This book discusses current trends in contraceptive use, socioeconomic and program variables that affect the demand for and supply of children, and the relationship of increased contraceptive use to recent fertility declines.
- FACTORS AFFECTING CONTRACEPTIVE USE IN SUB-SAHARANAFRICA
- Copyright
- Preface
- Contents
- Executive Summary
- 1 Introduction
- THE CONTRACEPTIVE REVOLUTION IN THE DEVELOPING WORLD
- CONTRACEPTIVE USE IN SUB-SAHARAN AFRICA
- Historical Factors Leading to High Fertility
- Family Planning Initiatives
- Potential Effect of AIDS on Contraceptive Use
- Implications of the Rise in Contraceptive Use
- LEVELS OF SOCIOECONOMIC ORGANIZATION AFFECTING CONTRACEPTIVE USE
- National Level
- Regional Level
- Community, Kinship, and Household
- Individual Level
- ORGANIZATION OF REPORT
- 2 Levels and Trends in Contraceptive Use
- SOURCES OF DATA ON CONTRACEPTIVE USE
- DEFINITION OF CONTRACEPTIVE USE
- PREVALENCE OF CURRENT CONTRACEPTIVE USE IN SELECTED COUNTRIES
- Results from Demographic and Health Surveys Conducted from 1986 to 1990
- Results of WFS, CPS, and Other Surveys, 1975–1990
- Trends in Modern Contraceptive Prevalence
- Differentials in Use
- Reason for Use: Spacing Versus Limiting
- OTHER INDICATORS RELATED TO CONTRACEPTIVE PRACTICE
- Ever Use of a Modern Method
- Discontinuation
- Knowledge of a Modern Contraceptive Method
- Sources of Modern Contraceptive Methods
- Fertility Preferences
- RESULTS FROM MALE SURVEYS
- CONCLUSION
- 3 The Socioeconomic Context
- SOCIOECONOMIC DIFFERENTIALS OF FERTILITY
- National-Level Relationships
- Mortality
- Educational Attainment of Adults
- Schooling of Children: The Quantity-Quality Trade-Off
- The Combined Relation of Per Capita Income, Mortality, Education, and Fertility
- Household-Level Research
- EVIDENCE ON CHANGES IN CHILD MORTALITY
- EVIDENCE ON CHANGES IN THE QUANTITY-QUALITY TRADE-OFF
- Opportunity Costs of Schooling
- Direct Costs
- Perceived Benefits of Schooling
- ECONOMIC STAGNATION AND ADJUSTMENT: EFFECTS ON FERTILITY
- Access to Education and Health
- Consequences for Human Capital Investment
- Summary
- CONCLUSION
- 4 The Household, Kinship, and Community Context
- THE HIGH-FERTILITY RATIONALE: AN OVERVIEW
- LINEAGE AND DESCENT
- The Predominant View of African Lineages and Descent
- Distinction Between Patrilineal and Matrilineal Societies
- An Alternative Perspective
- Summary of the Implications of Lineage Orientation
- KIN NETWORKS AND CHILD FOSTERING
- Child Fostering
- Fostering of Young Children
- Fostering of Older Children
- Summary of the Implications of Child Fostering
- THE CONJUGAL BOND
- Separate Residence
- Separate Economic Responsibilities and Resources
- Evidence for Emotional Nucleation
- Implications of the Weak Conjugal Bond
- PROSPECTS FOR CHANGE
- Land
- Schooling and Child Costs
- Economic Crises and Their Aftermath
- Contraceptive Innovators
- Summary
- LOCAL SOCIAL ORGANIZATION AND THE DIFFUSION OF FAMILY PLANNING
- National Female Political Associations
- Market Associations
- Local Women's Groups
- Local Government
- Summary
- CONCLUSION
- 5 Family Planning Programs and Policies
- THE AFRICAN CONTEXT FOR POPULATION AND FAMILY PLANNING PROGRAMS
- Weak Policy Support
- Relatively Late Program Implementation
- Generally Inadequate Resources
- Weak Absorptive Capacity
- Interregional Disparities
- INTERNATIONAL AND REGIONAL INFLUENCES ON POPULATION POLICY DEVELOPMENT
- HISTORICAL EVOLUTION OF FAMILY PLANNING PROGRAMS
- First Stage: Pioneers
- Second Stage: Mixed Private and Public Activities and Service Expansion
- Third Stage: Increasing Consolidation of Service Delivery
- Fourth Stage: Effects on Fertility
- PROGRAM DEVELOPMENT IN SELECTED COUNTRIES
- Countries with Programs Demonstrating the Most Success to Date
- Kenya
- Botswana and Zimbabwe
- Countries with Historical Variation in Policy Development and Program Implementation
- Countries with Consistently Weak Support for National Family Planning Programs
- Countries Where Rapid Progress in Family Planning May Occur
- MAJOR DONORS FOR POPULATION ACTIVITIES
- LESSONS LEARNED FROM PROGRAMS AND PROJECTS
- Evidence of Demand for Fertility Regulation Services in Diverse Settings
- A Range of Service Delivery Strategies Have Been Successful
- Pilot and Operations Research Projects Have Contributed Substantially
- Family Planning Effort Is Associated With Contraceptive Prevalence19
- Access to Family Planning Is Associated With Contraceptive Prevalence
- Donor Support Is Essential
- New Mechanisms Are Needed to Increase Resources
- Project and Program Success Needs to Be Interpreted Broadly
- PRIVATE VERSUS PUBLIC SERVICE DELIVERY, INCLUDING SOCIAL MARKETING
- THE IMPACT OF AIDS ON FAMILY PLANNING PROGRAM ACTIVITY
- CONCLUSION
- 6 Regional Analysis of Contraceptive Use
- FEMALE EDUCATION AND CONTRACEPTIVE PRACTICE
- Ideal Family Size
- Knowledge and Use of Modern Contraceptive Methods
- MULTIVARIATE ANALYSIS OF MODERN CONTRACEPTIVE USE
- Relationships Among Background Variables
- Relative Importance of These Background Variables in Contraceptive Practice
- Conclusions
- 7 Contribution of Modern Contraceptive Use Relative to Postpartum Practices to Fertility Decline
- THE TWO-PHASED FERTILITY TRANSITION
- Regional Patterns of Nuptiality
- Regional Patterns of Postpartum Infecundability
- Role of Education in the Two-Phased Transition
- CONTRACEPTION, NONSUSCEPTIBILITY, AND FERTILITY DECLINE
- THE UNCERTAIN FUTURE
- CONCLUSION
- 8 Conclusions
- FINDINGS
- RESEARCH GAPS
- Levels and Trends in Contraceptive Use—Contraceptive Discontinuation
- Socioeconomic Context
- Effects of Economic Downturns
- Effects of Child Mortality and AIDS on Demand for Children and Attitudes Toward Family Planning
- Costs of Investments in Children, Including Education
- Female Education, Income, and Contraceptive Use
- Community/Kinship/Household
- Extent of Nucleation of the Family and Child Fostering
- Quantification of Kinship Factors
- Local Social Organization and the Diffusion of Family Planning
- Population Policies and Program Implementation—Service Availability at the Regional Level
- Appendix A Adapting the Easterlin-Crimmins Synthesis Model to Sub-Saharan Conditions
- DEMAND FOR BIRTHS
- SUPPLY OF BIRTHS
- Appendix B Sample Sizes for the WFS and DHS Regional Files
- References
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