Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Abstract

Background: Accurate assessments of current and future fertility—including global, regional, and national trends and shifting population age structures—are vital for planning across multiple domains such as resources, healthcare, labor supply, education, gender equality, and family planning.

Methods: Utilizing the GBD 2021 framework, this study estimated key fertility indicators from 1950 to 2021 and projected them to 2100 using a reference scenario and alternative policy-dependent scenarios.

Results: The global total fertility rate (TFR) has declined from approximately 4.84 children per woman in 1950 to 2.23 in 2021. Annual livebirths peaked around 142 million in 2016 and declined to approximately 129 million in 2021. Projections indicate the global TFR will continue to decline to about 1.83 (1.59–2.08) by 2050 and further to 1.59 (1.25–1.96) by 2100 under the reference scenario. The proportion of countries maintaining fertility above the replacement level (around 2.1) is expected to drop from 49 countries (24%) in 2050 to only 6 countries (2.9%) by 2100, largely concentrated in low-income regions of sub-Saharan Africa.

Interpretation: Unless counteracting demographic policies are implemented, global fertility is projected to fall significantly below replacement levels by the end of the century, with potential wide-ranging consequences for population aging, labor markets, and socio-economic stability.