The study analyzes the links between family planning programs, contraceptive prevalence and fertility trends in sub-Saharan Africa. It is based on case studies of countries with demographic surveys. The study reveals a variety of situations. Some countries have completed their fertility transition, while others have reduced their fertility level rapidly in urban areas, but less so in rural areas. In some countries, fertility remained very high, or declined very little, in rural areas, when population policies and family planning programs remained insufficient or almost non-existent. The role of family planning programs in fertility decline is highlighted by contrasting countries with similar characteristics, one of which experiencing a sharp drop in fertility, while the other one is showing a small decline or no decline at all. In each case, the political, economic, and social context is presented in order to explain the differences between family planning programs and their outcomes. These case studies make it possible to draw conclusions about the conditions of fertility control in African countries.