This paper investigates the determinants of infant and child mortality in Tanzania using the 1991/92 Tanzania Demographic and Health Survey. A hazards model is used to assess the relative effect of the variables hypothesized to influence under-five mortality. Short birth intervals, teenage pregnancies and previous child deaths are associated with increased risk of death. The Government of the United Republic of Tanzania should therefore maintain its commitment to encouraging women to space their births at least two years apart and delay childbearing beyond the teenage years. Further, this study shows that there is a remarkable lack of infant and child mortality differentials by socioeconomic subgroups of the population, which may reflect post-independence health policy and development strategies. Whilst lack of socioeconomic differentials can be considered an achievement of government policies, mortality remains high so there is still a long way to go before Tanzania achieves its stated goal of 'Health for All'.

This study aimed to identify the views of young people, parents and teachers concerning sex education in Lesotho. It was conducted at a time when the national government was considering the introduction of Population and Family Life Education, which includes sex education, into the national school curriculum. Forty-six focus group discussions were held with young people (10), parents (30) and teachers (6) to identify current sources of sex education and views of the proposed introduction of school-based sex education in Lesotho. Findings show the limited and problematic sources of sex education for adolescents in Lesotho. They also highlight broad support for the introduction of sex education in the national school curriculum among young people, parents and teachers. Of key importance for the development of a sex education curriculum is the balance between providing young people with information and developing their skills in sexual empowerment and negotiating sexual pressure. The use of pupil-centred interactive pedagogies was seen as essential. Teachers, however, highlighted the need for training in the delivery of sex education, which includes instruction on course materials, teaching methodologies and developing sensitivity to teaching sexual issues to young people.

This study investigated the knowledge, attitudes and opinions of parents on various aspects of adolescents' sexual and reproductive health in Lesotho. The study used a qualitative methodology. Findings reveal that parents are aware that male and female adolescents engage in sexual relationships. Some parents believe that adolescents are too young to initiate sexual activities while others said they don't mind older unmarried adolescents having sex. In addition, parents felt that adolescents do not face discrimination in obtaining family planning services. In relation to passing sexual and reproductive health knowledge to adolescents, there seems to be a dilemma on who should take the responsibility. A number of policy implications have emerged from this study. There should be awareness campaign for parents who are not aware that adolescents engage in sexual relationships. Parents should be encouraged to communicate with their adolescent children on sex-related matters. Government should carry on with the dialogue on introducing sex education in schools curriculum. méthodologie qualitative. Les résultats ont révélé que les parents sont au courant que les adolescents de sexes masculin et féminin s'engagent dans des rapports sexuels. De plus, les parents ont estimé que les adolescents ne subissent pas la discrimination par rapport à l'accès aux services de la planification familiale. Quand il s'agit de la transmission de la connaissance sur la santé sexuelle et reproductive aux adolescents, il paraît qu'il y a un dilemme pour savoir qui doit pendre la responsabilité. Cette étude a révélé pas mal d'implications pour la politique. Il faut qu'il y ait des campagnes de sensibilisation pour les parents qui ne sont pas au courant que les adolescents s'engagent dans des rapports sexuels. Il faut encourager les parents de communiquer avec leurs enfants adolescents en matières liées à la sexualité. Il faut que le gouvernement continuer le dialogue sur l'introduction de l'éducation sexuelle dans les programmes scolaires. (Rev Afr Santé Reprod 2003; 7[2]: 25-33)

The paper discusses factors associated with sexual risk behaviour, i.e. failure to use condoms consistently during sexual intercourse, among unmarried sexually experienced youths in South Africa. Data from the 'Transitions to Adulthood in the Context of AIDS in South Africa' surveys of 1999 and 2001 were analysed to identify factors associated with high sexual risk behaviour among the youth. The multinomial regression models for male and female youths were fitted separately for the 1999 and 2001 data sets. The results show increasingly consistent use of condoms during sexual intercourse and that high sexual risk behaviour among youths is predominantly determined by social factors such as 'ever-pregnant' or 'ever made pregnant', 'ever given something for sex', age of sexual partner, currently in school, pressured by friends to have sex, peer influence on safe sex and education level for males. There is evidence that availability of contraception information is important in strategic interventions that seek to change the sexual behaviour of the youth in South Africa.

This paper provides an assessment of the nature and magnitude of Tanzania's recent fertility decline, using robust methods for the identification of fertility trends. A decline in Tanzanian fertility began some time in the late 1970s or early 1980s. The pattern of decline exhibits similarities to patterns identified some years ago in Zimbabwe and Kenya. The decline has been especially marked in urban areas. It has been accompanied by a rapid rise in contraceptive prevalence from the very low levels before 1990 to just under 20 per cent of currently married women of reproductive age. Although falling marital fertility associated with a rise in contraceptive use is the main contributor to the decline in fertility, a rise in the average age at marriage has also made a (smaller) contribution, as has the AIDS epidemic. The fact that fertility is declining in Tanzania raises questions about the social and economic requirements for fertility transitions to begin in sub-Saharan Africa.