POPULATION DYNAMICS OF SUB-SAHARAN AFRICA
DEMOGRAPHIC CHANGE IN SUB-SAHARAN AFRICA
DEMOGRAPHIC EFFECTS OF ECONOMIC REVERSALS IN SUB-SAHARAN AFRICA
EFFECTS OF HEALTH PROGRAMS ON CHILD MORTALITY IN SUB-SAHARAN AFRICA
FACTORS AFFECTING CONTRACEPTIVE USE IN SUB-SAHARAN AFRICA
POPULATION DYNAMICS OF KENYA
POPULATION DYNAMICS OF SENEGAL
SOCIAL DYNAMICS OF ADOLESCENT FERTILITY IN SUB-SAHARAN AFRICA
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WORKING GROUP ON KENYA
WILLIAM BRASS (Chair),
Centre for Population Studies, London School of Hygiene and Tropical Medicine, England
LINDA H. (WERNER) ARCHER, Independent Consultant,
Nairobi, Kenya
JOHN KEKOVOLE,
Population Studies and Research Institute, University of Nairobi, Kenya
SIMON W. NDIRANGU,
Ministry of Culture and Social Services, Nairobi, Kenya
AINEAH O. OYOO,
Nairobi City Commission, Kenya
WARREN ROBINSON,
Economic Research Associates, Washington, D.C.
CAROLE L. JOLLY, Staff Officer
SUSAN M. COKE, Senior Project Assistant
JOAN MONTGOMERY HALFORD, Senior Project Assistant*
PANEL ON THE POPULATION DYNAMICS OF SUB-SAHARAN AFRICA
KENNETH H. HILL (Chair),
Department of Population Dynamics, Johns Hopkins University
ADERANTI ADEPOJU,
Institut de Développement Economique et de la Planification (IDEP), Dakar, Senegal
JANE T. BERTRAND,
School of Public Health and Tropical Medicine, Tulane University
CAROLINE H. BLEDSOE,
Department of Anthropology, Northwestern University
WILLIAM BRASS,
Centre for Population Studies, London School of Hygiene and Tropical Medicine, England
DOUGLAS C. EWBANK,
Population Studies Center, University of Pennsylvania
PHILIPPE FARGUES,
Centre d'Etudes et de Documentation Economique, Sociale et Juridique (CEDEJ), Cairo, Egypt
RON J. LESTHAEGHE,
Faculteit van de Economische, Sociale en Politieke Wetenschappen, Vrije Universiteit Brussel, Belgium
PATRICK O. OHADIKE,
Regional Institute for Population Studies (RIPS), Accra, Ghana
ANNE R. PEBLEY,
The RAND Corporation, Santa Monica, California
DANIEL M. SALA-DIAKANDA,
Institut de Formation et de Recherche Démographiques (IFORD), Yaoundé, Cameroon
COMMITTEE ON POPULATION
SAMUEL H. PRESTON (Chair),
Population Studies Center, University of Pennsylvania
JOSE-LUIS BOBADILLA,
World Bank, Washington, D.C.
JOHN B. CASTERLINE,
Department of Sociology, Brown University
KENNETH H. HILL,
Department of Population Dynamics, Johns Hopkins University
DEAN T. JAMISON,
School of Public Health, University of California, Los Angeles
ANNE R. PEBLEY,
The RAND Corporation, Santa Monica, California
RONALD R. RINDFUSS,
Department of Sociology, University of North Carolina, Chapel Hill
T. PAUL SCHULTZ,
Department of Economics, Yale University
SUSAN C.M. SCRIMSHAW,
School of Public Health, University of California, Los Angeles
BETH J. SOLDO,
Department of Demograpby, Georgetown University
MARTA TIENDA,
Population Research Center, University of Chicago
BARBARA BOYLE TORREY,
Population Reference Bureau, Washington, D.C.
JAMES TRUSSELL,
Office of Population Research, Princeton University
AMY O. TSUI,
Carolina Population Center, University of North Carolina, Chapel Hill
LINDA G. MARTIN, Director
BARNEY COHEN, Research Associate
SUSAN M. COKE, Senior Project Assistant
KAREN A. FOOTE, Research Associate
DIANE L. GOLDMAN, Administrative Assistant*
JAMES N. GRIBBLE, Program Officer
JOAN MONTGOMERY HALFORD, Senior Project Assistant**
CAROLE L. JOLLY, Program Officer
DOMINIQUE MEEKERS, Research Associate*
PAULA J. MELVILLE, Senior Project Assistant
Preface
This report is one in a series of studies that have been carried out under the auspices of the Panel on the Population Dynamics of Sub-Saharan Africa of the National Research Council's Committee on Population. The Research Council has a long history of examining population issues in developing countries. In 1971 it issued the report Rapid Population Growth: Consequences and Policy Implications. In 1977, the predecessor Committee on Population and Demography began a major study of levels and trends of fertility and mortality in the developing world that resulted in 13 country reports and 6 reports on demographic methods. Then, in the early 1980s, it undertook a study of the determinants of fertility in the developing world, which resulted in 10 reports. In the mid-and late-1980s, the Committee on Population assessed the economic consequences of population growth and the health consequences of contraceptive use and controlled fertility, among many other activities.
No publication on the demography of sub-Saharan Africa emerged from the early work of the committee, largely because of the paucity of data and the poor quality of what was available. However, censuses, ethnographic studies, and surveys of recent years, such as those under the auspices of the World Fertility Survey and the Demographic and Health Survey Programs, have made available data on the demography of sub-Saharan Africa. The data collection has no doubt been stimulated by the increasing interest of both scholars and policymakers in the demographic development of Africa and the relations between demographic change and socioeconomic developments. In response to this interest, the Committee on Population held a meeting in 1989 to ascertain the feasibility and desirability of a major study of the demography of Africa, and decided to set up a Panel on the Population Dynamics of Sub-Saharan Africa.
The panel, which is chaired by Kenneth Hill and includes members from Africa, Europe, and the United States, met for the first time in February 1990 in Washington, D.C. At that meeting the panel decided to set up six working groups, composed of its own members and other experts on the demography of Africa, to carry out specific studies. Four working groups focused on cross-national studies of substantive issues: the social dynamics of adolescent fertility, factors affecting contraceptive use, the effects on mortality of child survival and general health programs, and the demographic effects of economic reversals. The two other working groups were charged with in-depth studies of Kenya and Senegal, with the objective of studying linkages between demographic variables and between those variables and socioeconomic changes. The panel also decided to publish a volume of papers reviewing levels and trends of fertility, nuptiality, the proximate determinants of fertility, child mortality, adult mortality, internal migration, and international migration, as well as the demographic consequences of the AIDS epidemic.
This report, one of the two in-depth country studies, analyzes the population dynamics of Kenya, with particular emphasis on recent fertility change. Kenya was chosen because of interest in recent survey results indicating substantial demographic change in a country that once had the highest population growth rate in the world. The report examines trends in fertility and mortality and their relationship to socioeconomic changes. As part of this examination, the proximate determinants of fertility are analyzed, and multivariate analysis is used to assess the factors associated with contraceptive use. The report does not examine, in any detail, recent migration patterns because of very limited access to data from the 1989 census.
As is the case for all of the panel's work, this report would not have been possible without the cooperation and assistance of the Demographic and Health Survey (DHS) Program of the Institute for Resource Development/Macro Systems. We are grateful to the DHS staff for responding to our inquiries and facilitating our early access to the survey data.
We are also grateful to the organizations that provided financial support for the work of the panel: the Office of Population and the Africa Bureau of the Agency for International Development, the Andrew W. Mellon Foundation, the William and Flora Hewlett Foundation, and the Rockefeller Foundation. Besides providing funding, the representatives of these organizations, particularly Steven W. Sinding of the Rockefeller Foundation, were a source of information and advice in developing the working group's overall work plan.
This report results from the joint efforts of the working group members and staff and represents a consensus of the members' views on the issues addressed. The Committee on Population and the Panel on the Population Dynamics of Sub-Saharan Africa appreciate the time and energy that all the
working group members devoted to the study. The following people deserve recognition for their special contributions: Warren Robinson synthesized a diverse literature on socioeconomic and program factors related to demographic change and drafted Chapters 2 and 6. He also drafted the introduction to the report and was instrumental in guiding the research of the members living in Kenya during the initial stages of the project. Linda H. Archer (formerly Werner) and John Kekovole collected much of the socioeconomic data used to explain recent demographic change and wrote a background paper for the report on socioeconomic changes during the last 20 years. Archer also played a key role in organizing the efforts of the working group members living in Kenya during the later stages of the project. Simon W. Ndirangu and Aineah Oyoo participated in all the working group meetings, and their intimate understanding of the Kenyan experience was useful in drafting the report.
William Brass served admirably as the working group's chair and directed the research of the group. He had primary responsibility for analyzing changes in fertility and mortality and their relationship to socioeconomic change. The results of his efforts are presented in Chapters 3, 4, and 7, which he drafted. Carole Jolly analyzed the proximate determinants of fertility, drafted Chapter 5, and performed the multivariate analysis of the factors associated with contraceptive use, which is presented in Chapter 7. Brass and Jolly served as the principal editors and coordinators of the report. Linda Martin provided substantive comments on numerous drafts of the report and participated in all the group's meetings. Jay Gribble took care of unnumerable details in the final drafting stages. As noted above, however, this report reflects the views of the working group as a whole, and considerable effort by all the members and staff went into its production.
The working group was assisted in its efforts by several other people. Simon Murote Kangethe collected socioeconomic data from numerous Kenyan government agencies. Anne Scott performed data analysis of fertility and mortality trends. Jordan Shapiro authored a paper on migration in Kenya. John Blacker provided extensive analyses of Kenya fertility and mortality, much of which is unpublished.
Special thanks are also due Susan Coke and Joan Montgomery Halford for providing superb administrative and logistical support to the working group, to Florence Poillon for her skillful editing of the report, and to Elaine McGarraugh for meticulous production assistance. Eugenia Grohman was instrumental in guiding the report through the report review process and production.
SAMUEL H. PRESTON, Chair
Commottee on Population