Fertility Fertility Entire pot

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Compiled by the Child, Youth and Family Development Research Programme,Human Sciences Research Council Published by HSRC PublishersPrivate Bag X9182, Cape Town 8000, South Africawww.hsrcpublishers.ac.za© 2003 Human Sciences Research Council and Department of Social DevelopmentFirst published 2003All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means,including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the HSRC and the Department of Social Development.ISBN 0-7969-2035-4Cover by Jenny YoungBeaded dolls crafted by township women from the Monkeybiz bead project,Te l: (021) 426-0145, email monkeybiz@iafrica.com, www.monkeybiz.co.zaProduction by comPressDesign and typesetting by Christabel HardacrePrinted by Creda PressDistributed in Africa by Blue Weaver Marketing and Distribution,PO Box 30370, Tokai, Cape Town 7966, South Africa.Te l: +27 +21-701-4477Fax: +27 +21-701-7302email: booksales@hsrc.ac.zaDistributed worldwide, except Africa, by Independent Publishers Group,814 North Franklin Street, Chicago, IL 60610, USA.www.ipgbook.comTo order, call toll-free: 1-800-888-4741All other inquiries, Tel: +312-337-0747Fax: +312-337-5985email: Frontdesk@ipgbook.comFree download from www.hsrcpress.ac.za ContentsForeword: Dr ZST Skweyiya, MP, ixPreface: Dr Mark Orkin xiiiOverview: Department of Social Development xvAcknowledgements xviiAcronyms xviiiIntroduction: Christine Varga 1Paper 1 Fertility transition in South Africa and its impact on the four major racial groups 7Leon SwartzPaper 2 Fertility, poverty and gender 27Barbara A AndersonResponse to Paper 2 57Monde B MakiwanePaper 3 Youth and fertility 59Kim Eva DicksonResponse to Paper 3 72Eric O UdjoPaper 4 HIV/AIDS and fertility 77Gretchen du PlessisPaper 5 Fertility issues in Southern Africa 117John C Caldwell and Pat CaldwellFree download from www.hsrcpress.ac.za List of figuresFigure 1.1: Comparative levels of fertility in Southern and East Africa 8Figure 1.2: Poverty rates among population groups, South Africa, 1998 9Figure 1.3: Poverty gap by population group, South Africa, 1998 9Figure 1.4: Differentials in total fertility rate by race, 1960–1998 10Figure 1.5: Contraceptive use in sexually active women, South Africa, 1999 13Figure 1.6: Comparison of contraceptive use by racial group, 1990–1998 18Figure 2.1: Total fertility rate – lifetime births to a woman under current fertility rates, 1950–2000 28Figure 2.2: Total fertility rate in South Africa in comparison with other African countries, 1950–2000 29Figure 2.3: Total fertility rate by population group, South Africa,1960–1998 30Figure 2.4: Infant mortality rate – number of deaths by age one year per 1 000 births, 1950–2000 34Figure 2.5: Infant mortality rate in South Africa in comparison with other African countries, 1950–2000 35Figure 2.6: Percentage of population living in urban areas,South Africa, 1994–1999 38Figure 2.7: Percentage of population with clean water,South Africa, 1994–1999 39Figure 2.8: Percentage of population with flush or chemical toilet,South Africa, 1994–1999 40Figure 2.9: Estimated and modelled percentage of children aged 0–14 years whose mother is dead 43Figure 2.10: Percentage of African children with a living mother and who reside in a different household than the mother, Africans, 1995–1998 45Figure 2.11: Relation of illness of mother to whether child is fostered,Africans, 1995 45Figure 2.12: Relation of illness of mother to whether child is fostered,Africans, 1998 46Figure R3.1: Reported and adjusted age-specific fertility rates, Limpopo province, 1998 75Figure R3.2: Reported and adjusted age-specific fertility rates,North West province, 1998 75viFree download from www.hsrcpress.ac.za List of tablesTable 1.1: Teenage pregnancy and motherhood: percentage of women aged 15 to 19 who are mothers or who have been pregnant by background characteristics, South Africa, 1998 15Table 1.2: Contraceptive use by residence, 1998 18Table 1.3: Contraceptive use by level of education, 1998 18Table 2.1: Actual and ideal fertility of women aged 15–49, 1998 32Table 2.2: Relation of various characteristics to the infant mortality rate,ten-year period before 1998 37Table 2.3: Alcohol and tobacco use among women aged 15 years or older, 1998 42Table 3.1: Adolescent pregnancy and motherhood, South Africa, 1998 62Table R3.1 Total fertility rate in South Africa from various sources 74Table 4.1: Global HIV/AIDS estimates 80Table 4.2: HIV prevalence by province, 1998 81Table 4.3: Estimates of total and age-specific fertility rates,South Africa, 1996 81Table 4.4: Unmet need for family planning services, South Africa, 1998 87Table 4.5: Planning status of births in the five years preceding the survey,according to birth order and mother’s age at birth,South Africa, 1998 88Table 4.6: Comparative figures for total wanted fertility rates and total fertility rates, South Africa and selected sub-Saharan countries 89Table 4.7: Percentage ever use of condoms (various DHS-rounds) 99Table 4.8: Estimated risk and timing of MTCT of HIV 102viiFree download from www.hsrcpress.ac.za FERTILITY: THE CURRENT SOUTH AFRICAN ISSUESviiiFree download from www.hsrcpress.ac.za ForewordAlthough fertility has declined in South Africa in overall terms, high levels ofchildbearing still appear to be a demographic reality in certain segments ofthe population. In this respect the South African population policy addressesthe issue of fertility by expressing concern about ‘the reduction of humandevelopment potential influenced by the high incidence of unplanned andunwanted pregnancies and teenage pregnancies’.Whereas a woman has the right to as many or few children as she wishes, it isessential that specific services should be offered and information should bemade available to protect women and especially mothers from abuse and sex-ual exploitation.South Africa can indeed pride itself on the reduction in fertility levels amongall the population groups that has taken place in recent decades. In 1980 thetotal fertility rate for all South African women stood at 4.9 children perwoman. By 1990 it had declined to 4.0. In 1998 the South African Demo-graphic and Health Survey (SADHS) established the total fertility rate as only2.9. Looking at the 1996 census results, it is clear that there are statistical dif-ferences between the races. On average:•Whites had 1.9 children per women of childbearing age;•Indians had 2.7 children;•Coloureds had 2.9 children; and•Africans had 3.7 children.The 1998 SADHS found that the total fertility rate for Africans had declinedeven further, to 3.1, while there were no significant changes amongst the othergroups.Te enage childbearing is an issue of great concern in South Africa. The highrate of teenage pregnancies has far-reaching consequences. The majority ofteenage pregnancies are neither planned nor wanted. The father of the childseldom acknowledges or takes responsibility for the financial, emotional andixFree download from www.hsrcpress.ac.za practical support of the child. The mother often leaves school, thus ending heropportunities for personal development. She thus exposes herself to a futureof poverty, exploitative and violent sexual relationships, and diminishedcareer opportunities. Indeed, the 1998 DHS found that teenage pregnancy wasthe most frequent reason for leaving school amongst African and colouredwomen between the ages of 15 and 24 years.In spite of the dramatic decline in fertility amongst Africans, a high incidenceof poverty persists. Women remain the primary caregivers to children and arealso frequently burdened with the responsibility of earning the means to doso. This is simply because male partners are often absent, thereby making thewoman the sole breadwinner. The result is an increase in female-headed fam-ilies with the associated social problems of vulnerability and a lack of positiveadult male role models.HIV/AIDS and fertility is another issue that needs to be explored. Somedemographers and policy-makers argue that the HIV/AIDS situation in SouthAfrica will fast-track the downward trend in fertility rates. The impact ofHIV/AIDS on fertility is expected to be threefold:•As more women die young before the completion of their reproductiveyears, total fertility will decline;•AIDS will reduce the fecundity of women who would otherwise haveborne more children; and •Increased condom use as a result of public education about the prevention of HIV infection will further reduce fertility.The rate of change in people’s reproductive behaviour, and the accompanyingfertility decline, is one of the most significant in the sub-Saharan Africanregion and indeed the whole of Africa. In the Southern African DevelopmentCommunity (SADC) region, only South Africa and Zimbabwe have total fer-tility rates of less than five children per woman in the childbearing age group.Several social and economic factors have influenced the decline in fertility. Wehave a dynamic regional economy that offers more women the opportunity towork.Levels of literacy are high in comparison with other sub-SaharanAfrican countries. The overall standard of living is improving for many SouthAfricans as access to social services, clean drinking water, electricity, healthand education increases.FERTILITY: THE CURRENT SOUTH AFRICAN ISSUESxFree download from www.hsrcpress.ac.za Let us however not be under any illusions. There are still huge challenges toovercome:•Infant mortality is still high;•High levels of teenage pregnancy still persist;•Levels of abuse of women are still high;•The sexual integrity of women continues to be abused by men;•Poverty and inequitable access to basic services are widespread,especially in the Eastern Cape, Limpopo, KwaZulu-Natal and Free State;and•The continuing high incidence of HIV infections is wreaking havoc withthe stability of our demographic structure.Government needs to continue to address these challenges. Existing andfuture policies, programmes and projects should prioritise interventions thatwill overcome these challenges. Specific focus needs to be placed on empow-erment programmes for teenagers and for vulnerable women in rural areasthat will assist them to take control of their reproductive choices.I trust that this publication will make a useful contribution to addressing fertility issues in South Africa by suggesting and developing innovative andsustainable methodologies to overcome the challenges.Dr ZST Skweyiya, MPMinister of Social DevelopmentFOREWORDxiFree download from www.hsrcpress.ac.za FERTILITY: THE CURRENT SOUTH AFRICAN ISSUESxiiFree download from www.hsrcpress.ac.za PrefaceThe mission of the Human Sciences Research Council (HSRC) is to doresearch that makes a difference.This means working with partners and user-groups, clients and funders, from the inception of research to its implementa-tion, on social problems of national significance.The Department of Social Development is a key government user and ally ina great deal of the work that the HSRC does, and especially in the work of theresearch programme Child, Youth and Family Development (CYFD). Jointprojects include research to support family policy, social security for vulnera-ble children and the development of a disability assessment tool.To gether the Department of Social Development and CYFD have planned a series of meetings to reconsider fertility in the light of changing social circumstances. Some of these changing conditions include the impact ofHIV/AIDS, the empowerment of women, the importance of youth develop-ment and the role of men in programmes to support sexual and reproductivehealth.Fertility rates are dropping faster than expected, with far-reaching impli-cations and this is an issue of obvious importance for future projectionsaround the provision of services such as schooling and social security grantsfor children. For this reason it is important that the relevant communities of practitioners and researchers scrutinise and debate emerging trends in fertility.The HSRC is proud to be able to assist the Department of Social Developmentin its work. We appreciate the financial assistance of the Department, and lookforward to future joint meetings and publications on fertility as well as on anumber of other issues of mutual interest.Dr Mark OrkinChief Executive Officer, HSRCxiiiFree download from www.hsrcpress.ac.za [...]... intermediate fertility country,3 many questions remain with regard to fertility dynamics in the country What factors have led South Africa to such low fertility rates? How have the critical and sweeping socio-political changes over the last decade influenced fertility in this country? What does the future hold for South African fertility profiles? Another distinctive characteristic of South Africa’s fertility. .. total fertility rate of South Africa stands at 2.9 (SADHS Project Team, 1999) Whites experienced a long and sustained fertility decline from the end of the nineteenth century until attaining below-replacement fertility by 1989, with a total fertility rate (TFR) of 1.9 (Chimere-Dan, 1993) Asian fertility also declined steadily, from a TFR of about 6.0 in the 1950s to 2.7 in the late 1980s Coloured fertility. .. in South Africa Overall, non-marital fertility has been declining more than marital fertility in South Africa, both on the national level and across the major population groups in the country (Mencarani, 1999) This intensive control of non-marital fertility appears to be the dominant force in the fertility transition in South Africa The decline in nonmarital total fertility is more likely to be driven... HIV/AIDS will affect fertility rates, demographic growth, and ultimately population well-being in South Africa? The papers in this collection provide insight on all these issues and lay the groundwork for further debate and exploration of fertility- related topics in South Africa Swartz provides a thorough rendering of South Africa’s fertility trends and explores the influence of potential mediating... the fertility agenda, that of theory and method Her paper brings to the fore the limits of a ‘proximate determinants’ framework in understanding fertility dynamics and suggests ways forward to gain a deeper and more meaningful undertanding of fertility dynamics Further, the paper argues for greater attention to qualitative research as well as more triangulated data-collection approaches to both fertility. .. where poverty usually goes hand in hand with high fertility This paper investigates issues around lower fertility, factors contributing to it, its impact on the different population groups, as well as policies to address its impact South Africa’s fertility compared to that of sub-Saharan Africa Figure 1.1 clearly illustrates that the South African fertility rate is significantly lower than that of... explained below in more detail Total fertility rate (women aged 15–49) Free download from www.hsrcpress.ac.za Figure 1.1 Comparative levels of fertility in southern and East Africa 8 6 6.1 5.9 5.6 5.6 5.1 4 4 2.9 2 0 Malawi Namibia Zimbabwe Uganda Zambia Tanzania South Africa Country Source: PRB, 2000 South Africa’s fertility trends South Africa’s experience in the fertility transition is among the most... provinces still holds The fertility trends among population groups in South Africa show the same patterns as those for poverty The African component, which is the poorest with regard to per capita income, has the highest fertility rate, while the white population, which has the highest per capita income, has the lowest fertility rate as explained below Thus, a decline of fertility has been observed... agespecific fertility rates Most sub-Saharan African countries have observed striking regularity in age-specific fertility declines – that is, fertility has 2 Free download from www.hsrcpress.ac.za INTRODUCTION declined across all age groups, and in particular among adolescents and young adult women (Caldwell, Orubuloye & Caldwell, 1992; Kirk & Pillet, 1998) In this country, adolescent fertility rates... late 1960s to about 3.0 by the late 1980s African fertility is estimated to have decreased from a high of 6.8 to a low of about 3.9 between the mid-1950s and the early 1990s Although it continues to decline, African fertility is still substantially higher than that of the other racial groups Reasons for fertility decline Despite this dramatic decline in fertility, the majority of the African population, . age-specific fertility rates. Most sub-Saharan African countries have observedstriking regularity in age-specific fertility declines – that is, fertility has FERTILITY: . 1990–1998 18Figure 2.1: Total fertility rate – lifetime births to a woman under current fertility rates, 1950–2000 28Figure 2.2: Total fertility rate in South
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