WORKING PAPERS |
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WORKING PAPER TITLES |
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| 1 |
Determinants for participation in a public health insurance program among residents of urban slums in Nairobi, Kenya: results from a crosssectional survey
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James K KimaniRemare EttarhCatherine Kyobutungi Blessing Mberu Kanyiva Muindi
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2012 |
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| 2 |
Closing the Disparity Gap: Cancer Screening Interventions Among Asians – a Systematic Literature Review
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Su-I HouDiadrey-Anne SealyCaroline W Kabiru
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2012 |
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| 3 |
"Making It": Understanding Adolescent
Resilience in Two Informal Settlements (Slums) in Nairobi, Kenya
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Caroline W. KabiruCaroline W. KabiruRobert P. Ndugwa EliyaM. ZuluRichard Jessor
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2012 |
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| 4 |
The effect of active teaching and subject
content coverage on students’ achievement: Evidence from primary schools in Kenya
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Moses W. NgwareMaurice MutisyaMoses Oketch
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2012 |
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| 5. |
Schooling among Nairobi Slum Residents in the Wake of Free Primary Education from Border to Crossing Borderland
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Chi-chi UndieCharles EpariAlex Ezeh
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2008 |
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ABSTRACT
In the year 2003, the Kenyan government launched a free primary education policy, which propelled a notable increase in the country’s primary school enrollment rates. The country’s capital city of Nairobi, however, lagged behind most of the nation, with an enrollment rate of 62%, compared to a 104% gross enrollment rate country-wide. Connections have been made between Nairobi’s poor enrollment rates and the high proportion of children living in the city’s informal settlements or slums. In this paper, therefore, we use a community case-study approach to examine the experiences of one informal settlement in Nairobi following the implementation of the free primary education policy.
Drawing on audio-taped, in-depth interviews and focus group discussions with a range of community members and school personnel, and longitudinal and demographic data, the paper thickly describes the aftermath of free primary education in this urban poor context, and the reasons behind the local popularity of cost-incurring, “informal” schools in the slums of Nairobi among a low-income population, despite the introduction of free primary education. Slum-based “informal” primary schools emerge as an under-explored
Site of creativity in which parents, teachers, and administrators attempt to bridge implementation gaps between educational policy and local realities among the urban poor in Nairobi, Kenya. The paper employs anemic perspective for understanding the dynamics of formal school enrollment among the urban poor, and for exploring informal schools as a potential space of empowerment for slum residents.
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| 6. |
Do Household Characteristics Matter in Schooling Decisions in Urban Kenya
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Alex EzehMoses NgwareMoses Oketch
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2008 |
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ABSTRACT
Using a cross sectional data set collected by the Education Research Project (ERP) of the African Population and Health Research Center
(APHRC), this paper examines household characteristics and schooling decisions in terms of enrollment and type of school in an urban setting in Nairobi, Kenya. ERP is nested in a demographic surveillance system (DSS) and is intended to assess the impact of Free Primary Education policy on access and schooling outcomes in Nairobi’s informal and formal settlements. Analysis shows that different household and individual attributes motivate different decisions. A considerable proportion (40%) of children from the poorest quintile attends non-public schools compared to 34% from the richest quintile. The findings reveal that better-off households are benefiting from free primary education while the poorest households are not. The predicted probability of a decision to attend a public school for a primary school-age child increases as the household wealth increases, but decreases if the household head is older. Overall, his paper concludes that poorer households are not benefiting from free primary education and may be excluded from free public schools. Instead, they are sending their children to low quality fee-paying informal schools. The benefits of free primary education have therefore not reached the poorest of the poor in Kenya’s informal urban settings. This may be explained by lack of availability of public schools places and the perceived low quality of education in public school as manifested in large class sizes.
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| 7. |
Pupil School Mobility in Urban Kenya
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Moses NgwareMoses OketchAlex EzehCharles EpariMaurice Mutisya
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2008 |
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ABSTRACT
This paper aims to examine pupil school mobility in urban Kenya. In doing so, it provides an analysis of parents’ demand for sending their children to private schools in informal settlements (slum housing) in Nairobi as well as the location characteristics that motivate schooling supply decisions in slum areas. Using APHRC household survey data which contain information on pupil transfers between schools, the paper aims to identify which informal school characteristics attract the greatest demand for incoming transfers. The analysis reveals that there are more frequent transfers between schools in the informal settlements than there are in the formal settlements. The former is attributable to parents searching for a better school for their child. Fewer pupils move from one
school to another in the non-slum settlements.
For most parents, children are transferred with the intention of finding a better quality school and/or in order to find a free or cheaper school. Quality schools are associated with good discipline and better teacher performance. Policy wise, it appears that the government has a dilemma to deal with: Either it recognizes the informal private schools which serve nearly half of the pupils in the slums, risking endorsing a ‘second-class’ education due to poor structures in the slums, or it provides more schools in the slums that are publicly funded and has to face the considerable difficulties of where to construct them.
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| 8. |
Determining Appropriate Entry Point for Health Promoting Schools Intervention in Nairobi slums
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Alex EzehOsnat Keidar
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2008 |
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ABSTRACT
Background:
Nairobi’s informal settlements (slums) are characterized by high levels of child morbidity and mortality and poor academic performance. The Health Promoting Schools (HPS) initiative aims to improve the health of school communities as well as the academic performance of students. This study is based on a baseline needs assessment for planning an entry point for the implementation of a HPS initiative and its evaluation in two informal settlements in Nairobi, Kenya.
Methods:
22 primary schools located in two slum communities in Nairobi participated in this cross-sectional study. Data was collected from head
teachers, teachers and classes 5 and 6 students using different questionnaires. Main study outcomes included school health profile, teachers’ training on health issues and their engagement in Health Promotion in class, and students’ healthy behaviors and nutrition status.
Findings:
No significant difference was found between the two slums in most of the variables assessed. Public schools were found to have higher school health profile than informal schools (p<0.0001) and students from public schools had healthier personal hygiene and nutrition behaviors. However, Only 12% of children reported washing hands with soap while in schools. Teachers’ training in the health domain was found to be significantly associated with engagement in Health Promotion. Recommendations: Implementation of personal hygiene with a focus on washing hands with soap was identified as a primary entry point for the HPS initiative. The intervention should include upgrading of schools’ water facilities and teachers’ health promotion training.
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| 9. |
What Quality of Primary Education are Children in Urban Schools Receiving Evidence from Nairobi
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Moses NgwareMoses OketchAlex Ezeh
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2008 |
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ABSTRACT
This paper examines the quality of primary school inputs in urban settlements in Kenya in relation to the country’s set benchmarks of
education quality indicators. Data from a school survey that involved 83 primary schools collected in 2005 was used. The data set contains information on school quality characteristics of various types of schools i.e. government-owned schools, private-owned (schools) by individuals, religious groups, NGOs and communities in Nairobi. Based on national quality benchmarks, the quality of education provided in government schools was shown to be ‘better’ with regard to infrastructure, teacher qualifications and text book provision than that provided in all the non-government owned schools. However, non-government schools have smaller class sizes (22) and lower pupil-teacher ratio (27). The bad news is that government schools have large class sizes (50) and higher pupil-teacher
ratio (47) hence low levels of teacher-pupil interaction. Non-government schools had poor classroom structures and a higher pupil-textbook ratio, particularly private individually owned schools (5) and community-owned schools (3.8). It also emerges that while in the
government schools, student learning space is constrained by the class size, the student learning space in non government schools is constrained by the classroom size. Meeting quality benchmarks in schooling therefore remains a challenge among urban populations. A public-private partnership targeting urban school quality improvement is one way of mobilizing resources for improving quality of education.
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| 10. |
Why are there Proportionately more Poor Pupils Enrolled Non-State Schools in Urban Kenya in spite of FPE Policy
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Moses OketchMoses NgwareMaurice MutisyaAlex Ezeh
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2008 |
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ABSTRACT
One of the conundrums of free primary education policy in several countries in Sub-Saharan Africa is the ‘mushrooming’ of fee-paying private schools. Several researchers have become interested in studying this phenomenon and have raised the question - does free primary education meet the needs of the poor? Emerging voices among this group of researchers suggest that the impact of FPE, particularly in meeting the educational needs of the poor, may be over-stated in situations where the poor still utilize what is referred to as ‘private schools for the poor’. The concerns expressed by those voicing this point of view point to the question of why the poor choose fee-paying low quality private schools when there is, presumably a free state school? To respond to this question and to contribute to this debate, this paper adapts the excess demand and differentiated demand frameworks to analyze how slum (poor) and
non-slum (non-poor) parents utilize education in Nairobi, Kenya following the implementation of free primary education in 2003. We conclude that the answer to the ‘mushrooming’ of private schools for the poor is ‘excess demand’. As to whether free primary education meets the needs of the poor, we argue that where supply does not match demand, excess demand is likely to arise in the initial stages. We recommend that what is required is greater and possibly differentiated and better targeted investment in education whereby unequal are treated unequally in order for the Kenyan government not to under-invest in the education of the poor.
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| 11. |
Factors Associated with Low Achievement among Students from Nairobi’s Urban Informal Neighborhoods
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Charles EpariAlex EzehMoses NgwareMoses OketchMaurice Mutisya
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2008 |
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ABSTRACT
This paper contributes new evidence on factors associated with low achievement among pupils in urban informal neighborhoods in Nairobi, Kenya. We use three different data sets to examine the effect of residence in particular neighborhoods, pupil gender, primary school type and household socio-economic status on pupil achievement in the Kenya Certificate of Primary Education (KCPE) examination results for 2005 and 2006. Our results suggest that residence in the informal neighborhoods of Korogocho and Viwandani,
enrollment in a public school and one’s gender if female, are the strongest explanatory variables for low achievement. Policy implications from our results are discussed.
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| 12. |
SCHOOL ENROLLMENT AMONG NON-SLUM, SLUM AND RURAL CHILDREN IN KENYA IS THE URBAN ADVANTAGE ERODING
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2006 |
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ABSTRACT
FOR LONG NOW, THE URBAN CHILD HAS BEEN CONSIDERED TO BE MORE LIKELY THAN HIS/HER RURAL COUNTERPART IN BEING ABLE TO REALIZE THE DREAM OF FULLY PARTICIPATING IN SCHOOL. THIS OBSERVATION HAS MAINLY BEEN ATTRIBUTED TO WHAT IS COMMONLY KNOWN AS THE URBAN ADVANTAGE. THIS URBAN ADVANTAGE IS ASSOCIATED WITH INCREASED ACCESS TO FACILITIES SUCH AS SCHOOLS IN URBAN AREAS. RECENT WORK DOCUMENTING POPULATION HEALTH IN URBAN AND RURAL AREAS HAS HOWEVER BEGUN TO SUGGEST THAT SOME SECTIONS OF THE URBAN POPULATION DO NOT BENEFIT FROM THE URBAN ADVANTAGE. FOR EXAMPLE, A CHILD IN THE SLUMS OF NAIROBI IS MORE LIKELY TO SUFFER FROM DIARRHEA THAN A CHILD IN RURAL KENYA. IN ADDITION, A CHILD FROM THE RICHEST HOUSEHOLD IN THE SLUMS IS MORE LIKELY TO SUFFER FROM DIARRHEA THAN A CHILD FROM THE POOREST FAMILY IN RURAL KENYA. THIS PAPER EXPLORES PATTERNS OF SCHOOL ENROLLMENT COMPARING URBAN SLUM, URBAN NON-SLUM AND RURAL CHILDREN. THE PAPER USES DATA FROM THE KENYA DEMOGRAPHIC AND HEALTH SURVEY (KDHS) FOR 1993, 1998 AND 2003. A CONTRAST WITH SCHOOL ENROLLMENT IN NAIROBI SLUMS IS DONE USING THE KDHS-TYPE NAIROBI CROSS-SECTIONAL SLUM SURVEY FOR 2000. DATA FROM FOCUS GROUP DISCUSSIONS COLLECTED IN THE SLUMS OF NAIROBI IN 1999 PROVIDES THE CONTEXT FOR DISCUSSION. THE RESULTS SUGGEST THAT SCHOOL ENROLLMENT IS HIGHER IN URBAN NON-SLUM THAN IN URBAN SLUM, AND IS HIGHER IN SLUMS THAN IN RURAL AREAS AT YOUNGER AGES. HOWEVER, THIS IS ONLY TRUE UP TO AGE NINE FOR
FEMALES AND 11 FOR MALES, THERE AFTER, SCHOOL ENROLLMENT FOR SLUM CHILDREN DECLINES AND THE RATE OF DECLINE IS FASTER THAN AMONG THEIR RURAL COUNTERPARTS. THE CORRESPONDING AGES AT WHICH THE ENROLLMENT AMONG THE RURAL CHILDREN BEGINS TO VISIBLY DECLINE ARE THIRTEEN
YEARS FOR MALES AND FOURTEEN YEARS FOR FEMALES. FACTORS CONTRIBUTING TO THESE RESULTS POINT TO THE POOR QUALITY OF PRIMARY SCHOOLS IN SLUMS, LIMITED ACCESS TO SECONDARY SCHOOLS FOR SLUM CHILDREN, INCREASED VULNERABILITY TO COERCION INTO SEXUAL ACTIVITY AND OTHER ILLS THAT
HINDER SCHOOL PARTICIPATION, DISABLING ENVIRONMENT AT HOME, AND INCREASED CHILD LABOR.
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| 13. |
THE STATE OF KNOWLEDGE ON SEXUALITY IN AFRICA A SYNTHESIS OF LITERATURE
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Chi-chi Undie
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2006 |
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ABSTRACT
SEXUALITY AS A FIELD REMAINS AN UNDERDEVELOPED DOMAIN IN SUB-SAHARAN AFRICA, WITH FEW SCHOLARS DEMONSTRATING KEEN INTEREST IN, AND FOCUS ON, THE SUBJECT. IRONICALLY, SEXUALITY UNDERLIES NUMEROUS SOCIO-ECONOMIC AND DEVELOPMENT CHALLENGES CURRENTLY CONFRONTED
IN SUB-SAHARAN AFRICA. THE CHALLENGES FACING THE REGION ARE NUMEROUS MOST NOTABLY, PERHAPS, THE HIV/AIDS EPIDEMIC. THE URGENT NEED TO STEM THE DISEASE HAS NECESSITATED AN ALMOST EXCLUSIVE FOCUS ON BEHAVIOR CHANGE. THIS HAS, UNFORTUNATELY, LIMITED A FULLER
UNDERSTANDING OF SEXUALITY AND HOW IT IS CONCEPTUALIZED AND APPLIED IN VARIOUS SOCIETIES IN SUB-SAHARAN AFRICA. THE PURPOSE OF THIS PAPER IS, THUS, TO SYNTHESIZE ACCESSIBLE LITERATURE THAT EXAMINES SEXUALITY AS A BROAD CONCEPT WITHIN THE CONTEXT OF SUB-SAHARAN AFRICA. BY SO DOING, THE PAPER ATTEMPTS TO FILL IN GAPS LEFT BY THE CONVENTIONAL APPROACH TO SEXUALITY IN SSA, WHICH HAS TYPICALLY FIXATED UPON CRISES RELATED TO SEXUALITY, TO THE NEGLECT OF MORE CONCEPTUAL ISSUES THAT ARE EQUALLY IMPORTANT TO DEFINE. IN A WORD, THE PAPER PRESENTS THE KNOWLEDGE BASE ON SEXUALITY IN SUB-SAHARAN AFRICA THAT HAS EMERGED AS A CONSEQUENCE OF THE REGION'S SOCIO-ECONOMIC AND DEVELOPMENT CHALLENGES. IT THEN EXAMINES SEXUALITY ISSUES MORE COMPREHENSIVELY, IN AN ATTEMPT TO REDRESS SOME OF THE IMBALANCES WITHIN THE BASE OF KNOWLEDGE THAT IS MOST READILY AVAILABLE IN THE REGION.
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| 14. |
URBAN-RURAL DIFFERENTIALS IN CHILD MALNUTRITION. TRENDS AND SOCIOECONOMIC CORRELATES IN SUB-SAHARAN AFRICA
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Jean-christophe Fotso
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2006 |
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ABSTRACT
THIS PAPER EXAMINES LEVELS AND TRENDS OF URBAN-RURAL DIFFERENTIALS IN CHILD MALNUTRITION, AND INVESTIGATES WHETHER RESIDUAL DIFFERENCES EXIST BETWEEN URBAN AND RURAL AREAS, GIVEN COMPARABLE MEASURES OF SOCIOECONOMIC STATUS OF HOUSEHOLDS AND COMMUNITIES. USING
DATA FROM DEMOGRAPHIC AND HEALTH SURVEYS OF 15 SUB-SAHARAN AFRICAN COUNTRIES, AND MULTILEVEL MODELING, THE STUDY SHOWS THAT URBAN-RURAL DIFFERENTIALS: (I) ARE CONSIDERABLE IN ALL COUNTRIES, (II) HAVE NARROWED IN MOST COUNTRIES DUE PRIMARILY TO AN INCREASE IN
URBAN MALNUTRITION, AND (III) HAVE WIDENED IN FEW COUNTRIES AS A RESULT OF SHARP DECLINE IN URBAN MALNUTRITION. HOWEVER, WHEN SOCIOECONOMIC STATUS IS CONTROLLED, THESE URBAN-RURAL GAPS DISAPPEAR IN ALMOST ALL COUNTRIES. THESE RESULTS SUGGEST THAT POLICIES AND
PROGRAMS CONTRIBUTING TO THE ATTAINMENT OF THE MILLENNIUM DEVELOPMENT GOALS SHOULD PAY PARTICULAR ATTENTION TO THE URBAN POOR.
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| 15. |
INTERNAL MIGRATION AND HOUSEHOLD LIVING CONDITIONS IN ETHIOPIA
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Blessing Mberu
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2005 |
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ABSTRACT
USING THE 1998 MIGRATION, GENDER AND HEALTH SURVEY IN FIVE REGIONS OF ETHIOPIA, THIS PAPER EXAMINES THE RELATIONSHIPS BETWEEN MIGRATION STATUS AND HOUSEHOLD LIVING CONDITIONS. THE ANALYSIS FINDS NO SIGNIFICANT ASSOCIATION BETWEEN INTERNAL MIGRATION AND IMPROVED LIVING CONDITIONS. WHILE PERMANENT MIGRANTS ARE NOT SIGNIFICANTLY BETTER OFF THAN NON-MIGRANTS, TEMPORARY AND RETURN MIGRANTS SHOW WORSE LIVING CONDITIONS. FOLLOWING PROLONGED CIVIL WAR, FAMINE AND FORCED RESETTLEMENT BY GOVERNMENT, MOST INTERNAL MIGRANTS IN ETHIOPIA QUALIFY AS STRESS MIGRANTS MARGINALLY EMBEDDED IN THE PRIVILEGE STRUCTURES OF THEIR PLACES OF ORIGIN AND LACKING LOCATION-SPECIFIC ADVANTAGES TO STAY. HIGHER EDUCATION, LARGE HOUSEHOLD STRUCTURES, URBAN RESIDENCE, LIVING IN OROMIYA AND TIGRAY REGIONS ARE SIGNIFICANTLY RELATED TO BETTER WELFARE. THE RESORT TO MIGRATION AND/OR RESETTLEMENT AS INDIVIDUAL AND GOVERNMENT POLICY RESPONSE TO PERIODIC UNFAVORABLE CONDITIONS IN PLACES OF ORIGIN FINDS NO EVIDENCE FROM THIS ANALYSIS AS THE KEY TO IMPROVED LIVING CONDITIONS IN THE COUNTRY.
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| 16. |
PARENTAL PRESENCE AND ADOLESCENT REPRODUCTIVE HEALTH AMONG THE NAIROBI URBAN POOR
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2003 |
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ABSTRACT
ADOLESCENTS LIVING IN NAIROBI SLUMS FACE A DAUNTING ARRAY OF HEALTH AND LIVELIHOOD CHALLENGES BECAUSE OF THEIR EXTREME POVERTY. IDENTIFYING PROTECTIVE FACTORS FOR THEM IS A PREREQUISITE FOR ANY SUCCESSFUL ADOLESCENT REPRODUCTIVE HEALTH INTERVENTION IN SUCH
SETTINGS. THIS PAPER INVESTIGATES WHETHER THE PRESENCE OF PARENTS CONSTITUTE A PROTECTIVE FACTOR AGAINST ADOLESCENTS’ ADVERSE REPRODUCTIVE HEALTH OUTCOMES. THE DATA COME FROM A CROSS-SECTIONAL SURVEY THAT CANVASSED A RANDOM SAMPLE OF 4,564 HOUSEHOLDS IN THE SLUMS OF NAIROBI. STRUCTURED QUESTIONNAIRES ON HOUSEHOLD CENSUS, REPRODUCTION AND ADOLESCENT HEALTH WERE VERBALLY ADMINISTERED TO HOUSEHOLD HEADS, WOMEN OF REPRODUCTIVE AGES, AND ADOLESCENTS RESPECTIVELY. WE RESTRICT THE ANALYSIS TO A SUB-SAMPLE OF 788 NEVER MARRIED ADOLESCENT GIRLS AGED 12-19 YEARS. WE COMPARE REPRODUCTIVE HEALTH OUTCOMES OF ADOLESCENTS WHO LIVE WITH NEITHER PARENT, FATHER ONLY, MOTHER ONLY, AND BOTH PARENTS.
RESULTS SHOWED THAT WHEN THE FATHER IS PRESENT IN THE HOUSEHOLD (I.E. FATHER ONLY OR BOTH PARENTS PRESENT), ADOLESCENT GIRLS ARE 42 PERCENT LESS LIKELY TO HAVE EVER HAD SEX (P<0.05), 45 PERCENT LESS LIKELY TO HAVE BEEN SEXUALLY ACTIVE IN THE MOST RECENT FOUR-WEEK PERIOD (P<0.1), AND 59 PERCENT LESS LIKELY TO HAVE EVER EXPERIENCED AN UNWANTED PREGNANCY (P<0,05) THAN WHEN NEITHER PARENT, OR ONLY THE MOTHER, IS PRESENT IN THE HOUSEHOLD. THE STUDY CONCLUDED THAT IN THE SLUMS OF NAIROBI, FATHER’S PRESENCE, UNLIKE THAT OF THE MOTHER, IS ASSOCIATED WITH STRONGER RESILIENCE AMONG ADOLESCENTS. WHEN PROGRAMMING FOR ADOLESCENTS IN THESE RESOURCE-CONSTRAINED SETTINGS, IT IS IMPORTANT, THEREFORE, TO INVOLVE PARENTS.
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| 17. |
PREGNANCY AND CHILD HEALTH OUTCOMES AMONG ADOLESCENTS IN ETHIOPIA
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2003 |
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ABSTRACT
ADOLESCENT MOTHERS AND THEIR CHILDREN IN DEVELOPING COUNTRIES FARE LESS IN MOST SOCIAL AND ECONOMIC OUTCOMES OF EARLY CHILDBEARING. CLINIC-BASED NON-REPRESENTATIVE DATA IS THE MAINSTREAM SOURCE OF OUR CURRENT KNOWLEDGE ON THESE OUTCOMES. THE STUDY COMPARED TEENAGE (BELOW 20 YEARS OF AGE) AND ADULT (20-34 YEARS OF AGE) MOTHERS ON SOCIO-DEMOGRAPHIC CHARACTERISTICS, PREGNANCY OUTCOMES, AND CHILD SURVIVAL FROM A POPULATION-BASED NATIONAL DATA.
DEMOGRAPHIC AND HEALTH SURVEY (DHS) DATA WAS USED TO CONDUCT THE COMPARISON. A TOTAL OF 663 TEENAGE AND 721 ADULT MOTHERS WHO GAVE BIRTH TO THEIR FIRST CHILD WITHIN FIVE YEARS PRECEDING THE SURVEY WERE IDENTIFIED FROM THE DATASET. SIGNIFICANTLY LARGER PROPORTION OF THE TEENAGE MOTHERS LIVED IN RURAL AREAS, WERE POORER, LESS EDUCATED, AND GAVE A HISTORY OF NO MARRIAGE. CONTROLLING FOR POTENTIAL SOCIO-DEMOGRAPHIC CONFOUNDERS CANCELLED THE DIFFERENCE BETWEEN TEENAGE AND ADULT MOTHERS IN THE RATE OF PRE-NATAL CARE ATTENDANCE, AND OPERATIVE AND LOW BIRTH WEIGHT DELIVERIES. A LARGER PERCENTAGE OF HOME DELIVERY WAS REPORTED AMONG TEENAGE MOTHERS. CHILDREN OF TEENAGE AND ADULT MOTHERS WERE LIKELY TO HAVE COMPARABLE VACCINATION AND MORBIDITY STATUS AND RECEIVED EQUIVALENT LEVEL OF CARE DURING ILLNESS EPISODES. MATERNAL AGE WAS STRONGLY ASSOCIATED WITH CHILD SURVIVAL. THE RESULT WAS CONTRASTED WITH RECENT DHS DATA FROM KENYA AND UGANDA WHICH ALSO SHOWED SIMILAR PATTERN OF PREGNANCY AND CHILD HEALTH OUTCOMES. MOST FACTORS AFFECTING CHILD SURVIVAL MIGHT BE ASSOCIATED WITH THE POOR SOCIO-ECONOMIC ACHIEVEMENTS OF TEENAGE MOTHERS THAN WITH THEIR AGE AT CHILDBIRTH.
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| 18. |
FERTILITY DECLINE IN FRANCOPHONE SUB-SAHARAN AFRICA ; 1980 – 2010
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2002 |
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| 19. |
Institutional Change and the African Fertility Transition. The Case of Kenya
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Alex Ezeh
F. Nii-amoo Dodoo
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2001 |
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ABSTRACT
This paper discusses key elements underlying the fertility transition in sub-Saharan Africa with special
attention to Kenya. Notwithstanding the contribution of family planning services and programs, we argue that
a significant part of the sustained decline in fertility observed in Kenya, and probably other African countries,
derives from fundamental shifts in the educational, economic, family and marriage institutions in the region.
The changes occurring in these institutions maintain an independent effect on fertility. The contributions of
marriage and education are particularly significant. The authors argue that, as these institutional changes
become more manifest in other sub-Saharan African countries, similar effects will be observed in their fertility
patterns, even in settings where the family planning environment remains weak.
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| 20. |
INSTITUTIONAL CHANGE AND THE AFRICAN FERTILITY TRANSITION - THE CASE OF KENYA
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Alex Ezeh
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2000 |
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ABSTRACT
THIS PAPER DISCUSSES KEY ELEMENTS UNDERLYING THE FERTILITY TRANSITION IN SUB-SAHARAN AFRICA WITH SPECIAL ATTENTION TO KENYA. NOTWITHSTANDING THE CONTRIBUTION OF FAMILY PLANNING SERVICES AND PROGRAMS, WE ARGUE THAT A SIGNIFICANT PART OF THE SUSTAINED DECLINE IN FERTILITY OBSERVED IN KENYA, AND PROBABLY OTHER AFRICAN COUNTRIES, DERIVES FROM FUNDAMENTAL SHIFTS IN THE EDUCATIONAL, ECONOMIC, FAMILY AND MARRIAGE INSTITUTIONS IN THE REGION.
THE CHANGES OCCURRING IN THESE INSTITUTIONS MAINTAIN AN INDEPENDENT EFFECT ON FERTILITY. THE CONTRIBUTIONS OF MARRIAGE AND EDUCATION ARE PARTICULARLY SIGNIFICANT. THE AUTHORS ARGUE THAT, AS THESE INSTITUTIONAL CHANGES BECOME MORE MANIFEST IN OTHER SUB-SAHARAN AFRICAN COUNTRIES, SIMILAR EFFECTS WILL BE OBSERVED IN THEIR FERTILITY PATTERNS, EVEN IN SETTINGS WHERE THE FAMILY PLANNING ENVIRONMENT REMAINS WEAK.
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| 21. |
THE TRIAD OF POVERTY, ENVIRONMENT AND CHILD HEALTH IN NAIROBI INFORMAL SETTLEMENTS
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2000 |
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ABSTRACT
TWENTY FOUR FOCUS GROUP DISCUSSIONS AND 62 IN DEPTH INTERVIEWS WERE CONDUCTED IN FOUR NAIROBI INFORMAL SETTLEMENTS IN 2002 TO EXPLORE THE COMMUNITY MEMBERS’ EXPRESSION AND UNDERSTANDING OF THE LINKAGES BETWEEN URBAN POOR ENVIRONMENT AND CHILDHOOD ILLNESSES. COMMUNITY MEMBERS IDENTIFIED RESPIRATORY TRACT INFECTIONS, DIARRHEA, MALARIA, SKIN PROBLEMS AND MALNUTRITION AS THE
FIVE LEADING ILLNESSES AMONG CHILDREN AGED UNDER-5 YEARS. THE MOTHERS LINKED THESE ILLNESSES TO LACK OF ADEQUATE AND CLEAN WATER, UNSAFE WASTE DISPOSAL SYSTEMS, LACK OF ADEQUATE AND NUTRITIOUS FOOD AND AIR POLLUTION. THE ABILITY OF THE MOTHERS TO MAKE THESE LINKAGES, WHICH ARE QUOTED VERBATIM IN THE PAPER, SHOWS THAT THEIR CHILDREN’S ILLNESSES COULD MAINLY BE DUE TO THE IMPOVERISHED STATUS AND ENVIRONMENTS RATHER THAN MOTHER’S LACK OF BIOMEDICAL CONCEPTUALIZATION OF DISEASE PROCESSES. COMMUNITY’S KNOWLEDGE OF THEIR CHILDREN’S ILLNESS AND THE LINK BETWEEN ENVIRONMENT AND CHILD HEALTH OUTCOMES CREATE OPPORTUNITIES TO DESIGN AND IMPLEMENT EFFECTIVE
AND SUSTAINABLE CHILD SURVIVAL PROGRAMS.
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| 22. |
SOME SOCIOECONOMIC CORRELATES OF FERTILITY IN KENYA - A DISTRICT LEVEL ANALYSIS
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2000 |
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ABSTRACT
THIS PAPER HIGHLIGHTS SOME KEY SOCIAL AND ECONOMIC FACTORS THAT ARE ASSOCIATED WITH FERTILITY AT THE DISTRICT LEVEL IN KENYA AND STATES THEIR POLICY IMPLICATIONS. DATA FROM VARIOUS GOVERNMENT OF KENYA SOURCES ARE ANALYZED USING BOTH BIVARIATE AND MULTIVARIATE REGRESSION PROCEDURES TO EXAMINE THE NATURE OF THE RELATIONSHIP BETWEEN FERTILITY AND SELECTED SOCIOECONOMIC VARIABLES. THE FINDINGS INDICATE THAT LOWER FERTILITY WAS SIGNIFICANTLY ASSOCIATED WITH HIGHER EDUCATIONAL ATTAINMENT AND WAGE EMPLOYMENT. ALSO, LEVEL OF URBANIZATION AND CONTRACEPTIVE USE WERE SIGNIFICANT DETERMINANTS OF LOWER FERTILITY. THE PAPER UNDERSCORES THE IMPORTANCE OF THESE FACTORS IN UNDERSTANDING FERTILITY CHANGE IN KENYA.
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| 23. |
ETHNICITY, MODERNITY AND FERTILITY IN KENYA
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2000 |
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ABSTRACT
ETHNICITY IS A POWERFUL FACTOR IN AFRICA WHICH AFFECTS ALL ASPECTS OF LIFE FOR THE INDIVIDUAL. FOR MOST AFRICANS, ETHNIC BELONGING IS A MORE POWERFUL REFERENCE THAN THE WIDER NATIONAL IDENTITY. IT IS NOT A SURPRISE THAT ETHNIC VARIATIONS IN REPRODUCTIVE OUTCOMES IN DEVELOPING COUNTRIES INCLUDING AFRICA HAVE RECENTLY CAPTURED THE INTERESTS OF SCHOLARS AND POLICY MAKERS. THIS IS PARTLY BECAUSE SOCIETIES ARE STRUCTURED AMONG OTHER CHARACTERISTICS, BY ETHNIC GROUPS FROM WHICH INDIVIDUALS DERIVE THEIR FUNDAMENTAL IDENTITIES AND VALUES. THE
INDIVIDUALS CULTURAL ATTACHMENT AND IDENTITY DETERMINES BEHAVIOR INCLUDING REPRODUCTION.
KENYA, LIKE MOST AFRICAN COUNTRIES, HAS MANY ETHNIC GROUPS, EACH OF WHICH HAS ITS OWN HOMELAND AND DISTINCTIVE LANGUAGE, VALUES AND CULTURE. IT IS THEREFORE NOT SURPRISING TO EXPECT GROUP VARIATIONS IN ASPECTS OF REPRODUCTIVE IDEALS AND BEHAVIOR. IN THIS PAPER WE ARGUE THAT THERE EXISTS ETHNIC DIFFERENCES IN REPRODUCTIVE BEHAVIOUR LEADING TO DIFFERENCES IN FERTILITY OUTCOMES. RESULTS SHOW THAT THE CENTRAL BANTU COMPRISING OF KIKUYU, EMBU AND MERU, THERE AFTER TO BE REFERRED AS KEM, ASPIRE FOR SMALLER FAMILIES THAN THE OTHER GROUPS AND ACHIEVE THEM BY USING MORE MODERN CONTRACEPTIVES COMPARED TO THE OTHER GROUPS. THESE DIFFERENCES PERSIST EVEN WHEN SOCIO-DEMOGRAPHIC FACTORS SUCH AS PLACE OF RESIDENCE, EDUCATIONAL ATTAINMENT AND MARITAL TYPES ARE CONTROLLED FOR. WE FURTHER DISCUSS IN THIS STUDY THE HISTORICAL AND CONTEMPORARY EVENTS WHICH MAY HAVE PREDISPOSED THE KIKUYU/EMBU/MERU IN A RELATIVELY UNIQUE POSITION
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| 24. |
FAMILY PLANNING AND SEXUAL BEHAVIOUR IN THE ERA OF STDS AND HIVAIDS
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2000 |
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ABSTRACT
IN THE RECENT TIMES, THERE HAS BEEN A REMARKABLE INCREASE IN THE PREVALENCE OF CONTRACEPTIVE USE IN KENYA. WHILE USE OF MODERN CONTRACEPTIVES HAS BEEN SOMEWHAT SUCCESSFUL IN PREVENTING UNWANTED PREGNANCY AND ALLOWING INDIVIDUALS TO ENJOY SEXUAL INTERCOURSE, IT HAS NOT BEEN SO SUCCESSFUL IN PREVENTING HIV/AIDS. THE TWIN RISK OF UNWANTED PREGNANCY AND HIV/AIDS INFECTION IS A CENTRAL CONCERN OF REPRODUCTIVE HEALTH PROGRAMMES.
HOWEVER, WE NEITHER KNOW HOW SEXUALLY ACTIVE MEN AND WOMEN PERCEIVE THESE RISKS, NOR THE STRATEGIES THEY CONSIDER APPROPRIATE TO COPE WITH THESE RISKS, NOR THE DIFFICULTIES THEY FACE IN TRYING TO ADOPT A SEXUAL BEHAVIOR CONSIDERED APPROPRIATE IN THIS ERA. THIS STUDY PROVIDES INSIGHTS INTO PERCEPTIONS, COPING STRATEGIES AND CONSTRAINTS IN CHANGING SEXUAL BEHAVIOR OF SEXUALLY ACTIVE MEN AND
WOMEN IN NAKURU DISTRICT OF KENYA. THE STUDY IS PART OF A MULTI-COUNTRY STUDY COVERING SUCH COUNTRIES AS UGANDA, TANZANIA, ZIMBABWE, ZAMBIA AND SOUTH AFRICA.
A TOTAL OF TWELVE FOCUS GROUPS DISCUSSIONS COVERING SEXUALLY ACTIVE MEN AND WOMEN (CONTRACEPTIVE USERS AND NON-USERS) IN BOTH RURAL AND URBAN AREAS WERE CONDUCTED. THE RESULTS SHOW THAT PEOPLE CONSIDER BOTH UNWANTED PREGNANCY AND HIV/AIDS SERIOUS PROBLEMS BUT DO VERY LITTLE TO PROTECT THEMSELVES. MANY DO NOT TALK ABOUT SEX, THEY DO NOT USE A CONDOM WITHIN MARRIAGE DESPITE THE WIDESPREAD KNOWLEDGE ABOUT CONDOMS, THEY WILL NOT REFUSE THEIR PARTNERS SEX EVEN IF THERE IS A PERCEIVED RISK OF HIV INFECTION. THESE FINDINGS SUGGEST SEXUAL BEHAVIORS THAT ARE INCOMPATIBLE WITH PERCEIVED AND KNOWN RISKS, AND THIS CALLS FOR: CONCERTED EFFORTS TO ENCOURAGE UNMARRIED PEOPLE TO ABSTAIN FROM SEX; DEVELOPING INNOVATIVE PROGRAMMES AIMED AT PROMOTING RESPONSIBLE SEXUALITY; INCREASED MALE
INVOLVEMENT IN REPRODUCTIVE HEALTH ISSUES; AND MARRIED PEOPLE TO STICK FAITHFULLY TO THEIR PARTNERS.
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| 25. |
Variations in antenatal care between women of different communities in Kenya
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2000 |
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ABSTRACT
Appropriate antenatal care is important in preventing adverse pregnancy outcomes for both the mother and the baby but many mothers in the developing world do not receive such care. This paper uses data from the 1993 Kenya demographic and health survey to study the variations in the use of antenatal services in Kenya. The analysis is based on modeling the frequency and timing of antenatal visits using three-level linear regression models.
The results show that the use of antenatal care in Kenya is determined by a range of socio-economic, cultural and reproductive factors, including the availability and accessibility of health services and the desirability of a pregnancy. Unwanted and mistimed pregnancies are associated with poor attendance at antenatal clinics but this effect varies significantly between women. The results also indicate that women are highly consistent in the use of antenatal care during pregnancies and the correlation is strongest in urban areas.
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| 26. |
SLUM RESIDENCE AND SEXUAL OUTCOMES EARLY FINDINGS OF CAUSAL LINKAGES IN NAIROBI, KENYA
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Alex EzehEliya M Zulu
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2000 |
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ABSTRACT
RELATIVELY LESS ATTENTION HAS BEEN PAID TO UNDERSTANDING THE REPRODUCTIVE HEALTH CONCERNS AND EXPERIENCES OF URBAN WOMEN AND YOUTH COMPARED TO THOSE OF THEIR RURAL COUNTERPARTS IN SUB-SAHARAN AFRICA. THIS HAS BEEN SO BECAUSE THE MAJORITY OF PEOPLE LIVE IN RURAL AREAS WHERE RESIDENTS ARE BELIEVED TO BE RELATIVELY DISADVANTAGED WITH RESPECT TO EVEN BASIC AMENITIES SUCH AS MEDICAL AND EDUCATIONAL FACILITIES. YET, THE RAPID AND UNPRECEDENTED POPULATION GROWTH TAKING PLACE IN AFRICAN CITIES, AND THE ACCOMPANYING DISPROPORTIONATE GROWTH IN THE NUMBER OF UNDERPRIVILEGED PEOPLE WITHIN THESE CITIES POSE NEW CHALLENGES FOR HEALTH CARE IN THESE SETTINGS.
POPULATION PROJECTIONS INDICATE THAT BY THE YEAR 2025 CLOSE TO 60% OF AFRICANS WILL BE LIVING IN URBAN AREAS. THE EXTREME POVERTY IN SLUM AREAS OF AFRICAN CITIES HAS SEVERE IMPLICATIONS AS FAR AS SOCIAL AND HEALTH OUTCOMES ARE CONCERNED, AND THIS IS PARTICULARLY TRUE FOR WOMEN AND CHILDREN. THIS STUDY EXAMINES THE RELATIONSHIP BETWEEN SEXUAL BEHAVIOR AND LIVING CONDITIONS AMONG NAIROBI CITY’S SLUM RESIDENTS. RESULTS BASED ON QUANTITATIVE DATA SHOW THAT SLUM RESIDENTS INITIATE SEX AT EARLIER AGES AND HAVE MORE SEXUAL PARTNERS THAN OTHER CITY RESIDENTS. QUALITATIVE DATA COLLECTED IN THE SLUMS SHOW FURTHER THAT SEXUAL EXPOSURE AND BEHAVIOR OF SLUM RESIDENTS ARE
CLOSELY INFLUENCED BY THE ACUTE ECONOMIC AND SOCIAL CONDITIONS IN WHICH THEY LIVE. ADDITIONALLY, THE DEFICIENCY OF REPRODUCTIVE HEALTH SERVICES IN SLUM COMMUNITIES LIMITS THEIR ADOPTION OF PREVENTIVE AND CURATIVE MEASURES AGAINST REPRODUCTIVE HEALTH PROBLEMS, INCLUDING SEXUALLY TRANSMITTED INFECTIONS. THESE FINDINGS SUGGEST THAT INTERVENTIONS TO IMPROVE IMPOVERISHED PEOPLE’S REPRODUCTIVE HEALTH STATUS MAY ACHIEVE LIMITED SUCCESS IN THE ABSENCE OF ANY IMPROVEMENTS IN THEIR ECONOMIC CIRCUMSTANCES.
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| 27. |
Individual and community level factors associated with premature births, size of baby at birth and caesarean section deliveries in Kenya
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Nyovani Madise
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1999 |
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ABSTRACT
Most previous studies addressing factors associated with adverse birth outcomes have been based on hospital statistics. This is a serious limitation in the developing countries where the majority of births do not occur within the health facilities. This paper examines factors associated with premature deliveries, small baby’s size at birth and cesarean section deliveries in Kenya based on the 1993 Kenya demographic and health survey data. Due to the hierarchical nature of the data, the analysis uses multilevel logistic regression models to take into account the family and community effects. The results show that the odds of premature births, small size of baby at birth and cesarean section deliveries are significantly higher for first births than higher order births. Furthermore, antenatal care (measured by frequency of antenatal care visits and tetanus toxoid injection) is observed to have a negative association with
The incidence of premature births. For baby’s size at birth, maternal nutritional status is observed to be a predominant factor. Short maternal stature is confirmed to be a significant risk factor for caesarean section deliveries. The observed higher odds of caesarean section deliveries among women from households of high socio-economic status is attributed to the expected association between socio-economic status and the use of appropriate maternal health care services. The odds of all the birth outcomes included in this study vary significantly between women. In addition, the odds of caesarean section deliveries vary significantly between Districts, after taking into account the individual level characteristics of the women and specific pregnancies.
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| 28. |
WORKING PAPER - THE EVOLUTION AND ROLE OF FAMILY PLANNING ( CATHY TOROITICH-RUTO)
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Eliya M Zulu
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1998 |
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ABSTRACT
THIS PAPER EXAMINES THE EVOLUTION OF THE KENYA FAMILY PLANNING PROGRAM AND ITS ROLE IN THE ON-GOING FERTILITY TRANSITION. THIS ISSUE HAS CRITICAL POLICY AND PROGRAMMATIC IMPORTANCE BECAUSE THE FERTILITY TRANSITION IS NOT YET UNDERWAY IN MANY SUB-SAHARAN COUNTRIES. POLICY MAKERS AND PROGRAM IMPLEMENTERS WILL FIND THE INFORMATION IN THIS PAPER IMPORTANT IN EVALUATING THE EFFICACY OF THE CURRENT FAMILY PLANNING PROGRAMS AND UTILIZE LESSONS LEARNED TO IMPROVE THE PERFORMANCE OF THE PROGRAMS IN OTHER AREAS WHERE FERTILITY DECLINE HAS NOT YET STARTED. RESEARCHERS WILL SHOW THE SOURCE OF FERTILITY DECLINE
OUTSIDE THE CONVENTIONAL ARGUMENTS ABOUT SOCIAL AND ECONOMIC DEVELOPMENT.
SOME OF THE QUESTIONS THIS STUDY ENDEAVORS TO ANSWER INCLUDE: WHAT HAVE BEEN THE MAJOR DEVELOPMENTS OF THE KENYA FAMILY PLANNING PROGRAM?; HOW HAS THE POPULATION POLICY ASSISTED IN THIS DEVELOPMENT OVER THE YEARS?; WHAT HAS BEEN THE ROLE OF THE
GOVERNMENT, NGOS AND OTHER KEY ORGANIZATIONS IN INFLUENCING THE PROGRAM?; WHAT SERVICES ARE AVAILABLE AND WHERE ARE THEY LOCATED?; HAVE THESE PROGRAMS CHANGED THEIR STRATEGIES OVER THE YEARS?; HOW HAS THE ISSUE OF PROXIMITY TO SERVICES BEEN ADDRESSED?.
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| 29. |
TRENDS AND CORRELATES OF CONTRACEPTIVE USE IN KENYA - 1977-1993
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Eliya M Zulu
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1998 |
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ABSTRACT
THIS STUDY OF TRENDS AND CORRELATES OF CONTRACEPTIVE USE EMPLOYS DATA COLLECTED IN FOUR NATIONAL SURVEYS CONDUCTED IN KENYA BETWEEN 1977 AND 1993. SINCE THE MID-1980S, KENYA HAS EXPERIENCED PERHAPS ONE OF THE MOST REMARKABLE FERTILITY TRANSITION IN HUMAN HISTORY. KENYA’S TOTAL FERTILITY RATE OF 8 CHILDREN PER WOMAN WAS RATED THE HIGHEST IN THE WORLD IN 1978. THE TOTAL FERTILITY RATE DECLINED BY 33 PERCENT FROM ABOUT 8 CHILDREN PER WOMAN IN 1977 TO 5.4 CHILDREN PER WOMAN IN 1993. THE DRAMATIC CHANGES ALSO REFLECT IN THE CONTRACEPTIVE PREVALENCE RATE, WHICH INCREASED FROM 7 PERCENT IN 1977 TO 27 PERCENT IN 1989 AND FURTHER TO 33 PERCENT IN 1993. THE CONTRACEPTIVE REVOLUTION HAS BEEN EXPERIENCED ACROSS THE BOARD, ALBEIT AT DIFFERENT RATES. THERE IS ALSO A GENERAL CONVERGENCE WHEREBY PREVIOUSLY LOWER CONTRACEPTING GROUPS ARE IMPROVING MORE
RAPIDLY THAN PIONEER USERS. THE RESULT IS NARROWING CONTRACEPTIVE RATE DIFFERENTIALS ACROSS RESIDENTIAL (RURAL-URBAN), EDUCATIONAL, AND REGIONAL BOUNDARIES. KENYA’S TRANSITION IS A RESULT OF GREATER AVAILABILITY OF FAMILY PLANNING SERVICES, SOCIOECONOMIC PROGRESS OF THE 1960S AND 1970S, AND THE ECONOMIC HARDSHIPS OF THE 1980S, ALL OF WHICH HAVE INFLUENCED KENYANS TO DESIRE FEWER CHILDREN. SOCIAL, ECONOMIC, CULTURAL AND ENVIRONMENTAL CHANGES HAVE ALSO CONTRIBUTED TO THE TRANSITION. REFLECTIONS OF THESE CAN BE FOUND IN THE COMPOSITIONAL CHANGES IN WHICH THE PROPORTIONS OF WOMEN
WITH CHARACTERISTICS ASSOCIATED WITH HIGHER CONTRACEPTIVE USE, AND DESIRES FOR LOWER FERTILITY HAVE INCREASED. MOST REMARKABLE IS THE SUBSTANTIAL INCREASE IN THE PROPORTION OF WOMEN WITH PRIMARY AND SECONDARY EDUCATION. LIKEWISE, THE PROPORTIONS OF WOMEN WORKING OUTSIDE THE HOME, LIVING IN URBAN AREAS, IN MONOGAMOUS UNIONS, AND APPROVING USE OF CONTRACEPTION HAVE INCREASED.
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| 30. |
TRENDS AND CORRELATES OF UNMET NEED FOR CONTRACEPTION IN KENYA
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Cheikh Faye
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1998 |
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ABSTRACT
THIS PAPER PRESENTS THE RESULTS EMANATING FROM THE ANALYSIS OF DATA COLLECTED IN THE 1989 AND 1993 KENYA DEMOGRAPHIC SURVEYS ON UNMET NEED FOR CONTRACEPTION. THE PREVALENCE OF UNMET NEED FOR CONTRACEPTION IS A REFLECTION OF A LAG BETWEEN THE RECOGNITION OF THE DESIRE TO CONTROL FERTILITY AND ADOPTION OF CONTRACEPTION; AND SERIOUS IMPEDIMENTS PREVENTING INDIVIDUALS FROM USING CONTRACEPTION. THE RESULTS INDICATE THAT ABOUT 38 AND 36 PERCENT OF THE MARRIED WOMEN INTERVIEWED IN 1989 AND 1993 HAD UNMET NEED FOR CONTRACEPTION.
THE LEVEL OF UNMET NEED HAD SUBSTANTIALLY DECLINED IN URBAN AREAS, IN CENTRAL AND RIFT VALLEY PROVINCES, AND FOR WOMEN WHO HAD ATTAINED SECONDARY LEVEL OF EDUCATION, DESIRED LESS THAN 3 CHILDREN AND THEIR HUSBANDS APPROVED OF FAMILY PLANNING DURING THE ABOVE PERIOD. IT HAD HOWEVER, INCREASED FOR WOMEN RESIDING IN NYANZA AND WESTERN PROVINCES, FOR THOSE WITH NO EDUCATION AND WHOSE HUSBANDS AND THEMSELVES DISAPPROVED OF FAMILY PLANNING. THE RESULTS DERIVED FROM THE MULTIVARIATE ANALYSES INDICATED THAT THE MOST SIGNIFICANT FACTORS CORRELATED WITH UNMET NEED FOR CONTRACEPTION WERE TYPE OF RESIDENCE (RURAL OR URBAN), PROVINCE OF RESIDENCE, LEVEL OF EDUCATION, RESPONDENT’S AND HUSBAND’S APPROVAL OF FAMILY PLANNING, DESIRED FAMILY SIZE, RELIGIOUS AFFILIATION AND PARITY. THESE FINDINGS UNDERSCORE THE FACT THAT EFFORTS SHOULD BE MADE TO ADDRESS THE ISSUE OF UNMET NEED IF THE PACE OF THE ON-GOING FERTILITY TRANSITION IS TO BE ENHANCED.
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| 31. |
HOW WELL DOES SPOUSAL DISCUSSION PREDICT PARTNER (DIS)APPROVAL OF FAMILY PLANNING - EVIDENCE FROM THREE KENYAN SURVEYS
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1998 |
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ABSTRACT
THE MEASUREMENT OF SPOUSAL DISCUSSION IN SURVEYS IN THE DEVELOPING WORLD HAS CONTRIBUTED TO THE CURRENT CONSIDERATION THAT THE IMPROVEMENT OF SPOUSAL COMMUNICATION IS A VIABLE POLICY TOOL FOR BRIDGING THE GENDER GAP IN REPRODUCTIVE INCLINATIONS AND, ULTIMATELY, REDUCING FERTILITY. MUCH OF THE PREVIOUS WORK THAT HAS UNDER-GIRDED THIS POSITION HAS FOCUSED ON SPOUSAL GAUGING OF PARTNER APPROVAL, WHICH IS OBSERVED TO IMPROVE WITH DISCUSSION. FURTHER, BECAUSE WOMEN WHO INDICATE THAT THEIR SPOUSES REPRESENT OBSTACLES TO THEIR USE OF CONTRACEPTION ALSO OFTEN STATE THAT THEY HAVE NEVER DISCUSSED FAMILY PLANNING, THEIR STATEMENTS OF HUSBAND-AS-OBSTACLE HAVE OFTEN BEEN QUESTIONED. RECENT WORK HAS CHALLENGED THE NOTION THAT DISCUSSION NECESSARILY CONVEYS KNOWLEDGE ABOUT PARTNER ATTITUDE. THOSE FINDINGS, HOWEVER, EMANATE FROM A KENYA 1998 DEMOGRAPHIC HEALTH AND SURVEY OF 1195 COUPLES, OF WHO ONLY ABOUT 10 PERCENT DISAPPROVE OF FAMILY PLANNING. THUS, THE CONCLUSIONS, WHICH OBTAIN FROM THE VARIANCE IN FINDINGS ASSOCIATED WITH DISAPPROVAL VERSUS APPROVAL, ARE BY
DEFINITION TENTATIVE. THE CURRENT STUDY POOLS THREE DATA SETS TO PROVIDE A LARGE ENOUGH SAMPLE TO VERIFY THE FINDINGS FROM THE EARLIER STUDY. THE STUDY GOES FURTHER TO EVALUATE, IN A MULTIVARIATE FRAMEWORK, THE HYPOTHESIS THAT DISCUSSION IMPROVES SPOUSAL KNOWLEDGE OF PARTNER ATTITUDE. THE RESULTS CONFIRM THAT THE IMPROVEMENT IN REPORT OF PARTNER APPROVAL THAT
HAS BEEN NOTED TO OCCUR WITH DISCUSSION AND ATTRIBUTED TO IMPROVED KNOWLEDGE MAY, IN FACT, BE A RESULT OF GUESSING, OR OF PROJECTING ONE’S OWN ATTITUDES ONTO THOSE OF THE PARTNER. THE IMPLICATION IS THAT ANTICIPATED REDUCTIONS IN UNMET NEED FROM IMPROVEMENTS IN SPOUSAL DISCUSSION MAY BE OVERSTATED.
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| 32. |
AIDS RELATED CONDOM USE AMONG MARRIED KENYAN MEN
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1998 |
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| 33. |
RURAL - URBAN DIFFERENCES IN THE RESOLUTION OF FERTILITY GOALS IN KENYA
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1998 |
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ABSTRACT
THIS STUDY EXPLORES THE SIGNIFICANCE OF THE RURAL-URBAN DIVIDE AS A SOCIAL FORCE THAT CIRCUMSCRIBES THE GENDERED NATURE OF REPRODUCTIVE DECISION MAKING IN KENYA. WE SEEK TO EXAMINE HOW THE RELATIVE INFLUENCE OF FEMALE AND MALE PREFERENCES ON REPRODUCTIVE DECISION MAKING DIFFERS BETWEEN RURAL AND URBAN AREAS, AND THE REASONS FOR SUCH VARIATION. WE FIND THAT WHEREAS GENDERED REPRODUCTIVE PREFERENCE EFFECTS ON CONTRACEPTIVE BEHAVIOR ARE COMPLETELY EXPLAINED BY FACTORS SUCH AS FEMALE EDUCATION IN URBAN AREAS, IN RURAL AREAS, MALE PREFERENCES CONTINUE TO DOMINATE FEMALE PREFERENCES IN REPRODUCTIVE OUTCOMES. THE IMPLICATIONS OF THE FINDINGS ARE DISCUSSED.
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