Fertility and contraceptive use in poor urban areas of developing countries

Abstract

In developing countries urban population size is growing rapidly especially among the poor. Continued rural-urban migration contributes sizably to this growth (40-50% of urban growth) especially since most people who migrate to the cities are young. Natural increase accounts for the remaining urban growth (50-60%). Even though the urban poor tend to have fertility rates either lower than the urban mean or intermediate to those of rural and urban areas young demographic profiles ensure expanding urban populations. In addition fertility rates of the urban poor are different between cities and within cities. Factors encouraging fertility are a fall in traditional fertility- inhibiting behaviors especially breast feeding and postpartum abstinence taboos. The rise of women in the labor force adoption of modern ideas increased need for child labor and the breakdown of the extended family contribute to these changes. Factors which decrease fertility are falling proportions of people marrying at an early age increased age at first marriage increased spousal separation and increased use of contraception. Socioeconomic differentials and issues of equity explain to a certain extent the high fertility and low contraceptive use in some poor urban areas. Policymakers need to complement any social and economic development strategies with definite improvements in the structure of family planning. These improvements include expanded economic geographic and cultural access to contraceptives; diversified contraceptive outlets; and attention to quality of family planning services. Further effective communication of family planning information to individuals and the population is needed to increase contraceptive use. Communication and improved family planning strategies must include promotion of condoms to reduce the spread of HIV and to prevent unwanted pregnancies. Existence of family planning services does not reduce population growth without individual and community participation in using and promoting family planning.