The Role of Public-Sector Family Planning Programs in Meeting the Demand for Contraception in Sub-Saharan Africa

2017 ◽  
Vol 43 (2) ◽  
pp. 41 ◽  
Author(s):  
Bongaarts ◽  
Hardee
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Frank Götmark ◽  
Malte Andersson

Abstract Background The world population is expected to increase greatly this century, aggravating current problems related to climate, health, food security, biodiversity, energy and other vital resources. Population growth depends strongly on total fertility rate (TFR), but the relative importance of factors that influence fertility needs more study. Methods We analyze recent levels of fertility in relation to five factors: education (mean school years for females), economy (Gross Domestic Product, GDP, per capita), religiosity, contraceptive prevalence rate (CPR), and strength of family planning programs. We compare six global regions: E Europe, W Europe and related countries, Latin America and the Caribbean, the Arab States, Sub-Saharan Africa, and Asia. In total, 141 countries are included in the analysis. We estimate the strength of relationships between TFR and the five factors by correlation or regression and present the results graphically. Results In decreasing order of strength, fertility (TFR) correlates negatively with education, CPR, and GDP per capita, and positively with religiosity. Europe deviates from other regions in several ways, e.g. TFR increases with education and decreases with religiosity in W Europe. TFR decreases with increasing strength of family planning programs in three regions, but only weakly so in a fourth, Sub-Saharan Africa (the two European regions lacked such programs). Most factors correlated with TFR are also correlated with each other. In particular, education correlates positively with GDP per capita but negatively with religiosity, which is also negatively related to contraception and GDP per capita. Conclusions These results help identify factors of likely importance for TFR in global regions and countries. More work is needed to establish causality and relative importance of the factors. Our novel quantitative analysis of TFR suggests that religiosity may counteract the ongoing decline of fertility in some regions and countries.


1997 ◽  
Vol 29 (1) ◽  
pp. 33-49 ◽  
Author(s):  
YAW OHENEBA-SAKYI ◽  
BAFFOUR K. TAKYI

Using data from the 1988 Ghana Demographic and Health Survey, this study examines couples' demographic and socioeconomic characteristics in the context of their attitudes towards family planning, and the impact of these factors on the use of contraceptives. The characteristics of the husbands and their influence on wives' behaviour illustrate the role of intra-household relations between men and women and their effect on fertility-related behaviour in patriarchal African societies.


Genus ◽  
2020 ◽  
Vol 76 (1) ◽  
Author(s):  
John Bongaarts

Abstract A common explanation for the high fertility prevailing in sub-Saharan Africa (SSA) is a widespread desire for large families. This situation poses a challenge to population policy-makers in the continent. If the desired family size is high, then presumably family planning programs can only have a limited effect on fertility because these programs aim to assist women in achieving their reproductive goals. But this conclusion is based on the assumption that family planning programs do not affect the desired family size, which is questionable and is investigated here. This study examines the determinants of trends wanted and unwanted fertility in SSA using fixed-effects regressions of country-level data. The dependent variables include the total fertility rate, and its wanted and unwanted components. Explanatory variables include a family planning program score and four socioeconomic variables (women’s educational attainment, child mortality, GNI per capita, and percent urban). Data come from 103 DHS surveys in 25 countries in SSA with at least two DHS surveys between 1989 and 2019. Women’s education and family planning programs are found to be the dominant determinants of fertility decline and their effects operate by reducing both wanted and unwanted fertility. The effects of education are not surprising but the finding that family planning programs can reduce wanted fertility implies that their impact can be larger than conventional wisdom suggests. Indeed, in a few poor countries, the implementation of high-quality programs has been associated with substantial declines in wanted fertility (e.g., Ethiopia, Malawi, Rwanda). The mechanism through which this effect operates is unclear but likely involves media programs that diffuse knowledge about the benefits of smaller families.


2009 ◽  
Vol 40 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Roy Jacobstein ◽  
Lynn Bakamjian ◽  
John M. Pile ◽  
Jane Wickstrom

2018 ◽  
Vol 77 (2) ◽  
pp. 135-145 ◽  
Author(s):  
Lauren Wallace ◽  
Philip Baba Adongo

Studies suggest that men's perceptions of family planning in sub-Saharan Africa would be improved if they were included more extensively in family planning programs. However, few studies capture how men's views change over time and what processes are responsible for these shifts. Examining the processes that underpin men's shifting family formation strategies is essential in order to understand the impact of family planning programs. This research, framed by a political economy of fertility approach that draws on life history data, highlights intergenerational change and continuity in men's perceptions of family planning in Kassena-Nankana West District of the Upper East Region of Ghana, where a family planning program involving men was implemented in the 1990s. Eight months of ethnographic fieldwork was conducted in rural village and clinic settings in 2013 and 2014. We find that men's sense of responsibility for the cost of schooling, against a changing economic backdrop, as well as shifts toward “companionate marriage” are among the most salient factors contributing to their growing approval of family planning. This study highlights the importance of paying attention to changes in the larger socioeconomic context that encourage men's acceptance of family planning. We argue that programs incorporating men should move beyond health education to consider broader social and economic drivers of attitudinal change.


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