THE DEMOGRAPHIC-IMPLICATIONS OF WEST-AFRICAN FAMILY SYSTEMS

West African families are characterized by strong lineage emotional an d economic bonds and relatively weak bonds between spouses. Marriage i s often unstable and a high proportion of children are reared by coupl es containing only one or none of the children's parents. Spouses typi cally maintain separate budgets. The implications for children's healt h treatment are the following. (1) The parent who pays usually decides which treatment to employ. (2) Mothers are usually concerned with min or illnesses and less expensive treatments and fathers with major sick nesses. (3) Children being reared in the same household, but where one or both parents are different, may receive very different levels of h ealth care. The implications for fertility are that the families of or igin of both wives and husbands - but chiefly the latter - participate in fertility control decisions. In a situation where much of the expe nse of rearing children falls on the mother, but where her husband usu ally makes the fertility control decisions and benefits most from chil dren's assistance in later life, low levels of fertility control and h igh levels of fertility are almost inevitable.