Afghan women and their children wait to be seen by a doctor near the village of Anbar Somuch in the Bamiyan district of Afghanistan July 31, 2002. Infant mortality in Afghanistan in 2000 was 165 per 1,000 live births, one of the highest figures in the world. Now it is 55 deaths per 1,000 live births. / Ami Vitale, USA TODAY
Afghanistan's fertility rate, one of the world's highest before the fall of the Taliban, is plummeting in a concrete accomplishment of a decade-long U.S. campaign to improve the well-being of Afghan women.
The average number of children Afghan women can expect to have in their lifetime fell from 8 in the 1990s to 6.3 in the mid-2000s and to 5.1 at the end of the decade, a USA TODAY analysis of birth data found.
The slide is especially significant considering that the Taliban did not allow girls to go to school, endorsed child brides and ignored women's health care.
"You have basically a new generation of Afghan girls who are more likely to have delayed for a few years their marriage," says Patrick Gerland, an analyst and demographer at the United Nations Population Division.
Experts say one reason for the drop is that the ouster of the Taliban was followed by a rise in aid from NATO countries that funded schools, maternal health, family planning services and birth control. Another is that the Taliban's ban on schooling for girlswas lifted by the current government. As a result, more Afghan women are getting an education and jobs, factors that typically delay a woman's decision to start a family.
Also, infant mortality plunged 50% during the 1990s and into the mid-2000s, from 111 infant deaths per 1,000 live births to 55.
"It's like, 'Wow!' '' says Carl Haub, demographer at the Population Reference Bureau. "It's a society that's really in the process of transforming itself. That's a very rapid transition. Basically, prior to the war, it was a country that lacked many, many basic health services, and now they're spreading."
As next year's drawdown of coalition forces nears, there is concern that progress might stall.
"If you have a return of much more conservative views that go back to a Taliban-type of thinking about women's access to education, to employment, much of this progress could eventually roll back instead of continuing," Gerland says. "What happens if the supply of contraception stops being available?"
Afghanistan's fertility rate still is high. The U.S. is right about at 2 children per woman - the replacement rate needed to keep the population stable - and more developed regions as a whole are even lower at 1.66.
In developing nations where fertility rates begin to slide, the decline usually continues, according to global birth rate histories, a sign that Afghanistan's birth rate may be on a permanent descent.
High fertility makes it difficult for countries to reduce poverty and improve health, education and living conditions, Haub says, and that increases their dependence on foreign aid.
A report on women in Afghanistan by the Liechtenstein Institute on Self-Determination at Princeton University stresses the need to protect the rights of women and their participation in political, economic and social life after international troops withdraw.
"If the trend of the last 10 years continue for one or two generations, it's very difficult to imagine going back to where it was but you need 10 or 20 years of sustained change," Gerland says. "Because a country like Afghanistan is still somewhat challenged in many aspects, the future remains quite uncertain."
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