A high birth rate generally means more than 30 live births per 1,000 people in a population per year. The global average sits at about 16 per 1,000, so countries with rates above 30 are producing babies at roughly double the world norm. The highest rates today exceed 40 per 1,000, concentrated almost entirely in sub-Saharan Africa.
How Birth Rate Is Measured
The crude birth rate (CBR) counts the number of live births in a year for every 1,000 people in a population, measured at midyear. A CBR of 9.5 in a country of one million people means about 9,500 babies were born that year. It’s called “crude” because it doesn’t account for the age or sex makeup of the population. A country with a large share of women in their childbearing years will naturally have a higher CBR than a country full of retirees, even if individual women in both places have the same number of kids.
That’s why demographers also use the total fertility rate (TFR), which measures the average number of children per woman. The TFR gives a cleaner picture of reproductive behavior. A TFR of 2.1 is considered “replacement level,” the point at which a population sustains itself without growing or shrinking. The global TFR has dropped from nearly 5 children per woman in 1950 to about 2.3 today. Countries with high birth rates typically have TFRs of 5 or above.
Which Countries Have the Highest Rates
As of 2023, these five countries top the list:
- Central African Republic: 46.4 per 1,000
- Chad: 42.4 per 1,000
- Niger: 41.9 per 1,000
- Democratic Republic of the Congo: 41.3 per 1,000
- Mali: 40.0 per 1,000
All five are in sub-Saharan Africa, and all have rates roughly two and a half times the global average. For comparison, most of Europe and East Asia falls below 10 per 1,000.
Why Some Countries Still Have High Birth Rates
Education is the single strongest predictor. Data from Ghana illustrates this sharply: women with no formal education had an average of five children, those who completed primary school had about three, and those who finished secondary school or higher had roughly one. Each additional level of education cut fertility significantly, with secondary-educated women being about 69% less likely to have more than four children compared to women with no schooling.
Several other factors cluster together in high-birth-rate countries. Access to modern contraception remains limited. Children still carry economic value as household labor or as a safety net for aging parents. Infant mortality, while declining, stays high enough that families have extra children as a hedge against losing some. And cultural expectations around large families persist longer in places where these economic conditions haven’t shifted.
The pattern reverses as conditions change. Rising costs of raising children, women entering the workforce, access to contraception, and media exposure (even something as simple as regular television watching) all correlate with smaller family sizes. These aren’t abstract forces. They represent a practical calculation: when children become more expensive to raise and women have more economic alternatives, families shrink.
The Demographic Transition Explained
High birth rates aren’t random. They follow a well-documented pattern called the demographic transition, which virtually every country moves through over time. In the earliest stage, both birth rates and death rates are high, so population growth stays flat. Then health improvements, better sanitation, and basic medicine cause death rates to drop while birth rates remain high. This is the stage where population explodes. It’s historically unusual, the brief window when large surviving families are the norm.
Eventually, birth rates catch up and fall too. Parents realize more of their children are surviving and adjust by having fewer. The economy shifts away from agriculture, making children less useful as labor. Women gain more autonomy. The population stabilizes at a new equilibrium of low births and low deaths. Most of sub-Saharan Africa is still in that middle stage, where death rates have dropped but birth rates haven’t fully followed.
Health Consequences of High Fertility
For individual women, having many children carries real physical costs. A 37-year follow-up study found that mothers of five to nine children had a 21% higher risk of dying from any cause compared to mothers of two to four children. For mothers of ten or more, the risk jumped to 49% higher. The cardiovascular toll was especially stark: heart disease risk was nearly three times higher for women with five to nine children, and nearly seven times higher for those with ten or more. Each additional child also raised the odds of obesity by 15% and diabetes by 11%.
At the population level, high birth rates strain maternal and child health systems. They increase child dependency ratios, meaning a larger share of the population is too young to work, which drags on economic development, living standards, and educational quality.
Economic and Social Effects
When a high-birth-rate country starts seeing fewer infant deaths, it creates what demographers call a “youth bulge,” a disproportionately large cohort of people between 15 and 29. This bulge can go one of two ways.
If jobs and education are available, the bulge becomes a demographic dividend. A huge working-age population with relatively few dependents generates extra tax revenue, and governments can invest in infrastructure and development instead of spending everything on child care and elder support.
If economic opportunity is scarce, the same bulge becomes destabilizing. Across the Middle East and North Africa, where 15-to-24-year-olds make up 21% of the population and 34% of the working-age population, youth unemployment runs at 26%. When a youth bulge of more than 15 to 20% of the population coincides with economic stagnation, research links it to increased political instability and even armed conflict. The problem isn’t the number of young people itself. It’s whether those young people have meaningful access to jobs, education, and participation in economic life.
Countries earlier in the cycle face a different version of the same challenge. A “baby bulge” of very young children who are economically unproductive puts immediate pressure on societies to generate enough growth just to keep up. Resources go toward feeding and housing dependents rather than building the infrastructure that could eventually absorb them into the workforce.