Executive Summary

The study of the population dynamics of Kenya was undertaken because of recent survey results that indicated dramatic demographic change during the late 1970s and 1980s. The interest in these changes stemmed from considerable debate about the possibilities for substantial fertility declines in sub-Saharan Africa, a region that has been characterized by longstanding high fertility and child mortality rates. The task of the working group was to examine these recent demographic changes in light of the socioeconomic conditions in Kenya, with the expectation that such a study would provide clues for future changes there as well as in other parts of sub-Saharan Africa. This report highlights fertility and mortality; migration patterns were not examined as part of this study due to lack of recent data.

MORTALITY

Between 1973 and 1984, child mortality fell 27 percent to approximately 110 deaths to children under 5 years of age per 1,000 births. Although mortality had decreased significantly in the 20 years before, this period was notable in that the rate of mortality decline accelerated markedly. The declines were shared almost equally between rural and urban areas, although significant differentials that existed in the 1970s still remain. Mortality differentials among educational groups were reduced, and the large improvement in the mortality rates of children of mothers with no education (a halving between the mid-1950s and the mid-1980s) was particularly noteworthy. Central Province showed the greatest improvements



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Population Dynamics of Kenya Executive Summary The study of the population dynamics of Kenya was undertaken because of recent survey results that indicated dramatic demographic change during the late 1970s and 1980s. The interest in these changes stemmed from considerable debate about the possibilities for substantial fertility declines in sub-Saharan Africa, a region that has been characterized by longstanding high fertility and child mortality rates. The task of the working group was to examine these recent demographic changes in light of the socioeconomic conditions in Kenya, with the expectation that such a study would provide clues for future changes there as well as in other parts of sub-Saharan Africa. This report highlights fertility and mortality; migration patterns were not examined as part of this study due to lack of recent data. MORTALITY Between 1973 and 1984, child mortality fell 27 percent to approximately 110 deaths to children under 5 years of age per 1,000 births. Although mortality had decreased significantly in the 20 years before, this period was notable in that the rate of mortality decline accelerated markedly. The declines were shared almost equally between rural and urban areas, although significant differentials that existed in the 1970s still remain. Mortality differentials among educational groups were reduced, and the large improvement in the mortality rates of children of mothers with no education (a halving between the mid-1950s and the mid-1980s) was particularly noteworthy. Central Province showed the greatest improvements

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Population Dynamics of Kenya in mortality among all provinces since the 1950s, with a reduction of about 70 percent. Coast Province did rather poorly during the same period, with a decrease of only 19 percent. The four remaining provinces, other than Nairobi, experienced declines closer to the national average of 54 percent. Attempts to link these trends to socioeconomic factors revealed a strong relationship to female education and adult literacy. Although individual education is probably key in sustaining differentials in mortality over time, evidence from this study indicates the importance of district-wide educational levels in the mortality declines, as demonstrated by the reductions in mortality of children with poorly educated mothers living in districts with relatively highly educated residents. Little association was found between decreases in child mortality and health indicators, although cross-sectional analyses found associations between levels of mortality and the incidence of malaria and malnutrition, as well as the ecological zone of residence. FERTILITY Fertility in the 1960s and 1970s was high, about eight births per woman and seemed to be rising slightly. In the decade from the late 1970s to the late 1980s, fertility fell approximately 20 percent to a little more than 6.5 births per woman. This decrease was unexpected by many and was due principally to an increase in contraceptive use. What is striking about the reduction in fertility was its occurrence across almost all subgroups. Declines in fertility occurred within all age groups, with the middle and later reproductive ages contributing more to the reduction than the earlier ages. Other than Western Province (where the evidence for the magnitude of the decline is inconclusive), there were moderate to substantial decreases across all provinces, regardless of level of socioeconomic development. Central Province had the largest decrease of 31 percent. Fertility fell 17 percent in rural areas, not much less than the 23 percent decline that occurred in urban areas. The reductions by level of education were almost equal in percentage terms, even with marked initial differentials in fertility levels. Decline occurred at all birth orders, a pattern that is clearly distinct from the fertility decline in Latin America and Asia, where fertility reduction began in the middle parities and spread to the higher and then to the lower birth orders. Analysis of other sub-Saharan African countries experiencing changes in fertility indicates that the pattern observed in Kenya is also occurring in Botswana, Nigeria, and Zimbabwe. The near universality of the decreases in fertility in Kenya indicate that the determinants of the decline have a strong central component affecting geographical and social categories of the population in a similar way although not to the same extent. This conclusion is supported by the weak associations found between the fertility reductions and district-level socio

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Population Dynamics of Kenya economic factors such as education, urbanization, mortality, and population density. The only factor that showed a relationship to fertility decline at the district level was employment (either female or male) in the modern sector. Given that increase in contraceptive use was the most important proximate cause of the fertility decline, multivariate analysis of the socioeconomic factors associated with use was undertaken. Although the model explained little of the variation in individual-level contraceptive use (which is consistent with the weak associations found at the district level), several important findings were revealed. The number of family planning service delivery points at the district level was found to be the factor most strongly related to individual contraceptive use. District-level and individual-level education had significant effects, as did variables associated with income or exposure to modern ideas—household electricity and type of flooring, membership in a woman's group, listening to the radio weekly, and density of roads within a district. District-level female employment in the modern sector was not significantly related to individual contraceptive use, but it was the most significant factor in determining whether a contraceptor used a modern versus a traditional method. Religion also was not significantly related to contraceptive use, an expected finding given the strong fertility decreases in the Coast Province, which is primarily Muslim, as well as in other provinces where other religions are more prevalent. THE FUTURE This study of population dynamics in Kenya suggests several continuing trends for the future of Kenya, in the absence of any marked political or socioeconomic changes. The reductions in child mortality, documented for more than 50 years, suggest that mortality will continue to fall. Because ideal family size dropped from 6.2 children in 1977–1978 to 4.4 children in 1988–1989, it is expected that women will continue to seek to meet this ideal in the next 10 years. The widespread uptake of contraception indicates that the acceptance of family planning has taken hold and will not easily be reversed. Thus, we can expect to see continued demographic change in Kenya, with future declines in fertility and child mortality.

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