Introduction to the Special Issue

This special issue of African Population Studies is produced under the theme ‘Population and Health’. It was coordinated by the Research Niche Area ‘Population and Health’ (RNA_PH) of the Faculty of Human and Social Sciences, North West University (Mafikeng Campus). The RNA_PH has a mission to conduct high quality research and train researchers in the broad area of population and health that will be relevant to South Africa and the wider region, with the aim of understanding society and informing policy-making and practice. The niche area is divided into three sub-programmes in line with the priority areas of population and health in South Africa and the continent as a whole: Household and Population Dynamics, Poverty and HIV/AIDS, and Quality of Life and Health

Gender differences in sexual behaviour amongst university students in Mahikeng, South Africa

Studies indicate that females are more prone to the consequences of ‘irresponsible’ sexual activities than males on university campuses. This paper presents gender differences in sexual behaviour among students on a university campus. Data were collected from 1,060 students (451 males and 609 females). Multivariate data analysis included both multiple OLS regression and multinomial logistic regression.  The results show that the proportion of virgin females was twice as much as males. The average age at first sexual intercourse was higher for females (18 years) than males (16 years). The analysis also shows that gender and year of study are significant determinants of age at first sex. Moreover, in a multivariate perspective, males are less likely to indulge in risky sexual activities compared to their female counterparts. It is recommended that the HIV/AIDS programme on campus should focus on ways to minimize ‘irresponsible’ sexual activities and put more emphasis on females

Trend and correlates of contraceptive use in rural and urban Ethiopia: is there a link to the health extension programme?

When international funders shifted funding priorities from family planning to HIV/AIDS in themid-1990s, most family planning programmes in Africa faced serious challenges. The government of Ethiopia took a creative route of establishing the Health Extension Programme (HEP) in 2004 that provides health care services including family planning and integrated population issues into the school curricula besides promulgating contraceptive use as a right for any women of reproductive age. This study aims at analysing the correlates of contraceptive use in rural and urban Ethiopia using the Demographic and Health Survey data of 2000, 2005 and 2011. Data were analysed using tabular and graphical methods, and a binary logistic regression model was fitted to identify factors associated with contraceptive use. Findings of the study reveal that contraceptive uptake, particularly injectable, has increased markedly in the rural areas as a result of the implementation of the HEP despite regional variations in the level of commitment to the family planning package. Other African countries need to emulate such an initiative but ensuring equal commitment throughout the nation to overcome any possible outrages

Predisposing factors and consequences of childbearing among young unmarried women in North West, South Africa

This study aims at describing the predisposing factors and consequences of pregnancy in young girls. The main research questions addressed are why young and unmarried women bear children? And what are the consequences of having a child at an early age? A qualitative study on young mothers was conducted in the North West province of South Africa. The results revealed that pregnancy for most of the participants was unintentional and happened due to ignorance. Other predisposing factors include external pressure, wrong or sporadic use of contraception and rape. Most participants had a strong negative attitude towards induced abortion. The study provides four recommendations: revisit the life orientation programme in schools and make it more efficient in delivering sexuality education; young unmarried women should be motivated to use contraception properly if they are sexually active; advocacy is needed on use of abortion services as an option; and measures should be put in place so as to improve parent-daughter communication on sexual matters

Introduction to the Special Issue

This special issue of African Population Studies is produced under the theme ‘Sexual and reproductive health challenges in sub-Saharan Africa’.  It was coordinated by the Research Focus Area ‘Population and Health’ (RFA_PH) of the Faculty of Human and Social Sciences, North-West University (Mafikeng Campus). The RFA_PH has identified sexual and reproductive health (SRH) as one of the research priority areas. The special issue is a single publication that collates what individual RFA_PH researchers have been doing recently in this area and also identifies gaps for further research.  In addition, selected researchers outside the RFA_PH have participated in this special issue to broaden the understanding of SRH in Africa.  The special issue comprises of 13 articles that cover research done in nine sub-Saharan African countries namely Ghana, Kenya, Malawi, Nigeria, South Africa, Swaziland, Tanzania, Uganda and Zimbabwe

Parents' Attitudes to Adolescent Sexual Behaviour in Lesotho

This study investigated the knowledge, attitudes and opinions of parents on various aspects of adolescents' sexual and reproductive health in Lesotho. The study used a qualitative methodology. Findings reveal that parents are aware that male and female adolescents engage in sexual relationships. Some parents believe that adolescents are too young to initiate sexual activities while others said they don't mind older unmarried adolescents having sex. In addition, parents felt that adolescents do not face discrimination in obtaining family planning services. In relation to passing sexual and reproductive health knowledge to adolescents, there seems to be a dilemma on who should take the responsibility. A number of policy implications have emerged from this study. There should be awareness campaign for parents who are not aware that adolescents engage in sexual relationships. Parents should be encouraged to communicate with their adolescent children on sex-related matters. Government should carry on with the dialogue on introducing sex education in schools curriculum. (Afr J Reprod Health 2003; 7[2]: 25–33)RésuméAttitudes des parents envers le comportement sexuel des adolescents à Lesotho. Cette étude a enquêté sur la connaissance, les attitudes et les opinions des parents sur les aspects différents de la santé reproductive et sexuelle des adolescents à Lesotho à l'aide d'une méthodologie qualitative. Les résultats ont révélé que les parents sont au courant que les adolescents de sexes masculin et féminin s'engagent dans des rapports sexuels. De plus, les parents ont estimé que les adolescents ne subissent pas la discrimination par rapport à l'accès aux services de la planification familiale. Quand il s'agit de la transmission de la connaissance sur la santé sexuelle et reproductive aux adolescents, il paraît qu'il y a un dilemme pour savoir qui doit pendre la responsabilité. Cette étude a révélé pas mal d'implications pour la politique. Il faut qu'il y ait des campagnes de sensibilisation pour les parents qui ne sont pas au courant que les adolescents s'engagent dans des rapports sexuels. Il faut encourager les parents de communiquer avec leurs enfants adolescents en matières liées à la sexualité. Il faut que le gouvernement continuer le dialogue sur l'introduction de l'éducation sexuelle dans les programmes scolaires. (Rev Afr Santé Reprod 2003; 7[2]: 25–33)Key Words: Adolescent, sexual behaviour, reproductive health, Lesoth

Patterns of fertility and contraceptive use in Tanzania

The evidence that fertility has started to decline in parts of sub- Saharan Africa is the major motive of conducting the current research. This is particularly important because the Tanzanian Government considers the current fertility levels to be very high. As a consequence, the Government of the United Republic of Tanzania has established a National Population Policy in 1992. This study examines the reproductive behaviour of Tanzanian women. The study of current levels and trends of fertility showed that, on the average, a Tanzanian woman bears six children. This is a decline from seven births per woman which prevailed between 1960s and early 1980s. Thr reduction in infant and child mortality and the rise in age at first marriage are among the factors responsible for the decline in fertility in Tanzania. It should be noted, however, that this decline is largely confined to urban areas. The percentage of women using contraception is still very low in Tanzania but a rising trend has been observed recently. Breasfeeding is both prolonged and universal in Tanzania and its importance in lowering fertility below its biological maximum is noted. In fact, the effect of breastfeeding durations in prolonging birth intervals is found to be statistically significant even after controlling for amenorrhea and after resuming sexual relations. Variations in durations of breastfeeding, length of birth intervals and the extent of using contraception are found to depend mainly on the region of residence, the type of place of residence and the age of women. It is important therefore to design separately programmes to lower fertility by regions of residence, by rural/urban residence and where relevant target young women separately

The Determinants of Birth Intervals Among Non-Contracepting Tanzanian Women

This paper deals with the determinants of birth intervals in Tanzania, placing emphasis on the effects of the duration of breastfeeding, postpartum amenorrhoea and postpartum abstinence. The analysis is based on the 1991/1992 Tanzania Demographic and Health Survey data. The major determinant of birth intervals in Tanzania is the duration of breastfeeding: the fertility-inhibiting effect of breastfeeding is significant even after controlling for postpartum amenorrhoea and abstinence. It was also noted that the death of the index child creates some additional effects (to those of breastfeeding) on shortening birth intervals. Women who gave birth when they are aged 30 years or more, who reside in urban areas, those in polygamous marriages, those who had a preceding birth interval of at least three years, those working in the modern sector and those whose index child is a boy have longer birth intervals than other women. Furthermore, women residing in West Lake regions have shorter birth intervals, whereas women residing in Southern regions have longer birth intervals than women residing in other regions. Ce papier traite des déterminants des intervalles entre les naissances en Tanzanie, en mettant l’accent sur les effets de la durée de l’allaitement au sein, l’aménorrhée après les couches et l’abstinence après l’accouchement. L’analyse se fonde sur les données de l’enquête démographique et de santé de 1991-1992. Le principal déterminant des intervalles entre les naissances en Tanzanie est l’allaitement au sein. L’effet d’inhibition de la fécondité qu’exerce l’allaitement au sein est significatif même si l’aménorrhée et l’abstinence après l’accouchement sont contr?lées. Il a également été découvert que la mort de l’enfant indice (index child) crée des effets additionnels (à ceux de l’allaitement au sein) sur la réduction des intervalles entre les naissances. Les femmes qui mettent un enfant au monde à l’age de 30 ans ou plus, qui vivent dans les zones urbaines, celles qui sont dans des ménages polygames, celles qui ont eu un intervalle précédent d’au moins trois ans entre les naissances, celles qui sont dans le secteur moderne et celles dont l’enfant indice est un gar?on ont un intervalle entre les naissances plus long que les autres femmes. En outre, les femmes qui vivent dans les régions de l’ouest du lac ont un intervalle entre les naissances plus court tandis que celles qui vivent dans les régions sud ont des intervalles entre les naissances plus longs que les femmes vivant dans d’autres régions