Suchergebnisse

Combining data from two Demographic and Health Surveys conducted in Ghana in 1991 and 1993 and information from focus group discussions held in four rural areas of that country, we analyze how the prevalence of polygyny in an area affects the gender hierarchy and relations within the family, and spousal attitudes to and communication on issues of reproduction and family planning. We find that in areas with higher levels of polygyny, where women and their roles in the household are seen as easily replaceable, gender inequality within the family with respect to these issues is more pronounced and enduring than in areas with lower polygyny levels. We briefly discuss implications of these findings for the future of gender relations in Ghana and in similar social contexts.

AbstractPrevious studies have documented significant differences in health and reproductive health outcomes between the poor and nonpoor across various countries in sub‐Saharan Africa. However, a number of these studies is dated, and the past decade has witnessed significant shifts in health and reproductive health outcomes in many African countries. Using recent data from the Demographic and Health Surveys, this paper updates and extends the literature by examining patterns in contraceptive practice among poor and nonpoor married women in urban settings in 19 African countries. First, we analyze changes in the rich–poor gaps in modern contraceptive prevalence (mCP) in urban Africa over time. We then determine the public source of the supply of modern contraceptives to the urban poor and how that supply may have changed over a 10‐year period. The findings show that, in most Eastern and Southern African countries, previous gaps in mCP between the rich and poor married women have disappeared. Countries in Central and Western Africa, however, continue to have significant gaps in mCP between rich and poor women, with urban poor women experiencing only a modest improvement in mCP over the past decade. This paper contributes to our understanding about sub‐regional dynamics in reproductive health outcomes in urban settings in sub‐Saharan Africa.

Research on fertility trends in Islamic northern Nigeria has rarely sought the perspectives of the people of that region concerning the causes of high fertility in the area. Relying on qualitative data elicited from women in northwestern Nigeria, we explore their views on high fertility in the region. A principal finding is that respondents ascribed to their husbands the responsibility for high parity; these women reported deliberately giving birth to many children in order to inhibit men's tendency to divorce or engage in plural marriage. We contend that the social meanings that women ascribe to their husbands' behaviors and the ways they respond to them are significant contributors to current high fertility in northern Nigeria.

This article examines the quality of primary school inputs in urban settlements with a view to understand how it sheds light on benchmarks of education quality indicators in Kenya. Data from a school survey that involved 83 primary schools collected in 2005 were used. The data set contains information on school quality characteristics of various types of schools in Nairobi. On the basis of the national benchmarks, the quality of education provided in government schools was shown to be "better" with regard to infrastructure, teacher qualifications, and textbook provision than that provided in all the nongovernment-owned schools. However, nongovernment schools have smaller class sizes and lower pupil—teacher ratio (PTR). The bad news is that government schools have large class sizes and higher PTR and hence low levels of teacher—pupil interaction. Nongovernment schools had poor classroom structures and a higher pupil—textbook ratio, particulary private individually owned schools and community-owned schools. It also emerges that although in the government schools, student learning space is constrained by the class size, the student learning space in nongovernment schools is constrained by the classroom size. Meeting quality benchmarks in primary schooling, therefore, remains a challenge among urban populations.

In Africa, fertility rates in the 1990s declined less rapidly than had been projected, and in a few cases the fertility transition appears to have stalled. This development has serious implications for future population growth because projected population size is sensitive to minor variations in current fertility trends. The 16 countries with three DHS surveys in sub-Saharan Africa can be divided into three subgroups: stalled transitions, insignificant declines, and significant declines. Half of the 16 countries experienced a stall, and an additional two experienced insignificant declines. The Population Council prepared a series of demographic and policy analyses that drew from the existing literature on fertility and family planning in Kenya. These analyses were presented at a meeting of key stakeholders in Kenya in 2008. This report presents the issues emerging from the analyses and discussions, and suggests some policy and programmatic actions that can be taken to help the Government of Kenya address the stall within the frameworks of the Millennium Development Goals and the country's "Vision 2030" plan for sustainable development.

As urbanization continues unabated in Kenya, the wellbeing of the urban poor ‐ whose majority live in slum settlements ‐ will increasingly drive national development indicators including Vision 2030, SDGs and FP2020 goals. It is therefore central to understand and identify ways to address the poor reproductive health outcomes among poor urban slum populations in the country. Taking advantage of APHRC's NCSS surveys conducted in 2000 and 2012 among a representative sample of slum households across Nairobi, we show that there has been a considerable increase in use of modern contraception among women in Nairobi slums, from 34% in 2000 to 53% in 2012, and a reduction in inequity in access through much higher increases among previously disadvantaged groups. Using decomposition analysis techniques, we show that much of the observed increase is due to behavioral changes in the effect of fertility preferences on contraceptive use; and to compositional changes in woman's education, child survival and exposure to FP information. This may be the result of efforts by the government of Kenya and its development partners to reduce the disparities in uptake and use of FP services through various programs and policies targeting the poor segments of the Kenyan population.

SummaryAlthough attitudes to premarital sex may be influenced by several factors, the importance of religion to that discourse cannot be underestimated. By providing standards to judge and guide behaviour, religion provides a social control function such that religious persons are expected to act in ways that conform to certain norms. This study investigated the interconnectedness of several dimensions of religion and premarital sexual attitudes among young people in the informal settlements of Nairobi, Kenya. Using reference group as the theoretical base, it was found that those affiliated with Pentecostal/Evangelical faiths had more conservative attitudes towards premarital sex than those of other Christian faiths. Additionally, while a high level of religiosity was found to associate with more conservative views on premarital sex, the effect was more pronounced among Pentecostal groups. The findings are discussed in relation to programmes on adolescent sexuality.

PurposeThe purpose of this paper is to examine household characteristics and schooling decisions in terms of enrollment and type of school in an urban setting in Nairobi.Design/methodology/approachThe paper uses a cross‐sectional data set collected in 2005. The sample comprises 7,475 primary school‐aged children. A probit model was estimated to show what influences decisions at household level.FindingsAnalysis shows that different household and individual attributes motivate different decisions. A considerable proportion (40 per cent) of children from the poorest quintile attends non‐public schools compared to 34 per cent from the richest quintile. The findings reveal that better‐off households are more represented in the free primary education (FPE) programme. The predicted probability of a decision to attend a public school for a primary school‐age child increases as the household wealth increases.Practical implicationsThe paper concludes that poorer households are least attending and may be excluded from free public schools.Originality/valueThe paper demystifies the notion that introduction of FPE in developing countries is a pro‐poor policy.

Abstract Background It has been almost a decade since HIV was declared a national disaster in Kenya. Antiretroviral therapy (ART) provision has been a mainstay of HIV treatment efforts globally. In Kenya, the government started ART provision in 2003 with significantly scale-up after 2006. This study aims to demonstrate changes in population-level HIV mortality in two high HIV prevalence slums in Nairobi with respect to the initiation and subsequent scale-up of the national ART program. Methods We used data from 2070 deaths of people aged 15–54 years that occurred between 2003 and 2010 in a population of about 72,000 individuals living in two slums covered by the Nairobi Urban Health and Demographic Surveillance System. Only deaths for which verbal autopsy was conducted were included in the study. We divided the analysis into two time periods: the "early" period (2003–2006) which coincides with the initiation of ART program in Kenya, and the "late" period (2007–2010) which coincides with the scale up of the program nationally. We calculated the mortality rate per 1000 person years by gender and age for both periods. Poisson regression was used to predict the risk of HIV mortality in the two periods while controlling for age and gender. Results Overall, HIV mortality declined significantly from 2.5 per 1,000 person years in the early period to 1.7 per 1,000 person years in the late period. The risk of dying from HIV was 53 percent less in the late period compared to the period before, controlling for age and gender. Women experienced a decline in HIV mortality between the two periods that was more than double that of men. At the same time, the risk of non-HIV mortality did not change significantly between the two time periods. Conclusions Population-level HIV mortality in Nairobi's slums was significantly lower in the approximate period coinciding with the scale-up of ART provision in Kenya. However, further studies that incorporate ART coverage data in mortality estimates are needed. Such information will enhance our understanding of the full impact of ART scale-up in reducing adult mortality among marginalized slum populations in Kenya.