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.     

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.     

Stall in fertility decline in Eastern African countries: regional analysis of patterns,determinants and implications

We use data from the Demographic and Health Surveys to examine the patterns of stall in fertility decline in four Eastern African countries. Contrary to patterns of fertility transition in Africa that cut across various socio-economic and geographical groups within countries, we find strong selectivity of fertility stall across different groups and regions in all four countries. In both Kenya and Tanzania where fertility decline has stalled at the national level, it continued to decline among the most educated women and in some regions. While fertility has remained at pre-transition level in Uganda over the past 20 years, there are signs of decline with specific groups of women (especially the most educated, urban and those in the Eastern region) taking the lead. For Zimbabwe, although fertility has continued to decline at the national level, stall is observed among women with less than secondary education and those in some of the regions. We link these intra-country variations to differential changes in socio-economic variables, family planning programme environment and reproductive behaviour models. The results suggest that declines in contraceptive use, increases in unmet need for family planning, increasing preferences for larger families, and increases in adolescent fertility were consistently associated with stalls in subgroup fertility across all four countries. These results are consistent with models that emphasize the role of declines in national and international commitments to family planning programmes in the premature stall in sub-Saharan fertility transition.     

Canadian fertility trends in perspective

This paper examines the broad movements of Canadian period and cohort fertility over the past 100 years, and compares them with corresponding trends in the US and other industrialized countries. The main movement in Canada was a decline in fertility extending from the 19th century to the present, interrupted in the 1940s and 1950s by a baby boom. Between 1871 and 1937 the total fertility rate (TFR) fell at about an average of 1.4% annually. The rate of fall in the US was similar, with the result that in the late 1930s the Canadian TFR was about 20% that of the US. The fertility boom that followed was steeper in the US than in Canada, and in the downswing that later followed, the rate of decline was similar in the 2 countries (3.4-4% annual average). But, the decline continued longer-- indeed still continues--in Canada, whereas the TFR in the US reached its lowest point in 1976. Moreover, the recent decline in fertility has been more severe in Canada than in almost any other industrialized country. The TFR relates to fertility in a single year and is highly sensitive to short-term changes in the timing of births. For the purposes of understanding and explaining long-term trends in fertility, the completed fertility rate (CFR) is a better index because it measures the ultimate family size of cohorts. Cohort fertility can be seen to fluctuate much less than does period fertility. In both the US and Canada, the peak cohorts, born in the early 1930s, had roughly the same completed fertility, and later cohorts continued to remain closely in step as the CFR fell sharply. In Canada the fall continues, though at a reduced rate, in the latest cohorts for which there is information. Apart from differences in amplitude, the dates of turning points and the shapes of the TFR and CFR curves of Canadian fertility are fairly similar. The long decline in cohort fertility is largely explained by the decrease in the proportions of families of 6 or more children. During the baby boom, for Catholics and non-Catholics alike, the proportion of ever-married women remaining childless fell by about 40%, the proportion having 2 children changed little, and the proportions having 3,4 and 5 children tended to increase substantially. The crucial difference between the 2 groups was in the proportions of women having 6 or more children. For non-Catholics, the proportion fell by over 4% from a high level. For non-Catholics, on the other hand, the proportion rose somewhat, though even after the rise, it was barely more than 1/2 the level to which the Catholic proportion had declined. Among Catholics, the effect of the massive decline in the proportion of women having 6 or more children was to swamp the effects of the increase in the proportions of women having 3, 4 and 5 children. The net effect was that fertility declined. Among non-Catholics, however, the comparable increases in the proportions of families of 3, 4 and 5 children, were not offset by any fall in the proportion of larger families, with the result that a baby boom occurred.     

Community-level education accelerates the cultural evolution of fertility decline

Explaining why fertility declines as populations modernize is a profound theoretical challenge. It remains unclear whether the fundamental drivers are economic or cultural in nature. Cultural evolutionary theory suggests that community-level characteristics, for example average education, can alter how low-fertility preferences are transmitted and adopted. These assumptions have not been empirically tested. Here, we show that community-level education accelerates fertility decline in a way that is neither predicted by individual characteristics, nor by the level of economic modernization in a population. In 22 high-fertility communities in Poland, fertility converged on a smaller family size as average education in the community increased—indeed community-level education had a larger impact on fertility decline than did individual education. This convergence was not driven by educational levels being more homogeneous, but by less educated women having fewer children than expected, and more highly educated social networks, when living among more highly educated neighbours. The average level of education in a community may influence the social partners women interact with, both within and beyond their immediate social environments, altering the reproductive norms they are exposed to. Given a critical mass of highly educated women, less educated neighbours may adopt their reproductive behaviour, accelerating the pace of demographic transition. Individual characteristics alone cannot capture these dynamics and studies relying solely on them may systematically underestimate the importance of cultural transmission in driving fertility declines. Our results are inconsistent with a purely individualistic, rational-actor model of fertility decline and suggest that optimization of reproduction is partly driven by cultural dynamics beyond the individual.     

Recent fertility trends in Suriname

A rapid decline in fertility took place in Suriname between 1962 and 1974, and then stopped. While this sudden stabilization is surprising, it is not unusual. Similar trends have occurred in some Caribbean and Latin American countries. This article analyzes the post-1960 trend in fertility in Suriname and seeks to determine whether the 1962-74 fertility decline resulted from changes in socioeconomic conditions or was caused by the activities of the Suriname Family Planning Association. The measures used are the general fertility rate, the total fertility rate by ethnic group as well as by 5-year age groups, and gross and net reproduction rates by ethnic group. All the measures point to a rapid continuing decline of fertility between 1962 and 1974, followed by a rise. The data suggest that major socioeconomic changes had already been under way for some years, when fertility started to fall in 1962. The Suriname Family Planning Association was not founded until 1968, which implies that the organization did not start the decrease. However, once the organization was founded, it continually expanded its activities and made an obvious contribution to the use of contraceptives that increased significantly in the 1970s. It is concluded that the drop in fertility resulted from the process of modernization along with the rapid increase in the use of contraceptives.     

The theoretical and political framing of the population factor in development

The silence about population growth in recent decades has hindered the ability of those concerned with ecological change, resource scarcity, health and educational systems, national security, and other global challenges to look with maximum objectivity at the problems they confront. Two central questions about population—(i) is population growth a problem? and (2) what causes fertility decline?—are often intertwined; if people think the second question implies possible coercion, or fear of upsetting cultures, they can be reluctant to talk about the first. The classic and economic theories explaining the demographic transition assume that couples want many children and they make decisions to have a smaller family when some socio-economic change occurs. However, there are numerous anomalies to this explanation. This paper suggests that the societal changes are neither necessary nor sufficient for family size to fall. Many barriers of non-evidence-based restrictive medical rules, cost, misinformation and social traditions exist between women and the fertility regulation methods and correct information they need to manage their family size. When these barriers are reduced, birth rates tend to decline. Many of the barriers reflect a patriarchal desire to control women, which can be largely explained by evolutionary biology. The theoretical explanations of fertility should (i) attach more weight to the many barriers to voluntary fertility regulation, (ii) recognize that a latent desire to control fertility may be far more prevalent among women than previously understood, and (iii) appreciate that women implicitly and rationally make benefit–cost analyses based on the information they have, wanting modern family planning only after they understand it is a safe option. Once it is understood that fertility can be lowered by purely voluntary means, comfort with talking about the population factor in development will rise.     

Proximate determinants of fertility in the Kathmandu Valley, Nepal: an anthropological case study

The analytical model of Bongaarts and Potter is employed to compare the proximate determinants of fertility among 3 populations in Nepal's Kathmandu valley. 3 sub-groups are studied: high caste (Brahmin and Chetri) urban residents, high caste urban fringe residents, and low caste untouchables (Sarki). Both survey and anthropological methods are employed. According to the analytical model, the transition in fertility follows 4 phases. The changes in fertility levels from Phase 1 to Phase 4 generally indicate that the transition from natural to controlled fertility is characterized by declines in the proportions of women married and the duration of postpartum infecundability, and a substantial increase in the prevalence and effectiveness of contraceptive practices. The results of this study show that Nepal as a whole is entrenched in Phase 1 of the fertility transition. However, data from the 3 populations reported here clearly indicate that each has begun to experience a demographic transition to different degrees. The Sarkis in this study fall between Phases 2 and 3, as indicated by the total fertility rate (TFR). The rural high castes most closely approximate a population in Phase 3, while urban high castes included in this study are approaching Phase 4. Each of the 3 populations is characterized by a decline in the proportion of women married when compared to all of Nepal. It is also apparent that the relative use-effectiveness of contraceptive methods currently employed is high. Gains in the reduction of fertility, then, will have to be made from increasing and retaining the number of acceptors and in reducing the desired family size of those at reproductive risk.     

Fertility preferences among Malaysian women: an analysis of responses to the new population policy

About 10% of 3887 ever-married women included in the 1984-85 Malaysian Population and Family Survey revealed that they were influenced by the new population policy to desire more children than they had originally wanted. These women were more likely to be rural Malays from the lower socioeconomic class. Ideal family size was more than four children. Children are desired for economic benefits and emotional support. The natality of the Malays has risen since 1980: their total fertility rate has increased while their contraceptive prevalence rate has dropped sharply. Coupled with a decline in the crude death rate, the present fertility preferences and behaviour of the Malays will render the target of the population policy more attainable than is reflected by the survey data.     

Gender relations: husband-wife fertility and family planning decisions in Kenya

Although Kenya's fertility rate has declined from 6.7 births per woman in the mid-1980s to 5.4 births per woman in 1993 (NCPD, 1994), population growth is still high, yielding a doubling time of 35 years. This study uses the 1993 Kenya Demographic Health Survey data collected from 1257 couples to examine the socioeconomic and sociodemographic characteristics of married men and women and their communication with their spouses over fertility and family planning decision-making practices. The logistic regression analysis shows that education for both men and women, discussion of fertility and family planning between spouses, male approval of use of contraception and male family size desires are important factors that influence ever-use of family planning.     

A conceptual model for the identification, organization, and measure of influence of fertility policies and programs.

The fertility program of any government is the procedural action intended to effect the government fertility policy. There may also be unintended results of any fertility program. A conceptual model was designed to measure the effect of governmental action on fertility and to identify sociocultural factors that have the greatest influence on fertility. The model uses sociocultural variables as intervening variables between fertility programs and changes in actual fertility. The structural variables considered by the model are characteristics of the pattern of social order; the cultural variables consist of shared values and norms. Fertility trend analysis is effected by polynomial regression formulae. Puerto Rican data from 1946 to 1970 were used to test the proposed model. Analysis of the data indicated that emigration between 1940-1962 had little effect on national fertility. Governmental family planning programs, beginning in 1946, contributed to a sharp decline in fertility. It is recommended that the model be used with data from other countries to assess the effects of their family planning programs.     

Whether to have a second child or not? An integrative approach to women's reproductive decision-making in current China

The transition to low fertility worldwide has led to introduction of diverse frameworks across disciplines to understand its causes and consequences. Previous attempts to compare the relative importance of the key factors influencing women's fertility decision-making largely focused on a single rather than multiple steps of decision-making—an important problem if different factors are associated with different steps. Furthermore, insufficient attention has been paid explicitly to husband's and already-born children's influences, two potentially important factors. Here we introduce a framework covering three steps of reproductive decision-making—ideal family size, fertility desire and fertility intention—and test it using multi-level survey data collected from Chinese one-child mothers. Mother's attitudes towards having two children were paramount factors underlying her ideal family size, and husband's and the firstborn child's attitudes were critical to her desire to have a second child, which in turn played a decisive role in her intention to have a second child. Although husband's attitude was related to all steps, most factors were only relevant to one step; e.g., perceived child mortality and value for old-age security predicted ideal family size, admiration—a prerequisite for social learning—for two-child families predicted fertility desire, and physical/economic constraints primarily predicted fertility intention. Our study emphasizes multiple decision-makers in family reproduction; indicates the relative importance of fertility-influencing factors could vary with steps of decision-making; and has important implications for population policy in low-fertility societies.     

Evidence of increasing natural fertility in Taiwan

Abstract

A comparison of the age‐specific marital fertility experience of three successive cohorts in Taiwan indicates that the later cohorts have experienced progressively higher rates of natural fertility at each age from 15–19 to 35–39. Their fecundability is correspondingly higher and post‐partum sterility, shorter. These changes in natural fertility levels occurred almost simultaneously with recorded changes in health and nutrition levels. These findings support the hypothesis that during the process of modernization and the fertility transition, the level of natural fertility increases, potentially as a result of improvements in health and nutrition, and changes in lactation practices. It is the net effect of increases in natural fertility on the one hand and deliberate fertility regulation on the other, that determines the course of fertility over time, especially at early stages of modernization and the fertility transition.     

International migrations and biodemographic dynamics: Fertility in a sample of Italian immigrants

This work goes beyond the limits of official anagraphic information: by the methodology of family biography it is possible to follow the evolution of demographic traits of a community of immigrants. Fertility is here considered as an important indicator of the population's degree of integration. In the Italian sampling in Belgium the value of this factor shows a rapid decline parallel to the italian natality indexes fall which occurred during the '60 and '70. It is interesting to notice that within the general fertility decrease in the taken sample, oscillations due to the immigrants regional origins and to the presence of mixed marriages, can be observed. Prize for the best Student Paper presented at VIIIth Congress of the E.A.A. held in Madrid, September 7–10, 1992.     

Reproductive change in Zimbabwe and Kenya: the role of the proximate determinants in recent fertility trends

This study examines trends in proximate determinants of fertility in Zimbabwe and Kenya. Findings from the four Demographic and Health Surveys conducted in these countries show that the dramatic fall in fertility in these countries is consistent with the underlying trends in the most important proximate determinants of fertility. In Zimbabwe, contraceptive use far exceeds other proximate determinants in influencing fertility levels and trends. The results show that the fertility inhibiting effects of contraception are more important than the effects of postpartum infecundability, marriage patterns, or sterility. The results also show that contraceptive use has its greatest suppressing effects in the middle and younger age groups. However, in Kenya, the dominant fertility inhibiting effect is postpartum infecundability, with contraception coming in second.     

The Trade-Off between Female Fertility and Longevity during the Epidemiological Transition in the Netherlands

Several hypotheses have been put forward to explain the relationship between women’s fertility and their post-reproductive longevity. In this study, we focus on the disposable soma theory, which posits that a negative relationship between women’s fertility and longevity can be understood as an evolutionary trade-off between reproduction and survival. We examine the relationship between fertility and longevity during the epidemiological transition in the Netherlands. This period of rapid decline in mortality from infectious diseases offers a good opportunity to study the relationship between fertility and longevity, using registry data from 6,359 women born in The Netherlands between 1850 and 1910. We hypothesize that an initially negative relationship between women’s fertility and their longevity gradually turns less negative during the epidemiological transition, because of decreasing costs of higher parities. An initially inversed U-shaped association between fertility and longevity changes to zero during the epidemiological transition. This does suggest a diminishing environmental pressure on fertility. However, we find no evidence of an initial linear trade-off between fertility and post-reproductive survival.     

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.     

The effects of infant deaths on the risk of subsequent birth: a comparative analysis of DHS data from Ghana and Kenya

This paper examines the conditions under which there might be a strong or weak relationship between childhood mortality and fertility at the micro level. The premise is that as a society undergoes transition during which a conscious effort is made to space and limit birth, the effect associated with infant death on the risk of subsequent birth reduces. Using the 1998 DHS data from Ghana and Kenya, our multivariate hazard models show that women who have experienced infant deaths tend to have a higher risk of subsequent births than those without any infant deaths at all parities studied in both countries. In a comparative context, however, the magnitude of the effect associated with infant death was weaker in Kenya at all parities, corroborating the hypothesis that the effect indeed reduces in the course of transition. Besides infant deaths, other demographic, socioeconomic and sociocultural factors were also found to associate with the risk of births. The limitations and policy implications of the findings are discussed.     

Continuing fertility transitions in a plural society: ethnic trends and differentials in Peninsular Malaysia

Fertility in Peninsular Malaysia has declined continuously from the late 1950s, reaching a total fertility rate of 3735 in 1983. All ethnic groups in Malaysia have contributed to this modern demographic transition but the rate of change has been most rapid for Chinese and Indians, Malay fertility having reached a plateau in the early 1980s. The effect of age structure, marital patterns and marital fertility (by parity) on the fertility declines for each ethnic community are analyzed. There has been a tendency, in each ethnic group, for the age distribution within the group of reproductive-age women to grow younger, reflecting the entry into the younger reproductive ages of the large birth cohorts of the 1950s and early 1960s. The effect of this on crude birth rates is hard to determine, because rising age at marriage and increasing use of contraception meant that fertility was increasingly concentrated in the more central reproductive ages. By the 1990s, the earlier declines in fertility will bring about a decline in the proportion of the total population made up of females in the main reproductive ages. After that point, further declines in fertility will be reflected in a sharper decline in the crude birth rate and hence the rate of population increase. Between 1947 and 1980, the age at marriage changed dramatically for females of all ethnic groups. The transition to higher age at marriage for Chinese was completed earlier, and since 1970 has risen by only a year. For Malays and Indians, the rise began later, proceeded faster and continued right up to 1980 when the medium ages at 1st marriage were Malays 22, Indians 23, Chinese 24 years. In 1980, Malay women on average were marrying 5 years later, and Indian women 6 years later than had their mothers' generation in 1947. The proportion never-married among Malay and Indian women aged 20-24 rose from 1/10 to 1/2 over this period; relatively greater changes are evident at ages 25-29. Other factors are the almost complete shift from parent-arranged to self-arranged marriages. Family size desired has decreased for all groups and the decline in breastfeeding has been offset by the sharp increase in the practice of contraception. Continuation of these trends would lead to replacement-level fertility for Malaysian Chinese and Indians by the year 2000. Malay fertility is likely to continue to decline but at a more moderate pace.