Making Modern Families: Family Size and Family Planning in Northern Ghana
Theses
Overview
Overview
abstract
This thesis draws on a political economy of fertility framework and the concept of biocitizenship to analyze changing family size and family planning among women and men in northern Ghana. I draw on a variety of ethnographic sources from eight months of fieldwork conducted under the umbrella of the Navrongo Health Research Centre in 2013 and 2014 in two rural communities in Kassena-Nanakana (K-N) West District in the Upper East region. The primary questions behind this thesis are: 1. How has the desire for smaller families emerged and to what is this transformation linked? 2. What role have family planning programs played in the reduction in family size? Have they been the most important driver of the transition to smaller families? 3. What are the current ideas about family planning and contraceptives in K-N West? Are they gendered? How have they changed over time? 4. Are local views about family planning and contraceptives in K-N West in keeping with those of public health practitioners? These questions are addressed in this sandwich thesis in three papers, which have been submitted or accepted for publication.
A major contribution of this thesis is its call for health programmes to pay greater attention to the social context of both women’s and men’s lives where family planning takes place. Contrary to existing public health studies, I argue that while health programming has affected fertility decline, larger social and economic shifts have been some of the most important drivers of women’s and men’s changing practices of family formation and views of contraceptives. In Kassena-Nakana West, the desire for smaller families is linked to processes such as decreasing levels of child mortality and agricultural productivity, as well as parents’ increasing focus on educating their children. In addition, the emerging concepts of responsible manhood and companionate marriage, combined with the decline of polygamy, have helped improve communication between husbands and wives about family planning.
Narratives of changing family formation from Kassena-Nankana West expand understandings of biocitizenship by illustrating the important role intergenerational relationships play in the construction of “political economies of hope”. When young people adopt family planning, they not only consider the well-being of their own children and the larger community, but make the decision in the context of their aspirations for a more successful life than their parents experienced. Due to larger political-economic shifts, the majority of Kassena women and men today think family planning is beneficial; however, worries about the side effects of contraceptives remain. Women’s ongoing concerns about infertility and the stability of their marriages and men’s conditional acceptance of family planning also reveal that gender inequality persists. I argue that typical policy recommendations, which focus primarily on educating and sensitizing communities to increase the use of contraceptives are problematic in that they often focus on decreasing fertility and are not articulated within a broader, multi-sectoral agenda. Greater attention to local biologies and expanding reproductive rights and freedoms would improve existing family planning programs.
