Elsevier

Social Science & Medicine

Volume 45, Issue 12, December 1997, Pages 1789-1804
Social Science & Medicine

Cultural eactors constraining the introduction of family planning among the Kassena-Nankana of Northern Ghana

https://doi.org/10.1016/S0277-9536(97)00110-XGet rights and content

Abstract

This study presents a focus group investigation of reasons why women in a rural, Sahelian community are reluctant to adopt family planning even when convenient services are made freely available. First, women opting to practice contraception must do so at considerable risk of social ostracism or familial conflict. Implementing individual preference is something that must be done without the support of others. Second, few women view personal decisions about contraceptives as theirs to make. Women and children are the property of the corporate family-kin and community militate against reproductive control. Third, although children are highly valued for a variety of economic, social, and cultural reasons, mortality risks remain extremely high. Low fertility imposes the unacceptable risk that a woman will have no surviving children at the end of her reproductive life. Taken together, these findings attest to the inadequacy of service strategies focused on the contribution of distribution, individual agency, or personal choice. Outreach should also build a sense of community legitimacy for the program, collective health action, and traditional leadership support for family planning behavior.

References (57)

  • W. Bleek

    Spacing of children, sexual abstinence and breast-feeding in rural Ghana

    Social Science & Medicine

    (1976)
  • K. Abu

    The separateness of spouses: conjugal resources in an Ashanti town

  • F.N. Binka et al.

    Risk factors for child mortality in northern Ghana: A case-control study

  • F.N. Binka et al.

    The Navrongo community health and family planning project

    Studies in Family Planning

    (1995)
  • C.H. Bledsoe et al.

    Constructing natural fertility: the use of western contraceptive technologies in rural Gambia

    Population Development Review

    (1994)
  • W. Bleek

    Sexual Relationships and Birth Control in Ghana: A Case Study of a Rural Town

    (1976)
  • W. Bleek

    Family planning or birth control: The Ghanaian contradiction

    Culture et Developpment

    (1977)
  • W. Bleek

    The value of children to parents in Kwahu, Ghana

  • W. Bleek

    Lying informants: a fieldwork experience from Ghana

    Population Development Review

    (1987)
  • W. Bleek

    Family and family planning in southern Ghana

  • J. Bongaarts et al.

    The proximate determinants of fertility in sub-Saharan Africa

    Population Development Review

    (1984)
  • E. Boserup

    Economic and demographic interrelationships in sub-Saharan Africa

    Population Development Review

    (1985)
  • J.C. Caldwell

    African Rural-Urban Migration: The Movement in Ghana's Towns

    (1969)
  • J.C. Caldwell

    Toward a restatement of demographic transition theory

    Population Development Review

    (1976)
  • J.C. Caldwell

    Variation in the incidence of sexual abstinence and the duration of postnatal sexual abstinence among the Yoruba

  • J. Caldwell et al.

    The role of marital sexual abstinence in determining fertility: A study of the Yoruba in Nigeria

    Population Studies

    (1977)
  • J.C. Caldwell et al.

    The function of child-spacing in traditional societies and the direction of change

  • J. Caldwell et al.

    Cause and sequence in the reduction of postnatal abstinence in Ibadan City, Nigeria

  • J.C. Caldwell et al.

    Cultural Forces Tending to Sustain High Fertility in Tropical Africa

  • J.C. Caldwell et al.

    The cultural context of high fertility in sub-Saharan Africa

    Population Development Review

    (1987)
  • S.H. Cochrane

    Fertility and Education: What Do We Really Know?

    (1979)
  • C. Debpuur et al.

    The baseline survey on contraceptive knowledge and use, reproductive preferences, and study population characteristics: A report of key findings

    (1994)
  • E. Evans-Anform

    Traditional Medicine in Ghana: Practice, Problems, and Prospects

  • A.C. Ezeh

    Gender differences in reproductive orientation in Ghana: A new approach to understanding fertility and family planning issues in sub-Saharan Africa

  • A.C. Ezeh

    Contraceptive practice in Ghana: does partner's attitude matter?

  • E.R. Fapohunda et al.

    Family structure, implicit contracts, and the demand for children in southern Nigeria

    Population Development Review

    (1988)
  • C.K. Fayorsey et al.

    The social organization in Kassena-Nankana District: Assessing the contexts for reproductive change in a traditional African society

    (1994)
  • R.G. Feachem et al.

    Changing patterns of disease and mortality in sub-Saharan Africa

  • View full text