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4 The Household, Kinship, and Community Context This chapter considers whether long-standing forms of African social organization will continue to inhibit contraceptive adoption and support high fertility. There can be little doubt as to the pronatalist past: Evidence from a wide range of African countries suggests that social institutions and shared values have supported high fertility well into the postcolonial era. What is under debate is the prospect for change. Are the past structures so deeply embedded and immutable that high fertility will persist? Is Africa indeed so unique with respect to social organization, and so different from the remainder of the developing world where fertility decline is in progress? Or might pronatalist values and constraints give way in the face of new socioeconomic pressures, as they have elsewhere? Much of the demographic literature, as exemplified by the writings of Caldwell (1991; Caldwell and Caldwell, 1987, 1988, 1990; Caldwell et al., 1989, 1991), Goody (1990), Frank (1987, 1988; Frank and McNicoll, 1987), Lesthaeghe (1989b), and Page (1989), has emphasized the probable conti- nuity of pronatalist forms of social organization. African productive and reproductive systems are described in terms of functional coherence and internal logic; high fertility is seen as an essential building block in this larger edifice. Implicit in such a perspective is the view that, absent some sweeping system-wide transformation, one should not expect modern sub- Saharan Africa to join in the fertility declines in progress elsewhere in the developing world. The very persistence of high fertility in the region is cited as testimony 85

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86 FA CTORS AFFECTING CONTRA CEPTIVE USE to the perseverance of pronatalist values. Yet as Chapter 3 has indicated, this aspect of the empirical record can be given a rather different interp~reta- tion. Persistent high fertility in Africa may well reflect the persistent high mortality characteristic of the region, its low levels of industrialization, the comparatively weak economic returns to schooling, the belated evolution of population policy, and the still-sporadic coverage of family planning pro- grams. In this alternative view, the absence of fertility decline across the continent is evidence not so much of deep-seated cultural resistance, as of the continued unevenness and superficiality of economic and political de- velopment. The recent surges in contraceptive adoption in Botswana, Kenya, and Zimbabwe testify to the profound influence of new socioeconomic forces associated with modernization; where similar forces prevail elsewhere in Africa, it is argued (see Chapter 3), fertility decline will follow. What is really at issue in these competing perspectives, therefore, is the degree of adaptability to be expected of African social organizations and cultures. There is a growing recognition in the literature that the African demographic situation is now in flux. As many of the authors cited above acknowledge, the changing economic circumstances of the 1980s and the gradual westernization of certain aspects of family life may have unsettled the past high-fertility regime (e.g., Caldwell and Caldwell, 1987; Lesthaeghe, 1989a; Caldwell et al., 1992~. Some observers detect a growing detachment of these older values from day-to-day behavior and note the potential for rapid change. For example, with reference to Kenya, Robinson (1992:454) asserts that cultural beliefs often "persist as ideals or values which become more and more divorced from practice until they end up being dropped or becoming meaningless rules like 'love the neighbor'." He cautions. , , ~ Establishing that traditional Kenyan culture and custom was supportive of high fertility in no way establishes how strongly held are these practices today or how quickly they may change as the socio-economic basis of the real day-to-day society changes. Culture and values are adaptive .... The task in what follows is to weigh the evidence regarding continuity and change. We view three broad areas of family and kinship organization as essential to an understanding of fertility decision making in Africa: lineages and systems of descent; kinship networks and child fostering; and the nature of conjugal bonds. In each of these areas, African social organization has been uniquely pronatalist or, at the least, strikingly different in degree from that prevailing elsewhere. No doubt in the past these forms of social organization provided a powerful rationale for high fertility, but as our examination shows, that rationale is no longer wholly intact. .

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT 87 Much of the evidence brought to bear on these matters is ethnographic in nature, and the record is regrettably thin for the 1980s a decade of social and economic turmoil in many African countries, which saw the beginnings of fertility decline in Botswana, Kenya, and Zimbabwe. A1- though the empirical base cannot support strong conclusions, we find nu- merous indications of a desire for moderate levels of fertility among certain socioeconomic groups and hints of a broader receptivity to change. We conclude that the long-standing supports for high fertility, although still strong across much of the continent, may no longer prevent fertility decline. We then ask whether existing forms of social organization at the level of the local community might facilitate fertility decline. That is, in what way might African local voluntary associations, on the one hand, and local government organizations, on the other, serve as conduits for information about modern contraceptive methods or even as providers of such methods? To put it differently, what aspects of local social organization might assist in the diffusion of family planning information and services? Such ques- tions, first advanced for Africa by Lesthaeghe (1989a) and recently taken up by Watkins (1991) and Hammerslough (1991a), are of special relevance for policy in an era of macroeconomic austerity, when African central gov- ernments may have little alternative but to rely on a network of nongovern- mental organizations and the private sector to extend family planning ser- vice delivery. THE HIGH-FERTILITY RATIONALE: AN OVERVIEW The case for the uniqueness of African high-fertility regimes is based on several interrelated points. Each point is said to be more characteristic of historical than modern African social systems, but each, nonetheless, is viewed as being persistent in influence and still potent in affecting repro- ductive decisions. The relevant factors include the importance accorded to descent and perpetuation of the lineage; the economic value inherent in children, not only as sources of labor, but also as a means of securing access to land and other resources; the implications of a lineage orientation for the bond between wives and husbands, and the degree to which the boundaries of the conjugal household are penetrated by other kin; the availability of mechanisms for sharing child costs and benefits among kin, principally through child fostering; and the special interests of women in the maintenance of high fertility. For example, a 1987 article by Caldwell and Caldwell argued that Afri- can societies have historically given great emphasis to perpetuation of the lineage. High fertility is the logical consequence if a family line is to be

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88 FACTORS AFFECTING CONTRACEPTIVE USE maintained in the face of high mortality risks. In this perspective, repro- duction becomes a matter of concern not only for the individual couple involved, but also for a wider network of kin, and the duty to ensure lineage survival assumes something of the character of a religious obligation. Labor, rather than physical or human capital, was the principal eco- nom~c resource in historical African settings) and the economic benefits of high fertility remain significant in what are still predominantly agricultural economies with few sources of savings, insurance, and economic security other than those derived from kin. Moreover, it was through control of labor that individuals laid claim to the other important agricultural resource, land. Land was itself held by corporate groups such as lineages, rather than being privately owned, and was allocated by the lineage to households who possess the requisite labor to establish and maintain use rights. Where descent is patr~lineal, as it is in much of sub-Saharan Africa, the husband's lineage secures rights to the reproduction of the wife through the device of bnde-price. The bonds linking husband and wife in marriage are weak in relation to the claims on spouses asserted by their respective lin- eages; the marriage bond is further undefined by the presence of co-wives and by high rates of widowhood and divorce. Within marriage the wife and husband shoulder different economic responsibilities for childrearing and may therefore assess the overall level of child costs rather differently. And the costs of high fertility need not be borne by the conjugal household alone but can be shared, through child fostering, among kin and even nonkin. In such settings, women may find benefits in high fertility that are distinct from the benefits enjoyed by men. In particular, high fertility may help women secure for themselves continued access to economic resources. Childbeanng provides women with one avenue to the resources held by their husbands or other men; it may help to fend off the competing claims of actual or potential co-wives; and following marriage dissolution, children may constitute a woman's only means of access to the household resources jointly produced by her husband and herself within the marriage (Bledsoe, l990b). A widow's claims on household resources via inheritance are se- verely circumscribed throughout sub-Saharan Africa, and often her only path to such resources runs indirectly through her children (see, among Menu (1984:5) writes that "the key measure of a man's wealth was the number of depen- dents in his household. The association of wealth with persons rather than with material goods is explained by the conditions of production. Unlike many other world areas, labor not land was the scarce factor of production in Africa. A man's ability to expand his control over land and his production of food and livestock depended crucially on the number of dependent men in his household and on the number of women farmers whose agricultural and domestic labor he could mobilize."

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT 89 others, Ladipo, 1987~. Because both widowhood and divorce are common (the former being due to the wide age gap between spouses characteristic of polygynous societies), women must anticipate an extended period of eco- nomic reliance on their children. If one takes a long historical perspective (Goody, 1976, 1990), these factors might be traced back in time to a few fundamental and enduring material elements characteristic of the sub-Saharan region: historically high mortality; a general lack of good soil that repays intensive cultivation; a general abundance of (adequate) land in relation to labor, so that in a sense labor becomes the more valued resource; and a great instability in income, giving rise to a need for kin and other social contacts to serve as networks of mutual insurance.2 This depiction is an essentially functionalist view of Afncan social organization. The critical examination to follow uncovers in this view numerous elements of caricature and instances of overgeneralization (Messina, 1992~. Nevertheless, the perspective outlined above has much to recom- mend about it. It is especially important to appreciate the nature of its challenge to the usual conceptual models of fertility decision making employed in demography, wherein the conjugal couple is viewed as the primary locus of reproductive decisions. The demographer's notion of the conjugal household, with its pooled resources and shared responsibilities, is very much at odds with the portrait of the African household sketched above. This theoretical emphasis on the conjugal household, which has shaped demographic data gathering and interpretation, is wholly inappropriate to sub-Saharan Africa. A review of the ethnographic record confirms that African households are internally divided (along cleavages of age as well as gender) and participate in a network of economic relations with kin that put into doubt the economic demographer's notion of a simple household budget constraint. To anticipate much of the argument to follow, we can state more pre- cisely here the limitations of the conventional economic model as regards Afncan family structure and decision making. To describe adequately the Afncan situation, the conventional macroeconomic household budget con- stra~nt would have to be amended in several fundamental ways. 1. The possibilities of transferring resources from one life-cycle pe- nod to another are severely 'constrained by the absence or limited penetra 20n the issue of insurance networks, Guyer (1981) cites Lewis (1978) to the effect that in Mali, families incorporated in large patrilineal groups can exhibit greater variability in food production per capita, by comparison with more isolated families who must more closely match their production to subsistence needs.

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9o FACTORS AFFECTING CONTRACEPTIVE USE lion of formal financial institutions. Thus, liquidity constraints are an es- sential feature of the intertemporal budget constraint. 2. One must recognize the possibility of transfers to and from other kin, both in the budget constraint and in the function describing intertemporal utility. Indeed, the notion of transfers among kin must include transfers between husband and wife; as noted later, sub-Saharan husbands and wives have distinct economic responsibilities and interests with regard to childrearing and resource allocation issues more generally. To suppose that the interests of husband and wife can be merged in a single utility function maximized subject to a common budget constraint, is to apprehend the situation badly. The term "transfer" is itself inadequate, because it does not fully con- vey the sense of mutual and reciprocal obligation involved in resource flows among kin. One receives assistance but in so doing incurs an obligation to reciprocate in the future; thus a transfer can be viewed as akin to borrow- ing, with the terms of repayment left vague and perhaps dependent on fu- ture circumstances. The lender may in turn derive positive utility from the act of lending, since being able to lend enhances one's standing within the kin group. Not lending, when one is in fact able to lend, threatens the system of mutual obligations and may incur severe social sanctions. The network of kin among whom transfers take place is a dynamic configuration. It changes with time, as the elders to whom one owes sup- port die, and the children, in whom one has inculcated an obligation, come of age. 3. Another necessary amendment to the conceptualization of the bud- get constraint is that transfers and bargaining within marriage may take place in a polygynous setting, where norms of fairness and equality across wives place constraints on the manner in which a husband can allocate his resources among his wives and children (Fapohunda and Todaro, 1988; Bledsoe, in press). 4. It is necessary to incorporate the uncertainty in individual access to a given spouse's resources that arises from marital dissolution and remar- riage. In particular, a wife's claims on her husband's resources may be only temporary and superficial unless she can lay down a basis for long- term claims by having children with him. 5. Owing to the material conditions surrounding agricultural produc- tion and the present weaknesses of industrial development, all incomes are subject to considerable uncertainty. Given the limited possibilities for indi- vidual savings, this uncertainty accentuates the need for a wide network of social contacts and contingent claims, many of which are established through children. On the whole we would agree with Page (1989:402), who writes that "one can question the extent to which one can even speak of a husband

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT 91 wife-child unit since neither economic nor kinship links are traditionally thus defined." African family structures, in which conjugal units are at once internally subdivided and permeable from the outside, may demand both a new conceptual model for demographers and new routes for effective policy intervention. LINEAGE AND DESCENT As outlined above, matters of descent and lineage are central both to African social organization and to the rationale for high fertility, and much of the ethnographic literature on sub-Saharan cultures has been in agree- ment. For instance, Bleek (1987:139) writes for the Akan of Ghana that "the lineage is the great, permanent and fundamental institution which per- meates every aspect of life." Yet there is an important dissenting perspec- tive, summarized by Kuper (1982a,b), in which the concept of lineage is seen not so much as a fundamental organizing principle, but rather as one among a great number of elements that make up social organization and shape individual identity. In this alternative view, the religious, social, and economic importance attached to the lineage is highly variable both across and within societies, and in terms of demographic behavior, the various descent ideologies of the region submit to no easy generalizations. In what follows we shall first summarize the predominant view in the demographic literature regarding the role of African lineages and ideologies of descent, and then consider the demographic implications of the alterna- tive perspective. The Predominant View of African Lineages and Descent An African lineage exhibits a depth of three to four generations among the living (Bleek, 1987, for the Akan of Ghana; Caldwell and Caldwell, 1987) and stretches infinitely back in time through ancestors. A larger grouping, the clan, is more difficult to define in any precise way, but it is generally regarded as being a set of lineages who view themselves as being related via a distant and perhaps mythical common ancestor. The lineage is often envisioned as a finite collection of souls or spirits moving through time, such that each new birth to the lineage provides a vehicle for the return of an ancestor. In consequence, enormous spiritual weight may be invested in maintaining the continuity of the family line (Caldwell and Caldwell, 19871. In indigenous African religions the dead of recent generations were regarded as being "powerful shades," with an inter- est and a capacity to intervene in the affairs of the living. To restrain fertility is in effect to forbid the rebirth of such an ancestor and thereby condemn that ancestor to oblivion. To risk childlessness through low fertil

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92 FACTORS AFFECTING CONTRACEPTIVE USE ity is to threaten indirectly the survival of the lineage as a whole, and to be childless by choice is all but unthinkable. Caldwell and Caldwell (1987) find that attitudes such as these remain deep rooted even among modern African elites, many of whom would be outwardly dismissive of these reli- gions. Certain fundamental economic and social functions are vested in the lineage and the wider clan, among which allocation of land is of prime importance. In the past, land was rarely owned by individuals; rather, it was controlled by the lineage and allocated to its male members, who re- tained use rights in the land and could pass these rights under certain condi- tions to their male heirs (see Brain, 1976, for Tanzania). To these functions were added a host of social sanctions that derived from the authority of the descent group. It is the lineage that buries its members, and the refusal of the lineage to do so is said to be the greatest sanction that can be brought to bear upon any individual (Bleek, 1987, for the Akan of Ghana). Even if such a sanction is rarely applied, it serves to reinforce the power of the earthly old, who are themselves near to becoming powerful shades and who may exert their influence on younger members of the lineage by threatening to bring down an ancestral curse. Thus the emphasis given to descent and to ancestors in sub-Saharan societies bears a logical relationship to gerontocracy, filial piety, and age grades of authority among the living (Caldwell and Caldwell, 1987~.3 Marriage is the means by which the lineage ensures its perpetuation, and in the vast majority of-cases, marriage arrangements are accompanied by payments of bride-price (Lesthaeghe et al., 1989a).4 In patrilineal soci- eties, the payment of bride-price gives the husband's lineage claim to the children borne by the wife (Caldwell and Caldwell, 1987; Frank and McNicoll, 1987, for Kenya; Page, 1989~. Frank and McNicoll (1987) note that for Kenya, there has been a practice of paying bride-pnce in installments, with a payment following successful births of the first, second, and third chil- dren. In matrilineal societies, by contrast, the children belong by right to their mother's lineage, and bnde-pnce is much reduced in social impor tance. A woman's fear in limiting her reproduction therefore lies not only in the breaking of an understanding or contract between families, but even more deeply in the possibility of angering the ancestors-her own, in the case of matrilineal societies, or her husband's ancestors in the patnlineal 3Sudarkasa (1981) describes such age grades of authority among the Yoruba of Western Africa. 4However, Guyer (1988b) has observed a recent decline in bride-price payments in Nigeria, which may reflect a broader decline in many types of tribute payments.

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THE HO USEHOLD, KINSHIP, AND COMMUNITY CONTEXT 93 case. In addition, should fertility limitation threaten the bride-pnce agree- ment, the woman's relations might be required to forfeit valuable resources. Thus, an array of relatives on both sides may confront the contraceptive innovator. Caldwell and Caldwell (1987:414) argue that the influence of lineages in reproduction is such that "even educated women working in the modern sector regard their reproduction as distinct from their sexuality- as being the decisionmaking province of their husbands and their husbands' families." The pressures from the lineage that can be brought to bear upon indi- vidual couples can be daunting, as is illustrated in a study regarding atti- tudes toward voluntary sterilization in five regions of Zaire: Kinshasa, Bas Zaire, Sud Kivu, Haut Zaire, and Shaba (Chibalonza et al., 1989). Focus group results show that a husband's family could exert considerable lever- age on the couple, even if the husband and wife had agreed between them- selves as to the desirability of sterilization. The wife's not continuing her childbearing can be construed by the family as a failure to honor the agree- ment implicit in her bride-price. Even if the husband's family at first agrees to sterilization, it may eventually seek another wife for the husband so that he can continue to bring children into the lineage.5 In general, the ties between a husband and wife in marriage are re- garded as being weak and subordinate to the interests of their respective lineages (Bleek, 1987, for the Akan of Ghana). A lineage needs marriage for procreation but sees to it by various means that the loyalty of the mar- riage partners remains with the lineage. With reference to the Akan of Ghana, Asante-Darko and van der Geest (1983:246) say that "relatives look askance at a marriage in which husband and wife develop a close relation- ship." A woman in no sense joins her husband's lineage upon mamage; rather, she remains part of her own (Caldwell and Caldwell, 1987~. More- over, it is not uncommon for women to return to live with their own lin- eages upon completion of childbearing (Sanjek, 1983, for Accra, Ghana). Indeed, if both wife and husband have relatives near at hand, they may maintain separate residences throughout the marriage, living with members of their own lineages (Robertson, 1976, for the Ga of Accra, Ghana; Abu, 1983, for Ashanti of Ghana; Hagan, 1983, for the Effutu of Ghana; Bleek, 1987). SIn Bas Zaire, by contrast, where the basis of descent is largely matrilineal, the husband's family was not viewed as so important in sterilization decisions (Chibalonza et al., 1989).

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94 FA CTORS AFFECTING CONTRACEPTIVE USE Distinction Between Patrilineal and Matrilineal Societies Certain significant features differentiate patrilineal from matrilineal de- scent groups.6 It is important to note first that the implications of matrilineality do not extend to patriarchal authority as such. Even in matrilineal societies, men still assume control over matters of inhentance, land, marnage, and politics (Henn, 1984~. In a matrilineal society it is the maternal uncle who passes his property and social position to his sister's sons.7 The key demo- graphic differences between these descent systems have to do with the so- cial importance accorded to marnage, and with certain mechanisms that in matrilineal groups are thought to enhance the social and economic security of women. By comparison to patrilineal societies, matrilineal societies typically place much less emphasis on the marriage ceremony. For example, Bleek (1987) reports never having seen a marriage ceremony, so little import attaches to it, in his field work among the matrilineal Twi-speaking Akan of Ghana. It seems that the husband-wife bond may be even weaker among matrilineal groups than among patnlineal groups, although little direct evi- dence is available on this pointy Several features of matrilineal societies contribute to the economic and social security of women (Henn, 1984~. First, a woman in such a society is less likely to move away from her maternal village upon first marnage. If her husband has not yet inherited land from his maternal uncle at the time of marriage, he may establish a household and begin to fawn in his wife's village.9 Second, if the marriage dissolves, a divorced woman who has moved away can reactivate land rights in her maternal village much more easily than a divorced woman in patrilineal societies. Third, upon divorce, a woman's children remain with her because they belong by right to their maternal rather than to their paternal kin (Brain, 1976, for Tanzania; Bleek, 1987; Page, 1989~. Thus, to the extent that economic insecurity per se 6In the Human Relations Area File data for Africa examined by Lesthaeghe et al. (1989a), 18 percent of ethnic groups are classified as matrilineal and 12 percent are both matrilineal and matrilocal. 7Yet the relationship between a man and his sister's son can be difficult, in part due to uncertainties surrounding inheritance. Sister's sons expect to inherit according to the seniority by age of their mothers, but their abilities to manage the inheritance also enter into the deci- sion by the lineage head and elders. 8There does appear to be a well-documented and significant association between matrilineal- ity and rates of divorce; see Lesthaeghe et al., (1989a). However, this association may reflect the greater ease with which women in matrilineal societies can obtain a divorce, instead of weaker bonds between husbands and wives. 9See Munachonga (1988) for a discussion of the implications of such arrangements for the authority of the husband vis-a-vis his father- and mother-in-law.

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT 95 provides women with an incentive for high fertility, it would seem that pronatalist pressures might be somewhat reduced in matrilineal settings. Yet because there is also a greater assurance of economic returns to chil- dren over the long term, the value of children may be greater in matrilineal groups that is, greater from the woman's perspective. These are compli- cated issues, to which we return below. The contrasts between matnlineal and patrilineal groups should not be overdrawn. For western Africa, Sudarkasa (1981:54) writes, "It was com- mon for women to have important roles within patrilineages as well as within matrilineages in West Africa, and in their roles as sisters and daugh- ters of the lineage, they often exercised de facto authority and/or power within the 'public sphere'." For the patrilineal Zulu and Swazi of south- eastern Africa, Ngubane (1987) describes a set of special provisions made in the bride-price agreement for the economic security of the bnde. An Alternative Perspective The region's documented high fertility has been consistent with an em- phasis on lineage orientation in sub-Saharan Africa, but the debate in the anthropological literature about the importance of lineage should not be overlooked. Kuper (1982a,b) has traced the course of the debate to nine- teenth century theorists of British anthropology, who were concerned with whether the origins of statehood could be found along the lines of kinship or terntory, or as Kuper puts it, in "blood" or in "soil." Those arguing in favor of temtory viewed lineages as being "secondary and often unstable embroideries" on the more fundamental terr~tonally based patterns of group residence and economic organization (Kuper, 1982a:78, citing Kroeber, 1938~. The work of Evans-Pntchard on the Nuer of Sudan, when coupled with that of Fortes (1945, 1949) on the Tallensi of northern Ghana, established the primacy of the lineage model in the British school of African anthropol- ogy, and it is of course this conceptual model of fully corporate lineages that dominates today's demographic literature. Yet even the fit of the lin- eage concept to the Nuer is in doubt. Evans-Pritchard (1940) himself (as quoted in Kuper 1982a: 84) admitted that a Nuer rarely spoke of his lineage as being distinct from his community. As he wrote, I have watched a Nuer who knew precisely what I wanted, trying on my behalf to discover from a stranger the name of his lineage. He often found great initial difficulty in making the man understand the information re- quired of him, for Nuer think generally in terms of local divisions and of the relationships between them, and an attempt to discover lineage affilia- tions apart from their community relations, and outside a ceremonial con- text, generally led to misunderstanding ....

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT Land 117 In many regions of sub-Saharan Africa, increases in population density, and consequent reductions in the viability of agricultural holdings, may have reduced the value of farm labor. Land density was among the most powerful motivations for the rapid fertility decline in Thailand (Knodel et al., 1987~. Its scarcity motivated Thai parents to invest in child schooling, substituting a new form of economic asset for the land they had previously passed down to their children. Although land scarcity is not an issue across the whole of the sub-Saharan region, there are pockets of high density in which a lack of land may emerge as a motivating factor in fertility control (e.g., in Rwanda or Burundi). Kenya provides a case in point. Bertrand et al. (1989) found lack of land cited as a prominent motive for family limitation among their Kenyan respondents. Hammerslough's (199lb) focus group studies and analysis of Kenyan Demographic and Health Survey (DHS) data support this view. A consistent theme in focus group discussions was that "the land is getting smaller" as rural population density rises. Interestingly, land scarcity in parts of Kenya has been accompanied more broadly by a change in the nature of land ownership. The traditional system, wherein land was controlled by communities and lineages, has to- day been largely replaced by a system of individual land ownership due to government resettlement and title registration schemes. The greater part of agricultural land and a significant fraction of pastoral land are now regis- tered as private freehold (Frank and McNicoll, 19874. As Robinson (1992:456) notes, this change to private freeholdings of land "internalizes the economic costs and benefits of many activities and also the decisions including family size within the conjugal co-resident family unit." However, as Frank and McNicoll (1987) point out, the land titles have been granted almost univer- sally to men. This policy may have removed one traditional source of economic security for women, perhaps increasing the need for women to rely on their children. Hence, the net fertility effect due to the transforma- tion of land ownership in Kenya remains uncertain. Schooling and Child Costs Perhaps the fundamental threat to the sub-Saharan high-fertility ratio- nale has to do with changes in the perceived costs of rearing children and, in particular, with the view that schooling is an increasingly necessary as- pect of childrearing, yet so costly that it renders large family sizes impracti- cal. Caldwell and Caldwell (1987:422) have expressed skepticism that the quantity-quality trade-off can be the decisive factor in a sub-Saharan fertil- ity transition:

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118 FACTORS AFFECTING CONTRACEPTIVE USE So weak [is the link between a man's reproductive decisions and his ex- penses], that there is little parallel to the situation in some other parts of the Third World where educated children will ultimately benefit parents but where there is such a financial crunch during the process of education that numbers must be restricted to ensure that any are sufficiently educated and adequately employed. Yet in the same article, Caldwell and Caldwell (1987:431) acknowledge that relative prices underwent dramatic change in the 1980s; for Nigeria, they note that the 1980s have witnessed growing unemployment, a decline in real wages, the imposition of school fees in all southern states, and most recently an exchange rate adjustment that has trebled the price of imported goods. Throughout the country there is an emphasis in conversation and in the media on the cost of children that encompasses all social classes and that would have been unthinkable only a few years ago. Interestingly, changes in child costs seem to have seized the attention of men as well as women, a phenomenon that could not have occurred if men, as is so often alleged, do little to share in the costs of childrearing. Robinson (1992:450), writing on Kenya, notes that men express a "keen awareness of the rising cost of children, especially education costs. They also indicated acute awareness of the growing difficulties in providing for large families and agreed that times were changing." Economic pressures were also the most-discussed issue in focus group discussions among men in Burkina Faso (McGinn et al., 1989a). The much-repeated refrain in these discus- sions was that couples should have children only according to their means, a view that was also emphasized in the Lagos focus groups of Adegbola et al. (l991~. It is very likely that such economic concerns have affected male atti- tudes across the sub-Saharan region. As Robinson (1992:450) observes for Kenyan men, the picture at present is one of inconsistency and contradiction among venous male attitudes. They ex- press "macho" values, but are worried about economic considerations. In short, the study shows traditional values under attack by modern economic considerations. Economic Crises and Their Aftermath If births are indeed analogous to the normal goods of economists, it should not be surprising that over the short term in Africa, income contrac- tions associated with the turmoil of the 1980s might exert an antinatalist

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THE HOUSEHOLD' KINSHIP, AND COMMUNITY CONTEXT 119 effect.34 As two Nigerian focus group participants reflected on the struc- tural adjustment program (SAP) in place since the mid-1980s (Adegbola et al., 1991~: Without any problem of childbearing I don't see the reason why you should do family planning. [But] when there is not enough food one would be compelled to stop. So if you say you will not plan your children, your Tempt thrill Alan it new [l~l,obterl If, ,,,,^ ~ ^~ ,^~^ an, .... There is SAP in Nigeria and this makes us to plan our families. [Yoruba woman, aged 50+1 This antinatalist pressure is perhaps keenest in urban areas, where changes in the costs of food and other necessities have often been dramatic over the past decade.35 If fertility is "normal" in respect to income, however, one would expect a resumption of economic growth to be accompanied by a resumption in family building. As Chapter 3 has argued, the basis for a longer-term fertility decline would then be found only in fundamental changes in rela- tive prices, aspirations, and foes of social organization. One possible change concerns the extent to which the costs of childrearing and schooling can continue to be shared by kin networks. Lesthaeghe (1989a) speculates that in times of general economic crisis the conjugal family is left more isolated and dependent on its own resources than before, and that where assistance from relatives is given there will be harder bar- gaining over the terms of assistance. This view is echoed in the comments of focus group participants in Lagos (Adegbola et al., 1991~: I can't render help to anybody now not to talk of someone else doing same to me. Because I have not eaten, talk less of rendering any help. If anybody eats and has a left-over, that is when he eats and remembers his relatives. My own idea is that everybody, presently with the Nigerian situation, everybody takes care of their responsibilities and mind their own business because in case where my own child and that of his brother falls sick, he'll mind his own business and take care of his own child before taking care of another person's. [Yoruba woman, aged 20-49] Okojie's (1991) findings for Kwara and Bendel states of Nigeria are simi- lar. Her respondents maintained that in the current economic crisis, one ~ A _ ;54For views similar to those expressed below, see Ladipo (1987) on economic circumstances and motivations for family planning in Ife, and Okojie (1991) for Kwara and Bendel states in Nigeria. 35As Chapter 3 notes, little is known about the effects of structural adjustment in rural areas. To the extent that the increased prices farmers receive for their crops increase the value of child farm labor, one might expect structural adjustment to exert a pronatalist effect in rural areas; but high prices might exert an antinatalist effect in urban areas. See Working Group on Demographic Effects of Economic and Social Reversals (1993) for more discussion.

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120 FACTORS AFFECTING CONTRACEPTIVE USE should not add any additional burdens to one's relatives through child fos- tering. There are also indications that the perceived need for joint conjugal decision making is greater36 in difficult economic times (Adegbola et al., 1991~: You see nowadays, you cannot leave everything for the man. The two should join hands because things are very difficult now. I mean the (eco- nomic) situation of the country is very hard. So, you can't say the husband should or the woman should take full responsibility. So two of them should join hands and do everything accordingly because it is their child. [Igloo man, aged 20-49] These changes in kin relations and conjugal decision malting may well persist into the postcrisis era.37 Contraceptive Innovators Yet how are couples to effect the change to family limitation in the face of opposition from lineage members and elders who may not fully compre- hend the new economic environment? Here a study of female sterilization in Kenya (Bertrand et al., 1989) is instructive.38 In some contrast to the earlier discussion of sterilization in Zaire, Kenyan women and men regard the economic burdens of large families as an important consideration, and the motivations of acceptors of tubal ligation were frankly economic in nature: Respondents mentioned a lack of land, financial constraints, and the expenditures required for children's schooling and daily necessities as being among their major motivations. Regarding the influence of the ex 36It is interesting to note that the Ghanaian male school teachers studied by Oppong (1987b:174) were situated in difficult economic circumstances relative to their expectations: Within this group, contraceptive users "differed from non-users in several aspects of their familial roles and relationships. Greater equality and flexibility in conjugal roles, more marked tendencies towards closure of the conjugal family or a cutting-down of obligations and exchanges associ- ated with kin ties, and more individual assumption of parental tasks and responsibilities, were characteristic features." Perhaps it is this coincidence of stressful economic circumstances and western-influenced views on conjugal obligations that facilitates family limitation. 370ther changes in kin relations may also occur. For instance, Lesthaeghe (1989a) specu- lates that the educational function of child fostering may be hit hard by rising costs and diminishing prospective returns to education, not only for the biological parents but also for the kin network. The implications for fertility, however, are unclear. 38Sterilization is being used here as an extreme example that may shed light on more moder- ate decisions regarding contraception. However, it may be mentioned in passing that the implications of voluntary sterilization for fertility levels in Kenya are considerable, even if sterilization takes place only at the high parities. Frank (1987), relying on 1984 data, estimates that a stop-at-six policy would reduce Kenyan fertility by some 34 percent.

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT 121 tended family, which was a decisive factor weighing against sterilization in Zaire, the Kenyan response was rather different. There was a widespread perception among both men and women that the husband's family would be opposed to tubal ligation, "but the solution to this was simply not to inform them. There was strong consensus that this was a private matter between husband and wife" (Bertrand et al., 1989:286~. The results of Adegbola et al. (1991) for Lagos are similar. When asked about the role of the extended family in matters of family size and contraceptive use, a young Yoruba woman replied: What I know is that the husband's relatives must not have a knowledge of this issue. We young ones of nowadays that have just gotten married do family planning and if the husband's relatives know about it, it is the husband's mother who will look for another wife for her son. She will call her son and say "This your wife does not want to give birth again when I am still alive. I should look for someone else for you." They will cause confusion between the husband and wife. It is not a proper thing to let the husband's relatives know about it, neither is it a proper thing to let the wife's relatives know about. Both relatives must not intervene. Thus, contraceptive innovators are more than aware of the pressures from the extended family that can be brought to bear upon them, but can them- selves devise ways of evading such pressures. Summary We must emphasize in closing this section that many of the arguments just made, which suggest the possibility of fertility decline and increases in contraceptive method use, remain speculative and are grounded not in large and statistically representative samples but in small qualitative or anecdotal studies. Moreover, the factors that we have emphasized do not operate with equal force across Afnca.39 They are surely more important in urban areas and among the educated, and doubtless vary considerably by social and economic circumstances. Furthermore, some observers male very different predictions regarding the effects of economic crisis and modernization on fertility. For instance, Frank and McNicoll (1987) argue that far from reinforcing joint conjugal decision making and helping to internalize costs and benefits, economic 39In addition, we do not expect these factors to have much effect on groups affected by involuntary sterility, because they may not have been able to meet their past fertility goals. As a result, these groups will likely be less receptive to family planning. Evidence from Zaire, for example, suggests that communities with historically high rates of primary sterility have expe- rienced smaller fertility declines than communities in which fertility has been very high (Sala- Diakanda, 1980).

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. 122 FACTORS AFFECTING CONTRACEPTIVE USE modernization in Kenya will more likely serve to further disassociate hus- bands and wives. Frank and McNicoll speculate that family systems may increasingly depart from a lineage basis without ever becoming more nuclear and conjugal in orientation.40 They envision a future for Kenya in which family structure comes to resemble the Caribbean mode of visiting unions and spousal autonomy. Boserup (1985) has also questioned the logic by which reductions in kin solidarity (as evidenced in child fostering, for instance) are expressed in lower fertility. She notes that in Bangladesh, a lack of wider kin support mechanisms and a greater dependence of parents on their children are ad- vanced as explanations for continuing high fertility. The principal theme that emerges from the discussion above is the great variation across sub-Saharan Africa in receptivity to fertility limitation and family planning. In some groups the high-fertility rationale remains largely intact. For others, however, the current economic situation has uncovered a demand for postponement or delay in family building, if not for lower lifetime fertility. And in certain selected subpopulations, principally in urban areas and among those better educated or with higher educational aspirations for their children, the profound changes of the past decade in incomes, relative pnces, and social organization have produced a desire for lower lifetime fertility. LOCAL SOCIAL ORGANIZATION AND THE DIFFUSION OF FAMILY PLANNING We have argued that among other factors, the economic crisis of the 1980s in parts of Africa has presented programs to increase contraceptive use with a window of opportunity. Yet as noted in Chapter 3, the irony of the situation is that the same economic forces that have opened the window on family planning have also reduced the governmental resources available to exploit the opening in settings where fertility decline is a policy goal. The challenge for policy in such settings, then, is how to seize on the themes and motivations brought out by economic stagnation and crisis in a cost-efficient way, recognizing that initially the appeal of family limitation will not be in evidence across the full socioeconomic spectrum, and even the appeal of birth spacing via modern contraception may be resisted in some traditional quarters. One proposal, advanced by Lesthaeghe (1989a), 40L`esthaeghe (1989c) notes that in Lesotho and Botswana, weakening of traditional marriage patterns led not to increasing conjugality, but rather to a greater reliance by women on their own kinship groups and less reliance on husbands.

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT 123 is to exploit the concept of diffusion and the potential presented by sub- Saharan forms of local social organization. It is clear that the provision of information and the social legitimation of modern contraception will be crucial to the prospects for service deliv- ery. Given the budgetary constraints and limitations of personnel with which sub-Saharan governments must cope, national delivery strategies must tap a variety of local social networks, including the private for-profit sector and nongovernmental organizations. What can the existing forms of social organization contribute? A great variety of local groups and networks exist. Some of these grass-roots networks have their own roots in precolonial dual-sex systems;4i others derive from the colonial era or have a more recent vintage. The following types of groups are of interest: (1) traditional birth attendants; (2) modern-day counterparts of the female secret societies in West Africa;42 (3) producer cooperatives and other modern-day descendants of traditional local work parties;43 (4) occupational groups, the most important of these 4lThe dual-sex systems described by Lesthaeghe (1989a) are cases in which female social- political organizations are a mirror image of male organizations. There were female counter- parts to the male paramount chief or regional chiefs, and female counterparts descending to the level of local work parties. Such groups would have a "queen," for instance, at the top of market women's associations. In middle, eastern, and southern Africa, both male and female branches of the dual-sex system are thought to have been much less developed. Thus, in these areas, greater relative importance was accorded to associations introduced during the colonial period: churches and government-sponsored associations. See Arhin (1983:93) on the traditional dual-sex system among the Akan of Ghana, where "female stools complemented the hierarchy of male stools." As in Nigeria (Okonjo, 1983), the British disrupted this system, failing to recognize women on their chief lists or as members of the native authority councils and courts. Such also appears to have been the case in Cute d'Ivoire for the Baule (Etienne, 1983). 42For example, in Liberia, Sierra Leone, Guinea, and Cute d'Ivoire, these societies were powerful in matters of procreation, infant and maternal health, education, local politics, and religion, and have been enlisted in formal health projects (Lesthaeghe, 1989a). Wipper (1984:74) notes that older women from the powerful land-owning lineages in Sande tended to be the most important midwives, and there was an important element of patronage: "Women prefer to patronize midwives of powerful lineages and those who occupy important leadership positions in the Sande society because they believe these women possess the most powerful medicine which will protect their own life and their baby's life. Women are highly dependent on the midwives' knowledge of obstetrics and gynecology and this knowledge is jealously guarded." Steady (1981:33), considering the Bondo or Sande secret societies in Sierra Leone and Liberia, says that "even in areas such as Freetown where; on account of urbanization much of the sacred aspect of Bondo societies is diluted rendering them more like voluntary associations and social agencies, they still serve to regulate relationships between the sexes through the maintenance of sororal bonds." 43Ladipo (1987) discusses family planning as a component of a women's cooperative in Nigeria.

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124 FACTORS AFFECTING CONTRA CEPTIVE USE being the western African market women's associations;44 (S) mutual aid societies and rotating credit networks;45 (6) a plethora of colonial-era asso- ciations including Christian missions, youth associations (Girl Guides and Boy Scouts, YMCA and YWCA), and church women's groups, the latter being particularly vigorous in eastern and southern Africa;46 and (7) local associations with roots in government initiatives.47 Lesthaeghe (1989a:498) argues that with regard to family planning, the "main function of grass-roots networks is to discuss the subject and to legitimize contraception in the process, thereby eventually developing their own referral system, more than in their direct financial sponsoring of family planning clinics." National Female Political Associations Lesthaeghe (1989a) is skeptical about the family planning potential of national-level female political associations. He notes that these are often dominated by elites, who are widely divorced in interests and social status from the grass-roots associations that operate at the local level.48 Further- more, local associations may strive to maintain a respectful distance from national organizations. The local associations have "an interest in coming to terms with current regimes (especially if some of their activities are sponsored by governments), but also an interest in never becoming too closely identified with the political powers of.the moment" (Lesthaeghe, 1 989a:497~. 44Lesthaeghe (1989a) notes that in eastern and middle Africa, by contrast to western Africa, trading is done primarily by men, and such powerful female groups are lacking. 45These include the esusu savings and credit groups of the Yoruba; their counterparts among the Ga (Robertson, 1976); rotating marriage and childbirth associations or associations that fund pilgrimages to Mecca, as among the Dioula of northern Cote d'Ivoire (Lewis, 1976). Wipper (1984) also mentions prostitutes' associations as mutual aid associations in Zaire, Ghana, and Nigeria, and beer-brewers' associations in Nairobi. 46Wipper (1984) discusses Protestant church associations in Sierra Leone (also see Steady, 1976); there are counterpart Muslim associations in Freetown, with interests in mutual aid. Muslim women's associations of Mombasa (descendants of the dance associations of the late nineteenth century and the colonial era) fall in this category, since they have taken interest in child welfare, adult literacy, and so on. See Strobel (1976) for a historical account. 47For instance, the so-called corn mill societies of Cameroon were government initiated in the 1950s; these first began around corn mills rented to the village by government and later expanded their functions (Wipper, 1984). 48Lesthaeghe's point is illustrated by the history of the largest women's association in Kenya, Maendeleo ya Wanawake (Progress for Women), as recounted in Wipper (1984). An initial militancy and close attention to the needs of its rural clubs degenerated as positions in the association began to be taken up by elite wives. A similar fate has met Muslim women's groups in Mombasa (Strobe!, 1976).

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT 125 Market Associations Certain creative efforts have been made to tap the potential of local- level market women's associations in Ibadan, Ilorin, Lagos, and Accra (Center for Population and Family Health, 1989, l990a-c; Webb et al., 1991~. These market-based distribution projects employed market traders, with requisite training in family planning service delivery, to retail contraceptives in the market, usually (although not always) in combination with other health treatments such as oral rehydration therapy and treatment for malaria. The projects were all of a pilot nature, but displayed considerable potential (see Chapter 5~. In the case of Ibadan, market associations are a relatively new phenom- enon; they may have arisen in response to growing local government inter- vention in market affairs and a need for an organization to represent trad- ers' interests vis-a-vis external bodies. The market associations in Accra were predominantly women's associations, headed by a market "queen," whereas in Ibadan men tended to dominate the upper reaches of the organi- zation. It proved important that vendors of contraceptives be seen as legitimate agents of a major health institution (in the Ibadan case, it was the Univer- sity College Hospital), no doubt because of the prevalence in western Af- rica of fake drugs and quackery. The research on contraceptive sales showed that the greatest proportion of clients were fellow traders rather than cus- tomers of the market, and many sales were made outside the market to neighbors of traders. Thus, the Ibadan project generated considerable diffu- sion of information and delivery of services, often through routes that were not at all anticipated by the researchers. In the Lagos project, the scheme was conceived as a two-way referral system, whereby private and govern- ment clinics would inform their clients about the marketing program, and at the market, those clients with problems, contraindications, or in search of other methods were told of the clinic system. Local Women's Groups Watkins (1991) and Hammerslough (1991a) have begun to explore whether local women's groups in Africa can provide a vehicle for the diffusion of family planning information. Hammerslough's analyses of the Kenyan DHS show that women who are members of such groups are more likely to know about modern methods of family planning and are also more likely to have used such methods. But the policy content of Hammerslough's analysis goes deeper. It appears that women who are not themselves group mem- bers, but who reside in communities in which such groups are important, also are more likely to know and to use contraception. This pattern is

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26 FA CTORS AFFECTING CONTRACEPTIVE USE precisely what one expects to see in a setting where the diffusion of infor- mation is taking place. As any one socioeconomic group comes to adopt innovative family planning behavior, knowledge of the new behavior begins to spread via what are termed "weak ties" to other socioeconomic strata. To the extent that the initial adopters serve as reference groups for those contemplating innovative behavior, a diffusion process is set in motion that may promise a broader adoption of contraception. The key point is that a diffusion process may very well begin with a few selected socioeconomic subgroups, but the process of social interchange extends the knowledge of innovative behavior along the links or weak ties among socioeconomic groups. Individuals must still evaluate, with reference to their own individual socioeconomic situations, the advisability of family limitation. That is, enhanced aware- ness does not translate automatically into contraceptive adoption. But to the extent that contraceptive adopters reduce the uncertainty surrounding this new behavior, and provide a concrete demonstration as to its benefits and costs, the broad base of attitudes and preferences concerning contracep- tive use may begin to shift. As far as we are aware, no one has yet investigated the role of men's groups in regard to diffusion. Yet study after study has emphasized the need to enlist African men in family limitation, and there is ample evidence of male receptivity to the economic rationale for limitation that the current economic situation has brought to prominence. Hence, this would appear to be a promising avenue for research and program development. Local Government Some observers remain doubtful about the likely role that African gov- ernments can play in the delivery of contraceptive services. Part of the issue is that state formation is so recent in much of sub-Saharan Africa, even by comparison to Asia; also, even within the complex and hierarchial African states that developed in precolonial times, there was little sustained bureaucratic penetration by the larger state to the local level (Hyden, 1990~. Nor are African nations now in a position to use family planning as a part of the apparatus of nation building, in contrast to India, Indonesia, Korea, Singapore, and the Peoples's Republic of China as noted by Lesthaeghe (1989a).49 Evidently, then, a key issue in the delivery of services will involve the decentralization of government authority and the devolution of 49Lesthaeghe (1989a:488) notes one interesting exception, in that "the present, allegedly strong program performance in Zimbabwe is a part of the ZANU government extending and consolidating its control over the country."

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THE HOUSEHOLD, KINSHIP, AND COMMUNITY CONTEXT 127 responsibilities to local levels, which may be more receptive and perhaps more flexible in responding to local concerns (Frank and McNicoll, 1987~. The case of Nigeria will bear watching because there the national govern- ment has given great emphasis to the creation of local political and eco- nomic structures. Summary In short, it is possible that local organizations constituted for other purposes could be enlisted in the diffusion of family planning information and services in Africa. The process of involving such organizations in family planning efforts can only happen gradually, and no doubt will be met in many cases with political resistance or indifference. Yet as outlined in Chapter 5, the 1980s witnessed a striking change in the receptivity of cer- tain African populations and governments to family planning, and the possi- bilities for tapping the energies of local organizations deserve continued exploration. CONCLUSION An analysis of African social organization clearly points to several factors supporting high fertility, namely, the high value attached to the perpetuation of the lineage; the importance of children as a means of gain- ing access to resources, particularly land; the use of kinship networks to share the costs and benefits of children, primarily through child fostering; and the weak nature of conjugal bonds. Changing economic circumstances, however, such as growing scarcity of land in areas with high population density, increased schooling and child costs, and perhaps deteriorating economies, are challenging this high-fertility rationale. These changing circumstances are resulting in lower fertility desires among certain populations, particu- larly those with high levels of education or with high educational aspira- tions for their children and those living in urban areas. The high-fertility rationale has not yet disappeared from the scene, to be sure, but it is cer- tainly giving way. Thus, our summary judgment, hedged as it must be with qualifications and caveats, is that sub-Saharan Africa is entering a new era of fertility control.