PIP: The persistence of high fertility in sub-Saharan Africa, while all other world regions have been able to control population growth, represents a grave threat. Tradtional explanations for this phenomenon--e.g., lower levels of income, education, health, and urbanization--are not adequate, given the fact that many Asian countries have been able to reduce fertility in the face of the same obstacles. It is suggested, instead, that the primary cause of sub-Saharan Africa's high fertility can be found in its social and family patterns. Central cultural precepts include the notions that many descendents must be produced to ensure the survival of lineage, the equation of female virtue with the production of a large number of children, the stronger influence of the lineage than the nuclear family, and a belief in the power of ancestral spirits. Given the overriding importance of lineage and the relative weakness of emotional and economic conjugal links, the factors believed to be producing lowered birth rates in other developed countries (e.g., the high costs of child raising and the negative impact of large family size on the standard of living in that family) are not operable in sub-Saharan Africa. Most African fathers receive far more from their children, in terms of loyalty and support, than they expend on them, giving them little motivation to restrict fertility. Women's growing determination to extend their current economic independence into the domain of reproduction represents the most likely source of change in sub-Saharan Africa's fertility patterns. Also essential is reduced infant and child mortality through integrated health services-family planning programs. Progress can be expected to be slow, however, given the persistence of the African traditional social structure and belief system.