Possible drivers of observed changes in fertility

FIGURE 1.17

Percentage of women married or in a union currently using any method of contraception by number of living children, Egypt, 1988–2014

80 75 70 65 60 55 50 45 40 35 30 1988 1992 1995 2000 2003 2005 2008 2014

Total 1–2 3–4 5+

Source: Egypt Demographic and Health Surveys, 1988–2014. Note: The share of women with no living children was less than 1 percent except for 1995, when it was 1.2 percent. In 2014, it was 0.1 percent.

POSSIBLE DRIVERS OF OBSERVED CHANGES IN FERTILITY

There are two possible sets of drivers behind the observed changes in fertility in Egypt: those directly related to fertility and family planning services (which come under the purview of proximate determinants) and those related to socioeconomic factors (distal determinants). For the proximate determinants, Egypt’s fertility increase is driven by the following: decreased exposure to family planning and reproductive health messages in the media and to less availability of information and counseling on family planning and reproductive health; limited contraceptive method mix and a shift in the methods women choose, from intrauterine devices (IuDs) to oral contraceptives; discontinuation of methods because of mismanagement of side effects; a trend toward earlier marriage, having the first child sooner, and having shorter birth intervals; fewer young women using contraception; and a steady decline in the age at marriage among educated, young women in urban areas—that is, they were marrying younger even as the overall age at marriage increased (JSI 2020; MOHP, El-Zanaty and Associates, and ICF International 2015; Radovich et al. 2018).

Simultaneously, the change in the overall economic and labor market situation in Egypt has also likely had an effect on women’s lives and fertility behavior (JSI 2020). Although the male labor force participation rate is close to 100 percent, that of women is very low, at under 24 percent in 2014 (CAPMAS 2017a), and is estimated to have declined since then (World Bank 2020). In parallel, unemployment has been high for some time and even increased slightly, reaching 25 percent for women and 9 percent for men in 2014 (goujon and Al Zalak 2018). The lack of job opportunities in the formal sector, unfavorable working environments for women (for instance, maternity policies, lack of flexible hours), and the disproportionate burden of household responsibilities are some of the contributing factors, which also contribute to women leaving the labor market to instead invest their time and effort in marriage and childbearing (Assaad, Krafft, and Selwaness 2017; Constant et al. 2020; girgis and Adel 2021; also see chapter 4).