Factors Affecting Contraceptive Use in Sub-Saharan Africa (1993) / Chapter Skim
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1 Introduction
1 Introduction
Pages 5-18
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From page 5... ...
, it is noteworthy that more than half the women of reproductive age in developing countries currently use some form of contraception (Population Reference Bureau, 1992~. The importance of this phenomenon lies in the close relationship between contraceptive prevalence and fertility (Mauldin and Segal, 1988~.
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From page 6... ...
The moderate to high levels of contraceptive use found in most Asian and Latin American countries generally reflect both existing social conditions (as measured by literacy, female education, life expectancy, infant mortality, and related indicators) and access to family planning services through the public or private sector (Mauldin and Ross, 1991~.
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From page 7... ...
Historical Factors Leading to High Fertility In virtually all societies, even those where contraception is not practiced, human fertility falls considerably short of its biological maximum as a consequence of cultural practices or physical impairments that curb reproduction. Such constraints were certainly in place in sub-Saharan Africa during the colonial and precolonial periods; prolonged breastfeeding coupled with long periods of postpartum abstinence supported a marked pattern of birth spacing.
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From page 8... ...
Reports from the early 1980s indicated that the practice of postpartum abstinence was on the wane throughout Africa (Page and Lesthae`ghe, 1981~. Increased female education and urbanization have affected patterns of union in a number of countries, making prolonged periods of sexual abstinence more difficult to observe.
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From page 9... ...
Government leaders and other policymakers in some African countries became increasingly concerned that rapid population growth would have a detrimental effect on socioeconomic development. Moreover, government officials recognized the potential health benefits of birth spacing and were willing to support family planning service delivery as a maternal and child health (MCH)
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From page 10... ...
This dramatic increase in inputs to family planning activities is reflected in the Family Planning Program Effort Index, developed originally by Lapham and Mauldin (1984) and revised by Mauldin and Ross (1991~.
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From page 11... ...
Or is the experience of a few countries unlikely to be repeated elsewhere, making them an exception to the reluctance to use modern contraceptives that has characterized much of Africa? Will the current economic crisis in many parts of Africa bring on a "crisis-driven" reconsideration of the desired number of children at the individual level or simply reinforce the demand for many children that accompanies high levels of infant and child mortality?
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From page 12... ...
For example, policies regarding education and, more specifically, female education are likely to influence contraceptive use and fertility. Similarly, policies regarding age of marriage may affect the potential reproductive span for childbearing.
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From page 13... ...
This political will is often reflected both explicitly, in the form of a national population policy with demographic goals, and implicitly, through policies affecting female education and occupational opportunities, legal restrictions on the importation of contraceptives, and policies governing access to specific contraceptive methods.
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From page 14... ...
Differences in economic activity, standards of living, transportation and communications infrastructure, and ethnic composition contribute to regional variation. Although the situation at the national level will determine in part what occurs at the regional level, there are other factors that influence regional outcomes.
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From page 15... ...
Also, they tend to be more accessible in those regions with a higher standard of living, because of improved infrastructure for health and social services, higher levels of female education, a greater degree of westernization, and thus greater receptivity to birth limitation. Community, Kinship, and Household The factors affecting contraceptive use outlined in Figure 1-1 are by no means unique to sub-Saharan Africa.
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From page 16... ...
suggest that a primary source of pronatalist pressure is from kinship structures, which have their roots in traditional African religions, as discussed in Chapter 4. Similarly, the weak conjugal bond that is evident throughout most of sub-Saharan Africa has direct implications for fertility decision making.
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From page 17... ...
Second, is the individual or the individual's partner at risk of pregnancy? Contraceptive prevalence rates estimated from the Demographic and Health Surveys are generally based on all women of reproductive age, married or living in union.
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From page 18... ...
Chapter 5 on population policies and family planning programs indicates how improvements in the family planning supply environment affect fertility decision making. In Chapter 6 we present the results of multivariate analyses of the relative importance of sociodemographic and economic factors in contraceptive use at the regional level.
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