Socio-Cultural Constraints to Family Planning in Swaziland

Abstract

In order for family planning (FP) policies and programs in Swaziland to be effective there must be recognition of the sociocultural constraints to fertility reduction. Infant and child mortality exerts a tremendous pressure on parents to have large families. The child mortality declines in Swaziland have not been sufficient to affect desired family size. Infant mortality is 99/1000 in Swaziland while in countries such as Zimbabwe and Botswana where fertility has declined the infant mortality rate is 70/1000. Womanhood is directly tied to motherhood and stigma and inferior status are attached to childless women. Contraception carries the fear of childlessness or sterility. The practice of bride price is understood to mean a womans obligation to bear many children. Swazi culture encourages large families. It also disapproves strongly of closely-spaced children. Old age support is only available from children. Male children are valued for carrying on the family name while female children may bring wealth from the bride price. The extended family pressures families to have a particular number of children. Husbands may disapprove of FP but women have shown some independence in decision-making. For instance many women strongly disapprove of condoms or conversely hide their contraceptive use from husbands by favoring concealed methods such as the IUD and injectables. False rumors about the side effects of contraceptives and ignorance about contraception are other obstacles to FP acceptance. High transportation costs are an impediment to obtaining services. Overcrowding and understaffing of FP centers at hospitals and industry clinics result in FP having a low priority and a poor quality of care. The program has been successful in increasing awareness and knowledge of FP methods but more effort must be directed to the sociocultural barriers and establishment of an explicit national population policy.