Factors affecting contraceptive use in sub-Saharan Africa

This report inquires into the economic, social, and programmatic causes of this disparity. Chapters examine: (1) current levels and trends in contraceptive use; (2) economic and social (community, kinship, household) factors affecting (sustaining or reducing) the demand for large families and so for contraceptive use; (3) the effects of population policy and family planning programs on fertility decisionmaking; (4) the relative importance, as determined by a multivariate analysis, of sociodemographic and economic factors in contraceptive use at the regional level; and (5) the relative importance of contraceptive use and traditional birth spacing methods. The report finds that Botswana, Kenya, and Zimbabwe have joined other regions of the developing world in a contraceptive revolution; major contributing factors have included political commitment, a supportive policy environment, excellent family planning programs, and high levels of female education. On the other hand, longstanding forms of social organization clearly inhibit contraceptive adoption and fertility decline. These include: the high value attached to perpetuation of the lineage; the importance of children as a means of gaining access to land and other resources; the use of kinship networks to share the costs and benefits of children; and the weak nature of conjugal bonds. Nonetheless, continued improvements in female education, reductions in infant and child morality, and strengthening of family planning programs should provide impetus for increased contraceptive use in Africa. (Author abstract, modified)