FHI - July 1998

Family Planning Only Half the Development Equation in Zimbabwe -- July 1998

Editorial-Opinion by Dr. Marvellous Mhloyi, Senior Lecturer, University of Zimbabwe

What is the impact of family planning on individual Zimbabwean women's lives and the lives of their families? Does it create opportunities for women to pursue an education, to participate in the workforce, and to play a leadership role in the community and the political arena?

For more than 50 years, family planning has been available in Zimbabwe's health clinics. Almost half of married women use some form of contraception, and the average family size has fallen from 7.8 in 1969 to 4.3 children in 1994. But the impact of family planning cannot be measured in numbers alone.

To learn more about the relationship between family planning and socioeconomic development, the University of Zimbabwe and Family Health International (FHI) conducted the Women's Studies Project (WSP-Z), a five-year effort that involved more than 4,000 Zimbabwe residents. Four separate studies were conducted to put women's voices at the center of research -- to listen to women's perspectives on how family planning has affected the quality of their lives and their ability to participate in the development process.

Researchers interviewed women from across Zimbabwe, in urban as well as rural areas. They interviewed single and married women, adolescents and older women, educated women and women with little formal schooling. Because other family members can influence a woman's use of contraception, researchers also interviewed husbands and mothers-in-law.

According to the women interviewed, family planning has benefited them in several ways: It has helped them plan and time their pregnancies, improved the overall quality of their lives, and improved the health of the mother and children. Yet, while family planning is valuable in its own right, contraceptive use alone does not guarantee that women a place in the development process. There has long been the assumption that as a country reduces population growth, socioeconomic development will follow. But there are factors that impede development. There is a lack of jobs for women, a lack of knowledge and skills, a lack of exposure to economic opportunities, and a lack of access to credit. While families are getting smaller, women also need to be gainfully employed if they are to fully participate in the country's development process.

In short, family planning is only half of the development equation.

What Women Say

Our study on women and the development process was the largest one in the WSP-Z, involving more than 2,400 women, ages 15 to 49, from the nation's 10 provinces. In this study, we learned that women in Zimbabwe follow a typical reproductive pattern. Their first menstruation occurs at age 15, their first sexual intercourse at 18, their first marriage at 19 years, and first birth at 21. One-fourth of all women reported that their first sexual intercourse occurred while they were in school, although that figure appears to be increasing among the younger generation. Thirty-one percent of those under age 30 reported first intercourse in school.

Contraceptive use has become a fact of life for many Zimbabwean women. In 1994, a national study found that 48 percent of all married women use family planning. Our WSP-Z study indicates this figure may now be as high as 61 percent. Yet, for most women contraceptive use occurs after first birth, not before first sex. Only 10 percent of women in the study said they had used family planning at first sexual intercourse, and only 8 percent said they used family planning at first marriage. Contraceptive use rose sharply after the first birth -- to 59 percent -- then rose again after second and third births (63 and 64 percent, respectively). After fourth birth, contraceptive use declined. This pattern is similar for both urban and rural women and reflects society's expectation that a woman must prove her fertility soon after marriage.

Yet, in spite of increases in contraceptive use, women's participation in the development process remains only marginal. Thirty-two percent of women we interviewed said they work outside the home -- similar to the percentage who were working outside the home in 1984. Childbearing affected women's participation in the work force; as women began having children, they frequently left their jobs. Urban women said they felt increased pressure to earn income as their family size grew, but rural women said they generally left the work force as their family size increased.

While women's work force participation was low, their participation community activities was even lower. Six percent of study participants were involved in community activities at the time of first sex, and the figure rose only slightly, to 11 percent, after fourth birth. Family planning use between births did not affect women's participation in community activities. However, women involved in community activities at first sex tended to continue their participation intermittently throughout childbearing.

We believe this study indicates that if women are introduced to contraceptive use early in their reproductive lives, they cannot only plan their family size, they can plan their participation in the community and the workforce.

Closing Doors for Young Girls

Just as access to family planning can mean increased opportunities for women, lack of family planning can close many doors. A second study, which surveyed more than 900 students at Marymount, Belevedere and Morgenster universities, found that for many students, sexual activity begins early, but contraceptive use begins late.

Fifty-nine percent of those interviewed said they were sexually active. Thirty-six percent said they became pregnant while in school, with three percent reporting a pregnancy as early as primary school and 9 percent reporting a pregnancy in secondary school. Nearly two-thirds of the women interviewed said they did not use contraception the first time they had sex. Only 40 percent knew about contraception before college. "It was my first time to have sex and it [becoming pregnant] just happened that day," one study participant explained. "I did not know that I could become pregnant at my first encounter."

While college-age women were able to obtain contraception at public, private or school clinics, or at pharmacies, younger women said they had a more difficult time getting the contraceptive method they wanted. One woman said, "My boyfriend had waited too long so he wanted and I also wanted to experience how it [sex] feels. I had tried to get some tablets but I was chased from the clinic, and I think it was because I looked very young at the time. ..."

For all study participants -- whether they were sexually active or not -- there was no difference in their academic or vocational goals. However, an unplanned pregnancy often changed their life course. Many women who had given birth dropped out of school and were unable to return, due to lack of money and the busy schedule of child care and housework. One woman summed up the dilemma. "If I had [had] access to the method of preventing pregnancy, I wouldn't have been pregnant, and I would have finished my O-levels. And you never know, I might have passed. And I would be working somewhere in town, and maybe I would be having a better life than this one." Another woman said, "I wish I could go back to school. You know, I have four subjects [at the] O-level, and I only need one to have a complete certificate. But my husband can't afford it, and I have a family to look after."

Quality of Life

In the WSP-Z study on women and development, study participants said family planning has improved the overall quality of their lives. But how do women define "quality"? Researchers interviewed more than 130 women and men, ages 18 to 40, who were living in Mashonaland East Province to find out.

Both sexes defined quality of life as peace and happiness within the home. However, women defined quality of life in holistic terms, as kugutsikana nehupenyu uine tarisiro -- living a contented life with realistic dreams, hopes and aspirations based on one's situation and circumstances. When men were asked what quality of life meant for their wives, men defined it as kuzvibata, kuvene tskia, runyararo mumba -- women with self-control, high principals and good character.

Women said that factors that contributed to quality of life were the wife and husband planning together and seeing those plans through as a couple. Men said that factors that contribute to women's quality of life were a good relationship with the husband, and they emphasized kudzorana -- consultation and concurrence -- and an important element in women's lives.

Women said they enjoyed working inside the home. They viewed work outside the home as an activity that could improve their financial status -- but could also improve their physical, mental and spiritual well-being. Men supported equal job opportunities for women, and both men and women said that education can enhance life; therefore, it is important for both boys and girls to attend school. Women also saw work as an activity that could increase their visibility within the community. They said women should support political activities to promote peace and stability in the nation, which they saw as a means to increase the quality of life for all individuals, but women said leadership positions for them were limited.

Both women and men agreed that family planning is an essential element of quality of life. Women said contraceptive use improved the health of the mother and the entire family, gave them more time for rest and leisure, and more time to devote to husbands and children. Men said contraceptive use had financial benefits but that it also improved women's physical and mental well-being. One man said, "Having 10 or 11 children may be detrimental to the psychological well-being of a wife, that she may feel she is being used as a human-making machine."

Women said that when they consider family planning use, they take into account a variety of possible consequences -- including the effects of contraceptive use on their own health and the financial well-being of the family. For example, women said they must consider whether they can afford to make family planning a part of the household budget.

Attitudes of Family Members

Although most family planning programs are designed for women, other family members can play a role in women's contraceptive use and their autonomy within the home and community. The fourth WSP-Z study examined the attitudes of family members and the ways in which those attitudes affect women's participation in the development process. Researchers interviewed women, ages 25 to 40, plus husbands and mothers-in-law.

Researchers found that mothers-in-law encouraged family planning but saw contraceptive use as a way to limit pregnancies after a woman had achieved her desired family size. While these older women felt it was important to have a large family to carry on the family line, they also acknowledged that larger families could mean economic difficulties. "Those with small families find it easy to send their children to school," said another woman.

Mothers-in-law said they participated in community activities, primarily sewing and knitting clubs, although younger women, who are busy raising families, were less likely to participate. Mothers-in-law supported women's participation in political clubs and organizations, believing women could best represent women's interests and that such participation ultimately will improve women's status. "[We] are still behind, but if we support each other, it might work," said one woman.

Although mothers-in-law offered advice on family issues, men were viewed as the ultimate authority in the home. Many men supported family planning but said that, because they are the chief financial provider, they should have the final say about family size.

Men also supported their wives' education as a means to improve family income. "We know that the wealth they acquire will trickle down to us," one husband said. However, lack of income was one of the reasons why women often did not return to school or pursue additional vocational training.

What Happens Next?

At the WSP-Z, we do not want our research results to sit on a shelf. We want them to be translated into action. We want these study findings to be used by policy-makers, women's advocates, family planning workers and others to improve women's lives.

We have made several recommendations based on study findings. These include:

Family planning should be introduced to women early in their reproductive lives. Since most women become sexually active at age 18 and some even younger, family life education programs offered in the schools could help women prevent an unplanned pregnancy. Also, education programs should inform women that, while contraceptives can be used after birth, to space pregnancies and limit pregnancies once a couple has achieved their desired family size, family planning also can be used before birth to delay pregnancy.
Although family planning programs are targeted to women, information should be offered to men and to other family members. These individuals play a role in determining women's use of contraception and also in determining women's opportunities both inside and outside the home. Family planning programs should increase their information and education efforts for men. Men have an important role to play in family planning. They can use male methods, or they can support their partners' use of contraception.
Health programs in rural areas should intensify their information, education and communication efforts to provide women with accurate information about contraception, as well as counseling on how to cope with side effects. In addition, health programs should subsidize the cost of family planning for rural residents.
Governments and nongovernmental organizations (NGOs) should explore the creation of new jobs and job opportunities for women. Both public and private sector should provide skills training and access to credit.
Schools and NGOs should consider life-long education programs for women, to help those who have left school find opportunities for continued education, skills development and income-generation.
Schools, health workers and community leaders should work together to develop family life education programs for primary, secondary and post-secondary students. This should include education about sexuality and information on contraceptives. It also should incorporate gender education to help students understand how society prescribes different roles for boys and girls and how these roles affect personal behaviors and educational and economic opportunities.
Political and civic organizations should create more leadership roles for women, which will enable them to work for improved quality of life for all Zimbabweans.

It is important to note that the WSP-Z is part of a much larger research effort. Nine countries in Africa, Asia and Latin America also conducted studies on the impact of family planning on women's lives. These studies were supported by Family Health International, a U.S.-based organization that conducts research on women's health, family planning and AIDS prevention worldwide, with funding from the U.S. Agency for International Development. Results from all studies were presented at an international conference in the United States in June.

New Opportunities

At the end of the day, Zimbabwe has made much progress in helping women plan their families. The country's private and public institutions have made contraceptives widely available. In the years ahead, these programs must be strengthened by expanding information and services to adolescent women, to men, and to people in rural areas.

But, in addition to family planning, women also need the resources to plan other aspects of their lives. The challenge now is to make educational and economic opportunities widely available, so that women can become full partners in the country's development. They have much to contribute. They only need the chance.

This project WSP-Z was part of the Women's Studies Project of Family Health International, a five-year international research project conducted in 10 countries and funded by the U.S. Agency for International Development. The goal of the research was to understand the impact of family planning on women's lives. FHI is a U.S.-based nonprofit organization that conducts research on women's health, family planning and AIDS prevention worldwide.

For more information, please contact Dr. Marvellous Mhloyi at: University of Zimbabwe Center for Population Studies, P.O. Box MP 167, Mount Pleasant, Harare, Zimbabwe. Telephone: (263) 4 303-211; Fax: (263) 4-333-672; Email: mhloyi@sociol.uz.zw

See Also:

Family Planning Only Half the Development Equation in Zimbabwe -- July 1998