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Cultural determinants of fertility5Womens Time and Their Role in Rural Production and Household Maintenance Systems7Promoting Environmentally Sustainable Agriculture8Infrastructure Development and Settlement Policy10Africas hopes for a better future depend in large part on improving the health of its people Sub-Saharan Africa is experiencing a period of extraordinary change Across the continent policy reforms are contributing to dynamic economic growth Greater political openness has strengthened the commitment of African governments to meeting the basic needs of their peopleDespite these positive trends sub-Saharan Africa faces a development challenge greater than any other region Much of the continents population remains desperately poor With record numbers of adolescents entering their childbearing years in less than three decades Africas population is projected to double again from the current level of 620 million Meanwhile many African nations are struggling to provide health and education services to populations expanding at a small percent a year In many countries rapid population growth is contributing to degradation of the environment and undermining prospects for prosperity Africas hopes for a better future depend in large part on improving the health of its people Better access to good quality reproductive health services particularly family planning is key to improving health status especially for women The reality of reproductive health in Africa however is far from ideal Women begin child-bearing in their teens and have an average of six children Meanwhile AIDS has struck hard in Sub-Saharan Africa where roughly 1 in 10 adults both men and women are infected with HIV Yet traditional attitudes favoring large families are changing rapidly owing to the growth of cities the rising cost of living and lower child death rates among other factors Demand for family planning has increased dramatically in some countries and the decline in birthrates limited as recently as a decade ago to only a few countries in the region appears to be spreading steadily across the continentIn much of Africa however large families are still the norm
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