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Background: Africa will double its population by 2050 and more than half will be below age 25. The continent has a unique opportunity to boost its socioeconomic welfare. This systematic literature review aims to develop a conceptual framework that identifies policies and programs that have provided a favorable environment for generating and harnessing a demographic dividend. This framework can facilitate sub-Saharan African countries’ understanding of needed actions to accelerate their demographic transition and capitalize on their demographic dividend potential. Methods: The search strategy was structured around three concepts: economic development, fertility, and sub-Saharan Africa. Databases used included PubMed and EconLit. An inductive approach was employed to expand the reference base further. Data were extracted using literature records following a checklist of items to include when reporting a systematic review suggested in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Results: The final review consisted of 78 peer-reviewed articles, ten reports from the gray literature, and one book. Data were categorized according to relevant demographic dividend typology: pre-dividend and early-dividend. The results from the literature review were synthesized into a framework consisting of five sectors for pre-dividend countries, namely 1) Governance and Economic Institutions, 2) Family Planning, 3) Maternal and Child Health, 4) Education, and 5) Women's Empowerment. An additional sector, 6) Labor Market, is added for early-dividend countries. These sectors must work together to attain a demographic dividend. Conclusions: A country's demographic transition stage must guide policy and programs. Most sub-Saharan African countries have prioritized job creation and employment for youth, yet their efforts to secure a productive labor market require preliminary and complementary investments in governance, family planning, maternal and child health, education, and women’s empowerment. Creating a favorable policy environment for generating and capitalizing on a demographic dividend can support their stated goals for development.

There is a great need to scale up proven health interventions for the urban poor, including improving access to contraception, in a sustainable and cost-efficient way.n To enable the scale-up of intervention packages across multiple geographies, The Challenge Initiative (TCI) platform includes regional technical assistance hubs that meaningfully engage local stakeholders and systems and a global partner that raises funds; supports shared learning; and upholds consistent practices, processes, and standards across all hubs.n Government self-selection and commitment of funds to participate in TCI are critical to the ownership and sustainability of the change process; they also complement and reinforce local leadership in program design, implementation, and management.

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