This population has experienced a sudden and massive rise in adult mortality. This can be accounted for by AIDS deaths. Mortality from non-communicable disease and (among men) injuries is also high. Antenatal HIV seroprevalence continued to rise in rural KwaZulu Natal in the late 1990s, reaching 40% in some clinics in this area. Adult mortality will continue to rise unless effective treatment interventions are introduced.

We investigated birth-interval dynamics in 24 African countries using data from 76 Demographic and Health Surveys conducted since 1986. Controlling for selection bias in the birth-history data using the Brass-Juárez method and regression models produced almost identical results. Birth intervals have lengthened in every country examined. This analysis uncovered a distinctive and previously undocumented pattern of childbearing that is prevalent across sub-Saharan Africa. After allowing for time trends in birth-interval length, the lengthening of birth intervals in almost every country varies little by women's age or parity. Moreover, in several countries, birth intervals are now too long to be explicable by birth spacing contingent on the age of women's youngest child. Rather, women are postponing births for other reasons. These findings offer empirical support for the idea that the fertility transition in sub-Saharan Africa is following a different pattern from that observed elsewhere.

The paper investigates levels, trends and age patterns of adult mortality in 23 sub-Saharan Africa countries using the sibling histories and orphanhood data collected by their Demographic and Health Surveys. In general, adult mortality rose sharply after HIV became prevalent, but the size and speed of this rise in mortality varies greatly between countries. Excess mortality is concentrated among women aged 25-39 and men aged 30-44. These data suggest that the increase in the number of deaths of men has exceeded somewhat that for women. It is time for a systematic attempt to reconcile the demographic and epidemiological evidence concerning AIDS in Africa.

Much of the literature on fertility transition presumes that women birth control is practiced either to limit family size or to space births. This paper argues that women also use contraception to postpone pregnancy. Postponement is not synonymous with spacing. It arises when women delay their next birth for indefinite periods for reasons unrelated to the age of their youngest child, but without deciding not to have any more children. Postponement has a distinctive impact on the shape of birth interval distributions that differs from those of family size limitation, birth spacing, or a mixture of the two behaviours. Some populations, such as that in South Africa, have developed fertility regimes characterized by birth intervals far longer than can be accounted for by birth spacing. Postponement of further childbearing that eventually becomes permanent may be an important driver of the transition to lower fertility in sub-Saharan Africa. Timaeus & Moultrie 3The main immediate motivation for using contraception is obvious: it is to avoid pregnancy, or at least to reduce the risk of conception associated with sexual intercourse. In other words, contraception is used for birth control. The reasons why women and their partners may wish to avoid pregnancy and childbearing are many and varied. However, much of the demographic literature on fertility transition classifies motives for birth control into two mutually exclusive and exhaustive theoretical categories -the limitation of family size and the spacing of births.This paper suggests that a third important motive exists for using contraception. It is to postpone or delay pregnancy and giving birth. Birth postponement is not synonymous with birth spacing. It is conceptually distinct and has a different impact on birth interval distributions. Fertility regimes characterized by very long birth intervals cannot arise from spacing but can only be explained by widespread postponement of births achieved by contraceptive and other means. Postponement can have a substantial impact on aggregate fertility. In particular, it may be an important driver of fertility decline in Africa.The arguments just summarized are developed in successive sections of the paper. The first of these critically reviews the literature on fertility intentions and motivations for contraceptive use. It argues that the substantive, measurement, and programmatic concerns of demography have tended to direct researchers' attention away from careful consideration of reasons for practicing birth control other than family size limitation. While the importance of distinguishing postponement of births from spacing of births has been pointed out before, it has not become part of the commonplace wisdom of everyone studying fertility transition.The second substantive section of the paper considers birth interval distributions. It argues that the impact of contraceptive use on the duration-specific hazard of giving birth differs depending on whether contraception is being used for stopping, spacing, or post...