The African continent is distinguished by a much higher fertility rate than other regions. Fertility in Africa has remained almost constant at slightly over six children per woman on average, while important declines have occurred elsewhere over the past 25 years. High fertility in Africa is often attributed to poor diffusion of family planning, early marriage, and low female educational attainment, but other cultural and economic factors are involved. The significant decline of infant mortality over the past several decades has produced growth rates never before observed. Africa's very young populations may be at the origin of uncontrollable political disorder, as young persons with bleak prospects fall easy prey to ethnic, religious, and political extremism. Demographic growth has become an additional barrier to development. High fertility is tolerated or encouraged as constituting a cultural trait, but the resulting population growth is not a cultural trait. Demographic pressure has increased environmental problems in many regions. It is estimated that over ten million rural residents of the Sahel have been affected by soil degradation. The per capita availability of arable land fell from one-half to one-third hectare between 1965 and 1987. Shortages of firewood and water have become more common. The relationship between demographic growth, environmental crisis, and poverty in the countryside depends on other factors such as production techniques, modes of access to land and water, and the degree of security of land tenure. Population pressure was not the initial factor that disturbed the balance of the traditional societies, but it exacerbated the effects of other forces such as the introduction of cash crops and monetarization of the economy. Rural exodus and accelerated urban migration have been prompted in large part by the higher incomes and greater availability of services of all types in the cities. Achieving control of fertility in Africa will require stabilization of rural populations, territorial management, and reduction of disparities between rural and urban areas.
At the Conference on Population and the Environment in Cairo, the Vatican, Malta, and about 10 Latin American countries would not endorse passages on sexuality, defense of life, and anything which might condone abortion. About 12 Islamic states opposed all references which may authorize premarital and extramarital sexual intercourse and sex education for adolescents. Another problem which held the attention of the delegates was family regrouping of immigrants in host countries. Most Western countries wanted the word ¿rights' removed from that part of the action plan addressing family regrouping of immigrants. Even though several developing countries are dissatisfied with immigration problems, they do not want to limit family regrouping. Delegates sanctioned US$ 17 billion to be dispersed for family planning in developing countries by 2000, but who will donate these funds? The controversy over abortion and sexuality made delegates forget to address the environment and development. Since 1992, pressure by nongovernmental organizations (NGOs) has forced development out of the economic sphere. NGOs stress the importance of the social dimension of development in developing countries. The debate on poverty, which was supposed to occur in Cairo, did not take place. According to many NGOs and representatives from developing countries, the conference spent 10 days on abortion and only 10 minutes on development. NGOs disapproved of the relegation of human development problems and structural adjustment problems to the background. Developing countries wanted to discuss foreign aid and the inequalities between rich and poor countries. By 2000, there will be 300 million more poor persons. Several delegates from developed countries conceded that their governments would reorient foreign aid to family planning programs in developing countries. Have they forgotten that development is an essential condition for slowing population growth, which is what they want?
In November 1994 in Senegal, Dakar will host the regional conference on women. Its purpose is to develop a common action plan that Africa will present in Beijing. Nongovernmental organizations (NGOs) and governments have already been preparing for this meeting. This conference had been organized by a series of meetings continent-wide, where governments and NGOs clarified their positions on the 3 themes: equality, development, and peace. The Ministry of Women and the Family has the task of preparing the Senegalese viewpoint of the operation. Senegalese authorities want to make the meeting in Dakar a success. They have decided to have expositions, cultural displays, a women's business forum, a village restaurant where representatives from each country will get to know the culinary wealth of other countries, and a gala event. Everyone is ready to discuss equality, women's access to decision making structures (especially in the education sector), and better distribution of income between the sexes. NGOs do not intend to sit back and do nothing at the conference, but intend to influence the editing of the action plan. Many women's and health-based NGOs are rising up against the gaps of the action plan which only consider women's biological and physical aspects but not their mental and psychological aspects. Participants should consider the disastrous effects of sexual abuse and early marriages. Are governments ready to reform their laws which tend to discriminate against women and institutionalize their low status? Do they have the political will to check the conservative forces, such as those that spoke out against women in the final report of the forum in Tunisia? The number of women in powerful posts in Africa is growing. They can certainly advance things more rapidly than in the recent past. Women at Dakar should work together to address conflicts in Africa. Women should insist that women participate in all peace negotiations.
Losing their life while giving birth is a risk that too many women face. More than 33% of all maternal deaths each year occur in Africa, which has less than 12% of the world's population. 30-60% of deaths among African women aged 15-44 are pregnancy-related. Africa has the highest global maternal mortality rate. Its rural areas have an even greater maternal mortality rate. Common causes of maternal death are hemorrhaging, infections, anemia, vascular-renal problems, and abortion complications. In Asia and Africa, girls receive a lower quality and quantity of food than boys. They are also taken for medical care later and when in a more serious state. The lack of attention directed to medical care in early childhood is extended to adolescence, when girls are exposed to the risks of pregnancy and premature births. The culture protects young single mothers less than young wives. Single mothers hide their pregnancy and avoid medical visits. Others try to terminate the pregnancy. In developing countries, 25% of pregnancies are terminated. Menopausal women in Africa also face health risks (e.g., uterine cancer). Few underequipped health centers, lack of personnel, and the relative high cost of medical fees contribute to high maternal mortality rates. In Burkina Faso in 1985, there was only one gynecologist, one midwife, and one maternity hospital for every 225,000, 6250, and 69,230 women of reproductive age, respectively. Access to quality care is still a luxury. The recent devaluation of the CFA franc and the total destabilization of the zaire only exacerbates the awful status of women's lives in Africa. Priorities should be: ensuring prevention and treatment of obstetrical problems, increasing information on pregnancy risks, making family planning services accessible, and improving the quality of care. The most important priority is to let women have control over their own bodies, sexuality, and fertility. An inalienable right of women is to not have to die during childbirth.
The urban population has surpassed 50% in the Maghreb: first in Tunisia, followed by Algeria and Morocco. This phenomenon has greatly affected the distribution of power and the forms of its exercise in the political, social, and economic domain. The old city social strata are becoming extinct while city management is falling more and more under the control of cadres originally from rural areas. Urbanization is occurring at a slower pace than in other developing countries, however. In Morocco, the small- and medium-sized towns are growing at a faster rate than the cities. Their lack of infrastructure and services, like those that exist in the periphery of large cities, preoccupies the small- and medium-sized towns. The urban explosion is much more contained than its management is adapting. Legal and illegal housing will dominate the Moroccan city in the future. In the last decade, Moroccan authorities have tried to establish mechanisms to integrate populations in slums and illegal housing with the urban space. The Tunisians are also working on this. In Algeria, the rigid, urban formal management leaves no room to develop any type of housing. The problem of housing is even more grave here than the other 2 countries. Structural adjustment policies promote selling rather than renting houses. The government is not involved in social and health services. Algeria has a 2-tier society: a minority involved in the private sector and the majority who depends on the collapsing public sector which cannot meet the great needs of the poor. Persons with college degrees are unemployed in Algeria. One no longer knows how to build towns with the traditional medinas. The transportation system is falling apart in cities. Cities dump liquid and solid wastes directly into the sea or the wadis. The major risk of maghrebian cities lies in socioeconomic inequalities.
