The evolution of the family planning programme and its role in influencing fertility change in Kenya

Kenya was one of the first sub-Saharan countries to enter the fertility transition, and analysts have suggested various explanations for this. This paper examines the growth in contraceptive availability in Kenya by looking at the Kenya family planning programme and its association with the fertility transition. This is of critical programmatic importance because the fertility transition is not yet underway in many sub-Saharan countries. Policymakers will find the information from this study helpful in evaluating the efficacy of current programmes and replicating the Kenyan programme in areas where fertility decline has not yet occurred. For researchers, the study attempts to highlight some of the major factors driving Kenya's fertility decline, apart from the conventional arguments about social and economic development.     

Desired family size, family planning and fertility in Ethiopia

This paper models the proximate determinants of children born to over 13,000 Ethiopian women and of the women's stated preferences for additional births using the data from the Ethiopian Demographic and Health Survey 2000. Empirical models for the number of children born to women were estimated using Poisson and ordinal regressions. The results show the importance of variables such as maternal education for smaller family size, and that variables reflecting desired family size are strong predictors of the numbers of children born to women. Secondly, binary logistic models for dichotomous variables for women not wanting more children and if getting pregnant would be a 'big problem' showed non-linear effects of the surviving and 'ideal' number of children. Moreover, the results indicated a desire on the part of women to limit family size, especially as the number of surviving children increased. Probit models were estimated to address potential endogeneity of certain variables. Overall, the results indicated that counselling couples about small family size and increasing the utilization of health care services can lower fertility in Ethiopia.     

It's all in the timing: coital frequency and fertility awareness-based methods of family planning

Fertility awareness-based methods of family planning help women to identify the days of the cycle they should avoid unprotected intercourse to prevent pregnancy. Therefore using fertility awareness-based methods influences the timing of sexual activity, which may affect the nature of the sexual relationship. Data are used from the clinical trials of two fertility awareness-based methods--the Standard Days Method and the TwoDay Method--to determine the frequency and timing of intercourse during the cycle, and the determinants of coital frequency. The mean coital frequency of study participants was similar to that reported by users of other methods. Results suggest that coital frequency increases with consecutive cycles of method use. At the same time the frequency of intercourse during the identified fertile days and during menses decreases. This evidence implies a behavioural change as couples get more experience using their method and communicating about the fertile days. Coital frequency was also influenced by the method used and by the study sites. Potential differences between the methods and sites that may contribute to this effect are discussed.     

Determinants of cumulative fertility in Kenya

This paper analyses the effects of age at first marriage, level of education, place of residence, marriage disruption, religion, contraceptive use, and work status on cumulative fertility in Kenya, using data from the 1977-78 Kenya Fertility Survey. Age at first marriage is the main determinant of cumulative fertility, but there are significant effects of level of education and marriage disruption. Place of residence is only significant for the Coast province. The implication of the findings is that to promote any real decline in fertility, emphasis should be placed on providing higher education and work opportunities for young women as an alternative to early marriage.     

Women's educational attainment and intergenerational patterns of fertility behaviour in Kenya

There is a strong theoretical and empirical relationship between educational attainment and fertility behaviour. However, a fundamental issue that has largely been neglected is the change in this relationship across cohorts resulting from differential improvement in educational opportunities for women over time and how it relates to fertility transition. Utilizing the 1998 DHS data from Kenya this study examines the differential effect of educational attainment on women's use of modern contraception and desire for cessation of childbearing across generations. The findings indicate that even after controlling for husband's education and other relevant factors, a woman's advanced education is positively associated with use of modern contraception. However, support for a similar hypothesis on a woman's desire for family limitation was only found among the youngest cohort of women. The results suggest that for Kenya's incipient fertility transition to be sustained the government needs to continue efforts to improve female education and support access to family planning among younger women.     

Fertility and family planning in Accra

A sample of 1000 currently married women aged 25-39 and living in 3 geographic areas of the Ghanaian capital were interviewed about their contraceptive knowledge and practice. Slightly over 90% of the respondents said that they had heard of ways to delay or prevent pregnancy. There was no difference between the 3 areas, but more of those aged 30-34 had heard about contraception. The chances that a respondent had heard about contraception increased with the level of education. Catholics were less likely to have heard of any contraceptive methods than Protestants. Also, women engaged in traditional informal occupations were the least likely to have heard of any contraceptive methods. Overall, education emerged as the most important differentiating factor. The pill, condom, and IUD were the best known methods. Regarding actual contraceptive practice, only 41% of the respondents were currently using some form of contraception, with about 19% using modern and 27% traditional methods. Results of contraceptive usage by user characteristics show that the majority of women in 2/3 of the areas rely on a mixture of traditional and modern methods; that the % of users (any method) increases with age up to 30-34 years, after which it decreases. The % of ever-users of any type of contraception in this study is highest for the highest education levels, at 84% for women with 2ndary and post 2ndary education. With the exception of the IUD, douche and folklore methods, better educated women have higher ever-use %s for both traditional and modern methods. While the %s of users increases with education for foam, diaphragm and withdrawal; the reverse is observed for the pill and IUD, probably due to fear of negative side effects. Overall, there are no significant variations in contraceptive use by migration status; but the % of non-users is highest among recent migrants who are also the least likely to have ever used modern methods. Fertility differentials across ethnic groups have been observed in Ghana. The Akan have the highest fertility, followed by the Ewe and Ga-Adangbe with moderate fertility, and the northern ethnic groups with the lowest fertility. The Akan also have the highest % of ever users of modern contraceptives, an inconsistency which may be explained by their recent recognition of the burdens of high fertility and their attempts to control it. Religious differences are pronounced, especially between the traditional category on the 1 hand, and Christians and Muslims on the other. Results of an analysis of variance suggests that family size is the strongest motivation for adopting modern contraception, and that it may be used for limiting rather than spacing births.     

Harijans and Girijans of Andhra Pradesh: an application of analysis of variance in the study of fertility,mortality and family planning

Research on the Bagatha tribe and the Malas and Madigas in India has been done for economic and social planning purposes in regard to family planning. Bagatha are mostly agricultural people where the nuclear family is prevalent and polygamy is popular as well as cousin marriage. The Madigas and Males (Harijans) are lower caste with the 1st being leather workers and the latter being agricultural helpers. The data was collected by direct interview of 202 tribesmen and 202 caste households with women from 15-49 years of age. The data collected on fertility include live births, child survival rate, fetal wastage, husband and wives education, income, and occupations. On mortality, the number of deaths, age at marriage, number of and intervals of pregnancies. As expected, educated and employed families show healthier and higher levels of fertility especially if the wife is educated. The wife shows more of the responsibility for family planning. The age at marriage and the number of pregnancies appears to have little effect on mortality. In the caste group the education level of the husband has little effect on fertility and again the wife has the primary responsibility in using family planning techniques.     

Differential fertility by intelligence: the role of birth planning

Urban, white, ever-married women, aged 15-44, were sampled in low and high income census tracts in 16 U.S. cities, using a short adaptation of the Peabody Picture Vocabulary Test as a measure of IQ. After analysis of covariance, in which IQ was the independent variable and children ever born (CEB) was the dependent variable, it was found that there is .19 difference between the mean CEB of high- and low-IQ groups when covariables are controlled. It was shown that there was no significant difference in desired family size associated with IQ. But since the low-IQ women have more fertility than high-IQ women, effectiveness of contraceptive methods was examined. Examination showed that lower fertility was achieved by more effective use by the high-IQ women of methods of theoretically similar effectiveness. Also, those women not using a physician administered contraceptive (PAC) in the 3-year study period had unwanted births at about 3 times the rate of those who used PAC for the entire period. Thus, all American women will have to learn to realize their own fertility goals.     

Systematic planning for river rehabilitation: integrating multiple ecological and economic objectives in complex decisions

1. Owing to intensive human use, freshwaters are among the most seriously threatened and modified environments on the planet. Their poor condition and the risk to services that humans need from these ecosystems make their rehabilitation a priority. However, many previous studies have reported the poor performance of many rehabilitation activities. 2. Here, we analyse reasons for this poor performance, focussing on the planning of rehabilitation activities, and propose a new approach. We argue that the failure to include driving factors at a scale adequate to capture the ecological processes involved, together with an insufficient incorporation of socio‐economic aspects, is a key factor leading the poor performance of many rehabilitation activities. 3. We propose a new approach, ‘systematic rehabilitation planning’, that brings together advances made in conservation planning (cost‐effectiveness analysis) and ecosystem science (understanding the complexity of ecosystem processes). This enables planning to be done at the catchment scale, and the trade‐offs between various rehabilitation actions to be integrated and prioritised. 4. Finally, it is important, given the constraints imposed by a lack of knowledge, that the planning process is part of an adaptive cycle where it can benefit from and consolidate the experience gained during the implementation and monitoring stages.