The Demographic Transition Model suggests that countries becoming more developed move from experiencing high death rates and high birth rates to lower death rates and lower birth rates. At one time, Kenya saw significant drops in death rates, followed by drops in birth rates.
However, over the past thirty years, figures for maternal death rates, under five death rates and infant death rates have been mostly rising. Improvements seen just after independence began to fade out in the early eighties and this trend continues to this day. Such trends are often blamed on the HIV/Aids epidemic but they began before the epidemic would have had much effect.
Could these phenomena be behind the current increase in birth rates noted in an article by AllAfrica.com? The increase started around a decade ago. The article mentions an 'unexplained explosion of many young women resorting to unprotected sex'. I don't know where they heard about this 'explosion' because from data I have seen there was never a time when many women used some form of birth control regularly.
Before HIV was recognised, development organisations worked with the assumption that underdevelopment is caused by overpopulation. They believed that the solution to underdevelopment was population control and they went about trying to persuade people in developing countries to have fewer children, to adopt modern birth control methods, to plan their families, etc.
Such organisations include Population Services International (PSI), Family Health International (FHI), The Futures Group International (TFGI). They are all American, despite the 'International'. And when HIV was identified, these same organisations continued to receive aid money, in even larger quantities, to continue what they had been doing for several decades.
The problem is, usage of modern contraceptive methods and birth control never reached very high levels. And when the organisations started to argue for contraception and birth control for the purposes of avoiding HIV, they had even less success. Usage of condoms, whether to avoid HIV or other sexually transmitted infections remains low and inconsistent. It has never reached a level that would reduce HIV transmission, nor prevent conception to any significant degree.
So perhaps this is a hint to the development community. They may have moved on from the assumption that population control is the key to development but they don't seem to have accepted that people's needs are the same as they have always been; they need food, water, health services, education, a good environment, infrastructure, peace, equality, employment and many other things.
Persuading people to have sex less often, to use condoms, to have fewer children, etc, are difficult to achieve. But it would be much easier to persuade people to plan their lives if they thought they had something worth planning for. They may be easier to persuade if they thought their children would grow up in a different, a better world.
Harping on about behaviour change and wagging fingers about abstinence, faithfulness and the rest may seem like a no brainer to the development community. But it's had little effect so far and it's been very expensive. Now that millions of Kenyans face starvation, wouldn't it be better to return to figuring out what people really need, basic things, the same things that people have always been in need of.
Thursday, August 27, 2009
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