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While life expectancy is projected to increase, South Africans are having fewer children. Should we be worried?
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South Africans are living longer, with the national life expectancy now 12 years more than it was at the turn of the century.
The continued rise in life expectancy is thanks to advances in healthcare, HIV prevention, and overall living conditions.
According to Statistics South Africa’s (Stats SA) 2025 mid-year population estimates, life expectancy at birth is now 64 years for males and 69 years for females.
This marks a recovery from the setbacks of recent years, including a major dip during the Covid-19 pandemic and continued health impacts of HIV and AIDS.
Life expectancy has improved
In 2002, males had an average life expectancy of 52 years, while females averaged 57 years. This year’s figures reflect a notable improvement, especially among men.
Life expectancy for both sexes declined sharply between 2020 and 2021 due to the Covid-19 pandemic.
In just one year, males saw a 3-year drop in life expectancy (from 62.8 to 59.8), while females experienced a 3.6-year decline (from 68.8 to 65.2).
Although the pandemic had a devastating impact, Stats SA notes that life expectancy began to recover steadily from 2022.
“Life expectancy at birth in South Africa improved by 1.9 years for males (61.7 years) and 2.2 years for females (67.4 years) in 2022,” it said.
As public health programmes expand and treatment coverage improves, particularly among women of reproductive age, the country’s long-term outlook continues to stabilise.
Progress in healthcare has also resulted in major improvements in child survival.
The infant mortality rate (IMR) has declined from 61.9 deaths per 1 000 live births in 2002 to 23.1 in 2025.
“Similarly, the under-five mortality rate (U5MR) declined from 79.9 child deaths per 1 000 live births to 26.1 child deaths per 1 000 live births between 2002 and 2025,” Stats SA noted.
The decline in child mortality is attributed to better maternal and child health services, expanded immunisation coverage, and reduced HIV transmission from mother to child.
These advances mean that more children are surviving into adolescence, even as fewer are being born.
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Fewer births
South Africa’s total fertility rate (TFR) has, however, fallen steadily over the last two decades, following global trends.
In 2008, the rate stood at 2.78 children per woman. By 2025, it had dropped to 2.21, according to Stats SA’s estimates.
This is worryingly close to, but still above, the replacement fertility rate of 2.1.
“More rural provinces of Limpopo and Eastern Cape indicate higher total fertility rates, whilst more urbanised provinces such as Gauteng and the Western Cape indicate lower rates of fertility,” Stats SA found.
South Africa has one of the lowest fertility levels on the continent, with a study on fertility and childbearing in South Africa noting the extent of the decline.
“Fertility in South Africa declined from an average of 6 to 7 children per woman in the 1950s to an average of 4 to 5 children in the 1980s and about 3.3 children per woman in the mid-1990s”.
Among the factors for the decline are delayed marriage, the desire for smaller families or economic challenges, improved healthcare and living conditions, contraceptives, and access to education.
Pretoria-based obstetrician and gynaecologist Dr Rogers Mmabatswa told The Citizen that many of his patients said they had decided on smaller families because of the rising cost of living.
“Many complain about the cost of raising their children. Food, clothing, and schooling are expensive. So, for a lot of people, there are financial considerations when deciding whether to have a child, or another.”
Should SA be worried?
A 2024 study by the economic policymaking institute, Centre for Economic Policy Research, outlined the economic dangers of a low birth rate.
“The challenge of low fertility is magnified by the fact that it causes older-age population shares to swell. Population ageing may naturally hamper economic activity insofar as older people impose significant burdens associated with public expenditures on health and long-term care and economic security and tend to work less than their younger counterparts.”
However, Mmabatswa says smaller families that come from reduced birth rates may have positives.
“Parents and caregivers are able to dedicate more time and energy to their children, giving them increased individual attention than if there were many other children vying for their attention.
“This will often translate to better performance at school, sport, or socially.”
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