# I. Overview of Family Planning in Zaire

## A. Brief Overview of Zaire

Zaire is a geographically large and ethnically diverse country in central Africa with a 1990 population of 36.6 million inhabitants. The country is carrently divided into 11 regions, one of which is the capital city of Kinshasa. With a crude birth rate of 47/1000 and a crude death rate of 14, the annual rate of population growth is 3.1 percent, which will result in a doubling of the population in 21 years [1).

Kinshasa, with a population of 2,664,000 at the time of the 1984 census [2], is the heart of political, economic, and social activity. A number of other sizeable cities exist, however, in the interior. The next largest are Lubumbashi (565,000), Mbuji-Mayi (486,000), Kisangani (318,000), Kananga (299,000), Kolwezi (221,000), Likasi (214,000), Bukavu (168,000), Kikwit (149,000), Matadi (139,000) and Mbandaka (137,000).

During the 1980s, many government and private offices in the interior received direction from the central offices in Kinshasa, but routine communication was hampered by the absence of reliable telephone lines or mail service. Air traffic played an important role in linking these cities in the interior to Kinshasa. By contrast, bus service operated only to the cities in close pIoximily to Kinsh-a. Tricks did carry passeng~ausd **_jWuJb_** bciween Cilit **anU** evcuiuaiy to Kinshasa, but the distances were long and the conditions difficult. The geographical size of Zaire (comparable to the U.S. east of the Mississippi) and the limitations in communication had a direct impact on family planning in this country, as described below.

# B. Family **Planning** Programs in Zaire

## _1._ **_Background_**

In 1972 President Mobutu Sese Seko gave a speech endorsing the concept of birth spacing as a means to improved maternal/child health. The President also coined the phrase "naissances ddsirables" (desirables births) which became the common name for all family planning activities in Zaire for the next two decades. President Mobutu's speech has been repeatedly cited as evidence of the government's positive stance toward birth spacing, though it should not be interpreted as support of family planning for the demographic objectives of reducing family size or population growth.

The 1972 speech did provide impetus for the development of the Comite National des Naissances Desirables (CNND, National Committee for Desirable Births), which was created as a para-statal entity in 1973 with assistance from the International Planned Parenthood Federation (IPPF). During the 1970s the CNND attempted to increase awareness of the benefits of birth spacing through a limited number of mass media and interpersonal communication efforts. Moreover, the CNND assisted in establishing family planning services at Mama Yemo Hospital, the largest in Kinshasa, and developed a network of 'antenna" in existing health clinics throughout Zaire. While some of these antennae clinics maintained close contact with the CNND Kinshasa staff, others simply obtained contraceptive products from the CNND warehouse. During the 1980s, the CNND converted to a totally nongovernmental, private status and changed its name to the Association Zairoise pour le Bien-Etre Familial (AZBEF, Zairian Association for