Sterility in Sub-Saharan Africa

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Citation: Larsen, U. Sterility in Sub-Saharan Africa.
Internet Archive Scholar (search for fulltext): Sterility in Sub-Saharan Africa
Tagged: uw-madison (RSS), wisconsin (RSS), sociology (RSS), demography (RSS), prelim (RSS), qual (RSS), WisconsinDemographyPrelimAugust2009 (RSS)

Summary

Most of the current measures of sterility are used on populations with natural fertility. Using data from WFS and DHS surveys, collected between 1977 and 1982 and 1986 and 1991 respectively, the authors calculate age-specific sterility rates from 'subsequently infertile' measures (uses all the information available for a woman until she is of an age which is five years lower than her age at censoring. The last five years are used to determine her status as fertile or infertile at the last observation. If she had no births, she is considered infertile. This provides age-specific sterility rates from incomplete birth histories) for all African countries for which data are available. Next they carry out a simulation analysis to help in assessing the degree to which sterility can be estimated in the presence of contraception. The sample contains women who had been sexually active for at least five years, with the date of onset of sexual activity assumed to be the date of entry into first marriage. The biasing effect of contraception was then evaluated for each country. Finally, the potential increase in fertility if pathological sterility were eliminated, was simulated. Compared to the occurrence of sterility among the Hutterite population, sterility was relatively high in African countries. Based upon data about the proportion contracepting, the type of contraception used, the number of years of use, the woman's parity when contraception is begun, and average contraceptive efficiency, simulations of sterility were produced. In Kenya (18%), Botswana and Zimbabwe (both other 30%), the proportion of women ages 15-49 using contraception was high compared the other African countries (under 6%). The authors conclude that contraception only has a minor effect on estimates of sterility in countries where under 6% of the eligible population use it. However, in Kenya, Botswana and Zimbabwe contraception use biases estimates of sterility. The authors conclude that the measured levels of sterility in many areas of sub-Saharan Africa still exceeds that of non-African populations with natural fertility. At age 34, the proportions sterile reach 40% (WHS, 1978) and 31% (DHS, 1991) in Cameroon, and 11% in Burundi (DHS, 1987), with all other countries falling in between these measures. The prevalence of sterility is lowest at all ages in Burundi. Up to the age of 42 it is highest in Cameroon and at older ages is highest in Sudan and Lesotho. The large variation between countries suggests that disease-induced sterility is more important in some countries than in others. The level and age-pattern of sterility are almost identical around 1980 and 1990 in Ghana, Kenya, and Senegal, while there is evidence of a slight decline at younger ages in Cameroon, Nigeria, and Sudan. Primary sterility is measured by the proportion childless among women who married before reaching the age of 20. In most African countries, primary sterility falls below 4%, but in Cameroon, Nigeria, and Sudan rates are above 5%. There is evidence that most women in Africa experience reproductive impairment only after having reached adolescence and producing one or two children. The trends in primary sterility are similar to those based on subsequently infertile measures. Finally if sterility in each country were reduced to the Hutterite level, the average number of children born to an African women between the ages of 20 and 44 would increase by 2.5. If sterility was reduced to the lowest African level (Burundi), it would increase by nearly 2.0 children per woman in some countries.