Fertility and family planning in southern and central Africa

Abstract

Southern Africa comprises a zone where the total fertility rate is below 6 births per woman. To the north is a ring of countries with higher fertility and relatively low contraceptive prevalence rates. The experience of South Africa, Botswana, and Zimbabwe, which have successful family planning programs, is compared with that of neighboring countries.

PIP: An overview of trends in the total fertility rate in Southern Africa is presented along with a comparison between the experiences of South Africa, Botswana, Lesotho,k Swaziland, and Zimbabwe and neighboring countries in central Africa (Angola, Malawi, Mozambique, and Zambia). a profile of each country is given. Sub-Saharan Africa has barely begun its fertility or population decline, and the reasons why are suggested. It is posited that stable governments are related to successful family planning (FP) efforts, however, except for Angola and Mozambique, the referenced African countries have had stability. Sometimes the multiparty compromises of a democratic system indicate less than a firm commitment by the national government. The example is given of Zambia with a strong Catholic family life movement which is active in opposing modern contraception, and Malawi with a 1-party state where there is little opposition to FP. Women's organizations can have a strong influence, and the example is given of Zimbabwe's and Zambia's Women's Leagues. Zimbabwe's First Lady's sister was the program coordinator for the National FP Council during the 1980s. The commitment of governments is only one reason for difficulties in achieving lower fertility and higher contraceptive prevalence. Implementation is another problem. In Zambia, transportation is difficult. There is lack of method choice and supply difficulties. Urban health services may receive the bulk of funding and rural health services are neglected. Abortion is illegal in many countries. Religious beliefs may be involved. Teenage pregnancy is of general concern throughout the region. In 1988, among Zambian women in school 1 out of 7 had a 1st pregnancy while in school vs. 1 in 5 for women aged 20-24 years. In Zimbabwe, new acceptors between 1984 and 1988 increased among al educational subgroups and among wives 25-34. Although the FP approaches have been different in Botswana, Zimbabwe, and South Africa, the programs have successfully made services available. Sometimes in the case of South Africa, this has been at the expense of public health services.