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Zaire Family Planning
Family planning began late and was accepted slowly in
Zaire. In
1972 the Mobutu regime officially expressed interest in
limiting
births to "desirable" ones and thus promoted family
planning for
reasons of health and as a human right. In 1973 a
presidential
decree created an official clearinghouse committee for
familyplanning information. It was not until 1978, however, that
the
state established a nongovernment organization dedicated
to family
planning, namely the Zairian Association for Family
Well-Being
(Association Zaïroise pour le Bien- Être Familial--AZBEF).
It was
formed in order to acquire technical and financial aid
from the
International Planned Parenthood Federation. Evaluation
teams sent
in 1981 were unable to evaluate the impact of the early
programs
because of the lack of data and the small numbers of
acceptors.
Not until the launching of an AID-funded program in
1982--the
Project for Planned Birth Services (Projet des Services
des
Naissances Désirables--PSND)--did family-planning efforts
begin in
earnest. Problems in coordinating PSND efforts with AZBEF
led to
the establishment of three systems working in parallel,
PSND,
AZBEF, and Rural Health (Santé Rurale--Sanru), a rural
family
health care project with a family-planning component.
PSND statistics have been the most complete. PSND
selected
fourteen urban areas with a target population of about
800,000
women and aimed to increase contraceptive use from 1
percent to 12
percent by 1986. Early returns were disappointing, with
only 1.6
percent usage reported by a mid-term evaluation mission in
1985.
Later trends were more encouraging, including a 1984-87
quadrupling
of family-planning acceptors (see
table 10, Appendix).
In rural areas, AZBEF family-planning units and Sanru
have been
active, although the numbers of personnel were
insufficient to
reach the bulk of the population. To supplement their
efforts, AID
funded efforts to make contraceptives available through
communitybased distribution projects. A Tulane University program
distributed birth-control pills, condoms, and
contraceptive foams
in Bas-Zaïre in a pilot project; the effort demonstrated
that such
distribution was less effective than making supplies
available in
health facilities. Companies such as Gécamines that
operated health
care facilities received aid from PSND to promote family
planning
among company workers and their families. Most significant
were
commercial marketing projects. Forty pharmacies in three
zones of
Kinshasa spread information on contraceptive methods and
products
and sold attractively packaged and well-priced
contraceptives,
which were quite popular. Recent efforts in social
marketing
organized by Family Health International have had
promising results
in their test areas, although the collapse of the economy
in the
early 1990s has compromised any precise evaluation of
their overall
effectiveness.
Barriers to acceptance of family planning remain,
however. As
long as child mortality remains high, both men and women
will
continue to value large families. Demand for
family-planning
services remains low. In fact, the availability of such
services
has been almost unknown by the community, even in the
immediate
neighborhood of family-planning units. Although occasional
radio,
television, and press programs have been generated, and
T-shirts,
posters, and brochures bearing family-planning messages
have been
distributed, follow-up has been lacking and evaluation of
familyplanning informational campaigns has not been done. Given
the
relative lack of success in promoting family planning and
birth
control, Zaire faces a continued high rate of population
growth,
which will exacerbate deteriorating social and economic
conditions.
* * *
Periodicals provide the best source of current social
and
cultural information on Zaire, although many of the best
are either
in French or unavailable in many libraries. Still, the
curious
reader can find may good and widely available books on
Zaire in
English. Crawford Young and Thomas Turner's The Rise
and Decline
of the Zairian State provides a good overview of the
country's
institutional history and development since independence.
The
extraordinary scope of state corruption is painstakingly
documented
as it pertains to Équateur Region by Michael G. Schatzberg
in
Politics and Class in Zaire and in The
Dialectics of
Oppression in Zaire; David J. Gould's Bureaucratic
Corruption and Underdevelopment in the Third World: The
Case of
Zaire does the same on a national scale.
Zairians' strategies of adaptation to their ongoing
impoverishment have been well documented in several more
recent
works. Edited anthologies such as Georges
Nzongola-Ntalaja's The
Crisis in Zaire: Myths and Realities and Janet
MacGaffey's
The Real Economy of Zaire both contain accounts of
the
dynamic informal economy and the varying survival
strategies used
by different ethnic groups, classes, regions, and genders.
The
literature on women's roles in adaptation is particularly
well
developed in books such as Jane L. Parpart and Kathleen A.
Staudt's
Women and the State in Africa. Articles by
Catharine Newbury
and Brooke G. Schoepf in this volume as well as in the
volume
edited by Janet MacGaffey provide insights into the ways
African
women have confronted state oppression by forming local
alliances
and by creatively exploiting the potential of the informal
economy.
Students of Zairian ethnography interested in an
overview would
do well to start with Jan Vansina's recent Paths in the
Rainforests; its bibliography contains references to
more
specialized studies and ethnic groups that the reader
could
subsequently consult. People interested in Zairian
religions would
profit from reading any of Wyatt MacGaffey's several books
on the
Kongo people, the most recent of which are Religion and
Society
in Central Africa and Astonishment and Power.
Finally, for those interested in health care, the
complexities
of its provision are detailed in The Social Basis of
Health and
Healing in Africa, edited by Steven Feierman and John
M.
Janzen. The volume includes discussions of indigenous
concepts of
disease and modes of diagnosis and therapy, elements not
always
considered in public health delivery planning. (For
further
information and complete citations,
see
Bibliography.)
Data as of December 1993
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