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Population dynamics of rural Cameroon and its public health repercussions. A socio-demographic investigation of infertility in Mbandjock and Jakiri districts.
Yaounde, Cameroon, Public Health Unit, Univ. Centre for Health Sciences, Univ. of Yaounde, 1979 Oct. 314 p.The preliminary findings of the Vital Statistics Survey Project, conducted under the auspices of the University of Yaounde in 2 rural districts of Cameroon in 1975-78, are reported. Vital statistics surveys were conducted in 20 villages in the Jakiri district and 3 villages in the Mbandjock district in 1976. Longitudinal surveys were conducted in 1976-77 and again in 1977-78 in Jakiri and in 1976-77 in Mbandjock. Jakiri's population is characterized by high fertility and high mortality. In contrast, Mbandjock shows low fertility and a stagnant or decreasing population trend. Data on factors related to fertility were collected from 3592 women in Jakiri and 251 women in Mbandjock. The crude birth rate in Jakiri was 37.5 livebirths/1000 population in 1976-77 and 27.5/1000 in 1977-78. In Mbandjock, the 1976-77 rates were 20.1, 31, and 12/1000 in the 3 villages surveyed. The average number of living children per woman was 2.67 in Jakiri and 1.55 in Mbandjock. 68.9% of Jakiro women and 79% of Mbandjock women ages 15-50 were currently married; however, the latter district is characterized by widespread marital instability. The average number of pregnancies per women was 3.1 in Jakiri and 2.67 in Mbandjock, with average child wastage ratios of 0.43 and 1.12, respectively. The infant mortality rate in Jakiri was 147/1000 livebirths in 1976-77 and 137/1000 in 1977-78. The rate in Mbandjock declined from 417/1000 livebirths in 1976 to 0 in 1977, a decrease attributed both to an effective measles campaign and the small sample size. The average desired family size was 9 in Jakiri and 6 in Mbandjock. Jakiri demonstrated a total infertility rate of 17%. The corresponding rates in the 3 Mbandjock villages were 48, 46, and 52%. The proportion of infertile women ages 20-29 was 18% in Jakiri and 22, 16, and 24% in the Mbandjock villages. According to the World Health Organization, a 15% infertility rate in this age group is the limit for declaring a serious public health problem. However, since Careroon authorities seem satisfied with the fertility situation in Jakiri, it is suggested that the limit be raised to 18%. Mbandjock, on the other hand, is considered to have a serious infertility problem. 4 recommendations are made to improve the health profile for this part of rural Cameroon: 1) family planning programs should be introduced in areas of population explosion; 2) health education campaigns should be directed against the high rates of communicable diseases and childhood immunization campaigns should be introduced; 3) nutrition education should be integrated into community development programs; and 4) vital statistics collection should be centrally supervised.