This paper examines the personal and social ramifications of infertility in an African urban population with low fertility. The study was conducted in Moshi, Tanzania, a multi-ethnic community with relatively high levels of education and a well developed health services infrastructure. The major question to be addressed was whether in a low fertility urban population, both primary and secondary infertility bring about serious personal ramifications for women similar to those in rural areas. The methodology included a survey of 2,019 women and in-depth interviews with 25 fertile and 25 infertile women. Of the 1,549 sexually active women in a regular union, 2.7% had never had a child in spite of trying to conceive for at least two years. Of the 1,352 women who had previously had a child, an additional 6.1% were subsequently infertile. The most important finding from the qualitative analysis concerns the major difference between childlessness and subsequent infertility (or primary and secondary infertility) in terms of implications for the effected women. These findings underline the importance of bearing a child in sub-Saharan African populations.

This paper examines how socio-economic contexts shape local meanings of infertility, how the prevalence of infertility affects these meanings, and how the above affect community responses, life experiences and infertility treatment-seeking behaviors in two African communities. The paper is based on interdisciplinary research conducted among the Ijo and the Yakurr people of southern Nigeria that included a survey of approximately 100 infertile women and a matching sample of 100 fertile women, as well as in-depth ethnographic interviews with infertile and fertile women in two communities: Amakiri in Delta State and Lopon in Cross River State. In-depth interview results show that female infertility is more problematic among the Ijo in Amakiri, where kinship is patrilineal (traced through the father's side), than among the Yakurr in Lopon, where kinship is double unilineal (traced through both parents). Childless women in Ijo society are not only disadvantaged economically but are prevented from attaining full adult womanhood. They therefore leave the community more often than other members. In Lopon there is also a strong preoccupation with fertility as a central fact of life, but infertile women receive support from maternal kin as well as voluntary associations serving as support groups. Our survey data confirm that there are significant differences between the life experiences of infertile and fertile women and between the infertile women of the two communities. The overall findings indicate that while there are variations in the extent to which infertility is considered problematic, the necessity for a woman to have a child remains basic in this region. Motherhood continues to define an individual woman's treatment in the community, her self-respect and her understanding of womanhood.

This paper advances understanding of the consequences of female infertility in subSaharan Africa on the individual level. It illustrates how local meanings of infertility are shaped by the social and cultural context and how they influence the life experiences and coping behaviours of infertile women in an Ijo community in the Niger Delta. Infertility in Amakiri is a stigma. Barren women cannot attain full womanhood and join appropriate age associations since they cannot be circumcised without having given birth. Uncircumcised women cannot be buried within the town, rather, their corpses are buried in a designated forest. The paper is based on over twenty years of ethnographic field work, a complete census of one of the town's quarters to estimate the level of infertility and on the life histories of infertile women. The life histories are used to illustrate how women of various ages, educational levels and occupations cope with their common experience of infertility. les expériences des femmes stérilés et sur les comportement qui leur permettent des s'en sortir dans une communauté ijo dans la région de Niger Delta. La stérililté est un stigmate à Amakiri. Les femmes stériles ne peuvent pas devenir de vrais femmes et ne peuvent pas appartenir à des associations d'âge appropriées puisqu'elles ne peuvent pas être excisées sans avoir déjà enfanté. Les femmes qui ne sont pas excisées ne peuvent pas être interrées à l'intérieur de la ville; plutôt, leurs corps sont interrés dans une forêt désignée. Cette étude est basée sur une enquête éthnographique sur le terrain d'une durée de plus de vingt ans, sur un recensement total d'un des quartiers de la ville afin d'évaluer le niveau de la stérilité et sur l'historie de la vie des femmes stériles. On se sert de l'histoire de la vie des femmes pour démontrer comment les femmes de différents âges, de divers niveaux d'éducation et d'occupation se débrouillent avec leur expérience commune de la stérilité. (Rev Afr Santé Reprod 2003; 7[2]: 46-56)