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5th African Population Conference: Emerging Issues in Population and
Development, Arusha, Tanzania 10-14th December 2007
Dr Eliya Zulu, Deputy Director APHRC, gives his opening speech.
The Realising Rights RPC was very well represented at the 5th African Population
Conference. APHRC organized the meeting in conjunction with the Union for African
Population Studies (UAPS) and the Ministry of Planning and Economic Empowerment of
the United Republic of Tanzania. Dr Eliya Zulu, Deputy Director of APHRC, is the
President of UAPS and delivered an opening speech to over 900 conference delegates
from many countries.
Members of all the consortium partners gave papers, chaired panels and acted as
discussants at numerous panels during the week. Partners from APHRC, INDEPTH,
LSHTM and IDS also attended the conference Pre-meeting – the Second Annual
Research Conference on Population, Reproductive Health, and Economic Development,
organized jointly by the Population Reference Bureau and the Hewlett Foundation. Hilary
Standing, Director of the RPC, gave the keynote address.
Click here for Hilary’s presentation
The RPC also held a special meeting on the third day of the Population Conference to
present its recent work. This was attended by over 70 participants and a lively
discussion followed.
Ayaga Bawah presented a recent analysis of Contraceptive Use dynamics in Africa:
preliminary evidence from DHS data. He highlighted the following:
 Low use of contraceptives
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Upsurge in condom use over time across countries
Declining use of IUD, sterilization and the pill in most countries
Norplant continuous increase in uptake but the proportions still quite low
Uptake in contraceptive use has slowed in most countries,.but there is increasing
use of barrier methods with non-barrier methods less popular.
Click here for Bawah’s presentation
John Cleland presented on The Big picture: Trends in protective behaviour among
young women
This examined trends in current contraceptive use among sexually active single women.
Key points were:
 Little upward movement in use of any method between 1993 and 2001 but
condom use for contraception has risen from median of 6% in 1993 to 18% in
2001, and is the most popular contraceptive method.
 Surveys of condom use at last sex showed increase of 18% to around 30% and
this was in less educated as well as more educated and in rural as well as urban
areas..
 1.44% increase per annum in condom use between 1993 to 2001, which is fast
for behavioural change.
 ‘Dual use’ for both pregnancy and disease prevention important motives in
condom use at last sex. Consistent use (percentage who report condom use for
contraception using at last sex) varies but is roughly around 80-90%
 Married cohabiting women show none of these positive trends. But figures on
attitudes support what would be expected from early stages of behavioural
change.
Click here for John’s presentation
Eliya Zulu presented findings on Poverty and Sexual Risk taking in Africa
This study covered several countries. Key findings were:
 Slum residents in Nairobi initiate sex much earlier than non-slum residents in
urban areas. This finding holds even when broken down by those who grew up in
slums versus those who grew up in rural areas.
 Women living in slums are much more likely to have multiple sexual partners
than those from other areas.
 In Nairobi, poverty seems to be correlated with initiation of sex. Compared to the
poorest groups in rural areas, the only group that is more likely to have multiple
sexual partnerships is the urban poor.
 For young people in a number of countries the poorest groups of young men are
initiating sex much earlier than other groups.
 Those in School are more likely to have had sex - for males, in all countries
studied and for females, in all countries except Burkina Faso (where school rates
are very low).
 Schools may provide protection, but also may present more opportunities for
young people to interact. Sexuality education very low –only around 20% in many
countries, so we are missing a chance to spread information on safe sex.
Click here for Eliya’s presentation
Sabina Faiz Rashid and colleagues at BRAC University contributed a paper on
Sexual and reproductive health concerns of males and role of providers in
Chakaria, Bangladesh (the paper was presented on her behalf by Hilary Standing)
Key findings from the study were:
 A survey of 600 married men in a rural area of Bangladesh showed that Sexual
and Reproductive Health (SRH) concerns being taken to providers are often very
different from the ones medical practitioners are trained to deal with. They are
frequently psycho-social in nature and suggest high levels of anxiety among men
of all ages.
 Bangladesh has a very pluralistic healthcare system, with many informal
providers, a commercial private sector and large numbers of pharmacies and
drug sellers. These are much more likely to be consulted by men with SRH
concerns than the formal public system..
 At the same time, private for profit qualified doctors were perceived by informants
to be visited most often, followed by indigenous practitioners. Confidence in the
quality of private MDs may be based on their higher fees. Among individuals,
only about 47% happy with the outcomes after treatment.
 Concerns of men do not always fit biomedical models, but they are spending
considerable amounts of money consulting difference types of provider. There is
a need to address the gap in services for men on SRH concerns outside the
‘disease’ model and.improve integration between formal and informal providers.
Click here for Sabina’s presentation
Ian Askew of the Population Council, Nairobi, acted as discussant for the papers. He
raised a number of challenging questions and issues. These included:
 Substantial changes in the contraceptive method mix in subSaharan Africa over
the last decade means that in many countries, we are seeing a narrowing of the
method mix down to almost two method programmes. What are the reasons for
these changes? There is not enough work on demand creation for contraceptive
methods.
 Is cost an issue in access to condoms for the poorest? Social marketing
programmes are affordable for many people. But being poor may affect people’s
feelings around using condoms more than the cost of buying them.
 Promoting the transition in condom use from single to marital use is a challenge.
It makes sense but is difficult to implement.
 Evidence now suggests that married males may not engage in multiple
partnerships so much more than women as has been thought.
 Condom use in consensual relations has different programmatic implications
than coercive or unwilling sex in or outside marriage.
 The big differences in age of sexual debut by poverty and by sexual status will
manifest in national effects soon. Is it poverty which leads to non-consensual sex
and early sexual debut, or is it because of greater freedom in urban areas or peer
pressure?
 More work is needed to understand female sexuality and female sexual
behaviours
 The role of the informal sector in addressing sexual health issues for men is also
huge in subSaharan Africa. The informal sector needs to be considered more
and strengthened.
 Psychosocial issues in sexual health are very important – there are lots of myths
around African male sexuality, and we need research on this. Also, men having
sex with men is much more frequent than many would like to admit in the African
context.
 The title of the programme is realising rights with a focus on vulnerable
populations and neglected issues. There is considerable challenge to take these
results and cast them in a rights framework for policymakers.