The Fertility Predicament

Lowering birthrates is the key to making Africa's economies stronger and reducing poverty

- Neil Munshi

A dozen women in motley-colored hijabs sat in the small courtyard of Rakiya Maitama's home, peppering the midwife with questions. It was late last year in Inusawa, a village in northern Nigeria on the arid outskirts of the region's biggest city. Over the course of a couple of hours, the women-who ranged in age from their early 20s to their early 40s and each had from two to eight children-talked about their ideal household size and why they'd sought family planning help. But first, they had practical questions.

"Will it change my menstrual cycle?" asked one. "Why is there always air in the tip of the condom?" another said.

Maitama, who acts as the local representative for a London-based nonprofit, holds the sessions regularly for small groups of women in villages around the city of Kano.

She encourages frank discussion, the kind rarely held in this conservative part of the world.

Countries in sub-Saharan Africa have the highest fertility rates in the world. Niger, to Nigeria's north, is at the top of the list with 6.7 births per mother, while nearby Mali and Chad are among those close behind. With 5.2 children per woman, more than twice the global average of 2.4, Nigeria is firmly in the world's top 10. The United Nations projects that the number of Nigerians will more than double by 2050, to 450 million, making it the world's third-most populous country.