HIV and Unintended Fertility in Sub-Saharan Africa: Multilevel Predictors of Mistimed and Unwanted Fertility Among HIV-Positive Women

Population Research and Policy Review - Sub-Saharan Africa (SSA) has a disproportionate burden of both unintended fertility and HIV infection, but the relationship between these two reproductive...     

SEXUAL PRIVACY AND EARLY SEXUAL DEBUT IN NAIROBI INFORMAL SETTLEMENTS1

The purpose of this paper is to examine sexual privacy as a factor that may influence the relatively earlier sexual debut among the urban poor in Nairobi. 40 focus group discussions were held with people aged 13–17, 18–24, 25–49 and 50+ years, community leaders and service providers in four informal settlements of Nairobi. Lack of sexual privacy was identified as a major problem. Although adults were reported to use various means to acquire some measure of privacy, such as waiting for children to fall asleep, switching off the lights and separating the sleeping areas using curtains, these measures were found inadequate. The participants therefore associated young people's early initiation of sexual activity with lack of sexual privacy. Sexual privacy has not received adequate research attention as a dimension of poverty that influences young people's sexuality. More studies are called for to unravel the specific association between sexual privacy among adults and young people's sexual behaviour. The living conditions of the urban poor should also be addressed to mitigate the effects of lack of sexual privacy.     

The inequality of maternal health care in urban sub-Saharan Africa in the 1990s

Numerous studies document the disadvantage in child health of the urban poor in African cities. This study uses Demographic and Health Survey data from 23 countries in sub-Saharan Africa to examine whether the urban poor experience comparable disadvantages in maternal health care. The results show that, although on average the urban poor receive better antenatal and delivery care than rural residents, the care of the urban poor is worse than that of the urban non-poor. This suggests that the urban bias in the allocation of health services in Africa does not benefit the urban poor as much as the non-poor. Multilevel analyses reveal significant variations in maternal health in urban areas across countries of sub-Saharan Africa. The dis-advantage of the urban poor is more pronounced in countries where maternal health care is relatively good. In these countries the urban poor tend to be even worse off than rural residents, suggesting that the urban poor have benefited least from improvements in maternal health care.