Despite the vast amount of studies on fertility transition in sub-Saharan Africa, our understanding of reasons for the region's high and unchanging (and more recently, stalling) fertility remains largely limited. In particular the linkage between change in household poverty and trend in fertility has not been fully explored.

Objectives
This paper uses Demographic and Health Survey (DHS) data from six countries with different fertility regimes to describe the various fertility patterns and trends in sub-Saharan Africa and how these are linked to household poverty status. We attempt to answer the following questions: 1) Are differentials in the fertility of poor and rich women related to overall trends in fertility? 2) To what extent are observed changes in fertility rates due to shifts in the proportion of poor women versus shifts in their fertility behavior? 3) Are the determinants of fertility different for poor and rich women? and 4) What are the implications of fertility patterns among the poor on efforts to reduce poverty?

Data and Methods
Data are from sub-Saharan African countries with high and unchanging fertility (Chad [1996/97, 2004] and Uganda [1995, 2000/01); stalling or reversals in fertility (Ghana [1993, 1998, 2003] and Kenya [1993, 1998, 2003]); and continuing declines (Namibia [1992, 2000] and Madagascar [1997, 2003/04]). Poverty status (poor, middle, rich) is defined from the household wealth index and trends in poverty are from other published sources. We use decomposition and standardization techniques to quantify the effects of fertility behavior and poverty status on fertility change over time.

Main Results
Preliminary results show that in countries with declining fertility rates, fertility declined across all wealth categories with the poor experiencing much larger declines in their fertility. In the countries with stalling fertility rates, divergent trends are observed in the fertility of rich and poor women with poor women experiencing increases in their fertility. In the high and unchanging fertility regimes, the patterns are less consistent with poor women generally maintaining high and often increasing fertility levels while rich women show signs of decline in their fertility.

In countries with overall declining fertility, the decomposition of change in fertility indicates that fertility behavior was the main driver of the decline (contributing close to 95% of the overall decline in Namibia and 76% in Madagascar). The change in fertility behavior was achieved through improved access to contraceptives among poorer women: Contraceptive prevalence among the poor increased nearly fourfold in Madagascar and threefold in Namibia. In countries with stalling fertility, two processes: increasing levels of household poverty and increasing fertility among women in poor households appeared to nulify the huge declines in the fertility of women in richer households, thus maintaining overall fertility levels. It is notable that in these countries, access of poor women to contraceptives declined or increased marginaly but, overall, remained low. While rich women in these countries were able to fully implement their fertility aspirations, large proportion of the fertility of poor women was unwanted.

Conclusion and Implications
With growing poverty and growing gap between the fertility of the poor and that of the rich in most African countries, greater proportions of children are increasingly born to poorer women. These children, if they survive to primary school age, will generally lack access to quality education, begin childbearing early (often unwanted), and continue the reproduction of poverty. To break this cycle, there is urgent need to improve and sustain access of poor women to reproductive health services.