population dynamics in the Middle East and North Africa during the past century have been intertwined with political upheaval and uneven economic development (the discussion in this paragraph and the next draws on Courbage (1999), Fargues (1989), and Tabutin and Schoumaker (2005)). Most of the countries were subject to European imperial rule, either directly or through externally imposed local political regimes, beginning in the nineteenth century (Egypt) and continuing until a decade or so after World War II. The breakup of the Ottoman Empire at the end of World War I was especially consequential for the political history of Western Asia, with reverberations to the present (Iraq, Palestine, and Syria). The nationalism of the 1950s and 1960s resulted in generous social policies and programs in some countries (e.g., Egypt), with consequences for demographic behavior (fertility and migration). In the period since 2000, the region has experienced excessive civil strife – Iraq, Palestine, and Syria, with the strife in Palestine a continuation of conflict which began in the late 1940s. Note that the extreme civil strife in these countries spills over into neighboring countries, thereby affecting a large fraction of the population of the region (all three of the demographic giants have been directly affected by conflict in nearby countries). The period since 2010 has also witnessed historically significant internal political upheaval – the ‘Arab Spring’ – which began in Tunisia and has rippled through the region. The ultimate outcome of this upheaval is not yet
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known, in particular the longer-term political influence of Islamist parties whose programs often include explicit pro-natalist prescriptions about family life. As for economic development, the oil wealth of the Gulf States has had a profound impact on the entire region from the 1970s to the present. Non-oil-producing states have benefited from oil wealth via labor migration and tourism (i.e., holiday visits by Gulf State nationals). More generally, international migration is a dominant feature of the landscape throughout the region. This includes intra-regional labor migration to the Persian Gulf states and northward migration to western Europe, especially from the Maghreb countries in northern Africa (Morocco, Algeria, and Tunisia). The Middle East and North Africa have also participated in the global surge in formal schooling in recent decades. The high rates of women’s secondary and university schooling in post-1980 birth cohorts represent a sharp departure from the past, with implications for marriage and childbearing.
Fertility Decline to Date Overview The level of fertility in these 22 countries in the period from the early 1950s to the present is summarized in Table 2. In this table the measure of fertility is the total fertility rate (TFR), which is the sum of age-specific fertility rates for women of reproductive age during the specified historical period. The TFR can be viewed as the average number of births at the termination of a woman’s reproductive career, were this career characterized by childbearing at the rates observed during the historical period in question. That is, this is a lifetime total for a hypothetical (or ‘synthetic’) cohort, not an actual birth cohort of women (whose reproduction would extend over three historical decades). In the early 1950s, when the region had largely recovered from the severe disruption caused by World War II, almost one-half of the countries in the region had TFRs which exceeded seven births per woman, and only two countries (Israel at 4.3 and Lebanon at 5.7) had TFRs below six births per woman. The average for the region was roughly seven births per woman. With the exception of Israel and Lebanon (TFR ¼ 5.7), these can be regarded as pre-decline levels of fertility which had obtained, with slight variation, for many generations in the past. Available evidence indicates that predecline fertility in the Middle East and North Africa was higher than in other major regions, including other subregions of Asia, Table 2
Sub-Saharan Africa, and Latin America and the Caribbean (Casterline, 2011; Rashad, 2000). This coincides with other quantitative and qualitative evidence of the fundamental pronatalism of these societies in the past: relatively early and nearly universal marriage, short postpartum abstinence, and a high valuation placed on children and childbearing. Six decades later in 2010–14, 16 of the 22 countries have TFRs below three births per woman, and the average fertility for the region is less than three births per woman, a decline in the level of fertility from the early 1950s of more than one-half. It is also evident from Table 1 that in the majority of countries the decline was concentrated in the two decade period from the early 1970s to the early 1990s, although to be sure further substantial decline has occurred from the early 1990s to the present. From a comparative perspective, fertility decline in this region was late to start; in the early 1970s, only five countries had TFRs below six births per woman (Bahrain, Egypt, Israel, Lebanon, and Turkey), and only two of these (Israel and Lebanon) were below five births per woman. Among major regions, only Sub-Saharan Africa experienced later onset of fertility decline. Through the 1960s and 1970s (and even into the 1980s), the Arab region appeared to be very reluctant to join in the gathering international movement toward lower levels of fertility, a fact frequently commented upon in the demographic literature and in policy forums; see Obermeyer (1992). Once commenced, the declines proceeded rapidly – as summarized in Table 3. During the 1980s, when the pace of decline was most rapid, 11 of the 22 countries experienced a decline in their TFRs that exceeded 1.5 births per woman. Of the more populous countries, only Sudan and Yemen were not caught up in the rapid fertility decline in this period (indeed, Yemen’s TFR is thought to have increased from the early 1970s to the early 1990s). As of 2010–14, seven countries in the Middle East and North Africa have TFRs which are equal to or below replacement level of 2.1 births per woman; these countries are Bahrain, Iran, Lebanon, Qatar, Tunisia, Turkey, and United Arab Emirates. The low fertility in the Persian Gulf States (Bahrain, Qatar, and United Arab Emirates) is striking. At the other end of the spectrum, four countries retain TFRs above four births per woman; these countries are Iraq, Palestine, Sudan, and Yemen. Each of these countries has its own distinctive political and demographic history, but it is difficult to ignore the fact that three of the four (excepting Yemen) have experienced severe civil strife in recent decades. Political demography is more tangible in this region than most (Fargues, 2000; Khawaja, 2003).
Distribution of country-level TFR by historical period
TFR
1950–55
1970–75
1990–95
2010–14
> ¼ 7.0 6.0–6.9 5.0–5.9 4.0–4.9 3.0–3.9 2.2–2.9 < ¼ 2.1 Total
10 10 1 1 0 0 0 22
9 8 3 1 1 0 0 22
1 3 3 3 8 3 1 22
0 0 0 4 2 9 7 22
Source: UN Population Division: World Population Prospects, 2012 Revision.
Table 3
Rate of decline in TFR: births decline per decade
TFR
1960s
1970s
1980s
1990s
2000s
TFR increase 0.00–0.49 0.50–0.99 1.00–1.49 > ¼ 1.50 Total
8 6 5 3 0 22
3 2 8 8 1 22
0 2 4 5 11 22
1 1 7 7 6 22
3 8 10 0 1 22
Source: UN Population Division: World Population Prospects, 2012 Revision.
Fertility Transition: Middle East and North Africa
Figure 1
Fertility decline in populous North African countries. Source: UN Population Division.
Fertility Decline by Country There is considerable inter-country diversity in fertility decline – both the historical timing of onset and the pace of decline. This becomes clear from examining trajectories countryby-country. Fertility trends for 12 of the 22 countries are shown in Figures 1–3. The fertility declines in North Africa (Figure 1) have several interesting features. The declines in Algeria and Morocco were rapid, especially in Algeria which from the mid-1970s to mid-1990s experienced one of the fastest declines on record (four-birth decline in merely 20 years). By comparison, the declines in Egypt and Sudan have proceeded more slowly, especially in Sudan which after 1990 has among the highest levels of fertility in the region. A final intriguing feature of Figure 1 is the increase in fertility observed in both Algeria and Morocco in
Figure 2
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the period after 2000; in both countries, the estimate for the most recent period (2010–14) has risen to nearly three births per woman after declining to around 2.5 births per woman in the early 2000s. This recent increase has surprised demographers, who fully expected fertility in both countries to continue downward to replacement level or below, following the pathway of most countries once rapid and sustained decline is underway. The Algerian case has been examined in some detail by Ouadah-Bedidi and Vallin (2013), who conclude that the rise is principally due to a fall in the average age at first marriage. Note that fertility increase in both countries preceded the political upheaval of the Arab Spring. The same diversity is evident in the populous countries of West Asia. Iran experienced a spectacularly rapid fertility decline from the mid-1980s to the early 2000s, following a slight rise after the 1979 Revolution (the new government
Fertility decline in populous West Asian countries. Source: UN Population Division.
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Fertility Transition: Middle East and North Africa
Figure 3
Fertility decline in select countries. Source: UN Population Division.
was initially explicitly pro-natalist). Abbasi-Shavazi et al. (2009) provide a comprehensive demographic portrait of this exceptional decline. Less remarked on is the substantial and relatively rapid fertility decline in Saudi Arabia in the period since 1980. In the most recent period fertility is still well above replacement level (the TFR estimate for 2010–14 is 2.7), so it remains uncertain whether fertility in Saudi Arabia will continue downward to replacement level (as has occurred in Iran and Turkey; the latter via slow and steady decline from the early 1950s to the present) or settle at a level above replacement or even increase (as has occurred in Algeria and Morocco). Iraq has experienced slow decline since the late 1960s; the UN estimates notwithstanding, its fertility patterns during the past decade of extreme civil unrest are murky due to disruption of demographic data collection. Figure 3 shows four countries that are, in one respect or another, idiosyncratic. Israel has a majority Jewish population, and the majority of them are first- or second-generation emigrants from Europe or North America. Hence it is not surprising that Israel’s level of fertility was markedly lower than other countries in the region through the 1950s and 1960s. What is perhaps unexpected is the stability of Israel’s TFR at around three births per woman in the period from the 1980s to the present. This national-level TFR is an average of widely varying levels within the Israeli population, with subreplacement fertility among the more secular and European segments offset by high fertility among Orthodox Jews (Fargues, 2000). Fertility in Palestine, by contrast, was quite high throughout the period from the early 1950s to the 1990s, and although it declined substantially after 1990 it remains moderately high up to the present (TFR ¼ 4.0 in 2010–14) (Khawaja, 2003). Apart from Israel, Lebanon is usually regarded as the forerunner for fertility decline in this region, and its trajectory in Figure 3 supports this. In the most recent period Lebanon’s fertility is far below replacement (TFR ¼ 1.5 in 2010–14), uniquely low among countries in this region. Finally, Tunisia is also often labeled as a fertility decline forerunner (Rashad, 2000), and this is indeed the case by
comparison with its North African neighbors Algeria, Egypt, and Morocco (see Figure 1). But Tunisia’s decline seems neither early nor rapid by comparison with several countries in West Asia (Iran, Lebanon, and Turkey).
Explanation Demographic A search for explanations for fertility decline in the Middle East and North Africa begins with demographic analysis of the direct determinants of fertility, namely sexual exposure and active birth control. With regard to the former, because sexual activity in the region is confined to formal marital unions – probably less so than in the past but to a larger extent than in most other regions (Tabutin and Schoumaker, 2005) – the timing of first marriage and the ultimate proportion marrying have marked effects on fertility levels. Several analyses demonstrate convincingly that nuptiality change has made a substantial contribution to the fertility decline to date in this region (Rashad, 2000; Tabutin and Schoumaker, 2005). Considering the region as a whole, the nuptiality contribution has been on the order of one-half of the fertility decline, with the other one-half due to more effective birth control within marital unions. This breakdown varies across countries; in particular, the nuptiality contribution has been especially large in the Maghreb countries such as Algeria, Morocco, and Tunisia – where the nuptiality change has been most dramatic – and Lebanon as well, and the nuptiality contribution has been of lesser magnitude in Egypt, Iran, and Turkey. The most direct evidence of the nuptiality change underway are declines in the proportion of women of reproductive age – especially under age 30 – who have ever married. Many of these declines are relatively recent, and hence it is too soon to determine whether the predominant phenomenon is delayed entrance to first marriage or an increase in celibacy (Rashad and Osman, 2003). This is an important distinction, not
Fertility Transition: Middle East and North Africa
necessarily from a mechanistic standpoint (lost reproductive exposure) but rather because of the societal implications, which in turn may indirectly bear on fertility. One might posit that an increase in celibacy is the more revolutionary of the two. If meaningful fractions of women (e.g., 10% or greater) remain unmarried through the reproductive years, almost necessarily this must force an acceptance of primary roles for adult women other than motherhood. To the extent such acceptance occurs, this could affect the formulation of childbearing goals of women in marital unions. Recent demographic survey data show considerable crosscountry variation in marriage patterns (Casterline, 2011). If one considers, for example, the percentage of women married under age 30, the percentage of those ever married at ages 20–24 ranges from 15% in Tunisia to nearly 60% in Palestine and Yemen, while at ages 25–29 the percentages range from below 50% in Algeria, Tunisia, and Lebanon to above 80% in Egypt and Yemen. The difference in reproductive exposure between, say, Algeria (16% married at ages 20–24) and Egypt (54% married at ages 20–24) is enormous. These are the ages at which reproductive unions tend to be most fertile. Turning to the second major direct determinant of fertility, that is, active birth control, one of the noteworthy developments in the demography of this region in the period since 1960 has been the growing prevalence of contraception as a means of birth control (Tabutin and Schoumaker, 2005). The majority of women live in countries where at least onehalf of the currently married women are using contraception (Casterline, 2011). Pursuing this in more detail, one can distinguish contraceptive methods according to their efficacy in preventing pregnancy. This investigation reveals several distinctive features of this region. First, ineffective ‘traditional’ methods are relatively prevalent in some countries. More specifically, withdrawal is popular in western Asia (Jordan, Lebanon, Syria, and Turkey), as has been evident in all fertility surveys in this subregion since the 1960s. Secondly, small percentages of women are sterilized, with the exception of several Gulf states (Oman and United Arab Emirates) and Iran. This is not surprising, as a common view among Arabs (most of whom are Sunni) is that sterilization is contrary to Islam. This is popular opinion, and not a view actively propounded by Islamic scholars (although it is the case that sterilization is rare in most Islamic countries). Recourse to sterilization to terminate childbearing once a desired number has been achieved is, therefore, regarded as an unappealing solution in most subgroups in this region. That leaves the inter-uterine device (IUD) and the oral contraceptive as the effective methods of choice; both are highly effective when used diligently but subject to error and deliberate discontinuation. A further method of birth control is induced abortion. Induced abortion is legal under most circumstances in Israel, Tunisia, and Turkey, in limited circumstances (woman’s physical and mental health) in most countries in the region, and only if the woman’s life is endangered in a few countries (including Egypt and Iran) (United Nations Population Division, 2013b). Whatever the legal standing, there is a common assumption throughout these largely Islamic societies that induced abortion is contrary to Islam. There are no sound estimates of incidence (Tabutin and Schoumaker, 2005), but it can be assumed to be relatively low except in
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Iran, Lebanon, Tunisia, and Turkey. The incidence of induced abortion is probably highest for pregnancies of unmarried women, but these are also the most strenuously kept secret. In all likelihood, induced abortion has contributed less to fertility decline in the Middle East and North Africa than in other regions. Possibly increased demand for birth control will lead to far more reliance on induced abortion in the future; this possibility cannot be simply dismissed out of hand, especially given the increased availability of medical abortion (which can be procured from a pharmacy and administered privately at home). But to this point there is little indication that social norms against induced abortion are weakening, and, in the absence of concerted political efforts to legalize abortion, access to safe surgical abortion will remain difficult and costly.
Other Factors Scholars have attributed fertility decline in this region to the constellation of factors posited to cause fertility decline in other major regions in the period since 1950: dramatic improvements in child survival, higher levels of formal schooling (especially for women), income growth and growth of secondary and tertiary sectors of the economy, and the emergence of norms of family life incompatible with high fertility. Existing scholarship contains no rigorous assessments of the relative weight of these and other hypothesized explanatory factors, but a number of scholars have rendered judgments on the basis of quantitative investigation (e.g., Rashad, 2000; Tabutin and Schoumaker, 2005). From a comparative perspective, the causes of fertility decline in the Middle East and North Africa appear to be distinctive in several respects. First of all, adult women’s participation in the formal labor market was relatively low in the past and up to the present is low from a comparative standpoint. This would seem to diminish the likely force of opportunity costs of childbearing, that is, the financial cost to the household of women foregoing income-generating economic activity in order to bear and raise children. Second, the establishment of expansive social welfare policies and programs in many countries in the region in the 1950s and 1960s created an unusual context for fertility decline. These programs included guaranteed employment in the public sector for persons with formal schooling credentials and subsidization of fuel and food. Directly and indirectly, these diffused the household-level cost of bearing and raising children. Arguably it was the weakening of the social welfare state beginning in the 1980s, as it became unaffordable and/or as the neoliberal economic policy came to dominate, which stimulated fertility decline in this region (see Courbage (1994) for the case of Syria). There is dispute about the causal contribution to fertility decline of the provision of family planning services through public sector programs. Tunisia is often cited as an historically early demonstration of fertility reduction due in part to enhanced availability of good quality family planning services (Brown, 2007). Egypt has supported the largest and longest standing public-sector program in the region; Robinson and El-Zanaty (2006) give it much credit for the fertility decline to date, and Rashad and Eltigani (2005) somewhat less credit. From a demographic standpoint and as compared to other
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Fertility Transition: Middle East and North Africa
countries in the region, a larger fraction of the Egyptian decline has been due to change in marital fertility than to change in nuptiality, a fact supportive of a relatively larger contribution of its family planning program. The Iranian decline too has been driven disproportionately by decline in marital fertility, and hence it is natural to credit effective provision of family planning services at the community level throughout Iran beginning in the late 1980s. But Abbasi-Shavazi et al. (2009) place more explanatory weight on shifts in the demand for children due to economic aspirations running ahead of economic opportunities. And the fertility decline in a few countries occurred in the absence of an active public-sector family planning program; Algeria is a notable instance (Ouadah-Bedidi and Vallin, 2013). Three salient features of the demography of the Middle East and North Africa since the 1950s suggest a distinctive causal structure underlying its fertility decline. The first is the relatively large contribution to the fertility declines in most countries of postponement of entry to first marriage, that is, nuptiality change. This is evidence in support of the argument that increased formal schooling of women has been a decisive factor driving fertility decline. The second demographic feature is the relatively high rates of international migration. It is plausible that this has disrupted existing high-fertility regimes through multiple pathways, including transformation of household economics and economic aspirations, changes in intra-family power structure, and diffusion of new norms about family life. A third salient feature is the preexisting patriarchal character of the family system which directly and indirectly was strongly pro-natalist. Some scholars have argued that undermining this system was a prerequisite for fertility decline in these societies (Courbage and Todd, 2011; Fargues, 2005). For this reason, formal schooling of women may have assumed more importance as a cause of fertility in this region than elsewhere. Other factors noted above, including economic transformation and international migration, also may have served to weaken the patriarchal family system.
Prospects for Future Trends in Fertility As of 2010–14, seven of 22 countries in the Middle East and North Africa have sub-replacement fertility, while six of the 22 countries have a TFR in excess of three births per woman. What does the evidence in hand suggest about prospects for future fertility change? This might consist of fertility increase in countries with the lowest fertility, and fertility decline in countries where fertility is well above replacement level. Considering first the subset of countries with subreplacement fertility, there is only one country with fertility far below replacement (i.e., TFR less than 1.8): Lebanon with a TFR of 1.5. Outside the Middle East and North Africa, the period since 2000 has witnessed substantial rebound in fertility in some countries with sub-replacement fertility, especially in northern Europe (most notably Sweden and the United Kingdom). But the more common pattern in western Europe, southern Europe, and East Asia has been rather a modest increase from TFRs far below replacement level (United Nations Population Division, 2013a). One might posit that Lebanon will adhere most closely to the Mediterranean pattern
(Greece, Italy, and Spain) of sustained low fertility (although, to be sure, both Italy and Spain have recovered from TFRs well below 1.5). To this point – historical experience with fertility far below replacement is limited – there is no evidence that fertility below replacement level constitutes an unstable equilibrium. More consequential is the future of fertility in those countries with recent TFRs in excess of three births per woman. Five of these six countries are in western Asia (Jordan, Iraq, Palestine, Syria, and Yemen), and the sixth is Sudan. Data from demographic surveys provide some basis for assessing the potential for further decline. These surveys routinely gather information on fertility desires. Over the decades, controversy has surrounded the measurement and interpretation of such data. But given that fertility is highly purposive, fertility desires are likely to be informative about fertility trends in the shortterm, even recognizing the constraints which couples face in implementing their desires. Elsewhere (Casterline, 2011) the author has examined survey estimates of the level of unwanted fertility. These suggest that unwanted fertility is relatively common throughout the region – the fraction of unwanted births ranges between one-sixth (Lebanon) to one-third (Yemen) – and therefore fertility should decline further if women become more successful in avoiding unwanted births. At the same time, attitudinal data on fertility ideals makes clear that in most Middle East and North African countries younger cohorts of women (under age 30) continue to find families with three or more children appealing. Mean ideal number of children of 3.4 in Algeria, 3.1 in Lebanon, and 4.3 in Syria are especially striking, as each is substantially higher than the recent TFR. Almost no women choose zero or one child as their ideal. These and other attitudinal data are emphatic in documenting weak attachment to small-family ideals (i.e., two children or less) (Casterline, 2011). Other data reveal that most women recognize many advantages of stopping at two children and also perceive various costs of having three or more children. Even so, a large fraction of women – in some countries a plurality, even among the younger cohorts – desire to have three (or more) children. In short, while the attitudinal data reveal the prevalence of motivation in most countries to reduce fertility below existing levels, these data also provide no grounds for projecting that fertility will fall to two births per woman (or lower) in all countries in the region in the near future. The behavioral factors that bear directly on fertility (see Section Demographic above) can also be examined for indications of the potential for further decline in fertility. There are, first of all, patterns of union formation. It was noted above that nuptiality change has made a substantial contribution to fertility decline in this region; does potential remain for further nuptiality change which would further depress fertility? Casterline (2011) examines the evidence and concludes that nuptiality change in the future has the potential to cause substantially more fertility decline in the region, especially in Egypt (most populous country in the region and characterized by relatively early marriage) and also in Morocco, Syria, and Yemen. And further nuptiality change does indeed seem likely; nuptiality change in the region appears to be driven by the (perceived) unaffordability of marriage, itself a function of heightened expectations about the material resources one
Fertility Transition: Middle East and North Africa
must bring to marriage (including the wedding itself) simultaneous with declines in economic opportunities for young adults (Rashad and Osman, 2003). Both could ease – the increase in expectations and the decline in economic opportunity – but this seems unlikely, at least in the short run. The second behavioral factor which bears directly on fertility is active birth control. The heavy reliance on ineffective methods in some countries (see Section Demographic) leaves room for fertility reduction as a consequence of shifting the contraceptive method mix toward more effective methods. But the evident resistance to sterilization and induced abortion as a means of birth control, especially in the cluster of countries where fertility remains high, presents an obstacle to decline of fertility to two births per woman (or lower). An important unknown factor is whether medical induced abortion will become a common resolution of unintended pregnancies. Finally, fertility prospects in Israel and Palestine resist conventional demographic analysis because of the unique confluence of political and demographic dynamics. It is reasonable to posit fertility decline in both countries, but it is not difficult to envision inter- and intra-country political developments which generate pressure toward maintenance of fertility levels substantially above replacement level. Summing up this assessment of prospects for further decline in fertility, there are factors which facilitate and factors which hinder such further decline. Chief among the former is the potential for further nuptiality decline, and also the possibility of more recourse to medical abortion. Factors working against fertility decline include weak attachment to the two-child norm, and the fact that to this point neither sterilization nor surgical abortion are readily available as methods of birth control in those countries in the region which at present have fertility well above replacement level. Fertility rates at replacement level (or below) are almost never attained without heavy reliance on one or the other of these two methods of birth control.
See also: Children, Value of; Fertility Theory: Embodied-Capital Theory of Life History Evolution; Fertility Theory: Theory of Intergenerational Wealth Flows; Fertility Transition: Cultural Explanations; Fertility Transition: Cultural Explanations; Fertility Transition: Economic Explanations.
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