title: The long-term fertility impact of the Navrongo project in northern Ghana.
abstract: This study assesses the long-term fertility impact of the Community Health and Family Planning Project of the Navrongo Health Research Centre in Ghana and addresses policy debates concerning the role of family planning programs in rural Africa. Conducted in a remote traditional area on Ghana's northern border, the study tests the hypothesis that convenient family planning service delivery can induce and sustain reproductive change in a societal context that would not be expected to foster demographic transition. By 1999, results indicated that significant fertility decline arose in the early years of the project, associated with the combination of services provided by community nurses and social mobilization activities focused on men. When project strategies were scaled up, social mobilization components were neglected. As a consequence, the long-term impact of scaled-up operations was negligible. Results suggest that initial effects met the need for child spacing without introducing a sustained demographic transition.
authors.affiliation: Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, P&S Box 043, 60 Haven Avenue, B-2, New York, NY 10032, USA. jfp2113@mail.cumc.columbia.edu
authors.forename: James F
authors.initials: JF
authors.lastname: Phillips
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Jackson
authors.forename: Ayaga A
authors.initials: AA
authors.lastname: Bawah
authors.forename: Bruce
authors.initials: B
authors.lastname: MacLeod
authors.forename: Philip
authors.initials: P
authors.lastname: Adongo
authors.forename: Colin
authors.initials: C
authors.lastname: Baynes
authors.forename: John
authors.initials: J
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D001723:Birth Rate; D003153:Community Health Services / Q000458:organization & administration*; D003466:Cultural Characteristics; D003710:Demography; D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D012423:Rural Health