Breastfeeding and infant and child mortality, in Amagoro Division of Busia District, Kenya

Abstract

This study examined the impact of breastfeeding duration and age at supplementation on infant and child mortality. Data was collected for both open and closed intervals from women aged 15-49 years and resident in Amagoro Division, Busia District, western Kenya. The study found that breastfeeding initiation is quite high, with an average of 99% of the women initiating breastfeeding. The duration of breastfeeding is long, with the majority of the women breastfeeding for 19-24 months. The major problem noted in the study is early supplementation. By the age of 3-4 months about 70% of children in the open and closed intervals were already being fed on other diets in addition to breast milk. The study also found that, for both the open and closed intervals, breastfeeding duration, age at supplementation, work status of the mother, type of toilet facility used by the household, and immunizations received by the child were significant in child survival. The major conclusion derived from the results of the study is that breastfeeding practices, environmental factors, and socio-economic factors are very significant in influencing infant and child deaths. However, the impact of breastfeeding and age at supplementation are greatly modified by environmental and socio-economic factors. The study therefore recommends the re-education of health personnel, especially those in the Maternal and Child Health clinics (MCH), on the importance of breastfeeding and proper age at supplementation for the children. The paper also recommends that female employment opportunities and female education be increased, since maternal education highly determines the work status of the mother and the nutritional, health care and sanitary conditions of the household.

The quality of care in family planning: a case study of Chogoria, Eastern Kenya

Abstract

This paper compares the quality of family planning services in the catchment areas of Chogoria and Maua hospitals, both in the Meru district of Kenya. The quality issues compared are personnel, types of methods, information, recruiting and counselling of clients, knowledge and source of modern contraceptives, desired family size, use of contraceptives, and satisfaction of providers and clients. A comparative approach is adopted to study the aspects of family planning that have made Chogoria relatively more successful than Maua and the rest of Kenya. The data used in this analysis is qualitative and was collected through personal observation, interviews, and group discussions with health care providers. The results show that while the family planning programmes of Chogoria and Maua are comparable in many respects, there are also important differences. For example, Chogoria family planning personnel were more knowledgeable about contraceptives and were more satisfied with the training provided by Chogoria hospital than were their counterparts in Maua. The relationship between the senior and the junior staff was more cordial in Chogoria. The content of the information about contraceptives provided to women attending clinics was similar in both hospitals. But the teachers in Chogoria were more knowledgeable and confident than those in Maua. In Chogoria, the decision to use family planning is jointly taken by the husband and the wife, and if a client fails to turn up for an appointment a follow-up is scheduled. In Maua, the decision to use family planning is taken unilaterally by the wife and defaulters are not followed up. The study showed that 78 percent and 33 percent of the participants were using modern family planning methods in Chogoria and Maua respectively. Three conclusions are drawn from the study. First, that the satisfaction of family planning providers and their clients contributes positively towards more knowledge and use of modern contraceptives. Second, that women feel more secure and comfortable with the methods they use if their husbands are involved in deciding whether or not to adopt them. Finally, follow-up services for those who fail to attend appointments helps to strengthen rapport between providers and clients and provides an opportunity to learn of the circumstances that lead to discontinuing the use of contraceptives.

Pourquoi les Femmes Arrêtent-Elles D’utiliser la Contraception? L’exemple du Botswana

Abstract

Cette étude examine les causes de l'arrêt des méthodes de régulation de la fécondité au Botswana en se basant sur les données de son Enquête Démographique et de Santé menée en 1988. La majorité des femmes qui ont arrêté l'utilisation de leur méthode de planification familiale ont évoqué deux causes principales: les problèmes de santé rencontrés et le désir d'avoir d'autres enfants. L'opposition du mari (ou du partenaire sexuel) est l'une des autres raisons importantes mentionnées par les femmes. L'auteur identifie ensuite les facteurs socioéconomiques et culturels qui peuvent influencer les femmes à arrêter leur méthode de régulation de la fécondité. Finalement, quelques implications pour les programmes africains de planification familiale sont discutées.

The Impact of Access to Health Services on Infant and Child Mortality in Rural Uganda

Abstract

This paper examines the impact of access to health facilities on infant and child mortality in Uganda. Using the proportional hazard model, the paper shows that access to health centers affects childhood mortality of rural children; however, the effect is only substantial for children born to non-educated mothers. This study was partly funded by the Rockefeller Foundation through the Macro International Small Grants Program.

La Dynamique de la Fecondite des Adolescentes au Senegal

Abstract

L'étude de la fécondité des adolescentes est en train de devenir une sous-discipline principale des études de population (Westoff et al., 1983). En Afrique, cette problématique ne fait que commencer à soulever l'intérêt. Dans plusieurs pays, elle est encore reçue avec beaucoup de scepticisme car elle n'est pas encore perçue comme un problème. Pourtant si l'on se place dans une perspective de diminution de la fécondité, l'apport des naissances des adolescentes est considérable, puisque dans la plupart des pays africains les naissances d'adolescentes comptent pour 20 % des naissances totales (United Nations, 1989). Les cas de grossesses avant le mariage deviennent également de plus en plus importantes (Nichols et al., 1986; Gyepi-Garbrah, 1985) avec des conséquences souvent dramatiques. En effet, le nombre des avortements illégaux a considérablement augmenté avec des conséquences néfastes sur la santé ; des abandons scolaires quand la grossesse survient chez les adolescentes en scolarité ; une augmentation de l'infanticide ; et des répercussions sur la santé des enfants (Omu, 1981; Senderowitz et Paxman, 1986; Akuffo, 1987; Hobcraft, 1987; Adetoro et Agah, 1988).