The Future of Family Planning in Sub-Saharan Africa

Abstract

Family planning programs have gained a foothold though still a tenuous one in Sub Saharan Africa. In a recent inventory of family planning program effort in 93 developing countries 27 of the 42 countries that rated very weak or 0 on a scale measuring policy initiatives service activities record keeping and the availability and accessibility of fertility control services were in Sub Saharan Africa. African political leaders are increasingly aware that reproductive health services are an important component of public health and maternal and child health programs. A number of obstacles stand in the way of large-scale contraceptive use in the region: 1) financial resouces are minimal 2) there are serious shortages of trained personnel 3) the structure of the traditional African family particularly the status of women discourages the concept of small families 4) many health professionals are opposed to family planning or to certain contraceptive methods and 5) the impact is a wide range of religious cultural and legal barriers. In Kenya where the World Fertility Survey of 1977-1978 found that average family size was 8 children and women said they wanted an average of 7 an integrated maternal and child health and family planning program was introduced as early as 1967. However between 1977-1979 fewer than half of the anticipated goal of 640000 new contraceptive users had been enrolled. In an effort to improve the situation in 1982 the Kenyan government strengthened the programs administrative structure. 2 other major reproductive health issues are causing great concern in Africa: 1) the spread of female circumcision and 2) the spread of sexually transmitted diseases. This 1984 conference sponsored by the World Federation of Health Agencies for the Advancement of Voluntary Surgical Contraception was a landmark event in the history of African family planning. The conference stressed the training of skilled workers to increase program availability.