|Ngalinda, Innocent: Age at First Birth, Fertility, and Contraception in Tanzania |
The United Republic of Tanzania is located in the Eastern part of Africa and consists of the mainland of Tanganyika and the islands of Zanzibar, altogether covering 945,234 km2, whereas 62,0500 km2 constitute inland water.<1> Initially, Tanganyika and Zanzibar were two different countries. Tanganyika achieved independence from the British rule on December 9, 1961 and Zanzibar became independent from the rule of the Sultanate of Oman on January 12, 1964. On April 26, 1964, Tanganyika<2> and Zanzibar were amalgamated to form the United Republic of Tanzania.<3>
Administratively, Tanzania is divided into 25 regions. Tanganyika has 20 regions. These regions include Arusha, Kilimanjaro, Dar es Salaam, Pwani, Tanga, Dodoma, Shinyanga, Singida, Lindi, Morogoro, Mtwara, Ruvuma, Kagera, Mwanza, Mara, Iringa, Kigoma, Mbeya, Rukwa, and Tabora. Zanzibar constitute mainly two islands Unguja and Pemba; has 5 regions ( Figure 1 ). Dodoma is the constitutional capital of Tanzania but Dar es Salaam actually remains the commanding post of the policy makers.
Tanzania is a poor country with a mixed economy in which agriculture plays a major role. The economy expanded after independence until the mid-1970s when various factors including droughts, oil price increases, the Tanzania-Uganda war, and the break up of the East African Community cumulatively had a devastating effect. Recently, however, steady growth has resumed. For instance during the period 1985-1990, the annual growth in the gross domestic product (GDP) measured in constant 1976 prices was 3.9 percent (United Republic of Tanzania/UNICEF, 1990). This growth followed
14the implementation of structural adjustment policies introduced since in the 1980s. However, Tanzanias economy is highly dependent on imports and the availability of foreign exchange. A shortage of foreign exchange has resulted in a reduction in government budgets, particularly for the education and health sectors.
Figure 1: Map of the United Republic of Tanzania showing administrative regions
Source: http://www.reliefweb.int/mapc/afr_east/cnt/tza/ of October 29, 1998
15The population density is 26 persons per km2 (according to 1988 census), a figure that gives the impression that Tanzania is a sparsely populated country in comparison for instance with Germany. According to the 1998 Population Data Sheet produced by the Population Reference Bureau, Tanzania has a population density of 35 persons per km2 in 883,589 km2 while Germanys population density stood at 236 persons per km2 of 349,269 km2. However, Tanzanians are unevenly distributed, and some areas are experiencing serious population pressure. This encouraged the government to formulate a population distribution policy which was enforced as long ago as 1969-74, in the second five-year plan (United Republic of Tanzania, 1969). The villagisation programme of the 1970s,<4> the plan to develop Dodoma in order to reduce the importance of Dar es Salaam, and the control of rural-urban migration are among the efforts made by the government towards a more even distribution of the population (United Nations, 1989). However, currently over 80 percent of the population reside in rural areas (Bureau of Statistics, 1994).
The education system of Tanzania has different levels of which some are compulsory. The first level is primary education, locally referred to as foundation education. Almost all primary schools are owned by the state. Primary education is compulsory and the minimum entry age is seven years. Children are supposed to spend seven years in primary school, standard one to standard seven. Enrolment in primary schools rose dramatically after the establishment of the policy of Universal Primary Education (UPE) in 1974 accompanied by the villagisation programme.<5>
The second level in the Tanzanian education system is secondary education comprising two parts: the first four years is called ordinary level and the next two years advanced level. A small number of primary school leavers are selected to join ordinary-level secondary schools (they compete it by doing a standard seven examination), as the
16number of secondary schools is very small compared with primary schools. The government owns most of the secondary schools. Recently, many private secondary schools have been established.
Few students, who succeed at the ordinary-level final examination, are chosen to join advanced-level secondary schools. The number of students joining university and higher educational institutions is a very small proportion of those who started at the foundation level. Despite the commitment of the government, the 1988 Population Census showed that almost 40 percent of the population (10 years and above) are illiterate (Kapinga and Ruyobya, 1994).
There are many religious groups in Tanzania. However, data on their membership representation are not available as questions on ethnicity and religion are considered sensitive and are not allowed to be asked for census purposes although permitted in surveys. In many regions, Christians (Catholics and Protestants) and Moslems co-exist beside traditional believers. Most of the traditional faiths are tribal religions, such as animism, i.e. the belief that objects and natural phenomena possess souls. In Tanzania there are also people without any faith.
General observation shows that in areas where missionaries settled and Christianity is a dominant religion (for instance in the Kilimanjaro region), there are relatively many primary and secondary schools. The literacy rate is higher. According to the 1988 census, regions with more than average percentage of literate population (aged 10 years and above) include Kilimanjaro (81 percent), Dar es Salaam (81 percent), Ruvuma (71 percent), Iringa (68 percent), Tanga (66 percent), Mara (64 percent), Morogoro (63 percent), and Mbeya (62 percent). Shinyanga has the lowest percentage of literate population (48 percent).
Since the independence, Tanzania has conducted three population censuses and three demographic surveys. The censuses were taken in 1967, 1978 and 1988; the first national demographic survey was conducted in 1973 (Henin et al., 1973), and the other two Tanzanian Demographic and Health Surveys were carried out in 1991/92 and 1996. Censuses and demographic surveys are the major sources of demographic statistics in this country, since the registration of vital events is still very incomplete.
17From these censuses, the Tanzanian population was found to be 12.3 million, 17.5 million, and 23.1 million in 1967, 1978 and 1988 respectively (Bureau of Statistics, 1994). Tanzanians are now estimated to be 30 million according to the 1998 World Population Data Sheet of the Population Reference Bureau. The intercensal population growth rate between 1967 and 1978 was estimated to be 3.2 percent. With an increase of the population to 23 million by the time of the 1988 census, for the period 1978-88 the annual growth rate was estimated to be 2.8 percent. These figures suggest that the population growth rate has been declining in Tanzania (Bureau of Statistics, 1989; Barke and Sowden, 1992). This decline has been questioned, particularly for the major city of Dar es Salaam. For instance, Briggs (1993) has discussed factors that might have caused the population of Dar es Salaam to be under-counted in the 1988 census. The World Bank puts Tanzanias annual growth rate at 3.1 percent for that period.
These population parameters show that the population of Tanzania grew by about 88 percent in a period of 21 years and population density increased from 14 to 26 persons per km2 in the same period. If this natural rate of increase is maintained, the population of Tanzania will double to about 60 million in 25 years. Consequently, there might be a great need of reducing this burden of population growth.
In order to tackle the population problems, the government of the United Republic of Tanzania has formulated the National Population Policy. The broad objective of this policy is to reinforce national development by developing available resources in order to improve the quality of the life of the people: ‘Special emphasis shall be laid on regulating the population growth rate, enhancing population quality, and improving the health and welfare of women and children. The mutual interplay between population and development shall constantly be borne in mind. Thus, the population policy shall always be the main guide of national development planning (Planning Commission, 1992:10). The goal of the Tanzania National Population Policy is to reduce the annual growth rate through a reduction in the numbers of births and an increase in voluntary fertility regulation. Therefore, special emphasis is given to the National Family Planning Programme.
Family planning services in Tanzania have a long history. Back in 1959 the Family Planning Association of Tanzania (UMATI) was founded in order to promote child
18spacing as a way of enhancing maternal and child health in Tanganyika at that time. During the early days program services were concentrated in urban areas. However in 1967 the program was extended nation-wide. In 1974 the government became actively involved in providing family planning services by launching the integrated Maternal and Child Health (MCH) programme. This led to family planning services being made available and facilitated by the Ministry of Health. Currently both the government and several non-governmental organisations like UMATI, the Marie Stopes Organisation and many other mushrooming NGOs provide family planning services.
The National Family Planning Program (NFPP) was formulated in 1988 and in 1989 the National Family Planning Unit was established to co-ordinate all family planning activities in Tanganyika. Although the NFPP is under the Ministry of Health administratively, its activities and other population activities are co-ordinated by the Population Planning Unit of the Planning Commission as the overall co-ordinator of population activities in Tanzania.
The major responsibility of the NFPP is the management and distribution of contraceptives to all service delivery points. The initial broad objective of the NFPP was to raise the contraceptive acceptance rate from about 7 percent in 1989 to 25 percent by 1993 (Ministry of Health, 1989).
The plan was that contraceptive acceptance would be achieved through improving the accessibility and quality of Tanzanian family planning services by consolidating past strengths and rectifying weaknesses. The specific objectives of the NFPP were:
UMATI continued to work closely with the Ministry of Health (through the NFPP) even after handing over the co-ordination of family planning activities. However, UMATI's
19major role (excluding the co-ordination) remained the same: to motivate, educate and inform the general public on the need for child spacing; to train both governmental and NGO service providers; and to procure and distribute contraceptives.
The NFPP operates through different institutions and agencies including the government, parastatal organisations,<6> the private sector, and NGOs (Ministry of Health, 1989). The Population and Family Life Education Programme (POFLEP) under the Ministry of Community Development, Women Affairs, and Children, is a population Information, Education, and Communication programme (IEC) responsible for creating awareness among the people about the relationship between population factors and development. POFLEP also aims at helping people to take action immediately on family planning activities. Another project designed to provide IEC support to the NFPP is the Health Education Division (HED) of the Ministry of Health. The HED helps printing IEC materials for clients in dispensaries, health centres and hospitals. Also, the HED is involved in research in family planning-related problems.
Other implementing agencies of the family planning policy include:
Tanzania has a network of health facilities including a total of 152 hospitals in 106 districts. At the divisional level, there are about 273 rural health centres. At the ward level, there are about 3,000 dispensaries. At the village level, there are village health posts, estimated to be 5,550 throughout the country. In total, the government provides about 60 percent of health services and the remaining 40 percent are provided by non-governmental organisations. Family planning is included in each of these health institutions mentioned, according to the results of the 1996 Tanzania service availability survey. Despite the efforts by the government and non-governmental organisations to make family planning services available and accessible, contraceptive prevalence among women (15-49 years) is still low. It was found to be 16.1 percent for all women, and 18.4 for currently married women (Bureau of Statistics, 1997).
Out of three processes by which population in Tanzania is changing, fertility and mortality are the most important ones. International migration is negligible except refugees from politically unstable neighbouring countries like Burundi, Rwanda, and the Democratic Republic of Congo. The 1988 population census estimated death rate to be 15 per 1,000, which shows that mortality is slightly reaching a stabilisation stage due
21to a fact that Tanzanian is a young population.<7> Therefore, fertility is the major population component that will determine Tanzanias future population growth rate since mortality is declining. This statement might be true if the mortality decline reaches a stage where it cannot decline further than to a level of 10 per 1,000 per annum. In lieu of this fact, fertility decline will reduce population growth rate.
The decline in fertility in every society often proceeds in two stages. The first stage is the decline in fertility due to an increase of age at first birth (natural fertility control). The second stage involves the adoption of contraception and a change in the fertility behaviour. Much attention on stimulating fertility decline has been devoted to the provision of family planning. Thus the first stage of the transition has received less policy attention.
The first visible outcome of the fertility process is the birth of the first child. The timing of this event measured by the mothers age has strong effects on both individual and aggregate levels of fertility, as well as broader implications for womens roles and social changes in general. Social background characteristics such as religion, place of residence, and the educational attainment are some of the factors that may biologically postpone the onset of the child bearing process.
The first birth marks a womans transition into motherhood. It has a significant role in the future life of each individual woman and a direct relationship with fertility. It is believed that the age at which child bearing begins influences the number of children a woman bears throughout her reproductive period in the absence of any active fertility control. Therefore the timing of the first birth has important demographic implications, as both the timing of subsequent births and completed family size are related to the age at first birth. For a country like Tanzania, where contraceptive use is relatively low,
22younger ages at first birth tend to boost the number of children a woman will have. However, even when family planning is widespread, the timing of first births can affect completed family size if contraception is used for spacing but not for limiting fertility. Several studies have found evidence of faster subsequent child bearing and an increased chance of unwanted births if the first child is born at an early age (Casterline and Trussell, 1980; Finnas and Hoem, 1980; Ford, 1984; Rao and Balakrishnan, 1988). On the other hand, delaying the first birth tends to reduce completed family size. But Turner (1992) in a similar study in Russia found fertility to be low despite early age at first birth and a lack of efficient contraceptive methods. The explanation for this situation may be attributed to abortion. Where contraceptives are expensive and access to abortion is easy fertility might be low. This is based on the assumption that in Eastern Europe couples have an interest in small families, yet women have had little access to or confidence in modern contraceptives. By default, abortion has become the primary means of limiting fertility in many Eastern European countries and the Commonwealth of Independent States (CIS), formerly the Soviet Union (Blum, 1991; Dennehy et al., 1995; Desantis and Thomas, 1987).
The birth of a child is an event of great social and individual significance and its importance is recognised in all human societies. It is of special importance as it signifies the transition of a couple into a new social status i.e. parenthood with its related expectations and responsibilities. It marks the sexual and social maturity of the mother and the visible consummation of sexual intercourse.
Traditionally, procreation was ensured through the institution of marriage. Marriage was geared towards the achievement of large family sizes necessary for meeting its economic, social, and psychological needs. Girls received parental coaching on motherhood and household roles from both their immediate family and the society, popularly known in Tanzania as Unyago.<8> As a result, sexual intercourse started after
marriage and eventually high age at first birth were achieved and premarital births was avoided. However, many traditional values and social practices have undergone changes during the course of modernisation, and it is likely that the traditional premarital sexual abstinence is on the decrease.
On average, Tanzanian woman marry at the age of 18 (Bureau of Statistics, 1997) although this varies with the level of education, the area of residence, and religion. For example, Reining (1972) in a study of the Haya in Northwestern Tanzania found the average age at first marriage to be between 14-16 years. In most cases fecund Haya women was found to start child bearing immediately after they got married.
It is a fact that girls in Tanzania engage in early sexuality and subsequent early child bearing according to studies undertaken by Uzazi na Malezi bora Tanzania-UMATI (Mpangile et al., 1993). Statistics from the Ministry of Education also show that a large proportion of school girls in primary and secondary schools drop out from school due to pregnancies and early births (Sawaya, 1995). Furthermore, a large proportion of women chooses to remain single nowadays in Tanzania but continue to bear children. Therefore, the concept of the universality of marriage, and births within marriage seems to be a misleading concept in modern times. In Demographic and Health Surveys Comparative Studies it was found that in sub-Saharan African countries 12-67 percent of women experienced intercourse one or more years prior to their first union (Arnold and Blanc, 1990). This suggests that age at first union is insufficient to capture all sexual exposure that leads to births prior to marriage. Moreover, marriage undergoes a shift from arranged marriages to romantic marriages of which sexual intercourse before marriage is a prerequisite. Sometimes these premarital sexual activities result in premarital pregnancies (Gage-Brandon and Meekers, 1992).
The data show a slight rise of median age at first marriage in Tanzania from 17.2 years among women age 45-49 to 19.0 years among women age 20-24 (Bureau of Statistics, 1993). The proportion of women married by the age of 15 declined from 22 percent among those at the time of the survey aged 45-49 years to only 4 percent among women at the age of 15-19 years at the time of the survey. This rise in age at first marriage had only a partial impact on fertility. This is due to the fact that a decline of the total fertility rate (TFR) by one child in 30 years, as discussed above, is negligible. Moreover, it
24seems that in Tanzania marriages are not stable now since data from the 1996 TDHS indicates that out of the 25 percent of ever married women between the age of 15 and 19 years, 10 percent are already divorced at this tender age.
The vast majority of Tanzanian women bear children at an early age (Bureau of Statistics, 1993). According to the 1991/92 TDHS data, women who had their first birth below age 15 range between 1 percent for women 15-19 years to 10 percent for women 45-49 years. Furthermore, it was found in the same data that 23 percent of the women age 15-19 were already mothers and 6 percent were pregnant with their first child at the time of the interview (Ngallaba et al., 1993).
Factors influencing age at first birth in Tanzania were classified into biological, social, cultural and behavioural factors (Ngallaba et al., 1993). With modernisation, we expect the age at menarche in Tanzania to decline due to better nutrition and household health. This is likely to initiate early child bearing depending of course on the exposure to sexual relationships and the availability and use of contraception. If deliberate measures to change the current situation are not taken, the prevailing fertility level will persist for many years to come.
Fertility in sub-Saharan Africa is higher than in other regions of the world, with an average total fertility rate (TFR) in excess of six children per woman. Moreover, until the late 1970s, the analyses of the World Fertility Survey (WFS) and other data showed a rising trend in fertility in most countries in sub-Saharan Africa (see for example Cochrane and Farid, 1989). It was believed that these persistently high fertility rates are related to strong pronatalist forces inherent in the kinship system in Africa (Caldwell and Caldwell, 1987; Frank and McNicoll, 1987).
However, analyses based on the Demographic and Health Surveys (DHS) data in the late 1980s, show a declining trend of fertility in several African countries. The most obvious countries where fertility has started to decline include Kenya, Zimbabwe, and Botswana (Arnold and Blanc, 1990; van de Walle and Foster, 1990; Robinson, 1992; Cohen, 1993; Rutenberg and Diamond, 1993). The onset of fertility decline in sub-
25Saharan Africa has engendered much interest since it has been suggested that sub-Saharan Africas fertility transition is different in certain important aspects from that experienced in the past elsewhere in the world (Robinson, 1992; Caldwell et al., 1992b). However, relatively little information is yet available with which to examine this hypothesis.
This study is meant to contribute to understanding African fertility by examining the situation prevailing in one particular country, Tanzania. The government of the United Republic of Tanzania considers the population growth rate (caused mainly by high fertility levels) to be very high. It has been demonstrated also that the rapid population growth in Tanzania has negative effects on the economy, health, education, employment, agriculture, environment and urbanisation (Mturi and Hinde, 1995). It is against this background that the Government of the United Republic of Tanzania formulated the National Population Policy, announced in July 1992, which, among other things, encourages a reduction of fertility (Planning Commission, 1992).
The success of the population policies particularly in Africa however has been doubted. For instance, Kenya recognised the implications of population growth on overall development long before most other African countries started to worry. As a consequence, the Kenyan family planning programme was established in 1967 (Frank and McNicoll, 1987). It was 20 years later that fertility started to decline in Kenya. This implies that more effort needs to be made towards an understanding of the determinants of fertility in African societies so that proper strategies can be formulated. To identify the sub-groups of the population where fertility is relatively high or resistant to decline is a step forward in any programme meant to reduce fertility.
In Tanzania the study of age at first child bearing, fertility and contraception is therefore very timely because of various reasons. It is important to understand when child bearing begins, and what current fertility levels, and factors associated with high fertility levels are in Tanzania so that the impact of the National Population Policy can be assessed. Also, the analysis of new data could be used to give a better understanding of fertility trends in Tanzania in the recent past. In other words, it is important to find out if Tanzania has joined the wave of fertility decline experienced in various African countries and to identify the factors associated with the observed trends.
26The Tanzanian National Population Policy (TNPP) document (Planning Commission, 1992) states that the major causes of the high fertility levels in Tanzania are early child bearing and the absence of effective fertility regulation within marriage. Other determinants of high fertility outlined in the same document include: a preference for male children, low levels of education, the low status of women, the large age difference between spouses, and a positive attitude towards large families. All these factors have been found to have a significant effect on fertility in different parts of the world. However, specific studies for Tanzania are rare.
The relationship between age at first birth and overall fertility is generally an underdeveloped area as far as demographic research is concerned, especially in developing countries. In Tanzania for example, most research has concentrated on other determinants of fertility and has ignored age at first birth. Most researchers have assumed that child bearing only occurs within marriage. This assumption might have been true in most traditional societies where births out of wedlock were not accepted and virginity was a prerequisite for marriage. This assumption however does not hold true in modern times, where a large number of children are born outside marriage.
Many scholars have tried to argue that direct effects of early child bearing are seen in the high total fertility and generally young population, the short biographical distance between generations, and a short doubling time of the population. If that is true, there is a need to avoid early child bearing by shortening the reproductive period in delaying age at first birth. The main problem, however, is related to the fact that most Tanzanian women are not using contraception as the 1996 TDHS data suggest. Although 84 percent of all women know of at least one modern contraceptive method, only 12 percent of all women surveyed actually use any of modern methods (1996 TDHS). Therefore, one does not expect 12 percent of the total women population to exert an impact on the whole women population for further fertility decline. This is an indication that the impact of family planning programmes on fertility has been very minimal so far. This is unlikely to change within the next decade unless extraordinary measures will be taken.
27Premarital and adolescent fertility have not been adequately distinguished because there is a tendency for them to occur concurrently. A premarital birth or conception can occur at any age within the reproductive period provided the woman has not been married. The feasibility and the nature of public policy that would affect the marital status at child bearing are different from those that would affect age at child bearing. There is a need to identify the magnitude and direction of the relationship between age at first birth and fertility. The high level of fertility in Tanzania can be attributed to both marital and premarital fertility. However, most of the studies done so far overlooked the contribution of premarital fertility. In these studies, based on age at first marriage, births that occur outside marriage were always ignored.
Age at first marriage is often used as a proxy for the onset of womens exposure to the risk of pregnancy, but many women are sexually active before marriage. Therefore the age at which women initiate sexual intercourse marks the beginning of their exposure to reproductive risk more precisely. The median age at first intercourse of Tanzanian women according to the 1996 TDHS is 16.8, that is about one and half years lower than the median age at first marriage of 18.3 years. More data indicate that by the age of 15, 23 percent of the women have had sexual intercourse and by age 18, 65 percent have had sexual intercourse whereas only half had married by this age (Bureau of Statistics, 1997). Therefore, studying the factors associated with age at first birth, its consequences and its contribution to the over-all fertility of the country will help policy makers to formulate better policies in order to fight the current situation. Furthermore, this study will help to expand knowledge about the relationship between age at first birth and fertility in the Tanzanian context. The question as to whether there is a relationship between age at first marriage and age at first birth is an empirical one, which the TDHS data can answer. For these reasons, this study takes a close look at the dynamics of reproductive histories, and especially at the sequencing of events within them.
The ultimate objective of this study is to provide policy makers with useful information for formulating policies on age at first motherhood with the aim to improve the status of women in order to lower fertility. The study also intends to examine the reproductive behaviour of Tanzanian women and to suggest possible measures that can be taken in
28order to reduce fertility. Initially, the trend in fertility for the period 1967-1996 is investigated, after which an examination of the contribution of each of the proximate determinants of fertility is carried out. In order to identify the sub-groups of the population with especially high fertility, the social, behavioural, biological and demographic determinants of fertility are analysed.
On the other hand, the length of the interval between the entry into a sexual union and the first birth has important implications for fertility. Since the child bearing process is confined to a period of about 35 years, it may be assumed that early entrance into child bearing will lead to higher fertility in a low contracepting society. Therefore, this study is trying to describe the way in which age at first birth influences fertility, the magnitude of its effects, and its demographic, social, economic and cultural determinants. The study will examine the proximate determinants of age at first birth and its socio-economic and cultural variations as well as the differentials, and consequences of age at first birth in the Tanzanian context.
Due to the importance of contraceptive use in the second stage of fertility decline, as explained previously, it is important to examine the knowledge, needs and use of contraception in Tanzania. The sub-groups of the population with a low acceptance rate are identified along with the related factors. The study also investigates the levels of unmet need and the demand for family planning. Ultimately the major is to find out the proportion of women exposed to the risk of pregnancy, who want to limit or space their births but are not using contraception, and to investigate the characteristics of these women.
Finally, this study describes the larger structure of factors affecting fertility as they operate through age at first birth, and ultimately influence fertility through the intervening variables of reproductive intentions and contraception practices.
Chapter 2 consists of the analytical framework and a literature review. The chapter tries to cover the state of knowledge on the subjects included in the analysis. Chapter 3 describes the sources of the data used along with an assessment of the data quality, and
29a brief discussion of the major statistical techniques used in the analysis. In this chapter, the social economic characteristics of respondents are examined. Chapter 4 is the first analytical chapter in which proximate determinants of age at first birth are examined. Differentials in age at first birth are also investigated with respect to background variables. The major goal is to provide policy makers with useful information for improving the status of women and formulating a policy on age at first birth in Tanzania with the aim of lowering fertility. Chapter 5 contains a general overview of fertility levels and trends in Tanzania as computed by using census data of 1967, 1978, and 1988. The second part of this chapter is on analysis of the fertility levels and trends by using the two TDHSs of 1991/92 and 1996. The third part deals with proximate determinants of fertility. The fourth part is about fertility differentials. Differentials of fertility have been mainly examined by using the 1996 TDHS. The reason is that these two TDHSs are nearly 4 years apart and the changes one expects will be minimal. Chapter 6 is on family planning issues. This chapter is divided into three main sections. The first section deals with levels and patterns of contraceptive awareness, and the second section is about contraception. The last section is on unmet need and the total demand for family planning in Tanzania. In this chapter we look at a way of raising age at first birth in order to limit fertility. An important section deals with unmet need and the demand for family planning. Chapter 7 provides a discussion based on factors and consequences of adolescence child bearing in Tanzania. This chapter examines premarital births among adolescents in Tanzania in comparison with other sub-Sahara African countries that conducted the DHS III. We further chose a country in each of the other continents as controls. The last chapter constitutes summary and conclusions.
|<1>||Tanzania has borders with Kenya and Uganda to the North, Rwanda, Burundi, and the Democratic Republic of Congo (former Zaire) to the West, and Mozambique, Malawi, and Zambia to the South. To the East of the Country is the Indian Ocean (see Figure 1.1)|
|<2>||In this study Tanganyika stands for the Tanzanian mainland.|
|<3>||In this study Tanzania stands for the United Republic of Tanzania.|
|<4>||In the 1970s the government moved over 90 percent of the Tanganyika's rural population into villages to make it easier to provide basic social services, e.g. health services, primary schools and clean water supply (United Republic of Tanzania/UNICEF, 1990). This was one of the governments policies based on socialism, equity and self-reliance as stipulated in the Arusha declaration (Nyerere, 1967).|
|<5>||In order to fulfil the target of the government in giving basic education to all, Universal Primary Education was introduced in 1974. It was a reaction to the low school enrolment rate, which was 48.6 percent in 1973. The target of this policy was to gain 100 percent enrolment for all children at school age by 1977 (Muze, 1980).|
|<6>||These are organisations owned, financed and managed by the government.|
|<7>||Tanzania is termed as a young population country because its population less than 15 years of age accounted for 33 percent of total population in 1988 in comparison with an old population country like West Germany. Before the unification 16 percent of West Germany population under the age of 15 in 1986, while the age group 65 and above were 27 percent. In Tanzania, the population 65 and over were 5 percent of the total population according to the 1988 population census.|
|<8>||Unyago means female initiation. Unyago might be equated with the traditional education system which all young girls attend. During this period a young woman is taught how to take care of herself after menstruation, to avoid sexual intercourse before marriage, and how to practise birth control (here the only contraceptive is abstinence as they are taught not to resume to sexual intercourse until a child is more than two years old). Traditionally a girl was allowed to get married after her parents were convinced that she was old enough (i.e. she had started to menstruate, which was the only measure of maturity).|
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