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Planning a family in Nairobi’s informal settlements: results of a qualitative study

Published online by Cambridge University Press:  08 July 2019

Catriona A. Towriss ,
Donatien Beguy ,
Alison Wringe ,
Barwako Hassan Hussein  and
Ian M. Timæus Open the ORCID record for Ian M. Timæus [Opens in a new window]
Catriona A. Towriss*
Affiliation:
Centre for Actuarial Research, University of Cape Town, Rondebosch, South Africa
Donatien Beguy
Affiliation:
UN-Habitat, Nairobi, Kenya Africa Population and Health Research Centre, Nairobi, Kenya
Alison Wringe
Affiliation:
Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
Barwako Hassan Hussein
Affiliation:
Independent Researcher, Nairobi, Kenya
Ian M. Timæus
Affiliation:
Centre for Actuarial Research, University of Cape Town, Rondebosch, South Africa Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Abstract

Childbearing intentions among women in high-fertility contexts are usually classified into those wanting to have a baby, those wanting to ‘space’ a birth and those wanting to ‘limit’ their family size. However, evidence from Africa increasingly suggests that women’s intentions are more complex than this classification suggests, and that there is fluidity in these intentions. This research explores women’s accounts of their childbearing intentions and decisions in order to examine how this fluidity plays out in a low-fertility context in urban Africa. Six focus group discussions were conducted in April and May 2012 with women of reproductive age in Nairobi, Kenya. Participants were recruited using random and purposive sampling techniques. The focus group discussions had an average of seven participants each. Data were coded thematically and analysed using Nvivo software. The analysis explored the factors that women consider to be influential for childbearing and found that the health of the mother and child, costs of raising a child and relationships were commonly reported to be important. Evidence of intentions to space births and limit family size was found. However, the data also showed that there is fluidity in women’s family planning intentions, driven by changes in relationships or household finances, which often result in a desire to avoid pregnancy in the present moment. The fluidity observed in women’s childbearing intentions cannot be accounted for by the concepts of either ‘spacing’ or ‘limitation’ but is best explained by the concept of ‘postponement’. The research reveals the need for family planning clinics to provide a full method mix, as well as high-quality counselling, to enable women to choose a method that best suits their needs.

Keywords

Family planningContraceptionReproductive health
Type
Research Article
Information
Journal of Biosocial Science , Volume 52 , Issue 2 , March 2020 , pp. 286 - 299
Copyright
© Cambridge University Press 2019 

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References

Africa Population and Health Research Centre (2002) Nairobi Informal Settlements Needs Assessment Survey. Africa Population and Health Research Centre, Nairobi, Kenya.Google Scholar
Agadjanian, V (2001) Negotiating through reproductive change: gendered social interaction and fertility regulation in Mozambique. Journal of Southern African Studies 27(2), 291–309.CrossRefGoogle Scholar
Agadjanian, V (2006) Fraught with ambivalence: reproductive intentions and contraceptive choices in a sub-Saharan fertility transition. Population Research and Policy Review 24(6), 617–645.CrossRefGoogle Scholar
Alder, G (1995) Tackling poverty in Nairobi’s informal settlements: developing an institutional strategy. Environment and Urbanization 7(2), 85–108.CrossRefGoogle Scholar
Bachrach, CA and Morgan, PS (2013) A cognitive–social model of fertility intentions. Population and Development Review 39(3), 459–485.CrossRefGoogle ScholarPubMed
Beguy, D and Mberu, BU (2015) Patterns of fertility preferences and contraceptive behaviour over time: change and continuities among the urban poor in Nairobi, Kenya. Culture, Health & Sexuality 17, 1074–1089.CrossRefGoogle ScholarPubMed
Bekker, LG, Black, V, Myer, L, Rees, H, Cooper, D, Mall, S et al. (2011) Guideline on safer conception in fertility HIV-infected individuals and couples. South African Journal of HIV Medicine 12(2), 31–44.CrossRefGoogle Scholar
Blanc, AK (2001) The effect of power in sexual relationships on sexual and reproductive health: an examination of the evidence. Studies in Family Planning 32(3), 189–213.CrossRefGoogle Scholar
Bledsoe, CH, Banja, F and Hill, AG (1998) Reproductive mishaps and western contraception: an African challenge to fertility theory. Population and Development Review 24(1), 15–57.CrossRefGoogle Scholar
Bledsoe, CH, Hill, AG, D’Alessandro, U and Langerock, P (1994) Constructing natural fertility: the use of western contraceptive technologies in rural Gambia. Population and Development Review 20(1), 81–113.CrossRefGoogle Scholar
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3(2), 77–101.CrossRefGoogle Scholar
Caldwell, JC (1976) Toward a restatement of demographic transition theory. Population and Development Review 2(3/4), 321–366.CrossRefGoogle Scholar
Caldwell, JC (1980) Mass education as a determinant of the timing of fertility decline. Population and Development Review 6(2), 225–255.CrossRefGoogle Scholar
Caldwell, JC and Caldwell, P (1981) Function of child-spacing in traditional societies and the direction of change. In Page, HJ and Lestaeghe, RJ (eds) Child Spacing in Tropical Africa: Traditions and Change Academic Press, London, New York, pp. 73–92.Google Scholar
Cleland, JG and Rutstein, SO (1986) Contraception and birthspacing. International Family Planning Perspectives 12(3), 83–90.CrossRefGoogle Scholar
Desgrées-Du-Loû, A and Brou, H (2005) Resumption of sexual relations following childbirth: norms, practices and reproductive health issues in Abidjan, Côte d’Ivoire. Reproductive Health Matters 13(25), 155–163.CrossRefGoogle ScholarPubMed
Emina, J, Beguy, D, Zulu, EM, Ezeh, AC, Muindi, K, Elung’ata, P et al. (2011) Monitoring of health and demographic outcomes in poor urban settlements: evidence from the Nairobi Urban Health and Demographic Surveillance System. Journal of Urban Health: Bulletin of the New York Academy of Medicine 88 (Supplement 2), S200–S218.CrossRefGoogle ScholarPubMed
Fotso, J-C, Kizito, P, Lumumba, V, Moran, G, Mukiira, C and Speizer, IS (2011) Contraceptive use in urban Kenya: recent trends and differentials set in the policy and program context. Paper presented at the Population Association of America meeting, Washington, DC, 2011.Google Scholar
Garver, S (2018) Navigating livelihood uncertainty: prevailing wisdoms guiding fertility preferences in rural Malawi. African Population Studies 32(1), 3964–3973.Google Scholar
Hayford, SR and Agadjanian, V (2017) Determined to stop? Longitudinal analysis of the desire to have no more children in rural Mozambique. Population Studies 71(3), 329–344.CrossRefGoogle ScholarPubMed
Hayford, SR and Agadjanian, V (2019) Spacing, stopping, or postponing? Fertility desires in a sub-Saharan setting. Demography, doi: 10.1007/s13524-018-0754-8.CrossRefGoogle Scholar
Johnson-Hanks, J (2005) When the future decides: uncertainty and intentional action in contemporary Cameroon. Current Anthropology 47(1), 363–385.CrossRefGoogle Scholar
Knodel, J (1987) Starting, stopping, and spacing during the early stages of fertility transition: the experience of German village populations in the 18th and 19th centuries. Demography 24(2), 143–162.CrossRefGoogle ScholarPubMed
Kodzi, IA, Johnson, DR and Casterline, JB (2012) To have or not to have another child: life cycle, health and cost considerations of Ghanaian women. Social Science & Medicine 74(7), 966–972.CrossRefGoogle ScholarPubMed
Kuhnt, AK and Trappe, H (2013) Easier said than done: childbearing intentions and their realization in a short term perspective. MPIDR Working Paper 2013–18. Max Plank Institute for Demographic Research, Rostock,Google Scholar
Lesthaeghe, RJ, Ohadike, PO, Kocher, J and Page, HJ (1981) Child-spacing and fertility in sub-Saharan Africa: an overview of issues. In Page, HJ and Lesthaeghe, RJ (eds) Child-Spacing in Tropical Africa: Traditions and Change. Academic Press, London, New York, pp. 2–23.Google Scholar
Lightbourne, RE (1985) Individual preferences and fertility behaviour. In Cleland, JG and Hobcraft, JN (eds) Reproductive Change in Developing Countries: Insights from the World Fertility Survey. Oxford University Press, Oxford, pp. 165–198.Google Scholar
Montgomery, MR, Stren, R, Cohen, B and Reed, HE (2004) Cities Transformed: Demographic Change and its Implications in the Developing World. Earthscan, London.Google Scholar
Morgan, SP (1981) Intention and uncertainty at later stages of childbearing: the United States 1965–1970. Demography 18(3), 267–285.CrossRefGoogle Scholar
Oketch, M, Mutisya, M, Ngware, M and Ezeh, AC (2010) Why are there proportionately more poor pupils enrolled in non-state schools in urban Kenya in spite of FPE policy? International Journal of Educational Development 30(1), 23–32.CrossRefGoogle Scholar
Oketch, M, Mutisya, M and Sagwe, J (2012) Do poverty dynamics explain the shift to informal private schooling systems in the wake of free primary education in Nairobi slums? London Review of Education 10(1), 3–17.CrossRefGoogle Scholar
Parish, WL and Willis, RJ (1993) Daughters, education, and family budgets: Taiwan experiences. Journal of Human Resources 28(4), 863–898.CrossRefGoogle Scholar
Pressat, R (1985) The Dictionary of Demography. Basil Blackwell, Oxford, UK.Google Scholar
Randall, S and Legrand, T (2003) Reproductive strategies in Senegal: the role of child mortality. Population 58(6), 687–715.CrossRefGoogle Scholar
Rossier, C, Senderowicz, L and Soura, A (2013) The one God sends to save me: conflicted fertility preferences and unmet need among Burkina Faso’s urban poor. Paper presented at IUSSP seminar 'Is Access Enough?', Nanyuki, Kenya.Google Scholar
Ryder, NB (1985) The structure of pregnancy intervals by planning status. Population Studies 39(2), 193–211.CrossRefGoogle Scholar
Sennott, C and Yeatman, S (2012) Stability and change in fertility preferences among young women in Malawi. International Perspectives on Sexual and Reproductive Health 38(1), 34–42.CrossRefGoogle ScholarPubMed
Sennott, C and Yeatman, S (2018) Conceptualizing childbearing ambivalence: a social and dynamic perspective. Journal of Marriage and Family 80(4), 888–901.CrossRefGoogle ScholarPubMed
Stecklov, G (1997) Intergenerational resource flows in Cote d’Ivoire: empirical analysis of aggregate flows. Population and Development Review 23(3), 525–553.CrossRefGoogle Scholar
Timæus, IM and Moultrie, TA (2008) On postponement and birth intervals. Population and Development Review 34(3), 483–510.CrossRefGoogle Scholar
Trinitapoli, J and Yeatman, S (2018) The flexibility of fertility preferences in a context of uncertainty. Population and Development Review 44(1), 87–116.CrossRefGoogle Scholar
Ware, H (1976) Motivations for the use of birth control: evidence from West Africa. Demography 13(4), 479–493.CrossRefGoogle ScholarPubMed
Yeatman, S, Eaton, JW, Beckles, Z, Benton, L, Gregson, S and Zaba, B (2016) Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa. Tropical Medicine and International Health 21(9), 1071–1085.CrossRefGoogle ScholarPubMed
Yeatman, S, Sennott, C and Culpepper, S (2013) Young women’s dynamic family size preferences in the context of transitioning fertility. Demography 50(5), 1715–1737.CrossRefGoogle ScholarPubMed