This examination of changes in adolescent fertility emphasizes the changing social context within which adolescent childbearing takes place.

Adolescent fertility tends to be valued and sanctioned in the countries of sub-Saharan Africa when parents have had adequate ritual or training preparation for adulthood and the child has a recognized father. Young women and adolescents who conceive and bear children within this context are widely accepted by society; those who conceive outside of marriage, however, are strongly condemned by society. Over the past 2-3 decades, most African countries have successfully raised their levels of education. Girls and women are increasingly privy to formal school education and training in trade apprenticeships, domestic service, and ritual initiation which had otherwise been denied in the past. These factors, combined with declining menarche in a few areas, and changing economic opportunities, law, and religion make it more difficult to define the exact date of entry into marriage. Many girls are taking advantage of these changing circumstances and their opportunities to obtain educations and resist early marriage and cildbearing. While defying the traditional entry into early marriage, many young women do not, however, refrain from engaging in sexual activities. Pregnancies to unwed mothers are thereby on the rise and may constitute the most profound change observed in the social context of adolescent fertility on the continent. Once pregnant, many women find themselves shut out by family planning programs and prenatal clinics which serve only married women. This paper ultimately concludes that the social context of adolescent childbearing has an effect on the outcome for mother and child which is as important as the physiological maturity of the mother.

Fertility rates and population growth influence economic development. The marked declines in fertility seen in some developing nations have been accompanied by slowing population growth, which in turn provided a window of opportunity for rapid economic growth. For many sub-Saharan African nations, this window has not yet opened because fertility rates have not declined as rapidly there as elsewhere. Fertility rates in many sub-Saharan African countries are high: the total rate for the region is estimated to be 5.1 births per woman, and rates that had begun to decline in many countries in the region have stalled. High rates of fertility in these countries are likely to contribute to continued rapid population growth: the United Nations projects that the region's population will increase by 1.2 billion by 2050, the highest growth among the regions for which there are projections. In June 2015, the Committee on Population organized a workshop to explore fertility trends and the factors that have influenced them. The workshop committee was asked to explore history and trends related to fertility, proximate determinants and other influences, the status and impact of family planning programs, and prospects for further reducing fertility rates. This study will help donors, researchers, and policy makers better understand the factors that may explain the slow pace of fertility decline in this region, and develop methods to improve family planning in sub-Saharan Africa.