What God Has in Store for Me: Fertility Desires and Contraceptive Practices among Burkina Faso’s Urban Poor

The slow pace of fertility declines observed in Sub-Saharan Africa, and especially West and francophone Africa, do not seem due to commensurate lulls in the general pace of development, as conventionally measured by urbanization, progress in education and wealth indexes. Using quantitative and qualitative data from the Ouagadougou Health and Demographic Surveillance System (which, since 2008, has followed 80 000 residents at the periphery of the capital of Burkina Faso), we examine why fertility levels remain relatively high in African cities. By examining which types of city dwellers (the urban poor, both uneducated and more educated, but also the uneducated rich) still want and have large families (high fertility intentions which are often ambivalent) and why that is so, we ultimately aim to shed some light on the reasons why fertility declines have been slower than expected on the continent. By examining barriers to access to family planning that remain in the city, especially for the uneducated poor, we will show that existing programs are not able to overcome the widespread ambivalent desires for family limitation, because of the poor quality of care (very little information on contraceptive methods is given), and high total costs of contraception (when including extra costs such as gloves, etc.)