These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Child survival, fertility, and family planning in Africa. Uncertain prospects].
    Author: Mbacke C.
    Journal: Pop Sahel; 1987 Oct; (4):36-40. PubMed ID: 12316349.
    Abstract:
    This work summarizes a paper by Cynthia B. Lloyd and Serguey Ivanov entitled "The Effects of Improved Child Survival on Family Planning Practice and Fertility" that was presented at the October 1987 conference in Nairobi on the health benefits of family planning for women and children. The paper presented results of a systematic literature review that sought to answer 2 questions: 1) do improved prospects of child survival reduce fertility, and 2) if so, what role does family planning play in the process. The 4 parts of the study defined the theoretical framework of the analysis, examined socioeconomic factors that could influence family building strategies, reviewed empiric research on the subject, and discussed policy implications. Improved survival prospects for children have 4 different effects which promote fertility decline. The transition effect refers to the parents' growing awareness that they can influence future events. The physiologic effect results when lactation is uninterrupted by early death of the child. When fertility behavior becomes more calculated and less fatalistic, demand and supply effects enter into play. The relationship between fertility and mortality is 2-directional. Socioeconomic factors determine the number of surviving children desired by a couple. In the traditionally agricultural societies of sub-Saharan Africa, the economic value of children far exceeds their costs, which at any rate are shared by the extended family and the community at large. The age distribution of death largely determines the predictability of child survival. High mortality after the 1st year as in Sahel countries which have the highest child morality rates in the world is unfavorable to family planning. The distribution of causes of death is also important because parents are more likely to notice improved survival prospects and change their fertility expectations accordingly if they themselves helped improve conditions rather than merely benefitting from externally-imposed improvements. Availability of family planning services becomes an important factor in the extent and speed of fertility decline once the desired number of surviving children becomes smaller than that implied in a natural fertility regime. The author found that sustained fertility declines were usually preceded by mortality declines, but improved health conditions did not automatically lead to fertility declines. The pronatalist attitudes of individual households, rational though they might be, are becoming a problem for African governments burdened by the need to provide services for ever growing populations. Lloyd and Ivanov believe that infant mortality is still too high in most of Africa to encourage family planning; they recommend that sterilization be stressed for families that have achieved their desired size. This work argues however that a future fertility decline is not assured and that reversible contraceptives should be available for the population sectors desiring them.
    [Abstract] [Full Text] [Related] [New Search]