RURAL DEVELOPMENT, HEALTH, MORTALITY AND FERTILITY IN RURAL NORTHEASTERN TANZANIA

The survey, the findings of which are analyzed in this report, found that infant and child mortality rates in this area of Tanzania have declined substantially over the past two decades resulting in mortality rates uncommonly low for tropical Africa. Perception of this decline by parents differed widely with level of parent education. Major influences on desired levels of fertility were found to be the mother"s age at first and last childbearing and the intervals between births. Women who marry later, generally the more educated, "catch-up" with or surpass women of the same age in fertility due to increased child survival and shorter birth intervals. Once women marry, fertility is determined by breastfeeding practices, sexual abstinence, and to some extent by infant mortality which shortens the interval between births. Of the socioeconomic variables analyzed, only one, "place of delivery" (hospital versus home) was consistently linked positively with lower infant mortality. This variable can be indirectly linked to education, economic status, pregnancy-related medical care, and occupation, although surprisingly, no direct correlations were found between these variables and infant survival. The study also found that a substantial proportion of parents desired to terminate childbearing after rearing five or more surviving children, but this desire could not be linked to educational or economic variables. The study suggests that the key factors promoting low fertility and mortality levels are basic education, especially for girls, and access to basic health care. It is recommended that promotion of family planning practices and immediate and prolonged breastfeeding be incorporated into the latter. A 60-item bibliography (1968-80) is appended.