Egypt, Jordan and Syria are three Arab countries whose fertility levels and recent trends
are comparable. The fertility rates for the three countries (TFR between 3 and 4) fall in
the mid-range1
and they are all experiencing a plateau in their declining trends. They
are also sharing the same medium human development level (UNDP, 2013). On the
other hand, these countries are very different in terms of their population sizes2
as well
as the approach to population policies.
The purpose of this paper is to identify population policy options in relation to fertility.
Such fertility policies have usually emphasized the growth challenge and specified
fertility targets consistent with economic and social resources as well as development
plans.
Notwithstanding the fact that national goals that build on the integration of population,
economic and social policies are considered necessary for sound development planning
and for the achievement of societal aspirations, this paper emphasizes the necessity of
situating these goals within a reproductive health paradigm. This paradigm appreciates
that the articulation of national goals derives from a concern for individual health and
wellbeing. The paradigm prioritarizes that every person should have an equitable
opportunity to live a healthy, productive, and fulfilling life in all matters relating to the
reproductive system and its functions and processes, according to 1994 ICPD.
In particular, this paper sees that the translation of this paradigm in relation to fertility
implies the following core principles:
 National fertility goals are not fixed but may vary in response to the economic
and social contexts and development plans.
 Regardless of such goals, they must adhere to the following:Protection of the human right for informed choice and non use of any form
of coercion.
o Supporting healthy satisfaction of reproductive intentions as well as
recognizing the importance of informed and responsible choices.
o In case of inconsistencies between national fertility goals and family
choices, such inconsistencies can only be addressed through public
policies that align both national and family goals. These policies serve to
make “healthy choices easy choices” through empowerment and
expansion of opportunities.
 Fertility concerns are indeed central ones but should be seen as one of many
concerns within the reproductive health challenges. All such concerns have a
clear impetus in gender dynamics that cut across all social groups and social
positions.
The Reproductive Health Paradigm is reflected in the analytical questions investigated
in this paper, mainly:
 The degree to which the current levels, trend and regional patterns of fertility is a
reflection of fertility desires and their satisfaction.
 The unhealthy features of the reproductive pattern that call for policy
interventions.
 The potential change in fertility levels that are to be expected with the healthy
satisfaction of reproductive intentions.
 The structural forces that are underlying both the current desires and the failure
to meet reproductive intentions in a healthy way. In particular, these include the
political and institutional aspects of family planning programs, the socioeconomic
determinants and the gender dynamics.
 The policy implications and the opportunities that are available to address the
current fertility plateau.
The paper is divided into six sections.
I. Fertility profiles and their proximate determinants
4
II. Fertility desires and their satisfaction
III. Unhealthy features of the reproductive pattern
IV. Why fertility is plateauing in Egypt, Syria and Jordan
V. Structural forces underlying fertility plateau
VI. Policy implications and opportunities