Victor Agadjanian

War, peace, and fertility in Angola

Using data from a nationally representative survey conducted in 1996, some two years after the end of a major outbreak of war, we examine the impact of war on the timing of recent births and war-related differences in reproductive preferences in Angola. We find evidence of a wartime drop and a postwar rebound in fertility, but these trends vary greatly, depending on the type and degree of exposure to war and on women’s socioeconomic characteristics. At the same time, variations by parity are nonsignificant. In fertility preferences, the relative antinatalism of Angola’s most modernized urban area stands out, but outside this area, differences between areas that were more and less affected by war are also noticeable. We offer interpretations of our findings and outline their implications for Angola’s demographic future and demographic trends in similar settings.

Religion, social milieu, and the contraceptive revolution

This study examines how the social environment of religious congregations affects the spread of contraceptive use in developing contexts, using Mozambique as a case study. Analysis of qualitative data collected in urban areas of that country in 1998-99 and of the data from the 1997 Mozambique Demographic and Health Survey suggests that, in urban areas, the environment of more socioculturally diverse and inclusive Roman Catholic and mission-based Protestant congregations is more propitious to the spread and legitimization of modern contraception than the milieu of smaller, relatively homogeneous, independent churches. In rural areas, however, sociocultural diversity within and across different religious denominations is minimal, and membership in any formal congregation offers an advantage in contraceptive learning.

PMTCT, HAART, and Childbearing in Mozambique: An Institutional Perspective

Maternal and Child Health (MCH) units, where VCT/PMTCT/HAART have been integrated with traditional services, play a critical role in the connection between the massive HAART rollout and reproductive behavior. In this article, we use data from semi-structured interviews with MCH workers and ethnographic observations carried out in southern Mozambique to explore this role from the institutional perspective. We find that, along with logistical and workload problems, the de facto segregation of PMTCT/HAART clients within the “integrated” MCH system and the simplistic and uncompromising message discouraging further fertility and stressing condom-based contraception may pose serious challenges to a successful formulation and implementation of reproductive goals among seropositive clients. Although the recency of PMTCT/HAART services may partly explain these challenges, we argue that they are due largely to cultural miscommunication between providers and clients. We show how the cultural gap between the two is bridged by community activists and peer interactions among clients.

Men’s migration and women’s fertility in rural Mozambique

Labor migration profoundly affects households throughout rural Africa. This study looks at how men’s labor migration influences marital fertility in a context where such migration has been massive while its economic returns are increasingly uncertain. Using data from a survey of married women in southern Mozambique, we start with an event-history analysis of birth rates among women married to migrants and those married to nonmigrants. The model detects a lower birth rate among migrants’ wives, which tends to be partially compensated for by an increased birth rate upon cessation of migration. An analysis of women’s lifetime fertility shows that it decreases as the time spent in migration by their husbands accrues. When we compare reproductive intentions stated by respondents with migrant and nonmigrant husbands, we find that migrants’ wives are more likely to want another child regardless of the number of living children, but the difference is significant only for women who see migration as economically benefiting their households. Yet, such women are also significantly more likely to use modern contraception than other women. We interpret these results in light of the debate on enhancing versus disrupting effects of labor migration on families and households in contemporary developing settings.

Husbands' labour migration and wives' autonomy, Mozambique 2000–2006

The separation of migrants from the family unit, as a result of labour migration, can have profound effects on family organization and the lives of family members. Using data from a 2006 survey of 1,680 married women from 56 villages in southern Mozambique, we examined the relationship between mens labour migration and the decision-making autonomy of women who stayed behind. The results show that both mens cumulative migration history and current migration status are positively associated with womens autonomy, and that the effects on autonomy may persist even after the mans return. Three intervening factors—womens employment outside the home, lower fertility, and residential independence from extended family members—did not fully mediate the effects of mens labour migration. This is consistent with the assumption that the migrants absence has a ‘direct’ effect on his wifes autonomy.

Civil war and child health: regional and ethnic dimensions of child immunization and malnutrition in Angola

This study arises from a general proposition that different levels and types of exposure to war are crucial in shaping health outcomes in a population under war-induced duress. We analyze civil war-related regional and ethnolinguistic differentials in age-adequate immunization (complete vaccination for age) and levels of malnutrition in Angola. Our analysis is based on data from a nationally representative survey conducted in 1996, some 2 years after the end of one of the most destructive periods of hostilities in the history of Angolan civil war. The data show that despite Angolas unique mineral wealth, the nations levels of child age-adequate immunization is lower and malnutrition rates are higher than in most of sub-Saharan Africa. To examine age-adequate immunization and chronic malnutrition we fit logistic regression models that include the regional degree of war impact and ethnolinguistic group, in addition to rural-urban differences and other conventional sociodemographic characteristics. The tests reveal a significant disadvantage of rural children relative to urban children in both immunization and chronic malnutrition. Net of the rural-urban differences, we also detect a significant disadvantage of children residing in parts of the country that had been most affected by the fighting. The tests also point to a lower level of immunization and higher level of chronic malnutrition among children from the ethnolinguistic group commonly identified with the opposition. These associations tend to be stronger among children who were born and/or grew up during war than among children who were born after peace was re-established.

From Soviet modernization to post-Soviet transformation: understanding marriage and fertility dynamics in Uzbekistan.

In this article we analyse the dynamics of marriage and childbearing in Uzbekistan through the prism of the recent socioeconomic and political history of that country. After becoming an independent nation in 1991 Uzbekistan abandoned the Soviet modernization project and aspired to set out on a radically different course of economic social and political development. We argue however that not only independence but also the preceding period of perestroika reforms (1985-91) had a dramatic effect on social conditions and practices and consequently the demographic behaviour of the countrys population. Using data from the 1996 Uzbekistan Demographic and Health Survey we apply event-history analysis to examine changes in the timing of entry into first marriage first and second births over four periods: two periods of pre-perestroika socialism the perestroika years and the period since independence. We investigate the factors that influenced the timing of these events in each of the four periods among Uzbeks the countrys eponymous and largest ethnic group and among Uzbekistans urban population. In general our results point to a dialectic combination of continuity and change in Uzbekistans recent demographic trends which reflect the complex and contradictory nature of broader societal transformations in that and other parts of the former Soviet Union. (authors)

A geographical perspective on access to sexual and reproductive health care for women in rural Africa

Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success.

Eager to Leave? Intentions to Migrate Abroad among Young People in Kyrgyzstan

This study examines young peoples intentions to migrate abroad in Kyrgyzstan, focusing in particular on differences between Asian and European-origin ethnic groups. The multivariate analyses of recent survey data show that even after controlling for socioeconomic characteristics and social embeddedness Europeans are significantly more inclined to migrate than Asians. Whereas no gender differences in migration intentions among either group are detected, marriage, childbearing, and social capital exhibit distinct ethnic-specific effects. Although economic considerations are prevailing stimuli for migration in both groups, the results point to the formation of two dominant ethnic-specific migration preference types – for temporary migration among Asians and permanent migration among Europeans.

Labor migration and child mortality in Mozambique

Male labor migration is widespread in many parts of the world, yet its consequences for child outcomes and especially childhood mortality remain unclear. Male labor migration could bring benefits, in the form of remittances, to the families that remain behind and thus help child survival. Alternatively, the absence of a male adult could imperil the households well-being and its ability to care for its members, increasing child mortality risks. In this analysis, we use longitudinal survey data from Mozambique collected in 2006 and 2009 to examine the association between male labor migration and under-five mortality in families that remain behind. Using a simple migrant/non-migrant dichotomy, we find no difference in mortality rates across migrant and non-migrant mens children. When we separated successful from unsuccessful migration based on the wifes perception, however, stark contrasts emerge: children of successful migrants have the lowest mortality, followed by children of non-migrant men, followed by the children of unsuccessful migrants. Our results illustrate the need to account for the diversity of mens labor migration experience in examining the effects of migration on left-behind households.