exclusively; most of the remaining 30 percent pursuecan settings, litt - PDF document

exclusively; most of the remaining 30 percent pursuecan settings, little work has been directed to researchingFamily planning services have cord, leading religious leaders to cThe role of religion as a fertility determinant has been theture. Throughout sub-Saharan Africa, traditional religioussystems that structure fortune to of communing with a weak, and largely endogenous, role in affecting behav-From this perspective, religion not only reflectsmines high fertility beliefs and practices.delivery for the Kassena-Nankana. Structuralist perspec- Volume 29Number 1March 1998cord if contraceptive innovation occurs. Moreover, if re-to be a spiritual continuum in which the rites of sooth-sembles compound heads, seeks their opinions, andpractice of religion represents a process of dialogue withform ceremonies on behalf of the entire lineage. The ritescally begins with the soothsayers incantations. A sacredfies messages from spirits symbolized by the charms.associated with the lineage, and inculcate respect for hi-planning in the community. Some individual lineagetion on such matters should g f bd Nankana people, Ghana Compound head Lineage head SoothsayerAncestral spirits hc proposition that high fertility is rarely perceived to be dis-The process of religious consultation and the uniquetice. views and were encouraged to participate, interpret, andopposed to such practices. Questions determined de-sires, intentions, or attitudes for paired interviews of lin-of responses would be stated preferences reinforced by concordant spiritualThe field procedure was as follows: First, lineagedom from the listing of lineages in each village. Next,the investigation. This exchange involved a frank expla-however; all individuals approached about the study Responses from ancestor interviews Responses from lineage headsFavorableNeutralUnfavorableFavorableSupportive (a)(c)(c)Neutral(d)Neutral(c) Unfavorable(d)(d)Opposed (b) Volume 29Number 1March 1998expressed by respondents. As one lineage head noted:Even the ancestors concur with the view that eco-is worse now than that faced by generations in the past.Q1:Is it good for women in your lineage to have many chil-that, should they give birthto many or few children?few . . . (long pause.) Theyfamily planning. Will this program help yourrative responses cover the full range of possibilities out- from one generation tonumber of children in theto have many children.them to have three chil-ody to have a small num-two or to ten children?many, they will suffer.have children, but I do notpear to be in the case of response pairs 1 and 6, in which the lineage number, Ghana QuestionLineage heads response Ancestors responseNot good forGood for thethe lineageNeutral, undecidedlineageIs it good for women in your lineage to have many children?Not good for the lineage3,4,527,8,9Neutral, undecided„„„Good for the lineage1,6„„More childrenAbout the rightFewer childrenthan they wantnumber, undecidedthan they wantIf you think about men in your lineage, do they have moreMore children than they want57„children than they want, fewer children than they want,About the right number, undecided136or about the right number of children?Fewer children than they want92,48Few children (5 or fewer)Undecided(6 or more)If you could start your family over again, how many childrenFew children (5 or fewer)4„5,7,8would you want to have?Undecided132Many children (6 or more)9„6Small are betterMedium are betterBig are betterIn this lineage, are big compounds better off thanSmall are better„„„small compounds?Medium are better„„7Big are better„5,61,2,3,4,8,9Girls are betterIt does not matterBoys are betterWhen babies are born in this lineage, is it better for a woman toGirls are better„„„have a boy or a girl, or does it not matter?It does not matter„2,5,8,97 Boys are better„41,3,6 thing. You have to buy. . . It is no longer the same Volume 29Number 1March 1998That is Gods own design.They need to have justmands a lot of money.The inconsistency of responses may portray underlyingThe inconsistency of responses may portray underlyinghelping us to have threechildren so that we cantake good care of them.We are able to space thebirth of our children now,Ancestor 2:They would like to haveeight children.Listen to what I have toend. We (ancestors) wantupon agriculture as the sole source of income, land avail-to sustain the extended family. Increasingly, families relyskills, trade connections, and other attributes of childrenrecent decades, rural Sahelian households have faced un-not the same. In those days, a woman couldhave four children and that was enough, butthem is final. They cannot do anything about it.Q2:If you think about men in your lineage, do they havemore children than they want, fewer children than they want,is no food to feed them orhave few children.Results from the second question reflect a degree cult to get them food.Q3:If you could start your family over again, how manyhad so many children, Icompound would mean I am lying to you.sionmaking„even in a society not practicing contracep-for example, polygyny was discussed as a means ofwhom has few children:be happy. When you mar-you want to have manyQ4:In this lineage, do you think big compounds are betterparents. They will give to six girls and six boys. Volume 29Number 1March 1998sons build their families within the lineage. Sons are thusa source of prestige for men. Men view sons as contribu-tors to the wealth of the extended family, whereas daugh-mally wish that the women give birth to girls or to boys?an gives birth to a boy,This is the wisdom our fa-In your opinion, are big com-No one prefers a smallcompound to a big com-people in it that deter-cause the smallcompounds.boys are preferred to girls. drug that is potentially harmful and that sometimes oth-Q6:Some men and women use certain methods to delay orno problem with them,but there are some who goI disapprove the use ofcouple wants to have.like them to use such(Probe: But which of thements of ambivalence reflecting the view that familycouples in my lineage, butadvise them against suchbad attitudes. of getting that thing. Sothey would not like mem-They do not inform themit. He (the ancestor) is onlybeing silent over it; if youIt is true that if womengive birth to only women,one sex cannot reproduce. Volume 29Number 1March 1998lem about that, but someroaming about, and that isjects the concept of contraception, whereas death and is often confused with abortion.Q:If they disapprove of such methods, and they want theQ:Why dont you like modern methods of family planning?health problem if you useit, but modern methodsmenting on them die out of it. Nor-to use a method, and fi- Table 3Responses of lineage heads and their ancestors on attitudes toward family planning, Ghana QuestionLineage heads response Ancestors responseApproveUndecidedDisapproveSome men and women use methods to delay orApprove5,6,7,8,9„2avoid pregnancy. In general, do you approve or disapproveUndecided4„„of couples in this lineage using a method of family planning?Disapprove3„1Approve(No response)DisapproveA project has been launched in this village to provide menApprove of the Community Health andand women with health care and family planning. Will this Family Planning Project7,8,91,2,3,4,5„program help your lineage in the future? Are there waysUndecided about the project„„„ in which this program is bad for your lineage?Disapprove of the project„6„ ily planning, you dont have to pour libation ofthis decision. . . . They just dont get up to pourlibation because of family planning. We cant dothat.Others professed the belief that ancestors are impo-tent in such matters: Soothsayers cannot teach you any-thing [about family planning].ŽAlthough ancestors may have a role in a mans de-liberations about the timing of childbearing, ancestorsare not consulted about preventing pregnancy. Familyplanning is not one of the things to be addressed by con-ducting sacrifices and pouring libations; it is a matterinvolving understanding between couples, often withdeference to compound heads or their wives, but withthe husband in the primary position of authority. As onehave to understand each other before you go forhave to understand each other before you go forplanning]. This one is what a doctor went andlearned about. For if we do that, it will help usthrough our health. Why do you have to go to asoothsayer to help you with that, or go to pourlibation . . . ?Some men went so far as to say that the decision topractice family planning is not a matter for soothsay-ers, but is a decision for women to make. This findingwas not anticipated, in light of the significance of an-cestor worship in Kassena-Nankana society, and the roleof soothsaying in assisting families in interpreting eventsaround them. Given the socioreligious context of thisexchange, and the fact that direct experience with fam-ily planning is rare in this society, responses must beinterpreted with caution. A man actually confrontedwith decisions about family planning might seek guid-ance from a soothsayer, just as any event in life may re-quire interpretation and spiritual advice. Moreover, astrong undercurrent of fatalism exists in this society,which holds that reproduction is not a matter for deci-sionmaking, but rather, a matter of fate. Focus-group exchanges about reproductive mattersconvey the sense that discussion of this issue is some-what alien and unnatural, possibly leading respondentsto conclude that soothsayers have nothing to do withfamily planning. Nonetheless, the cult of soothsayingshould not be viewed as a force aligned against familyplanning. Although a man may consult a soothsayer forspiritual guidance when he learns that his wife is preg-nant, he will not necessarily feel obligated to seek an-cestral advice if his wife is weighing decisions aboutfamily planning. Given the dominant role of men in re-productive decisionmaking, and the importance of reli-gion in general, this conclusion has implications for thesuccess of family planning programs in this environ-ment. Family planning is regarded as a decision to bemade in the physical and not the spiritual realm. Peopleare aware of and understand family planning, and mostknow where to go for consultation and methods. Con-sultation with soothsayers is considered to be an unnec-essary complication in this decisionmaking process.Attitudes Toward Service-Delivery OperationsOf the nine sets of ancestor interviews in this study, sixof the spiritual responses had no opinion about familyplanning services or the family planning experiment,whereas three interviews indicate ancestral support forthe project despite general ancestral approval of the con-cept of fertility regulation, as shown in Table 3. West-ern contraception and services are not typically subjectsthat lineage heads believe to be appropriately raisedwith soothsayers. Although soothsaying is important forguidance about auspicious timing, appropriate price, Volume 29Number 1March 1998terviewed about the program were silent on this mat-gion. The program itself is appreciated, mainly for theQ7:A project has been launched in this village to provideIt is good. Some years ago,ferred. We do not find itinitiative from men is grounded in the view that out-of communities benefits from the new Navrongo out-cates areas in which the program merits review and de-velopment. In focus-group studies, men sometimes char-They say they like theirno longer kills our chil-nurses. contacts with the women. If they would includemen in their activities, I think we would like it.Apart from this, I have no problem with thework they do.Community information, counseling, and other ac-tivities of the program are focused on the needs of men.Two contrasting views of the sociodemographic sig-tive behavior. Practitioners of traditional religion engagein practices that extend durations of postpartum absti-troduction of family planning. This structuralist perspec-however, also produced results that do not conform todo their corresponding lineage heads. Africa is a region of great cultural and demographicFindings from this investigation suggest that religiouserable value to large compounds and to the birth of sons,are consistent with the view that Kassena-Nankana maleriage, and spirits affirm this general reproductive goal;Ancestors are aware of the new hardships that familiespation in the program as to constrain their involvement.ing, family planning practice is a modern matter forCommunity reactions to the interviewing procedurethis setting respected, and that program management is listeningThis program of religious dialogue can be expandedseek guidance from the ancestors on ways to direct help Volume 29Number 1March 1998ductive means of communicating with men, soothsayers,be subverted if family planning programs are to suc-dating to new ideas about reproduction and family plan-naian regions. They comprise nearly all of the population of Kas-cent speaks Kassim, and the balance speaks mainly Buili. Al-et al., 1994). Although Kassena and Nankana ritualpractices differ somewhat, similarities outweigh differencesIn 1992, the Ministry of Health launched a program of social re-ning program (Health Research Unit, 1991a; 1991b; 1991c; and1994…95 period, a micropilot service-delivery study was con-ect (CHFP) is discussed in Binka et al. (1995a). The program ofPrevious NHRC studies among the Kassena-Nankana show thatGambia. Findings show that Islamic religion is not necessarily a11This consensus is summarized in a review of literature on theFoster (1990). The National Academy of Sciences review stresses See, for example, Lorimer et al. (1954) and Adegbola (1988). Somethat World Fertility Survey (WFS) respondents in seven sub-rations of postpartum coital taboos. Also, WFS respondents who13See, for example, van de Walle and Omideye (1988); Caldwell(1987: 427) argue, As traditional religion erodes, much of thebehavior that it ordained remains as part of the culture withinfluence of religion explains the absence of significant fertilityrican moral perspectives on family planning are sometimes ex-rican moral perspectives on family planning are sometimes ex-hanga-Akiiki [1974]). Cultural values associated with African15In Ghanaian traditional religions, infertility is depicted as a formhealing through rites and sacrifices. See, for example, Ebin (1994).16Certain exceptions to this rule can arise. For example, lineal rankof children of a polygynous, deceased lineage head is determined17Women can seek spiritual advice only by requesting their broth-18Initiation into the role of soothsayer begins with a spiritual rev-eage to designate a new soothsayer to undertake religious rites.to be suited to soothsaying, he is left alone for three days, duringitems. If all hidden items are found, the new soothsayer is pro-tors and is given a bag made from the skin of a sacrificial goatray these artifacts on the floor of a sacred hut and use them to19A detailed description of the rites of soothsaying, charms, and20Interviews were conducted in three separate chieftancy areas21The original aim was to complete a somewhat larger number ofinterviews and to follow the format of the Demographic andin this lineage how many children they should have, how manyThe design of this focus-group study is reviewed in Antwi-Nsiah24Reference here is to the symbolic importance of three children.25The reference to the bookŽ in this citation is a slang term refer-26In a larger and more general investigation of natural fertility de-havior that has been characterized in the literature as naturalfertility is more appropriately considered as deliberate fertility-ception. Low fertility reported in the Navrongo Demographic Sur-veillance System and various commstudy are consistent with the view that low fertility in traditionalbehavior rather than completely nonvolitional natural fertility27Focus-group studies and service-worker interviews indicate that28Studies have shown that fertility levels differ in Africa owing toterminants undoubtedly varies from setting to setting (see Com-29Findings suggesting that religion accommodates new ideas arenondogmatic belief systems. African religious practices are not30See, for example, case studies of religious dialogue in the pro- Volume 29Number 1March 199831African religions are sometimes characterized as monolithic andof Islam in fertility regulation on similar grounds. Despite char-acterization of Islam as a pronatalist religion, empirical evidencereproductive change in Islamic settings. As she points out, fac-tors other than Islam appear to be decisive determinants of re-Abu, K. 1983. The separateness of spouses: Conjugal resources inAdegbola, O. 1988. Religion and reproduction in sub-Saharan Af-the KAdongo, and Kofi Asobayire. 1995. Community reactions to theHealth Services Utilization in Rural Ghana.School of Graduate Stud-Benefo, Kofi D. 1994. Cultural perspectives on West African fertilityand Peter G. Smith. 1995b. Risk factors for child mortality inBinka, Fred N., Kubaje Adazu, Martin Adjuik, Linda A. Williams,1,2: 147…154.tine Oppong. Portsmouth, NH: Heinemann. Pp. 138…153.Stanford University Press. Pp. 265…282.in Africa.Ž In Ed. JohnS. Pobee. Legon, Ghana: University of Ghana Population Dynam-ics Programme. Pp. 124…139.Caldwell, John C. and Pat Caldwell. 1987. The cultural context of13,3: 409…437.„„„. 1990a. High fertility in sub-Saharan Africa.Ž „„„. 1990b. Cultural forces tending to sustain high fertility.Ž InGeorge T.F. Acsadi, Gwendolyn Johnson-Acsadi, and Rodolfo A.decline in Africa: A new type of transition?Ž London: G. Routledge andtors Affecting Contraceptive Use in Sub-Saharan Africa. WDebpuur, Cornelius, Alex Nazzar, James F. Phillips, and Fred N.From the Ground UpFortes, Myer. 1987. Religion, Morality, and the Person: Essays on TallensiGoody, E. 1973. Hagan, G. 1983. Marriage, divorce and polygyny in Winneba.Ž In„„„. 1991b. Wont it cause infertility?: An appraisal of commu-District.Ž Accra, Ghana: Ministry of Health, Health Research Unit.„„„. 1991c. The ability to keep secrets: An appraisal of commu-District.Ž Accra, Ghana: Ministry of Health, Health Research Unit.„„„. 1992.Howell, Allison M. 1997. Africa: An overview of organizing principles.Ž In Lesthaeghe, Ron and Frank Eelens. 1985. Social Organization andproductive Regimes: Lessons from Sub-Saharan Africa andInteruniversity Programme in Demog-Lorimer, Frank, Meyer Fortes, K.A. Busia, Audrey I. Richards, PriscillaNazzar, Alex, Philip B. Adongo, Fred N. Binka, James F. Phillips, andfamily planning program for the Navrongo Experiment.Ž Obermeyer, Carla M. 1992. Islam, women, and politics: The demog-Paper presented at the American Public Health Association 125thEds. N. Hafkin and E. Bay. Stanford, CA: Stanford Uni-versity Press. Pp. 111…133.Senah, K.A., Philip B. Adongo, A.A. Bawah, Margaret Gyapong, andducted by religious leaders on contraceptive acceptance and con-van de Walle, Etienne and Andrew D. Foster. 1990. Fertility DeclineNo. 125. Washington, DC: The World Bank.tural Context of Family and Fertility in Sub-Saharan Africa.Ž van de Walle, Francine. 1987. The diversity of fertility behavior: Volume 29Number 1March 1998life, it is reasonable to expect the custom of soothsayingThis article reports findings from an investigationin this setting.Ghanas northernmost region, the Navrongo CentreIn 1994, the Community Health and FamilyThe Influence of Traditional Religion onPhilip B. Adongo, James F. Phillips, and Fred N. Binka Philip B. Adongo is Social Scientist and Fred N. Binka isDirector, Navrongo Health Research Centre, Post Office Box114, Navrongo, Upper East Region, Ghana. James F. Phillipsis Senior Associate, Population Council.This article presents findings from a study of the influence of traditional religion on reproductivepreferences of Kassena-Nankana lineage heads in northern Ghana. Seven reproductive preferencequestions were administered to nine lineage heads who are primary practitioners of the cult of sooth-saying. With the assistance of soothsayers, interviews were repeated in conjunction with the invo-cation of religious rites in order to determine the views of ancestral spirits on the seven questions.Pairs of lineage head and ancestral interviews are compared to determine the role of traditional rel-igion in shaping male reproductive preferences. Interview pairs reflect a shared preference for sons,large cowant small families, some even wanting fewer children than corresponding lineage heads. Spiritualconsultations are nondogmatic and open to external ideas and influences, suggesting that familyplanning introduction will not encounter systematic religious opposition among the Kassena-Nankana. 1998; 29,1: 23…40)