This EIN aims to inform dialogue and foster learning on supporting fertility transitions in countries. The key question guiding this synthesis is: What have we learned from existing evaluative evidence about effective strategies to address fertility transitions through supply and demand-side drivers? The focus of this EIN complements IEG’s evaluation, World Bank Support to Aging Countries. Together, these analyses offer insights across the demographic spectrum.  

High-fertility countries are typically at the early stages of demographic transition, characterized by youthful populations and rapid growth, whereas aging countries face later-stage challenges such as low fertility, increased longevity, and shrinking working-age populations.  

The primary audience for this EIN includes the World Bank’s management and technical staff in the Health, Nutrition, and Population Global Practice; the Education Global Practice; the Social Protection and Jobs Global Practice; and the Gender Vertical. The EIN is also intended for external stakeholders such as development partners, policy makers, and practitioners who are engaged in supporting fertility transitions in countries.  

Supporting countries in their fertility transitions can involve multiple approaches and interventions, including in areas such as reproductive health, family planning, gender equality, and human capital development.   There are also a range of entry points, such as improving access to reproductive health services, raising awareness and knowledge of family planning, promoting female education and life skills, expanding women’s economic opportunities, and addressing social and cultural norms. The World Bank’s strategies highlight the critical intersection among reproductive health, gender equality, and human capital formation over the past two decades.  

What Are the Main Insights from This Synthesis?

• Ensuring sociocultural compatibility in interventions is critical for maximizing participation and acceptability, particularly in projects aimed at empowering women or addressing sensitive topics such as contraception and fertility.  
• Top-down planning without meaningful and active engagement with women and girls, and other key actors, such as men, religious and local leaders, and community members, can undermine the effectiveness and ownership of projects addressing the drivers of fertility. 
• An integrated approach that combines demand- and supply-side interventions is more likely to improve outcomes across the key drivers of fertility, accelerating a country’s fertility transition. 
• Tailoring project designs to the diverse needs and preferences of women and girls can enhance the uptake of family planning services and women’s economic empowerment. 
• A more gender-focused approach that considers gender (sociocultural) norms and gender power relations is more likely to address the drivers of fertility meaningfully. 
• Integrating gender-sensitive knowledge and analysis into project design is crucial for gender-focused interventions because it helps identify women’s needs and preferences while enabling the development of culturally sensitive solutions. 

The methodological approach for the EIN involved a rigorous and systematic process to derive lessons through three stages: search and identification of the evidence base, qualitative review and extraction of evidence, and narrative synthesis to distill actionable insights.