The Impact of the Navrongo Project on Contraceptive Knowledge and Use, Reproductive Preferences, and Fertility

The Navrongo Community Health and Family Planning Project is a quasi-experimental study designed to test the hypothesis that introducing health andfamily planningsen'ices in a traditional African societal setting will introduce reproducti!'e change. This article presents the impact ofthe initial three years of project exposure on contraceptive knowledge, mvareness ofsllppl~1/ sources. reproductive preferences, colltraceptive use, andfertility. Findings show that knowledgeofmethods and supply sources increased as a result ofexposure to project acfivilie..:; and that deployment of nurses to communities was associated with the emergence of preferences to limit childbearing. Fertility impact is e-uident in all treatment cells, most prominently in areas where llllrse-outreach activities are combined with strategies for involving traditional leaders and male i"'OIunteers ill promoting the program. In this combined celt the initial three years o.f project e:rposllTe reduced tlze total fertility rate by one birth, comprising a 15 percent fertility declille relati,." to fertility levels in comparison communities. (STUDIES IN FAMILY PLANNING 2002; 33[2]: 141-164) High fertility in Sahelian West Africa represents a con­ tinuing issue for population policy. Fertility levels in the region are double the levels observed in developing re­ gions of the world. Although some coastal cities have wit­ nessed the onset of fertility transition, the rural hinter­ land of West Africa has yeno enter the global fertility transition. Moreoverl the determinants of reproductive behavior and the prospects for change in the region have been widely debated. Many respected observers have emphasized the resilience of pronatalist social institu­ tions in this region in noting that African religiOUS cus