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Diffusion Processes and Fertility Transition: Selected Perspectives (2001)

Chapter: 5 Social Processes and Fertility Change

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Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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5
Social Processes and Fertility Change: Anthropological Perspectives

ANTHONY T.CARTER

At the core of recent studies of social processes and fertility change is the proposition that fertility declines are the result, in whole or in part, of the diffusion of new knowledge and ideas “from one locale, social group, or individual to another” (Retherford and Palmore, 1983:296; see also Cleland and Wilson, 1987, Rosero-Bixby and Casterline, 1993; Montgomery and Casterline, 1993). From the perspective of contemporary anthropology, this work has several salient features. Diffusion is thought to be at work in producing a fertility decline when two criteria are met. First, knowledge of parity-dependent birth control and ideas sanctioning its use must, in fact, be new. Second, their spread in space and time must match diagnostic patterns; “birth control and resulting marital fertility decline” spread to all parts of “culturally homogeneous populations” very rapidly (Cleland and Wilson, 1987:24), “date is a better predictor of the onset of decline than socio-economic indicators” (van de Kaa, 1996:421). Implicit in such theories is the assumption that ideas and items of knowledge remain unchanged as they spread from one population to another and from one person to another within a population. Diffusion, therefore, tends to move a population from one homogeneous state to another.

Accounts of fertility change emphasizing the role of social processes have been constructed against a background of microeconomic models of fertility determinants (e.g., Easterlin, 1978, 1983). Cleland and Wilson

Anthony Carter is professor of anthropology at the University of Rochester.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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(1987) see theories of diffusion and of economic demand as mutually exclusive, while Montgomery and Casterline (1996) see them as empirically indistinguishable and mutually reinforcing, but the two approaches always are opposed conceptually.1 Microeconomic theories attend to the choices of representative individuals or couples abstracted from their social settings. Diffusion theories attend to communities in which people interact. Observing, discussing, criticizing, and evaluating, people pass information from one to another and from public sources to groups. Communication along interpersonal channels and through impersonal media provides information about “the existence of new behavioral options,” narrows “the range of uncertainty regarding the consequences of new choices,” and “reduce[s] the costs of innovation” by modifying social norms (Montgomery and Chung, 1999:181). Learning is social as well as individual.

Attention to the role of social processes in fertility change has led to renewed interest in community-level effects.2 In microeconomic accounts of fertility change, structural characteristics of communities such as the level of nonagricultural employment, literacy, and accessibility are conceived of as determining the costs and benefits of children and the costs of fertility regulation. In accounts of fertility change based on diffusion, social learning may produce a process of endogenous feedback that causes changes in fertility to outpace changes in socioeconomic determinants. Influenced by one another, the members of a community also may develop distinctive patterns of contraceptive use. The boundaries between communities, whether ethnic, linguistic, or cultural, are seen as impeding the flow of communication, thus setting communities on divergent paths of fertility change.

All of this points us toward a socially informed theory of fertility change, but it remains dependent on outdated concepts of culture. Paralleling Hammers (1990:456) “agenda…for a culturally smart microeconomics,”3 this paper sketches an approach to research on diffusion informed by contemporary developments in the theory of culture.4 The first section of the paper briefly reviews the place of diffusion in three moments of twentieth-century anthropology: early studies of the history and geographical distribution of cultural traits, mid-century studies of the structure and function of sociocultural systems, and the more recent turn from structural functionalism to practice. The second section argues that key anthropological studies, largely in the classic structural functional mold, undercut or sharply qualify two key assumptions of theories of diffusion based on imitation or contagion: that knowledge and ideas concerning birth control are likely to be novel and that they remain unchanged as they spread from one culture to another. The third and fourth sections, based on contemporary developments in practice theory, outline

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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an alternative view of the social processes through which diffusion takes place and suggest some elements of a program of ethnographic research.

DIFFUSION IN ANTHROPOLOGY: A BRIEF HISTORY

Contemporary sociocultural anthropologists are likely to respond to ideas about diffusion with considerable suspicion (e.g., Kreager, 1998). Nevertheless, there is considerable anthropological interest in theories that comprehend human agency as embedded in or spread over culture and social organization. The key to these diverse responses to research on social processes and fertility change is the history of anthropological theory.

Diffusion theories played important roles in several anthropological debates in the nineteenth and early twentieth centuries. For a clear and sympathetic account of this work, we may turn to the distinguished American anthropologist, Alfred Kroeber. As Levi-Strauss (1953:533) noted, Kroeber was a “highly structure-minded scholar” who nevertheless devoted “most of his time to distribution studies.” In Kroeber’s (1931:139) words

[diffusion is the process, usually but not necessarily gradual, by which elements or systems of culture are spread; by which an invention or a new institution adopted in one place is adopted in neighboring areas and in some cases continues to be adopted in adjacent ones until it may be spread over the whole earth.

It was recognized that diffusion takes place from one individual to another, within as well as between cultures. However, the focus of anthropology was “cultures rather than…the persons carrying them, so that attention has been centered on the relations between cultures or between the several parts of one culture” (Kroeber, 1931:140). Kroeber observed that the “psychological basis” of all forms of cultural transmission, diffusion as well as tradition, is imitation.5 Diffusion occurs when persons belonging to different populations and carrying different cultural units are brought into proximity by “migration and colonization, that is, ethnic movements; conquest; missionization; commerce; revolution; and gradual infiltration” (Kroeber, 1931:140). Diffusion produces and may be recognized by patterns of distribution in time and space (Rouse, 1953:71).

In the later years of the nineteenth century and the first years of the twentieth, there were two principal schools of anthropological diffusionism. The German-Austrian school was polygenetic, conceiving of the history of human culture in terms of “seven or eight original” culture complexes (Kulturkreise) that originated at different times and places and subsequently spread over the whole world, mixing in different places in

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

varying ways. The rather more colorful English school was monogenetic. What were termed “primitive cultures” were regarded as stagnant. The history of human culture prior to the invention of civilization by the Greeks was held to be a consequence of the fact

at one time and place…namely in Egypt around 3000, B.C., an unusual constellation of events produced a cultural spurt leading to the rapid development of agriculture, metallurgy, political organization and kingship, priesthood, concern with the after life and mummification, writing and other cultural institutions. From this center of origination this great cultural complex was carried in whole or in part, with secondary embellishments and degenerations, to Mesopotamia and the Mediterranean world, to India, Oceania, Mexico and Peru and in fragmentary form even to remote peoples who remained otherwise primitive (Kroeber, 1931:141).

Elements of the German-Austrian school were introduced into American anthropology by its founding figure, the German immigrant Franz Boas, and his students. Recognizing that the partisans of the German-Austrian and British schools “very early took a long a priori leap” from a “modest empirical beginning” (Kroeber, 1931:142), American anthropologists eschewed historicist cultural archetypes and universal patterns in cultural history. Instead, they used careful historical accounts of the independent invention and diffusion of cultural elements as diagnostic devices to discern the ways in which the different components of a culture are connected.

Diffusionist arguments went out of fashion in anthropology between the two world wars. They lost their appeal when anthropology ceased to regard cultures as collections of distinct traits for which historical explanations were appropriate and began to conceive of cultures and societies as systems of mutually defining elements for which functionalist and structuralist explanations were appropriate.

Two arguments were decisive. One was Malinowski’s argument from functionalism. On the one hand, Malinowski strenuously objected to the idea that inventions could ever be independent. Beyond calling attention to the fact that particular inventions are made repeatedly by different persons in the same culture and in different cultures, he insisted that they are what would now be called socially distributed achievements.

Each invention is arrived at piece-meal, by infinitely many, infinitely small steps, a process in which it is impossible to assign a precise share to any one worker or still less to connect a definite object and a definite idea with a single contribution (Malinowski, 1927:29).

On the other hand, Malinowski argued that all cultures are independently driven by the demand to meet the functional requirements of human exis-

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

tence. Because the elements of each culture fit together to meet such requirements as the “biological need for propagation and the cultural need for educating each generation” any custom or artifact borrowed by one culture from another has to be “reinvented” to fit into—to function in—its new setting (Malinowski, 1927:37, 42). The borrowed element thus becomes something new. The result is that diffusion as it was conventionally defined

never takes place; it is always a readaptation, a truly creative process, in which external influence is remoulded by inventive genius… Civilization is fortunately not a disease—not always at least—and the immunity of most people to culture is notorious: culture is not contagious! (Malinowski, 1927:46).

The notion that a borrowed element became something different in a new environment was driven home by structuralism. First, preeminently, in the linguistics of Saussure (1986) and then in the anthropology of, for example, Radcliffe-Brown (1922), structuralism insisted that the meaning of an element of language or culture inhered not in its isolated essence but rather in its relationships to other elements of the system of linguistic or cultural signs in which it occurred. Together with attacks on “pseudo-history” (e.g., Radcliffe-Brown, 1950:1–2), these arguments resulted in a new emphasis on synchronic explanations. No longer were institutions and customs to be explained in terms of their origins. Rather, as Fortes (1953:25) put it in his inaugural lecture as William Wyse Professor of Social Anthropology at Cambridge,

Functional research investigates either the part played by institutions and customs in operating and maintaining the total structure of a society or of a type of society; or conversely, it seeks to analyse the action upon one set of institutions of the other parts of the social system.

In the past several decades, the mid-century structural-functionalist consensus has broken up, and not a few anthropologists have turned to one or another version of practice theory.6 Practice theorists reject structural functionalism’s sharp separation of culture and human agency, the former conceived of as a set of rules or meanings and the latter as universal, abstract rationality. From the perspective of practice theory, culture no longer exists outside of and prior to action but instead takes shape as it enters into activity. Conversely, human agency is shaped by and spread over its social contexts. As Hammel put it in his 1990 essay “A Theory of Culture for Demography,” culture is a “negotiated symbolic understanding” or an “evaluative conversation,” a “constantly modified and elaborated system of moral symbols” produced and reproduced by “the evaluative behavior of actors.” These evaluative behaviors or

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

symbolic expressions…become part of culture as guidance mechanism by entering into the social discourse. Actors respond to this discourse; their actions are guided by it, whether it is spoken in their presence, recalled from their socialization, or anticipated for their repute or their salvation.

Social action takes place in, is shaped by, and at the same times shapes “an intensely evaluative cloud of commentary” (Hammel, 1990:467). Nor is history secondary to synchronic analysis. The activities of human subjects are shaped by structured contexts that are the products of past human activity. At the same time, human activities, as structured products, become structured contexts that shape future activity. The formation of the populations/societies studied by demographers and anthropologists occurs “at the intersection of global and local histories…local groups… [are seen] as the products of centuries of social, economic, political, and cultural processes, some indigenous, other originating at regional, national, and global levels” (Greenhalgh, 1990:90)7 If structural functionalism decisively refuted theories of diffusion based on imitation or diffusion, these features of practice theory together point to a view of social processes in which a different form of diffusion is ubiquitous.

THE LIMITS OF DIFFUSION

Clearly, diffusionism in anthropology and in studies of fertility change are distinctly different beasts. Where diffusionism in anthropology was concerned with changes that take place over centuries, diffusionism in studies of fertility change is concerned with changes that take place over decades or even years. Where diffusionism in anthropology was concerned almost exclusively with the spread of cultural elements from one society to another, diffusionism in studies of fertility change gives at least equal attention to the spread of knowledge and ideas concerning contraception from one person to another within populations.8 In its heyday, diffusionism in anthropology was embedded in arguments about the meaning of human cultural diversity, the psychic unity of mankind, and the mechanisms of human progress. Until the advent of structural functionalism, the principal alternatives were various theories of universal stages of cultural evolution. Drawing on studies of the diffusion of new technologies, diffusionism in demography is embedded in much more focused arguments concerning the causes of fertility transition. In these debates, it has a close affinity to theories of ideational change and an ambiguous relation to microeconomic theories of the demand for children (van de Kaa, 1996:420–422).

Nevertheless, the two diffusionisms share some core ideas. Both are in their origins theories of “social imitation”9 modeled on contagion (Rosero-Bixby and Casterline, 1993:163–164; Montgomery and Chung,

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

1999:167). Both are historicogeographical as well. The operation of diffusion leaves behind, and can be studied through, characteristic patterns of distribution in time and space. It seems not unlikely, therefore, that “the limits of diffusionism” (Kreager, 1998) in demography are related to the limits of diffusionism in anthropology. These limits turn on arguments that birth control is not and cannot be new and that the meanings of birth control technologies change as they move from one culture to another.

On the Novelty of Birth Control

Cleland and Wilson offer the strongest claims for the novelty of contraception within marriage in pretransition societies. To begin with, they argue that “[t]he conscious exercise of birth control within marriage in its modern parity-specific form is probably absent in most traditional societies” (Cleland and Wilson, 1987:27). The evidence for this claim is diverse. In some cases, “natural fertility may be inferred with confidence from the age pattern of fertility.” In other cases, surveys find “[v]ery low levels of knowledge of any method of contraception” (1987:13). That the practice of parity-specific birth control within marriage was genuinely absent is supported by the fact that the level of fertility is not adjusted to the economic value of children for their parents. The absence of birth control within marriage can therefore be regarded as a real absence rather than as a consequence of “a universally high demand for children” (1987:11).

Anthropologists have expressed serious reservations about the novelty of parity-specific birth control for some little time. These reservations rest not on scattered ethnographic observations, but rather on fundamental theoretical principles. Ethnographers do not deny that Western contraceptive devices are new. Nor do they deny that it would be useful to trace their spread in societies into which they are introduced.10 However, like Cleland and Wilson, they recognize that parity-specific contraception can be achieved in the absence of modern contraceptives. And they argue that modern contraceptive technologies can be used for purposes other than the control of completed family size (see below). If family planning goals are separated from the means employed, two critical issues remain. One is the occurrence of parity-specific contraception. The other is the relation between family size goals and other family planning concerns.

In the conventional view of family formation (e.g., Easterlin, 1978, 1983; Bulatao et al., 1983), deliberate control of family size occurs in populations in which the supply of children exceeds the demand and the costs of fertility regulation are not prohibitively high. The supply of children is a group characteristic, the product of exogenous mortality and the biology of reproduction as modified by cultural norms. The gender of children usually is ignored. These propositions combine to support the pre-

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

conception that the conscious control of fertility within marriage takes only one form, the control of family size through parity-dependent contraception (Bongaarts, 1978).

Only if conscious control of family formation is limited in this way to parity-specific contraception does it make sense to think of it as either present or absent (see Polgar, 1972). However, though the presumption that effective control of fertility requires modern contraceptive technologies has a degree of plausibility,11 the claim that the supply of children is the product of “natural fertility” and exogenous mortality is clearly false. With it goes the presumption that fertility in pretransition populations is universally natural (see Carter, 1998:256ff).

The anthropologist Susan Scrimshaw (1978, 1983) argued in general terms that high infant mortality might be taken as a response to high fertility rather than the other way around. In effect, various forms of infanticide may be used to control family composition as well as family size ex post facto.12

More detailed analyses build on comparative studies of family systems and household management.13 The historian Thomas Smith’s (1977) work on farm families in Nakahara, an eighteenth-century Japanese village, was one of the first studies of this kind. Seen through the lens of the age pattern of marital fertility, eighteenth-century Japan appears to conform to the criteria for natural fertility (Smith, 1977:61–62; see also Hanley and Yamamura, 1977). However, analyses of the distribution of completed family size, the age at which couples stop child bearing, the gender of next surviving children in relation to the gender of previous children, and the length of particular birth intervals, all within the framework of the movement of persons and resources into and out of stem family households, demonstrate that parents in Nakahara actively attempted to control the composition and timing of formation as well as the size of their families. They did this in part through sex-selective infanticide. “[C]ouples had a marked tendency to have [that is, to permit to live and then to register] a next child of the sex underrepresented in their present [registered] family” (Smith, 1977:65).

A recent paper by the anthropologist G.William Skinner (1997) incisively synthesizes a broad range of work along these lines. As Skinner observes, “a given family system virtually specifies the relative desirability of differently configured offspring sets, thereby setting effective goals for family planning within the society” (1997:84). Again, there is considerable evidence of infanticide. The results of Skinner’s own studies of three villages in Mino Province, Japan, from 1717 to 1868 mirror Smith’s work in Nakahara. A different pattern of immediate or deferred infanticide is found in India. Much, though by no means all, of the subcontinent is characterized by virilocal joint family systems together with patrilineal

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

kinship groups, both systems with a pronounced gender bias in favor of males. In 1961–1962, when the Indian crude birth rate was in the neighborhood of 41 or 42 (Cassen, 1978:116) and the Khanna study was observing the convex age-specific fertility curves characteristic of natural fertility (Wyon and Gordon, 1977:141), data from the National Sample Survey on the incidence of surviving offspring sets with different gender compositions indicate a marked bias in favor of male children (Skinner, 1997:69–72).

Skinner also details evidence of the influence of family gender composition goals on stopping behavior. In samples collected in Taiwan in 1973 and Korea in 1974, both countries with patrilineal joint family systems, parity-specific stopping ratios vary sharply with the sex composition of the surviving offspring set. In both populations, at parity four the percentage of couples who have no further children is lowest among couples who have only female children, higher for couples who have only male children, and highest for couples who have one or two daughters.14

Skinner does not address the distribution of different kinds of contraceptive practices. Indeed, he suggests that “[f]amily systems per se are silent concerning means; the overall objectives of family planning may be deduced from family system norms, but not the mechanisms for achieving them” (1997:66). Nevertheless, his concern with the gender biases inherent in different kinds of family systems provides a useful link to the volume edited by Newman (1985) on Women’s Medicine: A Cross-Cultural Study of Indigenous Fertility Regulation. Skinner appears to assume that men and women share the family planning goals specified by the family system in which they participate. The gender bias that characterizes such systems thus would consist of nothing more than the fact that men are likely, in different ways, to benefit from the system more than women. Against this perspective, feminist scholarship on the household has suggested that gender biases in fact specify different goals and strategies for men and women (Dwyer and Bruce, 1988). Cutting through considerable ethnographic diversity, many of the studies collected in Women’s Medicine describe societies with patriarchal family systems in which men do not wish their wives to control their fertility. Concerned with their own health and that of their children and with their own family strategies, women in such societies commonly see things rather differently. Constrained to manage their reproductive health covertly, they often turn to traditional substances and practices that are at once emmenagogues and abortifacients. These substances and practices allow a degree of fertility control that shelters in a space defined as menstrual regulation and regarded as the exclusive concern of women. Such fertility control may not show up in studies of the age pattern of fertility or in conventional sur-

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

veys of knowledge of contraceptive methods, but it is likely to be quite widespread, nevertheless (see also van de walle and Renne, 2001).

On the Conservation of Meaning

The mid-twentieth-century structural-functionalist theories of sociocultural systems that played a key role in the demise of diffusionism in anthropology do not imply that birth control technologies cannot spread across the boundaries of societies or social groups. But they do cast doubt on the idea that the meanings of birth control technologies are conserved as they move from one sociocultural system to another.

Looking at the use of Western contraceptives—especially birth control pills and Depo-Provera—“through the local Gambian cultural lens,” the Bledsoe et al. (1994:86; 1998) study of contraceptive practices in a West African population is an unusually well-documented example of the ways in which the meanings of contraceptive technologies change as they are translated from one cultural setting to another. In general, contraceptive pills and Depo-Provera are not identical phenomena in the Western and Gambian contexts; “different attributes” of these technologies are salient in the two settings (Bledsoe et al., 1994:105).

Rural Gambia appears to be a classic natural fertility population with high fertility and long, highly regular birth intervals. Paradoxically, it also is a population in which the Gambian Ministry of Health, Save the Children (U.S.), the Gambian Family Planning Association (an affiliate of the International Planned Parenthood Federation), and a variety of private pharmacies and personal connections have managed to make Western contraceptives surprisingly widely understood and available. The 1990 Gambian contraceptive prevalence survey found “only 6 percent of all women and 7 percent of married women were using Western contraceptives,” but these levels were “quite high in view of the area’s negligible levels of female education” (Bledsoe et al., 1994:84–85).

The key observation of Bledsoe et al. is that rural Gambian women use Western contraceptives in ways that confound the expectations of the agencies that distribute them. Rather than using birth control pills and Depo-Provera to stop child bearing and reduce fertility, they employ them to manage birth intervals and enhance the ability to bear large numbers of children. Three elements of the Gambian cultural logic are crucial. First, men and women value large families. However, large families are not attained automatically if only nothing is done to prevent them. On the contrary, if they are to achieve their goals both men and women must nurture women’s reproductive capacities in the face of poor nutrition, frequent illness, and reproductive mishaps. Sec-

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

ond, Gambians continue to value long birth intervals, seeking to avoid a subsequent pregnancy until the preceding child is weaned. But, third, postpartum abstinence, the means through which this traditionally was achieved, is coming under increasing pressure, perhaps as the result of “increases in female schooling, declines in polygyny, women’s growing needs to maintain a sexual link to a supportive male, or nonpolygynous men’s growing insistence on resuming sexual relations earlier” (Bledsoe et al., 1994:88–90).

In this environment, Western contraceptives are used alongside traditional contraceptives in ways that were not anticipated by outside family planning agencies and Western social scientists. They are used in part to achieve the otherwise unreconcilable goals of resuming sexual relations while continuing to maintain long birth intervals. Thus the use of all forms of contraception, traditional as well as Western, rises steadily in the months following a delivery only to drop off sharply after the 29th month (Bledsoe et al., 1994:96). It also rises as women who have been fully breastfeeding their last-born child switch to partial breastfeeding but, again, drops off sharply when the last-born child is weaned (Bledsoe et al., 1994:99). Overall, “some 55 percent of the use of Western contraception ... is found within 18 months following a birth” (Bledsoe et al., 1994:97). The use of Western contraception is especially concentrated among women who have experienced a reproductive mishap—a miscarriage or stillbirth—and, still intent on a larger family, feel that they must rest from child bearing in order to restore their reproductive capacities (Bledsoe et al., 1998).

Rural Gambian contraceptive users are not the opinion leaders of diffusion theories, “a discrete group whose background characteristics set them apart” as especially educated or modern. Instead, they comprise “the tip of a moving wave of numerous temporary users who were simply using contraceptives for small slices of time to space their births. . . . Most ‘acceptors’ rapidly and predictably became ‘non-acceptors’ (and vice versa) over the sequence of pregnancy, lactation and weaning” (Bledsoe et al., 1998:21). Within this wave, the use of Western contraceptives was particularly concentrated among older women, while “most users of ‘traditional’ contraceptives” were younger women who were more likely to have some schooling. The younger women are concerned that the Western contraceptives are such powerful substances that they will put their capacity to bear subsequent children at risk, while the older women are more likely to be concerned about the “dangers of high-parity pregnancy and childbearing” (Bledsoe et al., 1994:100–102).

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

THE REACH OF SOCIAL PROCESSES

The arguments of mid-century structural functionalism established to the satisfaction of most anthropologists that simple imitation diffusion is at best a severely limited social process. But developments in practice theory suggest that a different form of diffusion is a ubiquitous feature of social life. These developments also suggest new ways to conceive of the social processes through which diffusion is accomplished.

The Ubiquity of “Diffusion”

The connection between conceptions of culture informed by practice theory and the ubiquity of a more complex variety of diffusion can be made through the work of the Swedish sociocultural anthropologist Ulf Hannerz. Hannerz’s work on “the global ecumene” has attracted the attention of scholars interested in the role of social processes in fertility change at the regional and global levels, but has been taken to reinforce the interest in spreading cultural uniformity. At the core of his work, however, is the very different idea that the normal state of culture is “the organization of diversity” rather than “the replication of homogeneity.” Hannerz relates this characteristic of culture to what he calls “cultural flow.” In common with many others, Hannerz (1992:3) defines culture as “the meanings which people create, and which create people, as members of society.” It is located “in a set of public meaningful forms, which can most often be seen or heard, or are somewhat less frequently known through touch, smell, or taste, if not through some combination of senses” (1992:2–3). It is produced and reproduced through human activities that interpret previous meaningful forms and make available new ones. “The cultural flow thus consists of the externalizations of meaning which individuals produce through arrangements of overt forms, and the interpretations which individuals make of such displays—those of others as well as their own” (Hannerz, 1992:4).

The ubiquity of diffusion follows from the idea that culture exists in practices or processes of communication rather than as bodies of knowledge. On the one hand, communication does not require nor does it necessarily produce a uniformly shared language code. People who share a great deal of linguistic knowledge still may fail to understand one another if they disagree about what is happening in their interaction. Conversely, people who speak different languages may succeed in communicating if they are able to negotiate some degree of agreement concerning the nature of their engagement (see Hanks, 1996b:229). On the other hand, if culture exists in practices of communication rather than as bodies of

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

knowledge, then “the collective cultural inventory of meanings and meaningful external forms…is [differentially and impermanently] spread over a population and its social relationships” (Hannerz, 1992:7). People are differently exposed to the flow of culture because of their different location in everyday forms of life, states, markets, and social movements (Hannerz, 1992:41–61). They possess their own perspectives on that flow as the result of their differentiated role repertoires and life histories.

As a social organization of meaning, culture can be seen as made up of …a network of perspectives, with a continuous production of overt cultural forms between them. In this manner, the perspectivation of meaning is a powerful engine in creating a diversity of culture within the complex society. Call the network a polyphony, as the perspectives are at the same time voices; term it a conversation, if it appears fairly low-key and consensual; refer to it all as a debate, if you wish to emphasize contestation; or describe it as a cacophony, if you find mostly disorder. (Hannerz, 1992:68)

Cultural anthropology’s emerging awareness of the polyphony of meanings and perspectives has strong parallels in contemporary linguistic anthropology where Hannerz’s “public meaningful forms” are conceived of as signs. “A sign,” in Peirce’s formulation, “is something which stands to somebody for something in some respect or capacity.” Communication takes place, culture flows, when a sign is produced and there is created in the mind(s) of the persons to whom they are addressed corresponding sign(s) that are the “interpretant[s] of the first sign” (Peirce, 1955:99). In the Saussurian view of language that underlies the ideas that cultures are homogeneous and that meaning is conserved as it is communicated from one person to another, a sign and its interpretant are taken to be identical. Following Peirce, however, linguistic anthropologists now recognize that signs and their interpretants can, and routinely do, differ from one another in an indefinitely large number of ways.

Social Learning

The linked concepts of social learning and social influence are key elements of work on diffusion and fertility change. A recent essay by Montgomery and Casterline (1996) outlines these concepts with particular care. In their view, “[s]ocial learning takes place interpersonally” when the information that a person takes into account “[i]n weighing alternatives and making decisions” comes from other individuals. Social learning takes place “impersonally” when some of the information taken into account by a given decision maker is formed “by communications emanating from impersonal sources, such as the mass media, markets, and other aggregate social structures.” Social influence has to do with

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

“the effects of interpersonal interactions…that are expressed in individuals’ preferences as well as in their information sets.” It includes “the pressure to be similar to peers” and to obey or defer to the wishes of those with authority or power (Montgomery and Casterline, 1996:153–157).

These notions separate diffusion theories in which individuals are seen as “embedded in various networks and other structures of social relationships” from economic theories in which “rational and autonomous individuals…act against a background of impersonal markets” (Montgomery and Casterline, 1996:152), but they remain tied to a conventional view of learning as intramental, “a process by which a learner internalizes knowledge, whether ‘discovered,’ ‘transmitted from others,’ or ‘experienced in interaction’ with others” (Lave and Wenger, 1991:47).

Contemporary anthropology offers a still more social conception of learning. In fact, there are hints of this in the pioneering study by Coleman et al. (1966) of the diffusion of a new drug among physicians in three small Midwestern cities. A key feature of this study is the authors’ careful distinction between approaches that take individuals as the unit of analysis and those that focus on the community. In the former, relationships among individuals are treated as external influences on any particular individual’s choices. Personal relationships with colleagues are thus equivalent to contacts with commercial representatives, the use of professional journals and commercial periodicals, participation in professional meetings, and visits to medical institutions in other cities. In analyses that focus on communities, the status of personal relationships among individuals is sharply altered, becoming itself the “target of outside stimuli.” Defined as “a set of personal relationships” or, alternatively, as a “structure of social and professional relations,” the community mediates the effects of outside stimuli on individuals. It is “a network of communication through which information, influence, and innovation flow” (Coleman et al., 1966:69–71).

Coleman et al. further argue that social processes involving community mediation are manifested in distinctive outcomes. One is the “snowball” effect in which the probability that an individual who has not yet done so will adopt the innovation during a given month increases over time. Community mediation also is manifested in the degree to which pairs of interacting persons employ similar practices at a given moment or adopt new practices simultaneously. Especially during the early phases of a diffusion process, when potential adopters are feeling their way with an unknown novel practice, pairs of individuals bound together by some variety of face-to-face relationship are likely to adopt new practices simultaneously (Coleman et al., 1966:114–120). In situtations involving no novelty but in which individuals are faced with similar ambiguity, the consequences of community mediation are such that pairs of interacting

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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individuals are likely to employ the same or very similar practices from the community’s existing repetoire (Coleman et al., 1966:120–123).

Though it is not such an explicit part of their analysis, Coleman et al. also suggest that channels of influence or outside stimuli have different sorts of effects when they are viewed from the perspectives of individual or interaction diffusion. Viewed from both perspectives, channels of influence provide information concerning the existence and defining features of a novel practice and legitimate its adoption. Impersonal mass media and face-to-face contacts with commercial representatives are especially connected with information. Participation in local organizations and personal contacts with other potential adopters are sources of legitimation (Coleman et al., 1966:60). Viewed from the perspective of community mediation or interaction diffusion, the community-level personal channels of influence that mediate the other outside stimuli also provide “share[d]…definition[s] of the situation,” in novel as well as other ambiguous circumstances (Coleman et al., 1966:123).

Confronted with the need to make a decision in an ambiguous situation—in a situation that does not speak for itself—people turn to each other for cues as to the structure of the situation. When a new drug appears, doctors who are in close interaction with their colleagues will similarly interpret for one another the new stimulus that has presented itself, and will arrive at some shared way of looking at it. (1966:117–119)

This appears to be a very social view of learning indeed. Rather unexpectedly, it intersects with much more recent research in anthropology and psychology on cognition in everyday contexts and on teaching and learning in formal and informal settings.15 In the terms of this research, learning is no longer confined to the heads of individuals. Nor does it become social merely because other individuals or organizations are the source of information or influence. On the contrary, learning is located in or distributed over relationships of coparticipation and the settings in which they occur. It is ineluctably social.

Channels of Communication

Social learning and social influence are accomplished through channels of communication among individuals and between individuals and impersonal sources. Though the diffusion literature contains many references to different, culturally specific kinds of communication—visits from drug company detail men, medical journals, hospital grand rounds, and consultations with other physicians in the American Midwest (Coleman et al., 1966); the famous Korean Mother’s Clubs (Park et al., 1976); and women’s voluntary associations (tontines) in Cameroon (Valente et al.,

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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1997)—in analysis these typically are reduced to standardized links that, as regards any two persons, are either present or absent. In the network models reviewed and elaborated on by Valente (1995), they are reduced to the lines that connect the points representing persons in a sociogram. In the simulation model of Rosero-Bixby and Casterline (1993), they are reduced to generic interpersonal contacts.

Moreover, where the channels of communication are reduced to generic interpersonal contacts, the content of communication tends to be treated as a set of propositions unambiguously and completing attached to sentences or other utterances independently of context. Against this, linguistic anthropologists and others have observed that the vast majority of utterances are elliptical and that few, if any, are unambiguous. Instead of being transparently attached to sentences, meaning is negotiated through processes of interaction inextricably bound up with their context.16 It follows that the forms of communication are extraordinarily diverse, that the differences between consulting a senior physician in Midwestern city and participating in a meeting of a Cameroonian tontine, for example, are differences that make a difference.

Among the tools developed by linguistic anthropologists to understand how meaning is produced, Levinson’s (1992) work on activity types and inference promises to be particularly useful for work on social processes and fertility change. Building on Wittgenstein’s (1958) concept of “language games”—a “form of use of language against a background context of a form of life” (Kenny, 1973:166)

take[s] the notion of an activity type to refer to a fuzzy category whose focal members are goal-defined, socially constituted, bounded, events with constraints on participants, setting, and so on, but above all on the kinds of allowable contributions. Paradigm examples would be teaching, a job interview, a jural interrogation, a football game, a task in a workshop, a dinner party, and so on.17 —Levinson (1992:69)

In relation to fertility change, we might add the “little universities” and convivial Monday evening gatherings of the artisans who, with their wives, produced the first fertility transition in Sicily (Schneider and Schneider, 1996:222–225); family planning counseling (Candlin and Lucas, 1986; Carter, 2001a, 2001b; Kim et al., 1998; Maternowska, 2000); and doctor-patient consultations concerning contraception (Todd, 1983, 1984; Fisher and Todd, 1986).

The meaning of utterances is inextricably bound up with and contingent on such activity types. On the one hand, the indexical functions of linguistic signs, those that point to or invoke the “copresence of [their] object[s] in the same place and time as [they] occur” (Hanks, 1996b:46), anchor utterances in an ever-shifting play of activity types. “To speak is

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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to take up a position in a social field in which all positions are moving and defined relative to one another” (Hanks, 1996b:201). On the other hand, “to each and every clearly demarcated activity there is a corresponding set of inferential schemata” (Levinson, 1992:72). Participants in communicative events draw on their culturally specific knowledge of these schemata to ascribe meaning to otherwise elliptical and ambiguous utterances.

It should be noted that from this point of view, gossip, which often is treated as a generic term for interpersonal communication, is a highly specific form of talk. Beyond the fact that it is framed or cued in particular ways, two features of gossip are relevant here. First, the parties to gossip—the person who produces it, the recipient, and the absent subject of gossip—must be acquainted with one another. Second, the information communicated in gossip is news for a particular social unit, some relatively small network of persons who are acquainted in some way (Bergmann, 1993:45–70). New information is unlikely to travel widely as a result of gossip.

Community and Social Structure

Sliding away from microeconomic accounts of fertility change along the continuum from gesellschaft to gemeinschaft, the new line of demographic research appears to assume that villages, provinces, nation-states, and regions are, in fact, more or less inclusive communities, collectivities of persons whose interactions are marked by communion and mutuality. It appears to assume, too, that as far as diffusion is concerned, the one critical characteristic of such communities is communication networks. Other aspects of social organization that might affect the flow of communication are given minimal attention. Anthropologists are prone to see rather less community and a great deal more variation in social structure.18 The dimensions of this variation include systems of kinship and marriage, social stratification, and relationships to state institutions.

One way to bring this into perspective and to sketch its implications is to contrast recent research on Thailand with studies of other developing peasant societies. Consider, for example, the descriptions of village structure in the fascinating recent study by Entwisle et al. (1996) of contraceptive choice in 51 villages in Nang Rong district, some 250 kilometers northeast of Bangkok. Armed with an unusual and valuable household survey that provided contraceptive choice data for all the women in the sample villages, Entwisle et al. (1996:1) are able to show that “[t]ypically one method predominated among users within a village but villages varied greatly as to which method was most popular.” To explain this remarkable finding, the investigators collected data on four groups of conventional village “structural characteristics”: agriculture, migration

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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patterns, social development, and accessibility. Interested in “social communit[ies], bound together by social interaction,” they also asked focus groups about conversational networks.

The paper makes excellent use of limited resources, but it entirely lacks any picture of the internal organization of Thai villages and its consequences for village talk.19 This is all the more remarkable from the perspective of anthropology, for anthropologists have long regarded the social structure of Thailand as distinctly unusual. As Potter (1976:149) observes, “Thai villages are extremely variable and no two are exactly alike. But they are recognizably Thai instead of Balinese or Indian or Chinese villages because they all are constructed from a limited number of structural principles.”

Thai villages do, in fact, appear to be unusually communal. Potter describes Chiangmai village, a village in the far north of Thailand with 875 inhabitants in 1972, as

a corporate group with a common identity; the temple committee and the school committee form quasi-governing boards which make decisions on behalf of the villagers as a whole and resolve disputes between community members. Village society includes cooperative groups and voluntary associations, ranging from the funeral society and neighborhood groups which send food to the temple, to labor exchange groups. Cooperation is the dominant ideology of village social relations. (1976:147)

One may doubt that one village is representative of the whole of Thai rural society and suspect that a dominant ideology is just that, but there are structural supports for the communal character of Thai villages. Though there is significant internal variation, much of rural Thailand has a “matrilineal stem family system.” When sons marry they leave their natal families and, for a time, live with the families of their wives. Daughters are expected to marry in order of age. “Each daughter and her husband lives in her parents’ house for a period which varies from a few months to several years,” forming a stem family consisting of two conjugal units. When the next older daughter marries and is joined by her husband, her elder sister’s family moves out of the parental household and establishes a new household nearby, preferably in the same compound, where they remain under the control of the wife’s parents until they can acquire their own land. The youngest daughter and her husband are expected to reside permanently in her parents’ household and succeed to their positions (Potter, 1976:121–123).

One of the consequences of this system is that Thai villages are populated by matrilineages of short genealogical depth (Potter, 1976:141–146). Thai women are thus placed in an unusual position. In the patrilineal joint family systems that predominate in South Asia and China, for ex-

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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ample, women are isolated from natal kin in their marital villages and must struggle over a period of years to construct networks of peers with whom they may gossip and who will support them in conflicts.20 Rural Thai women remain near their mothers and are surrounded by their sisters and other close female matrilineal kin.

The communal character of Thai villages also may be fostered by relatively moderate social stratification. The population of Chiangmai fell into five classes—landlords, rich peasants, middle peasants, poor peasants, and landless laborers—but, according to Potter (1976:58–59), landlords were landlords on “a Lilliputian stage” and were “not hated figures, as they are in many societies.” A consequence of the family system is that many landless and poor peasant households are linked by ties of matrilateral kinship to landed households and will, when inheritance is complete, become better off themselves.

Again, this picture of relative equality contrasts sharply with the situation in South Asia. Most villages in India are divided into a number of castes with enormous differences in economic and ritual status. Class status and ritual are conceptually distinct, but the two not infrequently overlap and mutually reinforce each other. Indian landlords often are hated figures. Because castes generally are endogamous, the numerous social strata of a stereotypical Indian village are not bound together by ties of kinship. Instead, the members of a caste in any one village are linked by horizontal ties21 of caste identity, affinity, and kinship with members of their caste in other villages. Fellow villagers do not entirely lack mutual interests, but in many respects Indian villages are the arenas in which caste differences are experienced and competition for ritual status is played out.22

The preceding paragraphs have been concerned with features of what Potter calls “the ‘natural’ village community.” In Thailand, this is a “spatially defined rural village, which receives the allegiance of its members, furnishes an important part of their social identity, manages its own affairs and its common property, and has its own temple and school” (Potter, 1976:203). I have also rather downplayed variation among Thai villages. One of the things Thai village communities share with village communities in other state systems is a complicated relation with changing administrative villages. In Thailand, administrative villages consist of territories delimited by the state, each with a headman elected according to procedures laid down by the state. Because

state bureaucrats drew uniform grids across the country-side, paying little attention to how the resulting administrative units corresponded to preexisting social, economic, and religious networks of the peasantry, about which the state functionaries knew little and cared less…administrative villages…often are different from nonadministrative commu-

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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nities, temple affiliations, market ties, and irrigation system memberships. (Potter, 1976:215)

This is one of the factors that produces variation among villages.23 Virtually all the possible geographical relationships between natural and administrative villages, temples, and schools are represented in the Thai countryside.24 Some natural villages are divided among two or more administrative villages. Some administrative villages contain more than one natural village.

The very interesting findings reported by Entwisle et al. (1996) cannot be fully understood without considering these features of village social structure. Nor can they be generalized without qualification to other parts of Thailand, let alone other agrarian societies, unless it is assumed that none of this affects the shape of communication networks and the ways in which their members communicate. This is patently not the case. The overwhelming weight of ethnographic research decisively demonstrates that people playing particular kinds of social roles talk or do not talk to people playing other kinds of social roles in particular kinds of ways about particular kinds of things. In some cases, certain sorts of persons may communicate about some topics in front of certain other sorts of persons, but not to them or with them. As communication takes place, the exchange of knowledge or ideas is saturated with and qualified by information concerning the social identities of the participants.

RESEARCH STRATEGIES

All of this underlines the Caldwells’ (Caldwell et al., 1988:263–273; Caldwell et al., 1987) call for ethnographic research in the study of population processes. Revolving around a commitment to being with the people one is studying while they are doing what one is studying, ethnographic research is designed to learn what activities mean from the actor’s point of view and how they fit into their cultural and social context. At its best, it aspires to shift analysis and interpretation from “experience distant” concepts derived from the theories of observers to “experience near” concepts used “naturally and effortlessly” by informants to make sense of their experience (Geertz, 1983:57). In order to track the political economy of fertility, i.e., the ways in which it is embedded in and responds to “historically developed local, regional, national, and global processes” (Greenhalgh, 1995:13; see also Greenhalgh, 1990), including initiatives of the international population movement, efforts should be made to carry out coordinated ethnographic studies in “multiple sites of observation and participation that cross-cut dichotomies such as the ‘local’ and the ‘global,’ the ‘lifeworld’ and the ‘system’” (Marcus, 1994).25

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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Ethnographic research on the diffusion or flow of knowledge involved in fertility change in some selected society might focus on local social structure or, as Valente (1995:1) puts it, “who communicates with whom.” What is the community’s stock of communicative activity types (see above)? How are these distributed over the network of groups and relationships around which the community is organized? In which kinds of communicative activity types is it appropriate to talk about which aspects of family formation, household management, sexuality, contraception, etc.? How is such talk managed? And what are its consequences?

Toward an Ethnography of Family Planning Counseling

The following reflections on the Kenya Provider and Client Information, Education and Communication Project, a study of family planning counseling in Kenya by Young-Mi Kim and others at the Johns Hopkins Center for Communications Programs (Kim et al., 1998; and Kim, Kols, and Mucheke, 1998), indicate some of the things that might be learned from ethnographic research on key communicative activity types thought to be involved in fertility change.

Much of the policy-related literature on family planning and reproductive health services and fertility change is prescriptive. In this literature, counseling is conceived of as “any face-to-face communication between providers and clients that helps clients make free and informed choices about family planning and to act on those choices” (Gallen, Lettenmaier, and Green, 1987:2). Service providers—“doctors, nurses, midwives, community-based health workers, and trained retailers selling contraceptives” as well as counselors—who use counseling skills appropriately are said to be able to adopt the “user” or “client perspective,” “finding out about and respecting clients’ values, attitudes, needs, and preferences.” Clients as well as providers participate actively, “exchang[ing] information and discuss [ing] the client’s feelings and attitudes about family planning and about specific contraceptive methods” (Gallen and Lettenmaier, 1987:3, 15; see also Bruce, 1987, 1990).

So defined, counseling is widely regarded as a key channel of communication through which the knowledge and recommendations of the international population movement are diffused to target populations and an essential component of effective family planning and reproductive health services in low- as well as high-fertility populations (AlwandoEdyegu and Marum, 1999; Baker, 1985; Bruce, 1987, 1990; Centers for Disease Control and Prevention, 1998; Gallen, Lettenmaier, and Green, 1987; Grimely et al., 1993; Kim, Kols, and Mucheke, 1998; Namerow et al., 1989; Nathanson, 1991:167–177; Nathanson and Becker, 1985; Strader and Beaman, 1992).

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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The Kenya Provider and Client Information, Education and Communication Project is arguably the best available study of family planning counseling. Unlike the studies of client-provider interactions in family planning agencies reviewed by Simmons and Elias (1994), the work of Kim and her colleagues is based on direct observation. The project staff observed, audiotaped, “translated…from the local language into English and made written transcript[s]” of 176 counseling sessions involving new and continuing “female family planning clients and clinic- and community-based providers at 25 service delivery sites in Kenya” in 1993 (Kim, Kols, and Mucheke, 1998:4, 6).

For an analysis of interaction between counselor and client, each turn taken by a participant in a transcribed interaction was coded using techniques borrowed from Roter and Hall’s (1987) studies of medical interaction. A client’s entire speech during a turn was coded as “asks question,” for example, if it was judged to fit the description “asks provider for information.” A provider’s speech was coded as “counseling” if it fit the description “advises clients based on their personal situation” (Kim et al., 1998:11–12). For an analysis of informed choice and decision making, Kim and her colleagues identified stretches of transcribed interaction that matched behavioral elements of a four-step model of decision-making thought to incorporate the criteria of informed choice: “[d]iscuss client’s reproductive goals,” “[o]ffer sufficient information,” “[e]xplore client’s reasons for choice,” “schedule future visits or further counseling,” etc. (Kim, Kols, and Mucheke, 1998:5–6).

Nevertheless, like the several “mystery client” studies of family planning counseling (e.g., Huntington et al., 1990; Huntington and Schuler, 1993; León et al., 1994), Kim and her colleagues appear to assume that the claims of the prescriptive literature are both accurate and complete. They attempt to measure the degree to which counselors conform to the GATHER guidelines of Gallen, Lettenmaier, and Green (1987) or the fit between the behaviors of counselors and clients and an idealized model of informed choice, but describe no other features of the content or context of counseling sessions. And, even though it is based on direct observation, the linked decisions to base all of the analyses on English translations of the original Kenyan-language transcriptions and to use observers’ categories to code the transcripts effectively erase the cultural content and social setting of the material. Indeed, one cannot be confident that an utterance in an English translation of a Kenyan counseling session that is coded as, say, a question without regard to what was said before and after it actually functioned as a question in the language of the original exchange.26

An ethnographic approach to the audiotapes collected by the Kenya Provider and Client Information, Education and Communication Project

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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would attempt to provide a richer picture of the social processes involved in counseling sessions by retaining their cultural and social specificity. Rather than using exclusively “experience distant” analytical categories, it would attend to the “experience near,” local “meanings that people create, and that create people, as members of society” (Geertz, 1983:57; Hannerz, 1992:2).

Family planning and reproductive health counseling sessions may be regarded as a culturally variable type of communicative activity (Levinson, 1992, see above) or, more generally, as a species of evaluative conversation (Hammel, 1990). They may be analyzed using the tools of linguistic anthropology. This focuses on the ways in which participants in counseling sessions use culturally specific language to represent their experience and concerns to their interlocutors and to themselves and the manner in which they “use such representations for constitutive social acts” (Duranti, 1997:3; see also Bakhtin and Medvedev, 1985; Bourdieu, 1991; Hanks, 1996b; Voloshinov, 1986). The ways in which the uses of language are anchored in and dependent on their contexts through the indexical character of linguistic signs, —their capacity, that is, to achieve meaning by invoking links between selected aspects of an ongoing activity and aspects of other activities (Duranti, 1997; Hanks, 1987, 1989, 2000a, 2000b)— is particularly important. Conversation analysis, with its focus on sequences of utterances in conversations and conversational activity and on positioned turns within sequences, offers additional insights.27

Studies in linguistic anthropology and conversation analysis of provider/client interactions in a variety of other settings and my own preliminary investigations of family planning counseling in the United States (Carter, 2001a, 2001b) suggest that the uses of language in family planning and reproductive health counseling sessions are very much more complicated than the analyses of the Kenya Provider and Client Information, Education and Communication Project would suggest. To begin, counseling is affected by a range of factors associated with setting. Provider-client interactions in office settings differ from those in the street or field (Rowe, 1999:89–105). Medical consultations in public hospitals differ from those in private clinics (Ainsworth-Vaughn, 1998:6). The shape of service encounters also is affected by status differences between providers and clients (e.g., Erickson and Shultz, 1982), by providers’ ideas about what they are doing and how (Peräkylä, 1995), and by the use of writing along with spoken interaction (Frankel, 1989). An ethnographic treatment of the Kenya Project material would pay attention to ethnic and other differences between providers and clients and to the differences between clinic- and community-based encounters.

If one of the aims of counselors is to create “an interpersonal context that enables [a client] to profit from” new information (Frank and Frank,

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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1991:45),28 then more is involved than “[e]xpressing positive feelings and praising clients” “[a]sking open-ended questions or asking for the client’s opinion,” and so on (Kim et al., 1998:11). In general, the interpersonal relationship of counseling, that is, the positioning and repositioning of the counselor and client in relation to each other, is accomplished through the performance, or socially situated and framed enactment, of cultural symbols and by indexical features of the spoken and written language of counseling. Performance and indexicality also anchor counseling to its contexts (Hanks, 1984, 1996a, 2000a, 2000b).

Turning to sequences of utterances in provider/client interactions, Ainsworth-Vaughn shows that both doctors and patients in American medical consultations use repetition “to show participation and agreement” and “formulations…of shared cultural knowledge” (1998:136).29 Peräkylä (1995:57) demonstrates that AIDS counselors in a London hemophilia clinic induce their patients to talk about sensitive, private concerns and to address “dreaded issues”—severe illness, disability, and death— they might prefer to avoid in part through the recurrent use of a common asymmetric pattern of interaction in which counselors produce questions and statements and clients produce answers. The counselor asks a question, the patient answers, the counselor then has an option to comment on the patient’s answer and the right to ask another question (1995). Explicitly using a theory of family interaction, the counselors also constrain their patients to speak about sensitive matters by formulating questions in a way that takes advantage of culturally specific notions of relationships and knowledge. Clients are understood to be the “owners” of their experience, but their relatives and partners should also have some knowledge of what the clients are experiencing. The latter notion constrains family members who accompany clients to respond to questions about the clients’ private concerns. The former notion constrains clients to confirm or disconfirm and to elaborate on the family members’ responses. Finally, the counselor may properly close discussion of a topic and/or the counseling session as a whole when the patient’s future has been “portrayed as manageable.” The patient’s face is protected “by constructing the future world in such a way where the client is an active, successful agent. After this restoration of the client’s ‘agency,’ the participants are free to exit from the world they thus have completed” (1995:327).

In his work on American doctor-patient consultations and related discussions among physicians, Cicourel (1985, 1986) demonstrates that people use different kinds of language to invoke and put into circulation different kinds of knowledge. Everyday, localized knowledge is talked and written about in informal language marked by the use of anaphora and deictic pronouns. Schematized, professional knowledge is indexed by displays of formal spoken and written language.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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The work of Ochs et al. (1997) suggests that the transfer of knowledge from one person to another may be seen in instances of co-narration. Narratives recapitulate and evaluate “past experience by matching a verbal sequence of clauses to the sequence of events which (it is inferred) actually occurred” (Labov, 1972:359). A co-constructed narrative is one in which the components of the verbal sequence are shared among two or more speakers. In their study of the stories told by “20 white, English-speaking, American families” at dinner, Ochs et al. (1997:95) stress the cognitive consequences of verbal interaction (see also Wertsch and Hickman, 1987). The sharing of the rights to tell a story “makes participants’ perceptions of the world vulnerable to coauthored change” (Ochs et al., 1997:109). This happens especially when a co-narrator feels that information vital to understanding the problem that motivates the actions and reactions of protagonists and others in the storytelling situation is missing. “Co-narrators [then] return, sometimes again and again, like Lieutenant Columbo, to pieces of the narrative problem in an effort to find ‘truth’ through cross-examination of the details, sometimes struggling for an illuminating shift in perspective” (Ochs et al., 1997:98). The occurrence of such cognitive changes on the part of a person whose story is conarrated is signaled by the emergence of new information and its incorporation into the story’s meaning.

Clearly, the patterns of interaction in counseling sessions are dauntingly complex. Nevertheless, there appear to be a variety of quantitative approaches to the assessment of counseling sessions that are simpler and easier to execute than the coding strategies used by Kim and her colleagues in the Kenya Provider and Client Information, Education and Communication Project. For example, Erickson and Shultz (1982) show that guidance counseling sessions in an American junior college, which participants subsequently characterize after reviewing audiotapes as having gone well, also have relatively few awkward pauses and other arrhythmias.30 This finding could be tested cross-culturally by measuring the association between participants, assessments of counseling sessions and the occurrence of “uh huh,” “umm,” and other speech particles or monitoring devices on the one hand, and pauses on the other. Conversational analysts have demonstrated that across a range of cultures, people use monitoring devices to show that they are interested in and paying attention to what is being said. They use long pauses to signal a lack of interest in continuing a conversation (Schegloff, 1982; Jefferson, 1989).31

Another approach focuses on what Silverman calls “disposal statements,” the utterances in which doctors indicate how they propose to deal with the results of a consultation. Silverman suggests that such utterances can be divided into three groups: those in which the doctor seeks to impose a decision himself [“Passive voice (‘Management would

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
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be’)”], those in which he seeks to persuade the patient or the patient’s parent(s) [“Voices of I and We (‘I think we should’)”], and those in which he elicits the patient’s and/or the patient’s parent(s) participation in a shared decision [“Voices of I, We and You (‘I think…but we would… if you thought’)”] (Silverman, 1987:57 and passim). In the English pediatric consultations studied by Silverman, the form of disposal statement the doctor uses in any particular consultation depends on prior sequences of verbal and nonverbal actions as well as overarching “medical” and “social” discursive environments. Given the concerns addressed in family planning counseling (contraceptive choice, abortion, etc., versus the management of severe heart defects) and the ideology of choice and empowerment that informs family planning and reproductive health counseling, one would expect that in “successful” or “proper” counseling sessions, disposal statements generally would be uttered by clients or, if the counselor utters a disposal statement, that it would be framed in a way that invites the client’s participation in a shared decision.

Finally, the talk that occurs in family planning and reproductive health service encounters (see Goffman, 1961:321ff) opens a window on other channels of communication and social processes involved in flows of knowledge concerning fertility. Talk about fertility and contraception in other settings is likely to be intermittent and difficult to observe ethnographically. But men as well as women not infrequently bring these concerns to counselors at family planning clinics, crisis pregnancy centers, and STD clinics; genetic counselors; the staff of school-based clinics; nurses, midwives, gynecologists, pediatricians, internists, and family medicine physicians; other kinds of healers; and clergy. Such consultations are themselves part of one’s sexual and reproductive life. In these settings, men as well as women provide accounts of their conduct that are endogenous to their ongoing projects rather than responses to exogenous research interventions. Here, as Hammel (1990:475) puts it, informants “speak to one another and can be overheard.”

For example, one of the counseling sessions I observed opens with an extended co-narrative (Ochs et al., 1997, see above) that includes the following references to a woman’s connections with friends, sister, and boyfriend:

1

Counselor

You came in for a pregnancy test today.

2

Client

Mm, mm.

3

Counselor

Tell me a little bit about why you decided to come in.

4

Client

Well I really already know I’m pregnant. I don’t really know what I want to do. It’s like I’m between two decisions—I don’t know if I want to have an abortion or if I want to keep it.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

5

Counselor

Okay.

6

Client

And it’s like, you know a couple of my friends, well my sister’s had an abortion before and a couple of my friends have had kids and they are like just go to Planned Parenthood and then make up your own mind.

7

Counselor

Yeah.

8

Client

It’s like most of my friends, you know, they’re like “oh have it.” It’s like well you guys aren’t going to be there, you know, all the time to help me with everything and it’s not just an easy decision, (nervous chuckle) [Several utterances deleted.]

21

Counselor

Okay. And tell me where, who you have talked to and what the conversations have been like.

22

Client

Well, I talked to my boyfriend, of course. I have talked to a couple of my friends. Oh my boyfriend is like, you know he is like a very important part for the—like he’s going to help me, I don’t know—he’s not very “there.” He’s like it’s your decision, but then again I don’t want you to have it. You know what I mean—he’s kind of like contradicting himself?

23

Counselor

Mm, mm.

24

Client

Like, I appreciate that he is being honest. That he’s not ready for one cause really I’m not either but there’s a part of me that really doesn’t want to have an abortion.

25

Counselor

Tell me why, tell me about that part of you that really doesn’t want to have an abortion, what is it that, that makes you feel that way?

26

Client

I’m pro-choice but I always—like I believe it’s the woman’s right to decide but for me I’ve always kind of been just for my personal, I guess, morals I never wanted to have an abortion like my sister. (Inaudible) But she’s had, she has three kids and she’s had a lot of abortions, a lot. And I’ve been there a couple of times when she was having an abortion and I just never wanted to be like that. I mean I don’t want to go through that. And I don’t think it’s the child’s fault that I’m not responsible. You know what I mean? I mean it’s somebody’s right to decide but I just think it’s wrong, well for me personally.

Here the client and the counselor together construct an account, albeit one that is selective and interpreted, of a “sequence of events which (it is inferred) actually occurred” (Labov, 1972:359). The presuppositions in terms of which narratives make sense are constituents of the knowledge

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

schemas—“expectations about people, objects, events and settings in the world” (Tannen and Wallat, 1993:60)—that participants use in everyday life (Giddens, 1979:57). As the Caldwells note, a body of such ethnographic material would help investigators using quantitative methods to develop culturally appropriate questions and hypotheses concerning the social processes and flows of knowledge that shape fertility conduct (Caldwell, Reddy, and Caldwell, 1988:263–273; Caldwell, Caldwell, and Caldwell, 1987).

Survey Research

The following reflections on the network questions used by Valente et al. (1997) in their research in Yaoundé, Cameroon, on the associations between contraceptive use and communication among members of women’s voluntary associations (tontines) indicate some of the ways in which quantitative research might be informed by ethnography.

In the first of this set of questions, informants are asked to name the five women in their group with whom they had talked most often in the past six months. A follow-up question confirmed that the person named was a member of the informant’s group. Women who were not members of the informant’s group were dropped from the analysis (Valente et al., 1997:679). Subsequent network questions ask how often the informant talked to each of the women she named, how long the informant and each of her interlocutors had known each other and how they were related, and what kinds of help and advice the informant received from each of her interlocutors. The remaining questions concerned the informant’s beliefs concerning her interlocutors’ use of and approval of contraception and whether or not the informant had been encouraged by her interlocutors to use contraception herself. The responses to the question concerning the way in which an informant and her interlocutors were related were coded as follows: “family member,” “tribal member,” “coworker,” “friend or neighbor,” and “other” (Valente et al., 1997:686–687).

From an ethnographic perspective, this set of questions features several notable absences. The positions in the social structure available to informants and their interlocutors—family, “tribe,” work, friendship, and neighborhood—are very restricted. Though it is probable that many social relationships in urban Cameroon are multidimensional, only one dimension is coded and that according to rules that are not specified. There is nothing on Cameroonian communicative activity types, the manner in which they are situated in the local social organization, or the kinds of topics appropriate in each.

An alternative approach would break the question concerning the relationship between informants and their interlocutors (“How are you

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

related to ___?”) into two more detailed sets. In the West African context, particular attention should be paid to kinship groups more inclusive than families or domestic groups and to the effects of polygyny and relationships among co-wives. In all but a few societies, attention also should be paid to the difference between natal family (i.e., family of origin) and marital family. Relationships formed in school also might be important. One set of questions would be aimed at the informant’s position in society: minimally natal lineage affiliation, natal tribal affiliation, marital history and current marital status, husband’s lineage affiliation and tribal affiliation, educational history, employment history and current employment, place of residence, and membership in voluntary associations. One imagines that many of these questions were included in Valente et al.’s larger questionnaire. If informants were asked to describe their interlocutors in parallel terms, it would then be possible to code more dimensions of the relationships between informants and their interlocutors. Where an interlocutor is a member of the informant’s “family,” it would be possible to code this relationship more precisely as mother, wife of male member of natal lineage, co-wife, husband’s mother, husband’s mother’s co-wife, wife of male member of husband’s lineage, etc. This would provide a richer view of an informant’s knowledge of her interlocutors and a fuller picture of the composition of voluntary associations.

An additional set of questions is required to identify the ways in which any two Cameroonian women discuss family planning. When (on what date and at what time of day) did you or do you and ___ discuss family planning? Where did or do these discussions take place? At the market, in your home or ___’s home, during or on the margins of a voluntary association meeting, etc.? Who else was or is present? What do people call this kind of talk?

It goes without saying that the language of the survey and the procedures used to administer it should be consistent with the discoursive practices of the community in which it is carried out (see Briggs, 1986; Duranti, 1997:102–110).

SUMMARY

Classic structural-functional anthropology decisively rejected its own diffusionist past and with it all versions of diffusion based on simple imitation or contagion. Elements of one culture routinely are adopted by others but they are systematically reinvented in the process. Birth control is new only if various forms of “child control” (Greenhalgh, 1988:639) are set aside by definition.

However, the contemporary turn to practice theory in which culture is produced and reproduced through processes of interaction suggests

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

that a very much more complicated version of diffusion is a pervasive feature of social life. The ubiquity of diffusion conceived of as cultural flow is not simply a reflex of the rapidity with which new knowledge is generated by the scientific establishment of the rich nations at the core of the global economy and transmitted to all the nooks and crannies of the periphery by global institutions devoted to development and technological transfer. Novelty is generated continuously throughout the global system, including its more or less peripheral nooks and crannies. Learning is inherently social, spread over the projects of interacting persons and the contexts of their interactions. The communicative resources through which new ideas concerning family planning are spread, translated, and continuously modified, and the social structures in which those resources are situated, are culturally defined and immensely variable. Variations in communicative resources and social structure are intimately connected to the outcome of diffusion processes.

Research on the spread, translation, and continuous alteration of new ideas concerning family planning requires detailed knowledge of a social system’s communicative resources and the social structure in which they are situated. Ethnographic research is a key tool for obtaining such knowledge.

It should be noted that if learning is social in this sense, that is, located in processes of co-participation and the contexts in which they occur, so are the decisions of economic men and women (Hammel, 1990; Carter, 1988, 1995, 1998). A culturally smart diffusion and culturally smart microeconomics are virtually indistinguishable.

NOTES

1.  

See also Rosero-Bixby and Casterline (1993) and Montgomery and Casterline (1993).

2.  

The Princeton European Fertility Project’s early work on communities as units of fertility change focused on the administratively established provinces of modern nation-states (Coale and Watkins, 1986; Watkins, 1991). More recent work has extended this concept of community to villages in developing countries (e.g., Entwisle et al., 1996, 1997; Kohler, 1997; Valente et al., 1997) and to regions composed of a number of culturally similar nation-states (Bongaarts and Watkins, 1996).

3.  

See also Carter (1988,1995,1998).

4.  

For a cognate approach to the role of education in fertility change, see Carter (1999).

5.  

Here Kroeber cites Tarde’s (1903) The Laws of Imitation.

6.  

The turn to practice theory in anthropology was announced, somewhat after the fact, by Ortner (1984). Key contemporary theoretical sources are Bourdieu (e.g., 1977) and Giddens (e.g., 1979, 1984).

7.  

See also Greenhalgh (1995) and Carter (1988, 1995, 1998, 1999).

8.  

Bongaarts and Watkins (1996) are unusual in extending studies of social interaction within national populations to the analysis of regions consisting of several such populations. There is, of course, a long-standing interest in the operation of agencies designed to transfer contraceptive technologies and ideas concerning their use from the societies in which they originated to societies that do not possess them (see, for example, Retherford and Palmore,

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

   

1983:312–319). This has been given renewed impetus in the work of Watkins and her colleagues (e.g., Hodgson and Watkins, 1997; Watkins and Hodgson, 1998).

9.  

Like Kroeber, Rosero-Bixby and Casterline (1993:165, n47) cite Tarde (1903).

10.  

Curiously, there appear to be very few studies of this kind. The only one I have found is the geographer Blaikie’s (1975) locational analysis of the family planning program in Purnea District, Bihar, India.

11.  

But see Schneider and Schneider (1992) and Santow (1993, 1995) on withdrawal.

12.  

On infanticide in South Asia, see also Chen et al., (1981), Das Gupta (1987), Levine (1987), and Miller (1981). Scheper-Hughes’ (1992) study of an impoverished and economically marginalized community in northeastern Brazil provides ethnographic support for Scrimshaw’s argument. European historical studies include Fuchs (1984, 1992), Kertzer (1991, 1993), and Ransel (1988).

13.  

There is an enormous anthropological literature on family or household systems, full of technical disputes. Early versions of the “developmental cycle in domestic groups” (e.g., Goody, 1958) are apparent in Lesthaeghe’s (1980) theory of “the social control of human reproduction.” For more recent work on the household, see Netting et al. (1984). For a discussion of the utility of distinguishing between families and households, see Carter (1984).

14.  

For Taiwan, Skinner cites Coombs and Sun (1978). His source for Korea is Park (1983). For an elegant analysis of “deliberate birth control in [rural] China before 1970,” see Zhao (1997).

15.  

For brief reviews of this work, see Carter (1999) or Pelissier (1991). Among the key texts are Lave (1988, 1989, 1991), Lave and Wenger (1991), Rogoff and Lave (1984), and Scribner (1997).

16.  

For a concrete example with important implications for health communications, see Nations and Monte’s (1997) analysis of the 1994 cholera control campaign in northeastern Brazil. In this radically stratified setting, the residents of urban slums denied the existence of cholera and actively resisted the efforts of public health workers. They understood posters with the caption “Cholera, Don’t Close your Eyes to Life: Help Combat Cholera” as signaling a campaign to exterminate not the disease, but “we the cholera poor” (Nations and Monte, 1997:458–59).

17.  

See also the discussions of genres of communication in Hymes (1974), Bergmann (1993:26–32), and Hanks (1996b:242–249 and passim).

18.  

See also McNicoll (1985, 1988), Cain (1985), and Greenhalgh (1990).

19.  

Also missing is any indication of village size.

20.  

See, for example, Wolf (1972:32–3).

21.  

Where marriage is hypergamous, “horizontal” should be read as “less vertical.”

22.  

This is a major theme of Mayer’s (1966) classic ethnography of “a village and its region.” For a general review of the literature, see Dumont (1980).

23.  

Other sources include the processes through which villages grow and produce new natural villages and the links between natural villages and agrarian ecology.

24.  

Since the data used by Entwisle et al. come from a census and concern units that have headmen, it would appear that the unit of analysis in this paper is the administrative village. However, the paper does not specify this. Nor does it say anything about the relationship between the administrative village and the natural village in Nang Rong district.

25.  

Much of the recent work of Watkins approximates this approach. See, for example, Kaler and Watkins (1999) and Watkins and Hodgson (1998).

26.  

Linguists commonly observe that there is no one-to-one correspondence between the form of an utterance and its meaning and force. On the contrary, the sense of an utterance is spread over and inseparable from its context (see Levinson, 1983:286ff; Hanks, 1996b; Duranti, 1997; Ainsworth-Vaughn, 1998). These difficulties are compounded by changes introduced by translation.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

27.  

On conversation analysis, see Sacks (1984), Sacks et al. (1974), Schegloff et al. (1977), and Levinson (1983:284–370).

28.  

As Kaler and Watkins (1999) demonstrate, this is very much an empirical question. The aims of counselors and of clients no doubt vary from one setting to another and in any case are unlikely to correspond perfectly.

29.  

See also Ferrara (1994:108–127) on “echoing” in psychotherapeutic interactions.

30.  

Felicitous sessions also have relatively few occasions on which the counselor takes over the conversation with protracted explanations, and more instances in which the counselor offers extra assistance.

31.  

On the cross-cultural robustness of some of the more straightforward findings of conversation analysis, see Boden (1994) and Lerner and Takagi (1999).

REFERENCES

Ainsworth-Vaughn, N. 1998 Claiming Power in Doctor-Patient Talk. Oxford: Oxford University Press.

Alwando-Edyegu, M.G., and E.Marum 1999 Knowledge Is Power: Voluntary HIV Counseling and Testing in Uganda. Geneva: UNAIDS.


Baker, A. 1985 The Complete Book of Problem Pregnancy Counseling. Granite City, IL: The Hope Clinic for Women, Ltd.

Bakhtin, M.M., and P.M.Medvedev 1985 The Formal Method in Literary Scholarship: A Critical Introduction to Sociological Poetics. Translated by A.J.Wehrle. Cambridge, MA: Harvard University Press.

Bergmann, J.R. 1993 Discreet Indiscretions: The Social Organization of Gossip. Translated by J.Bednarz. New York: Aldine de Gruyter.

Blaikie, P.M. 1975 Family Planning in India. London: Edward Arnold.

Bledsoe, C.H., F.Banja, and A.G.Hill 1998 Reproductive mishaps and Western contraception: An African challenge to fertility theory. Population and Development Review 24(1):15–57.

Bledsoe, C.H., A.G.Hill, U.D’Alessandro, and P.Langerock 1994 Constructing natural fertility: The use of Western contraceptive technologies in rural Gambia. Population and Development Review 20(1):81–113.

Boden, D. 1994 The Business of Talk: Organizations in Action. Cambridge, MA: Polity Press.

Bongaarts, J. 1978 A framework for analyzing the proximate determinants of fertility. Population and Development Review 20(1):81–113.

Bongaarts, J., and S.C.Watkins 1996 Social interactions and contemporary fertility transitions. Population and Development Review 22(4):639–682.

Bourdieu, P. 1977 Outline of a Theory of Practice. Translated by Richard Nice. Cambridge, Eng.: Cambridge University Press.

1991 Language and Symbolic Power, John B.Thompson, ed. Cambridge, MA: Harvard University Press.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

Briggs, C. 1986 Learning How to Ask: A Sociolinguistic Appraisal of the Role of the Interview in Social Science Research. Cambridge, Eng.: Cambridge University Press.

Bruce, J. 1987 Users’ perspectives on contraceptive technology and delivery systems. Technology in Society 9:359–383.

1990 Fundamental elements of the quality of care: A simple framework. Studies in Family Planning 21(2):61–91.

Bulatao, R.A. et al. 1983 A framework for the study of fertility determinants. In Determinants of Fertility in Developing Countries, R.A.Bulatao and R.D.Lee, eds. New York: Academic Press.

Cain, M. 1985 Intensive community studies. In The Collection and Analysis of Community Data, John B.Casterline, ed. Voorburg, Neth.: International Statistical Institute.

Caldwell, J.C., B.Caldwell, and P.Caldwell 1987 Anthropology and demography: The mutual reinforcement of speculation and research. Current Anthropology 28:25–34.

Caldwell, J.C., P.H.Reddy, and P.Caldwell 1988 The Causes of Demographic Change: Experimental Research in South India. Madison: University of Wisconsin Press.

Candlin, C.N., and J.Lucas 1986 Interpretations and explanations in discourse: Modes of “advising” in family planning. In Discourse Analysis and Public Life, T.Ensink, A.van Essen, and T.van der Geest, eds. Dordrecht, Neth.: Foris Publications.

Carter, A.T. 1984 Household histories. In Households: Comparative and Historical Studies of the Domestic Group, Robert McC.Netting, Richard R.Wilk, and Eric J.Arnould, eds. Berkeley: University of California Press.

1988 Does culture matter? The case of the demographic transition. Historical Methods 21(4): 164–169.

1995 Agency and fertility: For an ethnography of practice. In Rethinking Reproduction, Susan Greenhalgh, ed. Cambridge, Eng.: Cambridge University Press.

1998 Cultural models and reproductive behavior. In New Approaches to Anthropological Demography, Alaka Basu, ed. Oxford: Oxford University Press.

1999 What is meant, and measured, by “education”? Pp. 49–79 in Critical Perspectives on Schooling and Fertility in the Developing World. Committee on Population. C.H. Bledsoe, J.B.Casterline, J.A.Johnson-Kuhn, and J.G.Haaga, eds. Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

2001a Legitimate Tangential Participation: Toward an Ethnography of Family Planning Counseling. Paper presented at the IUSSP Seminar on the Production and Circulation of Population Knowledge, March 20–24. Providence, RI.

2001b Time and Temporalization in Pregnancy Test Counseling. Paper presented at the XXIV IUSSP General Conference, August 18–24. Salvador, Brazil.

Cassen, R.H. 1978 India: Population, Economy, Society. London: Macmillan. Centers for Disease Control and Prevention

1998 Fundamentals of HIV Prevention Counseling: Participant’s Manual. November 1998. Available: http://hivinsite.ucsf.edu/InSite.jsp?page=pr-02-02&doc=2098.445e [June 18, 2001].

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

Chen, L., E.Huq, and S.D’Souza 1981 Sex bias in the family allocation of food and health care in rural Bangladesh. Population and Development Review 13(1):77–100.

Cicourel, A.V. 1985 Text and discourse. Annual Review of Anthropology 14:159–185.

1986 The reproduction of objective knowledge: Common sense reasoning in medical decision making. In The Knowledge Society, G.Böhme and N.Stehr, eds. Dordrecht, Neth.: D.Reidel Publishing Co.

Cleland, J., and C. Wilson 1987 Demand theories of the fertility transition: An iconoclastic view. Population Studies 41:5–30.

Coale, A.J., and S.C.Watkins, eds. 1986 The Decline of Fertility in Europe. Princeton: Princeton University Press.

Coleman, J.S., E.Katz, and H.Menzel 1966 Medical Innovation: A Diffusion Study. Indianapolis: Bobbs-Merrill.

Coombs, L.C., and T.-h.Sun 1978 Family composition preferences in a developing culture: The case of Taiwan 1973. Population Studies 32:43–64.

Das Gupta, M. 1987 Selective discrimination against female children in India. Population and Development Review 13(1):77–100.

Dumont, L. 1980 Homo Hierarchicus. 2d ed. Translated by M.Saisbury, L.Dumont, and B.Gulati. Chicago: University of Chicago Press.

Duranti, A. 1997 Linguistic Anthropology. Cambridge, Eng.: Cambridge University Press.

Dwyer, D., and J.Bruce, eds. 1988 A Home Divided: Women and Income in the Third World. Stanford: Stanford University Press.


Easterlin, R.A. 1978 The economics and sociology of fertility: A synthesis. In Historical Studies of Changing Fertility, Charles Tilly, ed. Princeton: Princeton University Press.

1983 Modernization and fertility: A critical essay. In Determinants of Fertility in Developing Countries, Vol. 2, Rodolfo A.Bulatao and Ronald D.Lee, eds. New York: Academic Press.

Entwisle, B., R.R.Rindfuss, D.K.Guilkey, A.Chamratrithirong, S.R.Curran, and Y.Sawangdee 1996 Community and contraceptive choice in rural Thailand: A case study of Nang Rong. Demography 33(1):1–11.

Entwisle, B., R.R.Rindfuss, S.J.Walsh, and S.R Curran 1997 Geographic information systems, spatial network analysis, and contraceptive choice. Demography 34(2): 171–187.

Erickson, F., and J.Shultz 1982 The Counselor as Gatekeeper. New York: Academic Press.


Ferrara, K.W. 1994 Therapeutic Ways with Words. Oxford: Oxford University Press.

Fisher, S. and A.D.Todd 1986 Friendly persuasions: The negotiation of decisions to use oral contraception. In Discourse Analysis and Public Life, T.Ensink, A.van Essen and T.Van der Geest, eds. Dordrecht, Hol.: Foris Publications.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

Fortes, M. 1953 Social Anthropology at Cambridge since 1900. Cambridge, Eng.: Cambridge University Press.

Frank, J.D., and J.B.Frank 1991 Persuasion and Healing: A Comparative Study of Psychotherapy. 3d ed. Baltimore: The Johns Hopkins University Press.

Frankel, R.M. 1989 “I wz wondering—uhm could Raid uhm effect the brain permantently d’y know?”: Some observations on the intersection of speaking and writing in calls to a poison control center. Western Journal of Speech Communication 53:195–226.

Fuchs, R. 1984 Abandoned Children: Foundlings and Child Welfare in Nineteenth Century France. Albany: State University of New York Press.

1992 Poor and Pregnant in Paris: Strategies for Survival in the Nineteenth Century. New Brunswick: Rutgers University Press.

Gallen, M., C.Lettenmaier, and C.Green 1987 Counseling Makes a Difference. Population Reports, Series J, No. 35. Baltimore, MD: Johns Hopkins University, Population Information Program.

Geertz, C. 1983 Local Knowledge: Further Essays in Interpretive Anthropology. New York: Basic Books.

Giddens, A. 1979 Central Problems in Social Theory. Berkeley: University of California Press.

1984 The Constitution of Society. Berkeley: University of California Press.

Goffman, E. 1961 Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Garden City, NY: Anchor Books.

Good, B. 1994 Medicine, Rationality and Experience. Cambridge, Eng.: Cambridge University Press.

Goody, J., ed. 1958 The Developmental Cycle in Domestic Groups. Cambridge Papers in Social Anthropology, No. 1. Cambridge, Eng.: Cambridge University Press.

Greenhalgh, S. 1988 Fertility as mobility: Sinic transitions. Population and Development Review 14(4):629– 674.

1990 Toward a political economy of fertility: Anthropological contributions. Population and Development Review 16(10):85–106.

1995 Anthropology theories reproduction: Integrating practice, political economic, and feminist perspectives. In Situating Fertility: Anthropology and Demographic Inquiry, S.Greenhalgh, ed. Cambridge, Eng.: Cambridge University Press.

Grimely, D.M., G.E.Riley, J.M.Bellis, and J.O.Prochaska 1993 Assessing the stages of change and decision-making for contraceptive use for the prevention of pregnancy, sexually transmitted diseases and acquired immunode-ficiency syndrome. Health Education Quarterly 20(4):455–470.


Hammel, E. 1990 A theory of culture for demography. Population and Development Review 16(3):455– 485.

Hanks, W.F. 1984 Santification, structure, and experience in a Yucatec ritual event. Journal of American Folklore 97:131–166.

1987 Discourse genres in a theory of practice. American Ethnologist 14(4):668–692.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

1989 Text and textuality. Annual Review of Anthropology 18:95–127.

1996a Exorcism and the description of participant roles. In The Natural History of Discourse, M.Silverstein and G.Urban, eds. Chicago: University of Chicago Press.

1996b Language and Communicative Practices. Boulder, CO: Westview Press.

2000a Copresence and alterity in Maya ritual practice. In Intertexts: Writings on Language, Utterance, and Context. Lanham, MD: Rowman and Littlefield.

2000b Indexicality. Journal of Linguistic Anthropology 9(1–2):124–126.

Hanley, S.B., and K.Yamamura 1977 Economic and Demographic Change in Preindustrial Japan, 1600–1868. Princeton: Princeton University Press.

Hannerz, U. 1992 Cultural Complexity: Studies in the Social Organization of Meaning. New York: Columbia University Press.

Hodgson, D., and S.Watkins 1997 Feminists and neo-Malthusians: Past and present alliances. Population and Development Review 23(3):469–523.

Huntington, D., C.Lettenmaier, and I.Obeng-Quaidoo 1990 User’s perspective of counseling training in Ghana: The “mystery client” trial. Studies in Family Planning 21(3):171–177.

Huntington, D., and S.R.Schuler 1993 The simulated client method: Evaluating client-provider interactions in family planning clinics. Studies in Family Planning 24(3):187–193.

Hymes, D. 1974 Ways of speaking. In Explorations in the Ethnography of Speaking, R.Baumann and J.Scherzer, eds. Cambridge, Eng.: Cambridge University Press.

Jefferson, G. 1989 Notes on a possible metric which provides for a “standard maximum silence” of approximately one second in conversation. In Conversation: An Interdisciplinary Perspective, C.Roger and P.Bull, eds. Clevedon, Eng.: Multilingual Matters.


Kaler, A., and S.Watkins 1999 Disobedient Distributors: Pills, Parity and Clashing Agendas in Rural Kenya. Unpublished paper presented at the Annual Meeting of the Population Association of America, March 25–27, New York.

Kenny, A. 1973 Wittgenstein. Harmondsworth, Eng.: Penguin Books.

Kertzer, D.I. 1991 Gender ideology and infant abandonment in nineteenth-century Italy. Journal of Interdisciplinary History 22:1–25. 1993 Sacrificed for Honor: Italian Infant Abandonment and the Politics of Reproductive Control. Boston: Beacon Press.

Kim, Y.-M., A.Kols, and S.Mucheke 1998 Informed choice and decision-making in family planning counseling in Kenya. International Family Planning Perspectives 24(1):4–11.

Kim, Y.-M., A.Kols, M.Thuo, S.Mucheke, and D.Odallo 1998 Client-Provider Communication in Family Planning: Assessing Audiotaped Consultations from Kenya. Working Paper 5. Baltimore: Johns Hopkins University Center for Communication Programs.

Kohler, H.-P. 1997 Learning in social networks and contraceptive choice. Demography 34(3):369–383.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

Kreager, P. 1998 The limits of diffusionism. In New Approaches to Anthropological Demography, A. Basu, ed. Oxford: Oxford University Press.

Kroeber, A.L. 1931 Diffusionism. In Encyclopaedia of the Social Sciences, E.R.A.Seligman, ed. New York: Macmillan.

Labov, W. 1972 The transformation of experience in narrative syntax. Language in the Inner City. Philadelphia: University of Pennsylvania Press.

Lave, J. 1988 Cognition in Practice. Cambridge, Eng.: Cambridge University Press.

1989 The acquisition of culture and the practice of understanding. In The Chicago Symposia on Human Development, J.Stigler, R.Shweder, and G.Herdt, eds. Cambridge, Eng.: Cambridge University Press.

1991 Situated learning in communities of practice. In Perspectives on Socially Shared Cognition, L.B.Resnick, J.M.Levine, and S.D.Teasley, eds. Washington, DC: American Psychological Association.

Lave, J., and E.Wenger 1991 Situated Learning: Legitimate Peripheral Participation. Cambridge, Eng.: Cambridge University Press.

León, F.R., G.Quiroz, and A.Brazzoduro 1994 The reliability of simulated clients’ quality-of-care ratings. Studies of Family Planning 25(4):184–190.

Lerner, G., and T.Takagi 1999 On the place of linguistic resources in the organization of talk-in-interaction: A co-investigation of English and Japanese grammatical practice. Journal of Pragmatics 31(1):49–75.

Lesthaeghe, R. 1980 On the social control of human reproduction. Population and Development Review 6(4):527–548.

Levine, N. 1987 Differential child care in three Tibetan communities. Population and Development Review 13(2):281–304.

Levinson, S.C. 1983 Pragmatics. Cambridge, Eng.: Cambridge University Press.

1992 Activity types and language. In Talk at Work, P.Drew and J.Heritage, eds. Cambridge, Eng.: Cambridge University Press.

Levi-Strauss, C. 1953 Social structure. In Anthropology Today, A.L.Kroeber, ed. Chicago: University of Chicago Press.


Malinowski, B. 1927 The life of culture. In Culture: The Diffusion Controversy, G.E.Smith, B.Malinowski, H.J.Spinden, and A.Goldenweiser, eds. New York: W.W.Norton and Company, Inc.

Marcus, G.A. 1994 Ethnography in/of the world system: The emergence of multi-sited ethnography. Annual Review of Anthropology 24:95–117.

Maternowska, M.C. 2000 A clinic in conflict: A political economy case study of family planning in Haiti. In Contraception Across Cultures, A.Russell, E.J.Sobo and M.S.Thompson, eds. New York: Berg.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

Mayer, A.C. 1966 Caste and Kinship in Central India: A Village and its Region. Berkeley: University of California Press.

McNicoll, G. 1985 The nature of institutional and community effects on demographic behavior. In The Collection and Analysis of Community Data, J.B.Casterline, ed. Voorburg, Neth.: International Statistical Institute.

1988 On the local context of demographic change. In Micro-Approaches to Demographic Research, J.Caldwell, A.Hill, and V.Hull, eds. London: Kegan Paul.

Miller, B.D. 1981 The Endangered Sex. Ithaca: Cornell University Press.

Montgomery, M.R., and J.B.Casterline 1993 The diffusion of fertility control in Taiwan: Evidence from pooled cross-section time-series models. Population Studies 47:457–479.

1996 Social learning, social influence and new models of fertility. Population and Development Review 22(supplement):151–175.

Montgomery, M.R., and W.Cnung 1999 Social networks and the diffusion of fertility control in the Republic of Korea. In Dynamics of Values in Fertility Change, R.Leete, ed. Oxford, Eng.: Clarendon Press.

Namerow, P.B., N.Weatherby, and J.Williams-Kaye 1989 The effectiveness of contingency-planning counseling. Family Planning Perspectives 21(3):115–119.

Nathanson, C.A. 1991 Dangerous Passage: The Social Control of Sexuality in Women’s Adolescence. Philadelphia: Temple University Press.

Nathanson, C.A., and M.H.Becker 1985 The influence of client-provider relationships on teenage women’s subsequent use of contraception. American Journal of Public Health 75(1):33–38.

Nations, M., and C.G.Monte 1997 “I’m not dog, no!”: Cries of resistance against cholera control campaigns in Brazil. In The Anthropology of Infectious Disease, M.C.Inhorn and P.J.Brown, eds. Amsterdam: Gordon and Breach Publishers.

Netting, R.M., R.R.Wilk, and E.J.Arnould, eds. 1984 Households: Comparative and Historical Studies of the Domestic Group. Berkeley: University of California Press.

Newman, L.F., ed. 1985 Women’s Medicine: A Cross-Cultural Study of Indigenous Fertility Regulation. New Brunswick, NJ: Rutgers University Press.


Ochs, E., R.C.Smith, and C.E.Taylor 1997 Detective stories at dinnertime: Problem solving through co-narration. In Disorderly Discourse: Narrative, Conflict, and Inequality, C.L.Briggs, ed. Oxford: Oxford University Press.

Ortner, S. 1984 Theory in anthropology since the sixties. Comparative Studies in Society and History 26(1):126–166.


Park, C.B. 1983 Preference for sons, family size, and sex ratio: An empirical study in Korea. Demography 20:333–352.

Park, H.J., D.L.Kincaid, K.K.Chung, D.S.Han, and S.B.Lee 1976 The Korean Mothers’ Club Program. Studies in Family Planning 7(10):275–283.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

Peirce, C.S. 1955 Philosophical Writings of Peirce, Edited by J.Buchler. New York: Dover Publications.

Pelissier, C. 1991 The anthropology of teaching and learning. Annual Review of Anthropology 20:75– 95.

Peräkylä, A. 1995 AIDS Counselling: Institutional Interaction and Clinical Practice. Cambridge, Eng.: Cambridge University Press.

Polgar, S. 1972 Population history and population policies from an anthropological perspective. Current Anthropology 13(2):203–211.

Potter, J.M. 1976 Thai Peasant Social Structure. Chicago: University of Chicago Press.

Radcliffe-Brown, A.R. 1922 The Andaman Islanders. Cambridge, Eng.: Cambridge University Press.

1950 Introduction. In African Systems of Kinship and Marriage, A.R.Radcliffe-Brown and D.Forde, eds. London: Oxford University Press.

Ransel, D.L. 1988 Mothers of Misery: Child Abandonment in Russia. Princeton: Princeton University Press.

Retherford, R.D., and J.A.Palmore 1983 Diffusion processes affecting fertility regulation. In Determinants of Fertility in Developing Countries, Vol. 2, R.A.Bulatao and R.D.Lee, eds. New York: Academic Press.

Rogoff, B., and J.Lave, eds. 1984 Everyday Cognition: Its Development in Social Context. Cambridge, MA: Harvard University Press.

Rosero-Bixby, L., and J.B.Casterline 1993 Modeling diffusion effects in fertility transition. Population Studies 47:147–167.

Roter, D., and J.A.Hall 1987 Physicians’ interviewing styles and medical information obtained from patients. Journal of General Internal Medicine 2(5):325–329.

Rouse, I. 1953 The strategy of culture history. In Anthropology Today, A.L.Kroeber, ed. Chicago: University of Chicago Press.

Rowe, M. 1999 Crossing the Border: Encounters between Homeless People and Outreach Workers. Berkeley: University of California Press.


Sacks, H. 1984 Notes of methodology. In Structures of Social Action, J.M.Atkinson and J.Heritage, eds. Cambridge, Eng.: Cambridge University Press.

Sacks, H., E.Schegloff, and G.Jefferson 1974 A simplest systematics for the organization of turn-taking for conversation. Language 50:676–735.

Santow, G. 1993 Coitus interruptus in the twentieth century. Population and Development Review 19(4):767–792.

1995 Coitus interruptus and the control of natural fertility. Population Studies 49(1):19–43.

Saussure, F.de 1986 Course in General Linguistics. Translated by Roy Harris. La Salle, IL: Open Court.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

Schegloff, E. 1982 Discourse as an interactional achievement: Some uses of “uh huh” and other things that come between sentences. In Analyzing Discourse: Text and Talk, D. Tannen, ed. Washington, DC: Georgetown University Press, Round Table in Languages and Linguistics.

Schegloff, E., G.Jefferson, and H.Sacks 1977 The preference for self-correction in the organization of repair in conversation. Language 53:361–382.

Scheper-Hughes, N. 1992 Death without Weeping: The Violence of Everyday Life in Brazil. Berkeley: University of California Press.

Schneider, J., and P.Schneider 1992 Going forward in reverse gear: Culture, economy, and political economy in the demographic transitions of a rural Sicilian town. In The European Experience of Declining Fertility, J.R.Gillis, L.A.Tilly, and D.Levine, eds. Cambridge, MA: Blackwell.

1996 Festival of the Poor. Tucson: University of Arizona Press.

Scribner, S. 1997 Mind and Social Practice. Cambridge, Eng.: Cambridge University Press.

Scrimshaw, S.C.M. 1978 Infant mortality and behavior in the regulation of family size. Population and Development Review 4:385–403.

1983 Infanticide as deliberate fertility regulation. Pp. 245–266 in Determinants of Fertility in Developing Countries, Vol. 2, R.Bulatao and R.Lee, eds. New York: Academic Press.

Silverman, D. 1987 Communication and Medical Practice. London: Sage Publications.

Simmons, R., and C.Elias 1994 The study of client-provider interactions: A review of methodological issues. Studies in Family Planning 25(1):1–17.

Skinner, G.W. 1997 Family systems and demographic regimes. In Anthropological Demography, D.I. Kertzer and T.Fricke, eds. Chicago: Unversity of Chicago Press.

Smith, T.C. 1977 Nakahara: Family Farming and Population in a Japanese Village, 1717–1830. Stanford: Stanford University Press.

Strader, M.K., and M.L.Beaman 1992 Theoretical components of STD counselors’ messages to promote clients’ use of condoms. Public Health Nursing 9(2):109–117.

Tarde, G. 1903 The Laws of Imitation. Translated by E.C.Parsons. New York: Henry Holt and Company.

Todd, A.D. 1983 A diagnosis of doctor-patient discourse in the prescription of contraception. In The Social Organization of Doctor-Patient Communication, S.Fisher and A.D.Todd, eds. Washington, DC: The Center for Applied Linguistics.

1984 The prescription of contraception: Negotiations between doctors and patients. Discourse Processes 7:171–200.


Valente, T.W. 1995 Network Models of the Diffusion of Innovations. Creskill, NJ: Hampton Press.

Suggested Citation:"5 Social Processes and Fertility Change." National Research Council. 2001. Diffusion Processes and Fertility Transition: Selected Perspectives. Washington, DC: The National Academies Press. doi: 10.17226/10228.
×

Valente, T.W., S.Watkins, M.N.Jato, A.van der Straten, and L.-P.M.Tsitsol 1997 Social network associations with contraceptive use among Cameroonian women in voluntary associations. Social Science and Medicine 45(5):677–687.

van de Kaa, D.J. 1996 Anchored narratives: The story and findings of half a century of research into the determinants of fertility. Population Studies 50:389–32.

van de Walle, E., and E.P.Renne, eds. 2001 Regulating Menstruation. Chicago: University of Chicago Press.

Voloshinov, V.N. 1986 Marxism and the Philosophy of Language. Translated by L.Metejka and I.R.Titunik. Cambridge, MA: Harvard University Press.

Watkins, S., and D.Hodgson 1998 From mercantilists to neo-Malthusians: The international population movement and the transformation of population ideology in Kenya. Unpublished paper prepared for discussion at the National Academy of Sciences Workshop on Social Dynamics of Fertility Change in Developing Countries, January 29–30, Washington, DC.

Watkins, S.C. 1991 From Provinces into Nations: The Demographic Integration of Western Europe, 1870– 1960. Princeton: Princeton University Press.

Wertsch, J.V., and M.Hickman 1987 Problem solving in social interaction: A microgenetic analysis. In Social and Functional Approaches to Language and Thought, M.Hickman, ed. Orlando, FL: Academic Press.

Wittgenstein, L. 1958 Philosophical Investigations. Oxford: Blackwell.

Wolf, M. 1972 Women and the Family in Rural Taiwan. Stanford: Stanford University Press.

Wyon, J.B., and J.E.Gordon 1977 The Khanna Study. Cambridge, MA: Harvard University Press.


Zhao, Z. 1997 Deliberate birth control in China before 1970. Population and Development Review 23(4):729–767.

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This volume is part of an effort to review what is known about the determinants of fertility transition in developing countries and to identify lessons that might lead to policies aimed at lowering fertility. It addresses the roles of diffusion processes, ideational change, social networks, and mass communications in changing behavior and values, especially as related to childbearing. A new body of empirical research is currently emerging from studies of social networks in Asia (Thailand, Taiwan, Korea), Latin America (Costa Rica), and Sub-Saharan Africa (Kenya, Malawi, Ghana). Given the potential significance of social interactions to the design of effective family planning programs in high-fertility settings, efforts to synthesize this emerging body of literature are clearly important.

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