Search results

Sub-Saharan Africa will be the family planning frontier of the twenty-first century. Fertility levels and population growth rates are still high, and family planning programs suited to the region are still being developed. Nevertheless, by the end of the

Sub-Saharan Africa will be the family planning frontier of the twenty-first century. Fertility levels and population growth rates are still high, and family planning programs suited to the region are still being developed. Nevertheless, by the end of the

Sub‐Saharan Africa will be the family planning frontier of the twenty‐first century. Fertility levels and population growth rates are still high, and family planning programs suited to the region are still being developed. Nevertheless, by the end of the twentieth century, fertility transition was under way in Southern Africa and a few countries elsewhere. Successful regional family planning in the twenty‐first century will depend upon stronger political leadership, the development of family planning programs that meet the needs of all segments of society and not only currently married women, assistance to the market, and a recognition of the central importance of hormonal methods, especially injectables. Problems include stagnation in economic growth and in child mortality decline, as well as the persistence of the AIDS epidemic.

The outbreak of AIDS around the world in the last 15 or 20 years is usually referred to as the "AIDS epidemic," or occasionally "pandemic" (Grmek 1990). These terms have no great analytic value. The major medical dictionaries and epidemiological textbooks define an epidemic merely as an outbreak of a disease marked by a greater number of cases than usual (see Fox et al. 1970: 246–49; Mausner and Bahn 1974: 22, 272–77;Stedman's Medical Dictionary1977: 470; Kelsey et al. 1986: 212; Walton et al. 1986: 351; Harvard 1987: 247). This condition is contrasted with the endemic form of a disease at "its habitual level, or what previous experience would lead one to anticipate." The termpandemicis used to describe an epidemic widespread in the world and usually characterized by a large number of cases, for example, the fourteenth-century plague epidemic (or Black Death) and the influenza epidemic during the latter part of World War I. Some authorities stress the fact that epidemics are also characterized by a declining phase. This is true by definition, of course, for otherwise the disease could be described as shifting to a new and higher endemic level. But it is also of interest that most of these unusual outbreaks of disease are eventually limited by such mechanisms as a decrease in susceptibles as persons become immune or die; as interventions, either medical or behavioral, eliminate the source or interrupt transmission; or as the pathogen mutates and becomes less virulent.

SummaryData are employed from six surveys carried out in Ibadan City, Nigeria, during two survey programmes: the Nigerian segment of the Changing African Family Project in 1973, and the Nigerian Family Study in 1974–5. A distinction is made between contraceptive innovators, those who use any means to control fertility except the traditional Yoruba sexual abstinence, and demographic innovators, those who succeed in limiting their family size. It is shown that contraceptive innovation is now proceeding rapidly but has little connection with demographic innovation. Contraceptive innovation is a response to social change which has increased the likelihood of premarital and extramarital sexual relations and the desire to shorten the period of postnatal sexual abstinence while not increasing the interval between births. Such innovation has proceeded more rapidly because of the increased availability of contraceptives since about 1960 and because of the types of contraceptives which have been developed since then. Demographic innovation is on the increase but its incidence is still minute. Fertility restriction within marriages seems to take place only after profound changes have occurred in the economic relationships within both the extended and nuclear families which for the first time make the small family the economically rational choice. Such change probably depends more on the import of cultural patterns than on necessary cultural adjustments to imported economic change, but a strengthening of the conjugal bond is involved and this may be hastened by contraceptive innovation. Little innovational trauma or even awareness of profound change was detected, largely because the profound, and even disruptive, innovations are preceding social ones, but partly too because peer group behaviour changes at much the same time.