Determinants of fertility decline in developing countries: A Scoping Review.

Abstract

The decline in fertility rates is a phenomenon observed in nearly all countries worldwide, regardless of their level of economic development, and represents a key driver of population aging. This scoping review aimed to systematically synthesize evidence on factors influencing fertility decline among women in developing countries and identify research gaps to inform future studies in similar contexts.

A literature search was conducted through online databases covering publications from 1999 to December 2, 2024, following the PRISMA - ScR guidelines. After screening 4,581 records, 24 studies meeting the inclusion criteria were selected, comprising 19 national - level and 5 international - level studies.

The synthesis identified that fertility decline is determined by multidimensional factors, categorized into four thematic areas: (1) education and socio - economic status, (2) urbanization and living environment, (3) contraceptive use and intermediate determinants, and (4) population policies and cultural influences. Within diverse demographic contexts, these factors contribute to delayed childbearing, reduced total fertility rates, and shifts in reproductive behavior. The identified themes provide a comprehensive overview of the determinants of fertility decline in developing countries and may inform future research and policy development aimed at responding to sustained low fertility.

Keywords: fertility; reproductive health; population; PRISMA - ScR, scoping review