The determinants of the duration of postpartum sexual abstinence in West Africa: a multilevel analysis.

The question of how postpartum sexual abstinence responds to social change in West Africa is important because declines in the practice could increase fertility levels and worsen child and maternal health. This study uses data from the late 1970s in Cote d'Ivoire, Ghana, and Cameroon to examine effects of modernization and women's status on the length of abstinence. The results show that modernization and female status should be associated with declines in abstinence, which could lead to an increase in fertility and deterioration in maternal and child health.

Ethnic differentials in child-spacing ideals and practices in Ghana.

Postpartum sexual abstinence may be a major determinant of fertility and of maternal and child health in sub-Saharan Africa. This study examines the relationship between ethnicity and abstinence using data from the 1988 Ghana Demographic and Health Survey. There is considerable diversity in the length of abstinence although only for one ethnic group, the Mole-Dagbani and other Ghanaians, is abstinence, both actual and ideal, very long. Respondents in most ethnic groups believe their abstinence to be adequate. A key motivation for abstinence is the unwillingness to have sexual intercourse with nursing mothers. Education, urbanisation, changes in marriage patterns and religious traditions are major factors shaping the ethnic differentials in abstinence. In comparison to breast-feeding, abstinence appears to have relatively little impact on the length of the birth interval and for Ghana, has relatively few implications for fertility and child health.

PIP: Ethnic differences in the extent of postpartum sexual abstinence occur among the Mole-Dagbani, the Twi, the Fante, and the Akan as matrilineal and the Ga-Adangbe as patrilineal groups from Ghana. The recommendation is made that family planning (FP) programs would more effectively address postpartum FP among the Mole-Dagbani and other Ghanaians group by introducing modern contraception as a means of substituting or supplementing long abstinence periods. Policy interventions should also be directed more to breast feeding changes, which have a greater impact on fertility than abstinence changes. The ethnic differences in sexual abstinence practices appear to be more related to differences in exposure to modernization and changes in marriage patterns and religious traditions. The sexual taboos are a direct determinant of ethnic variation. For example, the Akan have the shortest delay in resuming sexual intercourse. Very few hold to the belief that intercourse should be delayed until after weaning. The Mole-Dagbani prefer to avoid intercourse with nursing mothers and practice long periods of sexual abstinence. Data were obtained from the 1988 Ghana Demographic and Health Survey of 4488 women aged 15-49 years. Life table methods were used in the determination of the number of months of sexual abstention postpartum and the duration of breast feeding. These methods avoid the bias of underestimation and heaping. Results are provided in a table comparing duration of sexual abstinence behavior and reported ideal sexual abstinence practices. The Mole-Dagbani and other Ghanaians group practice sexual abstinence for 24 months, while the remaining ethnic groups vary between seven and 11 months. The Twi, Fante, and other Akan have lengths of around seven months, while the Ewe, Guan, and other Africans have lengths of about 10-11 months. The median ideal of the sample is seven months and the median behavior is 8.8 months. The two Akan ethnic groups and the Ga-Adangbe have a median ideal of six months and the other groups range from 7-10 months. The Mole-Dagbani have the same ideal and practice of 24 months. All the ethnic groups practice lengthy breast feeding.