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Reproduction in Yemen

Reproduction in Yemen

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Published by Thalia Sanders
Strayer University
Strayer University

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Categories:Types, School Work
Published by: Thalia Sanders on Mar 12, 2013
Copyright:Attribution Non-commercial


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Over the last five decades, efforts to control global population growth have focused onfamily planning policies and programs. Since the 2004 International Conference onPopulation and Development (ICPD),' demographic studies on understanding fertility-controlling behavior have concentrated on reproductive health. The 2004 ICPD broadenedthe narrow view of population control to include individual health by asserting that pop-ulation growth could be managed through the economic, political, and social advancementof women.^ This parallels the recent shift in focus of population control studies from lim-iting family size to improving women's health and protecting human rights.^ Despite thischange, fertility-controlling behavior has yet to be thoroughly investigated in many coun-tries. One such example is the People's Republic of Yemen. To be sure, some demograph-ic studies have tried to unravel the complex fertility condition in the Middle East." Butthese studies have neglected several countries in the region primarily due to the lack ofavailability of national data. This study attempts to address this gap in the literature byfocusing on three factors in the continuum of the reproductive process (age at marriage,contraceptive use, and abortion/miscarriage) to understand the fertility-controlling behav-ior of Yemeni women.The importance ofage at marriage as a means of population control was first addressedin the late eighteenth century by the political economist Thomas R. Malthus who advo-cated postponement of marriage as a means to balance population size with limitedresources.' Early age at marriage (in some societies, marriage before the age of fifteen)has resulted in early childbearing, greater health risks for both mother and infant, andoften defines the social and economic characteristics of that society.''The use of contraceptives is another major factor that influences the fertility-control-ling behavior of women. The use of contraceptives to control population growth affects thehealth of the mother and child, the ability to avoid unwanted births, and the timing andspacing of children. Other factors that influence the use of contraceptives by womeninclude communication between spouses,' preferences and perceptions of the attitudes ofher partner," and husband's approval."The third fertility-controlling behavior addressed in this study concerns the use of abor-tion. Availability of abortion as an informed choice of birth control is generally considered ahuman rights issue in many countries. In countries where contraceptives are not easily acces-sible to women, abortion is considered the most viable form of birth control. Abortions haveplayed a crucial role in achieving a decline in fertility in many developing countries.'"T.S. SUNIL is an Assistant Professor of Sociology at the University of Texas-San Antonio;VIJAYAN K. PILLAI is a Professor in the School of Social Work at the University ofTexas-Arlington.
30 VOLUME 80, NUMBERS 3 & 4These three factors represent the major components emphasized in the United Nations'definition of reproductive health. They influence a woman's informed ability to engage insexual relationships, her ability to make effective, acceptable, and affordable choicesregarding the use of contraceptives, and her access to safe and appropriate healthcare serv-ices during pregnancy." In other words, a woman's reproductive health can be explained bythe extent of control she possesses over decisions regarding age at marriage, timing of sex-ual unions, pace of childbearing, access to contraceptives, as well as access to informationconcerning childbirth and the prevention and treatment of reproductive related illness.'^
Since the unification ofYemenin 1990, several structural reforms and policy changeshave been introduced to control that country's population growth. One ofthe major achieve-ments in this area has been the adoption of a national policy on population control. TheNational Committee for Population and Family Planning tried to reduce Yemen's death rateby at least fifty percent by 2000, reduce its total fertility rate by six births per woman overthe same period, decrease infant mortality by six deaths per 1,000 live births, and lowermaternal mortality by fifty percent from its 1991 level. Yemen is still in the early stages ofdemographic transition. Its annual population growth currently stands at 3.3 percent. Thecurrent fertility rate of Yemen is about 7.0. This reflects a high birthrate, forty-four per 1,000population, and a declining mortality rate, eleven per 1,000 population. Yemen's infant mor-tality rate, however, still ranks as one of the highest in the world (seventy-five deaths per1,000 live births). This includes an under age five mortality rate of eighty-five percentrecorded within the last decade.'^ From the late 1980s through the late 1990s, Yemen expe-rienced a high maternal mortality ratio of 351 maternal deaths per 100,000 live births.'"While this number seems low, maternal deaths represent about forty-two percent of alldeaths for Yemeni women between the ages of fifteen and forty-nine. Lastly, by 2002 theaverage life expectancy for the population of Yemen stood at fifty-nine (fifty-seven for malesand sixty-one for females, respectively). This represents a fourteen year increase since 1990but it remains four years below the average for less developed countries."Based on key social and economic indicators (notably, GNP, exports,
Yemen ranksamong the twenty-five poorest and least developed countries in the world."" According tothe latest Human Development Report, Yemen is ranked 144 out of 173 in the HumanDevelopment Index." Recent national surveys indicate that nearly three-fourths ofthe pop-ulation live in rural areas. This has a significant impact on the character of Yemen society.Marked differences are observed in educational levels between men and women, with thehighest gender gap occurring in enrollment rates (thirty-one percent).'* Furthermore, whilenearly ninety percent of urban households have electricity, only thirty percent of ruralhouseholds are electrified. Approximately forty-eight percent ofthe population is youngerthan fifteen years ofage, and unemployment has reached thirty percent."
Marriage has been universal in Yemen; few men and womenremain single throughout their lives. Children born outside of marriage are not common,and about forty percent of marriages are consanguineous.^" Although the minimum age ofmarriage is set at fifteen by law, girls in Yemen marry as young as twelve. Recent estimates,however, show that there has been a slight delay in first marriages in Yemen.^' As in the caseof other traditional societies in the Middle East, the reasons for young age at marriage inYemen are deeply rooted in the social and cultural characteristics of that society.
INTERNATIONAL SOCIAL SCIENCE REVIEW 31Age at marriage is important for understanding both the fertility behavior of Yemeniwomen as well as the economic and social conditions of that society.^^ Since reproductivelife begins with marriage, early age at marriage, as in many developing societies, signalsthe initiation of early reproductive life and a longer duration of reproductive years thatbegins immediately after marriage.CONTRACEPTIVE USE: The use of contraceptives is another important factor inunderstanding the fertility-controlling behavior of Yemeni women. Though the govern-ment lacks an explicit population policy, policy makers and government officials strong-ly believe that rapid population growth is a hindrance to the country's social and econom-ic development. They support the use of contraception and encourage family planning toimprove maternal and child health.In its efforts to provide better access and knowledge about contraceptives, the govern-ment, in 1996, established the Yemeni Family Care Association (YFCA). This agency pro-vides prenatal services to pregnant women, including information on child nutrition andimmunization. The number of centers around the nation increased more than three-fold inthe early 1990s, from 75 in 1991 to 235 in 1995." Additionally, family planning servicesare generally offered through the Ministry of Public Health, YFCA, and various pharma-cies throughout the country. Despite such efforts, contraceptive use is still not common inYemen. Yet, improvements in this direction are encouraging given the brief period sincethe unification ofthe country (1990). Indeed, the prevalence of contraceptive use amongmarried women doubled in less than a decade from ten percent in 1991/92 to twenty-onepercent in 1997.'*Aside from the social and economic characteristics of women, several other factors needto be taken into account when studying the determinants of contraceptive use in Yemen.These variables include the level of education and the occupation of the husband," hus-band-wife communication regarding family planning,^' and the husband's approval of con-traceptive use." Most studies show that the educational level of the wife is more stronglyand inversely correlated with family size than that of the husband.^' An educated husbandand wife are more likely to discuss the timing and number of children and the use of dif-ferent contraceptives. Education beyond the primary level is often associated with an open-ness to new ideas, a higher standard of living, exposure to an urban environment, higheroccupational achievement, and more options and interests outside the home. Women's edu-cation is positively related to knowledge and use of contraceptives and negatively related tofamily size in high fertility countries. The use of modem contraceptives in both developingand developed countries thus increases with the number of
of female education.^'In contrast, fertility differences between rural and urban women are due more tochanges in their marital pattern (increase in age at marriage) than to differences in con-traceptive
The rational process of fertility decision-making involves communicationbetween spouses.^' Studies reveal that limited communication between spouses regardingfamily size and family planning translates into low levels of contraceptive use.^' Like somecountries in sub-Saharan Africa, in Yemen one finds that the husband's disapproval is oneofthe major reasons for nonuse of contraceptives." When communication between spous-es exists, couples are more likely to use contraceptives. At minimum, this increases theperiod between pregnancies.
Abortion is the least discussed concept ofthe three proximate determi-nants of fertility. In some countries, abortion is considered the preferred method of fertil-ity control. Perhaps the 2004 ICPD bolstered discussion on abortion among policy mak-

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