Fraught with Ambivalence: Reproductive Intentions and Contraceptive Choices in a Sub-Saharan Fertility Transition

Demographic studies that search for signs of fertility transition in sub-Saharan Africa rarely examine the complex gamut of individual aspirations and misgivings, hopes and frustrations, failures and triumphs that accompany the emerging declines of fertility rates in the subcontinent. This study draws upon qualitative data collected in peri-urban areas of Maputo, Mozambique’s capital and largest metropolis, to explore contradictory meanings and feelings surrounding changes in fertility intentions and contraceptive choices. It argues that although changes in these two aspects of reproductive life are interrelated, they are predicated on distinct types and configurations of external pressures and psychological apparatus, which is often manifested as a puzzling disjunction between fertility preferences and contraceptive use. This disjunction can be further reinforced by persistent gender divisions in reproductive views and strategies. Informal social interaction plays an important role in building societal consensus over fertility matters, but because such interaction deals with reproductive intentions and contraceptive use through largely different mechanisms, it may also help accentuate the intentions-contraception disjunction. This study’s findings therefore call upon both researchers and policymakers to attend more closely to the multidimensionality of fertility transitions in sub-Saharan societies and specifically to the complexities underlying such popular notions as “unmet need for family planning,” “spacing” versus “limiting” births, or “spousal communication” on reproductive matters.     

Understanding the link between the economy and teenage sexual behavior and fertility outcomes

We use individual-level data from the 1997 National Longitudinal Survey of Youth and state unemployment rates to examine how the economy affects fertility and its proximate determinants for several groups based on gender, age (15–17 and 18–20 groups), and race/ethnicity. We find that, for 15- to 17-year-old females, several behaviors leading to pregnancies and pregnancies themselves are higher when the unemployment rate is higher, which is consistent with the counter-cyclical fertility patterns for this group. For 18- to 20-year-old males, the results suggested counter-cyclical patterns of fertility behaviors/outcomes for whites, but pro-cyclical patterns for blacks. This research was funded by grant R03HD47407 from the National Institute on Child and Health Development.     

Effect of Pregnancy Intention on Child Well-Being and Development: Combining Retrospective Reports of Attitude and Contraceptive use

Prior research has documented a relationship between unintended pregnancy and negative consequences for infants and children. Much of this research is based on retrospective reports of intention, but this method has been critiqued as subject to biases in recall and reporting. Non-retrospective measures have also been employed, but these are less widely available and tend to be hindered by limited samples. Using the 1988 National Maternal and Infant Health Survey and its 1991 Longitudinal Follow-Up, a composite measure of reported pregnancy intention and birth control use is constructed to attempt to overcome some limitations of the use of retrospective reports of intention. This composite measure is compared to more conventional measures through analyses predicting the effects of pregnancy intention on child health, activity, and development. Across the different constructions of the pregnancy intention measure, children from unintended pregnancies have poorer outcomes. They are more likely to have less than excellent health, undesirable activity levels, and below median scores on a development assessment. The composite measure predicts similarly to the more conventional measures of intention, but provides an additional dimension that helps address some of the concerns about bias in retrospective reporting, while maintaining the benefit of application in existing large and representative samples. Researchers and policy makers need to continue their concern about the effects of unintended pregnancies, and need widely available measures to understand determinants, consequences, and prevention strategies.     

Unmet need for couples: An analytical framework and evaluation with DHS data

While estimates of unmet need continue to be an important measure of the extent of demand for contraception and family planning programs success in developing countries, there are various reservations about the validity of these estimates. For instance, the traditional formulation of the measurement has relied solely on information from women while inferences from the findings are often drawn for couples. As more survey data have become available for both men and women in a number of countries, there is increasing evidence suggesting that husbands' preferences are indeed important determinants of the reproductive behavior of couples. This paper developsan analytical framework for measuring unmet need for couples. The approach: (1) takes a fresh look at the classification of pregnant and amenorrheic women, and (2) incorporates the contraceptive use and fertility preferences of husband and wife in estimating the level of unmet need in six sub-Saharan African countries. Our findings shows that taking these factors into account results in a 50 to 66 percent reduction in the level of unmet need in these countries. The importance of husbands' variables in determining the level of unmet need is clearly evident when examined among fecund couples in which the wife is neither pregnant nor amenorrheic. The implications of these findings for family planning programs and research are discussed.     

Estimating optimal expenditures on family planning in developing economies

This paper develops an analytical model of the effect of family planningexpenditures on per capita income. The perspective is that of constrained optimization: a predetermined level of overall development resources is to be allocated to family planning programs and alternative uses in the form of expansion of the generalized capital stock (plant and machinery, education and training, and social infrastructure). The principal functions of the model are power forms, so that an explicit solution may be obtained for the optimal ratio of family planning expenditures to overall development resources. Important insights into the nature of this policy question are derived from consideration of the formula. In addition, tentative numerical estimates of the optimal ratio are presented for several developing economies. These estimates suggest that quite a substantial proportion of overall development resources should be allocated to family planning programs in most developing nations. The paper is concluded with a brief evaluation of the advantages and disadvantages of the optimization approach to population policy issues.     

Bargaining over family size: The determinants of fertility in Brazil

Understanding how households make fertility decisions is important to implementing effective policy to slow population growth. Most empirical studies of this decision are based on household models in which men and women are assumed to act as if they have the same preferences for the number of children. However, if men and women have different preferences regarding fertility and are more likely to assert their own preferences as their bargaining power in the household increases, policies to lower fertility rates may be more effectively targeted toward one spouse or the other. In this paper, we test the relevance of the single preferences model by investigating whether men and women's nonwage incomes have the same effects on the number of children in the household. We find that while increases in both the man and woman's nonwage income lower the number of children in the household, an equivalent increase in the woman's income has a significantly stronger effect than the man's. In addition, we find that increases in women's nonwage transfer income have the strongest effects on the fertility decisions of women with low levels of education. The most important policy implication of our results is that policies aimed at increasing the incomes of the least-educated women will be the most effective in lowering fertility rates.     

Data quality and accuracy of United Nations population projections, 1950-95

Between 1951 and 1998, the United Nations (UN) published 16 sets of population projections for the world, its major regions, and countries. This paper reports the accuracy of the projection results. I analyse the quality of the historical data used for the base populations of the projections, and for extrapolating fertility and mortality. I study also the impact this quality has had on the accuracy of the projection results. Results and assumptions for the sets of projections are compared with corresponding estimates from the UN 1998 Revision for total fertility and life expectancy at birth, total population, and the projected age structures. The report covers seven major regions (Africa, Asia, the former USSR, Europe, Northern America, Latin America, and Oceania) and the largest ten countries of the world as of 1998 (China, India, the USA, Indonesia, Brazil, Pakistan, Russia, Japan, Bangladesh, and Nigeria).     

The transition to lower fertility in the West Bank and Gaza Strip: evidence from recent surveys

Using recent data from three national-level surveys conducted in 1995, 2000, and 2004, we provide evidence that Palestinian fertility rates in the West Bank and Gaza Strip, historically among the highest in the world, began to slow especially in the West Bank, but stalled in Gaza during the recent Intifada. The TFR in the early 2000s was 4.6 per woman, down from 6.2 a decade earlier. However, most of the decline in Gaza’s fertility appears to have taken place during the early 1990s, before the onset of the second Intifada. In Gaza, the TFR decreased from 7.4 to 5.7 during the 1990s, but changed only slightly to 5.6 during the second Intifada period. Surprisingly, contraceptive prevalence has not changed during these years, and the transition to lower fertility was mainly due to changes in nuptiality. Demand for children remains high, although there is evidence of unmet need for contraception. The continuing conflict and worsening economic situation provide clues to the persistence of high fertility among Palestinian women.

The impact of family policies on fertility in industrialized countries: a review of the literature

This paper examines the theoretical propositions and empirical evidence linking policies and fertility. More specifically, the analysis presented in this paper draws attention to the complex mechanisms that theoretically link policies and demographic outcomes: mechanisms that involve imperfect information and decisions that are rationally bound by very specific circumstances. As to the empirical evidence, studies provide mixed conclusions as to the effect of policies on fertility. While a small positive effect of policies on fertility is found in numerous studies, no statistically significant effect is found in others. Moreover, some studies suggest that the effect of policies tends to be on the timing of births rather than on completed fertility.

Marriage form and fertility in rural China: an investigation in three counties

Using data from two surveys in three counties where the prevalence of uxorilocal marriage differs greatly, this paper analyzes impact of marriage form, individual, family, and social factors on fertility and its regional differences. The results show that, under the Chinese patrilineal joint family system, uxorilocal marriage does not universally increase fertility, which is likely to be determined by other factors. It is further found that fertility differs greatly in the three regions, and is significantly lower in regions where uxorilocal marriage is common than in regions where virilocal marriage is dominant. Women’s marriage cohort, age at first marriage, and number of sisters all have significant effects on fertility. These findings address the process and consequences of change in rural family and marriage customs during the current demographic and social transition.     

Endogenous fertility in a model with non-dynastic parental altruism

A model of fertility choice is studied in which the utility of parents depends on how much they consume, on how many children they have and on the consumption of their children. Hence, parents are altruistic towards their children, but in a more limited sense than in the much discussed dynastic fertility model presented by Becker and Barro (1988). The concept of a (subgame perfect) bequest equilibrium is used to solve the non-dynastic model considered here. The steady state birth rate is lower in the non-dynastic model than in the Becker-Barro model. However, the key qualitative predictions concerning the dynamic behavior of fertility are strikingly similar in both models. JEL classification: J13, J11, D90. Received August 17, 1995/Accepted October 20, 1996     

Demographic determinants of perceived well-being in eight European countries

This paper reports results of a harmonised study of subjective social indicators carried out in eight member countries of the European Community, sponsored, on an experimental basis, by the Statistical Office of the European Communities (Luxembourg). Comparative data from nationwide representative samples from Germany, France, Italy, the Netherlands, Belgium, the United Kingdom, Ireland and Denmark are presented for three key dependent measures of perceived well-being: Self-Assessed Health, Satisfaction with Housing and Life Satisfaction. The cross-cultural generalisability of the influence of demographic variables on these three measures in examined, using 4-way analysis of variance. The analyses revealed a remarkable consistency across nations in terms of the effects of certain demographic variables on some of the dependent measures; however, some inconsistencies were also revealed. Substantial discrepancies in mean scores of the same sub-groups in different countries were also observed. While further research would be required to determine whether these differences were due to objective circumstances or to cultural differences in subjective perceptions or response patterns, some tentative interpretations of the differences were put forth.     

HIV testing,perceptions of AIDS risk,and condom use motivation among US women

As STD infections including HIV increase in the United States, it has become increasingly important to policy makers to ascertain the extent to which knowledge and perceptions of AIDS risk affect an individual's probability of altering their sexual or contraceptive behavior to avoid infection. This paper examines the extent to which women's perceptions of their own and their partners' risk of HIV infection affects the probability of using a condom for protection against sexually transmitted diseases. This paper also examines the extent to which HIV testing may affect motivation for condom use. Crosstabulations reveal that prophylactic condom use is more prevalent among women who have been tested for HIV and increase as perceptions of their chance (and their partner's chance) of being positive increases. The multivariate results from this study indicate that having an HIV test significantly predicts the likelihood of using a condom for STD prevention for US women. Furthermore, women who perceive themselves to be at least somewhat likely to be HIV positive have a higher probability of using a condom to prevent sexually transmitted disease, and women who perceive their partners to be HIV positive are twice as likely as other women to use a condom for STD prevention. However, women who consider themselves likely to be HIV positive are no more likely to use a condom than those who consider themselves not at risk.     

The demand for children in Arab countries: evidence from panel and count data models

This paper provides empirical evidence on fertility determinants in Arab countries. Adopting a macro and micro framework and exploiting panel and count data models the paper estimates the impact of cultural and economic factors on the demand for children. The results obtained strongly support the hypothesis that cross-country heterogeneity buttresses differentiated fertility and that female education mitigates high fertility. Child mortality and parent‘s preferences for sons positively affect fertility. By and large, demand for children is price and income inelastic. Received: 30 May 1995 /Accepted: 19 February 1998     

A comparative study of successful aging in three Asian countries

The purpose of this research is to examine successful aging in three Asian countries, Indonesia, Sri Lanka and Thailand, using data from the WHO regional studies of Health and Social Aspects of Aging. Successful aging is defined as having no ADL difficulties, and at most, one Nagi difficulty. For the most part, the results are similar to those using more developed populations in that gender, age, no morbid conditions, positive attitude toward one's own aging and the ability to manage money are all correlated with successful aging. An interesting finding is that for the least developed country, Indonesia, being an unskilled worker is significantly associated with increased odds for successful aging. The final section of the paper discusses the theoretical implications regarding a disability transition for elderly populations as countries develop. We also focus on the current political and economic situations in the countries under study, and consider the possible impacts on elderly health.     

The effect of immigration on wages in three european countries

We analyse the impact of immigrants on natives wages from reduced form wage equations for The Netherlands, United Kingdom and Norway. We find very small effects on natives wages and no dominant robust patterns of substitution and complementarity. Effects on earlier immigrants own wages are larger but less reliable. Further work should focus on these own effectsData on the Netherlands have been made available by CEREM, Statistics Netherlands(LSO 1997) and SEO (GPD). The British QLFS have been made available by the Office for National Statistics through the Data Archive, University of Essex. Norwegian KIRUT data have been made available by NSD, Bergen. We are grateful to these organisations. None of these organisations bear any responsibility for the analyses or interpretations of data sets used in this paper.Two anonymous referees and the editor-in-chief, Klaus Zimmermann, provided very valuable inputs for a substantial revision of an earlier draft. Responsible editor: Klaus F. Zimmermann.     

生育理性和生育决策与我国低生育水平稳定机制的转变

自改革开放以来 ,我国人口生育率水平出现了迅速的转变 ,特别是 1 992年我国确立了市场经济为目标的经济改革以来 ,生育率水平更是进一步降低到更替水平以下。如果说 ,生育率的迅速转变是在国家计划生育政策干预下启动的 ,那么 ,在 1 990年代生育率的下降应该主要是社会和经济发展的结果。以市场经济为导向的经济改革和经济的迅速发展 ,已经为稳定我国城市地区人口低生育率水平提供了必要的经济条件 ,同时 ,制度、技术和文化等因素的变革已经为我国个人生育决策理性化创造了条件 ,低生育水平的稳定机制已经开始从政策控制为主转向群众自我控制为主的转变     

新疆维吾尔自治区生育水平的演变过程及分布特征分析

本文通过分析新疆维吾尔自治区总和生育率、孩次率、生育率模式的演变过程。及其在地区间、民族间的差异。揭示了新疆地区生育水平的变动规律，为有关部门的决策提供依据。     

The influence of rural-urban migration on migrants' fertility in Korea,Mexico and Cameroon

The paper presents a comparative analysis of the relationship between rural-urban migration and fertility in Korea, Mexico, and Cameroon. Using an autoregressive model, the results show a significant rural-urban migration adaptation effect in Korea and Mexico, a reduction of 2.57 and 1.45 children during the entire childbearing period, respectively, when compared to a rural stayer, even after the effect of selection has been controlled. Rural-urban migration has a very small impact on fertility in Cameroon. The unexpected result for Cameroon is due to the fact that the fertility-increasing effect of urban residency on the improved supply conditions of births, such as reduced infertility, offsets the fertility-depressing effect of urban residency on the demand for births. As a result of the adaptation to urban fertility norms, the number of country-wide births was reduced significantly in Mexico and Korea over the time periods studied.     

Future population growth: researchers in three countries quantify causes and propose policies

This article discusses Population Council analyses conducted by social scientists from India, Kenya, and the Philippines. These scientists agreed that population momentum would continue to increase population size, and that governments must strengthen and create a range of economic, health, and social programs and policies to slow population growth. Multiple approaches will be needed. John Bongaarts is credited with being the first to identify the key role of population momentum and to decompose growth into unwanted fertility, high desired fertility, and population momentum. Unwanted fertility is responsible for about 19% of projected population growth in India, 26% in Kenya, and 16% in the Philippines. High wanted fertility accounts for 20% of future growth in India, 6% in Kenya, and 19% in the Philippines. Population momentum can account for under 50% or over 90% of growth. Unwanted fertility can be addressed by fulfilling unmet need and increasing knowledge of methods, reducing the fear of side effects and disapproval, and eliminating poor service. Family planning programs need to be strengthened and integrated with maternal and child health services. Preferred and actual family sizes can be reduced by lowering infant mortality by means of increasing infant and child health services and girls' educational attainment. Population momentum can be addressed by delaying age at marriage and childbearing through improving social conditions. Investments in human development through education, training, and income generation can create the conditions for slowing population growth. Countries should decompose population growth into its components of unwanted and high wanted fertility and population momentum as a means of distributing resources most effectively.