Reproductive Risks and Intentions in Six Countries in Sub-Saharan Africa

Abstract

Potential changes in reproductive patterns associated with high-risk births is analyzed using data from Demographic and Health Surveys (DHS) in 6 African countries: Botswana (1988); Burundi (1987); Liberia (1986); Mali (1987); Senegal (1986) and Zimbabwe (1988). < than 1 in 4 women in the samples had advanced beyond a primary education while in Burundi Mali and Senegal 75% had no education. Over 50% lived in rural areas (ranging from 97% in Burundi to 63% in Liberia). Child mortality is high; the women in Liberia (47%) Senegal (48%) and Mali (55%) all experienced the death of at least 1 child. Nearly 80% of the women did not know about modern methods of contraception. In evaluating the association between reproductive risk and intention women were assigned 1 of 3 categories of reproductive intention categories: limiter spacer and nonspacer. The study indicates that expressed intention to space births was common in the 6 countries ranging from 37% in Senegal to 62% in Mali. Programmatically this finding suggests that temporary methods of contraception are appropriate for meeting most of the demand in Africa especially as the traditional practices of postpartum abstinence and breastfeeding decline in prevalence. Reproductive risk factors (age parity and interval since last birth) were highly correlated with women;s intentions to limit births especially in Botswana and Zimbabwe where family planning programs are based on birthspacing. Women who had had 4 or more live births were as much as 79% more likely than lower parity women to express a desire to have no more children. Educated women those 35 and older those with some awareness of family planning methods and those who had 1 living male child were more likely to want to limit their births. Intentions to delay the next birth correlated with such factors as higher education never experiencing the death of a child and having with a male child. (authors modified) (summaries in ENG FRE and SPA)