Advertisement

Population Research and Policy Review

, Volume 24, Issue 6, pp 617–645 | Cite as

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

  • Victor Agadjanian
Article

Abstract

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.

Keywords

Contraception Fertility Mozambique Sub-Saharan Africa 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Agadjanian, V. 1998aEconomic security, informational resources, and women’s reproductive choices in urban MozambiqueSocial Biology456079Google Scholar
  2. Agadjanian, V. 1998bWomen’s choice between indigenous and western contraception in urban MozambiqueWomen and Health28117Google Scholar
  3. Agadjanian, V. 2001Negotiating through reproductive change: Gendered social interaction and fertility changes in MozambiqueJournal of Southern African Studies27292309CrossRefGoogle Scholar
  4. Agadjanian, V. 2002aMen’s talk about “women’s matters”: Gender, communication, and contraception in MozambiqueGender & Society16194215Google Scholar
  5. Agadjanian, V. 2002bInformal social networks and epidemic prevention in a third world context: Cholera and HIV/AIDS comparedLevy, J.A.Pescosolido, B.A. eds. Advances in medical sociologyJAI-Elsevier Science(Social networks and health)New York201221Google Scholar
  6. Agadjanian, V. (2003), The power of the insignificant: Capturing and measuring the impact of seemingly unimportant social interactions on demographic behavior. Unpublished manuscriptGoogle Scholar
  7. Akhter, H.H., Ahmed, S. 1992Determinants of contraceptive continuation in rural BangladeshJournal of Biosocial Science24261268Google Scholar
  8. Arnold, F. 1992Sex preference and its demographic and health implicationsInternational Family Planning Perspectives1893101Google Scholar
  9. Bankole, A. 1995Desired fertility and fertility behaviour among the Yoruba of Nigeria: A study of couple preferences and subsequent fertilityPopulation Studies49317328CrossRefGoogle Scholar
  10. Bauni, E.K., Jarabi, B.O. 2000Family planning and sexual behavior in the era of HIV/AIDS: The case of Nakuru district, KenyaStudies in Family Planning316980CrossRefGoogle Scholar
  11. Bawah, A.A. 2002Spousal communication and family planning behavior in Navrongo: A longitudinal assessmentStudies in Family Planning33185194CrossRefGoogle Scholar
  12. Bawah, A.A., Akweongo, P., Simmons, R., Phillips, J.F. 1999Women’s fears and men’s anxieties: The impact of family planning on gender relations in northern GhanaStudies in Family Planning305466CrossRefGoogle Scholar
  13. Bertrand, J.T., Mathu, N., Dwyer, J., Thuo, M., Wambwa, G. 1989Attitudes toward voluntary surgical contraception in four districts of KenyaStudies in Family Planning20281288Google Scholar
  14. Biddlecom, A.E., Fapohunda, B.M. 1998Covert contraceptive use: Prevalence, motivations, and consequencesStudies in Family Planning29360372Google Scholar
  15. Blanc, A. K., Wolff, B., Gage, A.J., Ezeh, A.C., Neema, S., Ssekamatte-Ssebuliba, J. 1996Negotiating reproductive outcomes in UgandaMacro International, Makerere University and Institute of Statistics and Applied EconomicsCalverton, MDGoogle Scholar
  16. Bledsoe, C.H., Banja, F. 2002Contingent lives: Fertility, time, and aging in West AfricaUniversity of Chicago PressChicago, ILGoogle Scholar
  17. Bledsoe, C.H., Hill, A.G., D’Alessandro, U., Langerock, P. 1994Constructing natural fertility: The use of Western contraceptive technologies in rural GambiaPopulation and Development Review2081113Google Scholar
  18. Bongaarts, J. 1992Do reproductive intentions matter?International Family Planning Perspectives18102108Google Scholar
  19. Bongaarts, J., Watkins, S.C. 1996Social interactions and contemporary fertility transitionsPopulation and Development Review22639682Google Scholar
  20. Caldwell, J.C., Caldwell, P. 2002Africa: The new family planning frontierStudies in Family Planning337686Google Scholar
  21. Caldwell, J.C. 1980Mass education as a determinant of the timing of fertility declinePopulation and Development Review6225255Google Scholar
  22. Caldwell, J.C., Orubuloye, I.O., Caldwell, P. 1992Fertility decline in Africa: A new type of transition?Population and Development Review18211242Google Scholar
  23. Castle, S. 2003Factors influencing young Malians’ reluctance to use hormonal contraceptivesStudies in Family Planning3486199CrossRefGoogle Scholar
  24. Castle, S., Konaté, M.K., Ulin, P.R., Martin, S. 1999A qualitative study of clandestine contraceptive use in urban MaliStudies in Family Planning30231248CrossRefGoogle Scholar
  25. Chibalonza, K., Chirhamolekwa, C., Bertrand, J.T. 1989Attitudes toward tubal ligation among acceptors, potential candidates, and husbands in ZaireStudies in Family Planning20273280Google Scholar
  26. Bruyn, M. 2003HIV/AIDS, pregnancy and abortion. A review of the literatureIpasChapel Hill, NCGoogle Scholar
  27. Silva, W.I. 1991Consistency between reproductive preferences and behavior: The Sri Lankan experienceStudies in Family Planning22188197Google Scholar
  28. Desai, S. & Alva, S. (1998), Unmet need for birth spacing: Is it real? San Francisco, CA: Paper presented at the annual meeting of the American Sociological Association, August 1998.Google Scholar
  29. Dodoo, F.N.-A., Seal, A. 1994Explaining spousal differences in reproductive preferences: A gender inequality approachPopulation and Environment15379394CrossRefGoogle Scholar
  30. Dwyer, J.C., Haws, J.M. 1990Is permanent contraception acceptable in sub-Saharan Africa?Studies in Family Planning21322326Google Scholar
  31. Ezeh, A.C. 1993The influence of spouses over each other’s contraceptive attitudes in GhanaStudies in Family Planning24163174Google Scholar
  32. Feldman, R., Maposhere, C. 2003Safer sex and reproductive choice: Findings from “Positive Women: Voices and Choices” in ZimbabweReproductive Health Matters11162173CrossRefGoogle Scholar
  33. Feyisetan, B.J. 2000Spousal communication and contraceptive use among the Yoruba of NigeriaPopulation Research and Policy Review192945CrossRefGoogle Scholar
  34. Feyisetan, B.J., Casterline, J.B. 2000Fertility preferences and contraceptive change in developing countriesInternational Family Planning Perspectives26100109Google Scholar
  35. Gaspar, M.D.C., Cossa, H.A., Santos, C.R., Manjate, R.M., Schoemaker, J. 1998Moçambique: Inquérito Demográfico e de Saúde, 1997. Maputo, MozambiqueNational Institute of Statistics, and Calverton, Macro International IncMDGoogle Scholar
  36. Green, C.P., Cohen, S.I., Belhadj-El Ghouayel, H. 1995Male involvement in reproductive health, including family planning and sexual healthUnited Nations Population FundNew YorkTechnical Report No. 28.Google Scholar
  37. Hunter, S.C., Isingo, R., Boerma, J.T., Urassa, M., Mwaluko, G.M. 2003The association between HIV and fertility in a cohort study in rural TanzaniaJournal of Biosocial Science35189199CrossRefGoogle Scholar
  38. Ibraimu, M.A. 1994Crescimento da População Urbana e Problemas de Urbanização da Cidade de MaputoNational Directorate of StatisticsMaputo, MozambiqueGoogle Scholar
  39. Kimuna, S.R., Adamchak, D.J. 2001Gender relations: Husband-wife fertility and family planning decisions in KenyaJournal of Biosocial Science331323CrossRefGoogle Scholar
  40. Kohler, H.-P. 1997Learning in social networks and contraceptive choiceDemography3436983Google Scholar
  41. Kohler, H.-P. 2001Fertility and social interaction: An economic perspectiveOxford University PressOxford, EnglandGoogle Scholar
  42. Lopes, L., Santos, C. 1995Aspectos Demográficos e de Saúde Materno-Infantil na Cidade de Maputo: Análise dos Dados do Inquérito, Julho de 1994Ministry of Health and Eduardo Mondlane UniversityMaputo, MozambiqueGoogle Scholar
  43. Makinwa-Adebusoye, P. 1994Changes in the costs and benefits of children to their parentsLocoh, T.Hertrich, V. eds. The onset of fertility transition in sub-Saharan AfricaInternational Union for the Scientific Study of Population [IUSSP] and Derouaux Ordina EditionsLiege, Belgium175192Google Scholar
  44. McGinn, T., Bamba, A., Balma, M. 1989Male knowledge, use, and attitudes regarding family planning in Burkina FasoInternational Family Planning Perspectives158487Google Scholar
  45. Meekers, D. & Oladosu, M. (1996), Spousal communication and family planning decision-making in Nigeria. Population Research Institute Working Paper in African Demography, No. AD96–03, April. Population Research Institute, Pennsylvania State UniversityGoogle Scholar
  46. Monreal, T. 1991Inquérito sobre o comportamento reprodutivo da mulher moçambicana, 1987Ministry of Health, Eduardo Mondlane University, and UNFPAMaputo, MozambiqueGoogle Scholar
  47. Montgomery, M.R., Casterline, J.B. 1996Social learning, social influence, and new models of fertilityPopulation and Development Review22151175Google Scholar
  48. Montgomery, M.R. & Casterline, J.B. (1998), Social networks and the diffusion of fertility control. The Population Council Policy Research Division Working Paper, No. 119Google Scholar
  49. Moultrie, T.A., Timæus, I.M. 2003The South African fertility decline: Evidence from two censuses and a Demographic and Health SurveyPopulation Studies57265284CrossRefGoogle Scholar
  50. Moyo, W., Mbizvo, M.T. 2004Desire for a future pregnancy among women in Zimbabwe in relation to their self-perceived risk of HIV infection, child mortality, and spontaneous abortionAIDS and Behavior8915CrossRefGoogle Scholar
  51. Mozambique (1995), Mozambique: Demographic and socioeconomic panorama. Series of the National Demographic Survey, No.5. Maputo, Mozambique: National Directorate of Statistics. (Moçambique: Panorama demográfico e sócio-económico)Google Scholar
  52. Mozambique (2003), Mozambique—the elusive quest for pro-poor growth, pp. 127–154, in 2003 Economic report on Africa. United Nations Economic Commission for Africa. Available at www.uneca.org/era2003 (last accessed March 2004)Google Scholar
  53. Mozambique (2005), Revisions of the epidemiological surveillance HIV data, 2004 round. Multisector Technical Group in support of the fight against HIV/AIDS in Mozambique. Maputo, Mozambique (in Portuguese)Google Scholar
  54. Mwageni, E.A., Ankomah, A., Powell, R.A. 1998Attitudes of men towards family planning in Mbeya region, Tanzania: A rural-urban comparison of qualitative dataJournal of Biosocial Science30381392CrossRefGoogle Scholar
  55. National Institute of Statistics (n/d). The results of the Second National Population Census on CD-ROM. National Institute of Statistics, Maputo, MozambiqueGoogle Scholar
  56. National Research Council, Committee on Population1993Factors affecting contraceptive use in sub-Saharan AfricaNational Academy PressWashington, DCGoogle Scholar
  57. Pictet, G. & Ouedraogo, C. (1999), Let’s talk about it: Married couples and fertility decisions in rural Burkina Faso, New York, NY: Paper presented at the annual meeting of the Population Association of America, March 1999.Google Scholar
  58. Pritchett, L.H. 1994Desired fertility and the impact of population policiesPopulation and Development Review20155Google Scholar
  59. Renne, E.P. 1993Gender ideology and fertility strategies in an Ekiti Yoruba villageStudies in Family Planning24343353Google Scholar
  60. Rutenberg, N., Watkins, S.C. 1997The buzz outside the clinics: Conversations and contraception in Nyanza Province, KenyaStudies in Family Planning28290307Google Scholar
  61. Rutenberg, N., Biddlecom, A.E., Kaona, F.A. 2000Reproductive decision-making in the context of HIV and AIDS: A qualitative study in Ndola, ZambiaInternational Family Planning Perspectives26124130Google Scholar
  62. Schutjer, W.A., Stokes, C.S., Poindexter, J.R. 1986Why not use contraception? Economics of fertility regulation among rural Egyptian womenSocial Biology33214228Google Scholar
  63. Valente, T.W., Watkins, S.C., Jato, M.N., Straten, A., Tsitsol, L.-P.M. 1997Social network associations with contraceptive use among Cameroonian women in voluntary associationsSocial Science and Medicine45677687Google Scholar
  64. Walle, E. 1992Fertility transition, conscious choice, and numeracyDemography29487502Google Scholar
  65. Watkins, S., Rutenberg, N., Wilkinson, D. 1997Orderly theories, disorderly womenJones, G.W.Douglas, R.M.Caldwell, J.C.D’Sousa, R.M. eds. The continuing demographic transitionOxford University PressNew York213245Google Scholar
  66. Watkins, S.C. 2000Local and foreign models of reproduction in Nyanza Province, Kenya, 1930–1998Population and Development Review26725759CrossRefGoogle Scholar
  67. Watkins, S.C. 1994Reproductive preferences and future fertility in developing countriesLutz, W. eds. The future population of the world. What can we assume today?International Institute for Applied Systems Analysis [IIASA] and Earthscan PublicationsLaxenburg, Austria and London, England8397Google Scholar
  68. Westoff, C.F. 1990Reproductive intentions and fertility ratesInternational Family Planning Perspectives16848996Google Scholar
  69. Wolff, B., Blanc, A.K., Ssekamatte-Ssebuliba, J. 2000The role of couple negotiation in unmet need for contraception and the decision to stop childbearing in UgandaStudies in Family Planning31124137CrossRefGoogle Scholar
  70. Yinger, N.V. 1998Unmet need for family planning: Reflecting women’s perceptionsInternational Center for Research on WomenWashington DCGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  1. 1.Department of SociologyArizona State UniversityTempeUSA

Personalised recommendations