scholarly journals Family planning in sub-Saharan Africa: progress or stagnation?TP

2011 ◽  
Vol 89 (2) ◽  
pp. 137-143 ◽  
Author(s):  
John G Cleland ◽  
Robert P Ndugwa ◽  
Eliya M Zulu
Keyword(s):  
Family Planning ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Promoting Scale-Up Across a Global Project Platform: Lessons from the Evidence to Action Project

2021 ◽  
Author(s):  
Laura Ghiron ◽  
Eric Ramirez-Ferrero ◽  
Rita Badiani ◽  
Regina Benevides ◽  
Alexis Ntabona ◽  
...  
Keyword(s):  
Family Planning ◽  
Scale Up ◽  
Scaling Up ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Country Level ◽  
Look Ahead ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Multi Stakeholder

AbstractThe USAID-funded flagship family planning service delivery project named Evidence to Action (E2A) worked from 2011 to 2021 to improve family planning and reproductive health for women and girls across seventeen nations in sub-Saharan Africa using a “scaling-up mindset.” The paper discusses three key lessons emerging from the project’s experience with applying ExpandNet’s systematic approach to scale up. The methodology uses ExpandNet/WHO’s scaling-up framework and guidance tools to design and implement pilot or demonstration projects in ways that look ahead to their future scale-up; develop a scaling-up strategy with local stakeholders; and then strategically manage the scaling-up process. The paper describes how a scaling-up mindset was engendered, first within the project’s technical team in Washington and then how they subsequently sought to build capacity at the country level to support scale-up work throughout E2A’s portfolio of activities. The project worked with local multi-stakeholder resource teams, often led by government officials, to equip them to lead the scale-up of family planning and health system strengthening interventions. Examples from project experience in the Democratic Republic of the Congo, Kenya, Nigeria, and Uganda illustrating key concepts are discussed. E2A also established a community of practice on systematic approaches to scale up as a platform for sharing learning across a variety of technical agencies engaged in scale-up work and to create learning opportunities for interacting with thought leaders around critical scale-up issues.

scholarly journals Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Martin K. Mutua ◽  
Yohannes D. Wado ◽  
Monica Malata ◽  
Caroline W. Kabiru ◽  
Elsie Akwara ◽  
...  
Keyword(s):  
Family Planning ◽  
West Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Rate Of Change ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sexually Active ◽  
Sub Saharan ◽  
Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

The changing value of children among the Kikuyu of Central Province, Kenya

Africa ◽  
1996 ◽  
Vol 66 (3) ◽  
pp. 411-436 ◽  
Author(s):  
Neil Price
Keyword(s):  
Family Planning ◽  
Social Institutions ◽  
Sub Saharan Africa ◽  
High Fertility ◽  
Central Province ◽  
Economic Insecurity ◽  
Family Planning Services ◽  
Value Of Children ◽  
Sub Saharan ◽  
Demand For Children

Within demography, high fertility in sub-Saharan Africa was considered until recently to reflect a demand for children firmly rooted in indigenous social institutions, which were resistant to external forces of change. On the basis of findings from recent Demographic and Health Surveys, Caldwell et al. (1992) suggest that many of the institutional supports for high fertility in sub-Saharan Africa—such as lineage-based descent systems, polygyny, bridewealth, extended kinship structures, child fostering, and communal land tenure—are being eroded. This article considers changes in the value of children among the Kikuyu of Central Province, Kenya, and the extent to which the social institutions which have traditionally supported high fertility have persisted. Fieldwork undertaken in two ethnically homogenous communities, one rural and one peri-urban, reveals significant variation in the fertility motives and value of children in the two communities. In the rural community many of the indigenous social supports for high fertility, although modified, cohere. In the context of economic insecurity and lack of access to land (especially for women without sons), manipulation of customary kinship and marriage practices (supported by the persistence of many indigenous religious beliefs and ideologies about fertility) has become strategically important for realising fertility desires. There is, however, unmet demand for modern contraception, due largely to lack of access to and the poor quality of family planning services. In contrast, in the peri-urban community, where access to family planning services is relatively good, there has been effective legitimation of fertility regulation and the use of modern contraception is widespread. There is markedly less economic insecurity: wage labour opportunities are available, and some women have successfully challenged male control over land. Consequently, there is reduced demand for children, although a number of the indigenous cultural supports for high : fertility retain residual importance.

scholarly journals Human fertility in relation to education, economy, religion, contraception, and family planning programs

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Frank Götmark ◽  
Malte Andersson
Keyword(s):  
Family Planning ◽  
Sub Saharan Africa ◽  
Gdp Per Capita ◽  
World Population ◽  
Relative Importance ◽  
Health Food ◽  
Family Planning Programs ◽  
Five Factors ◽  
Per Capita ◽  
Sub Saharan

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.

EFFECTS OF COUPLES' CHARACTERISTICS ON CONTRACEPTIVE USE IN SUB-SAHARAN AFRICA: THE GHANAIAN EXAMPLE

1997 ◽  
Vol 29 (1) ◽  
pp. 33-49 ◽  
Author(s):  
YAW OHENEBA-SAKYI ◽  
BAFFOUR K. TAKYI
Keyword(s):  
Family Planning ◽  
Health Survey ◽  
Contraceptive Use ◽  
Sub Saharan Africa ◽  
Men And Women ◽  
Socioeconomic Characteristics ◽  
Sub Saharan ◽  
Using Data ◽  
The Impact

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.

scholarly journals Integrating Oral PrEP Into Family Planning Services for Women in Sub-saharan Africa: Findings From a Multi-Country Landscape Analysis

2021 ◽  
Vol 3 ◽  
Author(s):  
Neeraja Bhavaraju ◽  
Rose Wilcher ◽  
Regeru Njoroge Regeru ◽  
Saiqa Mullick ◽  
Imelda Mahaka ◽  
...  
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Health Care Providers ◽  
Sub Saharan Africa ◽  
Management Service ◽  
Care Providers ◽  
Road Map ◽  
Sub Saharan ◽  
Exposure Prophylaxis ◽  
Oral Prep

Integration of HIV and family planning (FP) services is a renewed focus area for national policymakers, donors, and implementers in sub-Saharan Africa as a result of high HIV incidence among general-population women, especially adolescent girls and young women (AGYW), and the perception that integrating HIV pre-exposure prophylaxis (PrEP) into FP services may be an effective way to provide comprehensive HIV and FP services to this population. We conducted a focused desk review to develop a PrEP-FP integration framework across five key categories: plans and policies, resource management, service delivery, PrEP use, and monitoring and reporting. The framework was refined via interviews with 30 stakeholders across seven countries at varying stages of oral PrEP rollout: Kenya, Lesotho, Malawi, South Africa, Uganda, Zambia, and Zimbabwe. After refining the framework, we developed a PrEP-FP integration matrix and assessed country-specific progress to identify common enablers of and barriers to PrEP-FP integration. None of the countries included in our analysis had made substantial progress toward integrated PrEP-FP service delivery. Although the countries made progress in one or two categories, integration was often impeded by lack of advancement in other areas. Our framework offers policymakers, program implementers, and health care providers a road map for strategically assessing and monitoring progress toward PrEP-FP integration in their contexts.

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