Zimbabwe One of Family Planning’s Success Stories : Africa: Government program has cut birthrate. Soon, economic growth may outpace population growth.

Bathed in the smoke of a cooking fire inside a thatch-topped hut, Maureen Dick chatted softly in Shona as she carefully positioned her stethoscope and checked her patient’s blood pressure.

After a moment, she smiled. All was well. She reached into her bulging green satchel and handed over a month’s supply of birth control pills.

Edith Mayata thanked her warmly. At 34, she has six children and wants no more. “It’s difficult to look after them,” she said. “The cost of living goes up each day.”

Such scenes, once rare in rural Zimbabwe, are now common. The reason? Eight hundred women like Maureen Dick, and a handful of men, pedal bicycles into the far corners of the country each day, going from village to village and hut to hut to provide contraceptives and advice.

Neither dogs, lightning (a major cause of death here), flat tires nor wild animals (another occasional threat) stay these couriers from their appointed rounds. They reach an estimated 70% of the population.

And their impact has been dramatic. Ten years ago, Zimbabwe had one of the fastest-growing populations in sub-Saharan Africa, the region with the world’s fastest-growing population. Today, the nation of 11 million people boasts a declining birthrate and an expanding use of modern contraceptives.

Nor is Zimbabwe alone. Population experts say that family-planning programs are taking hold in a growing number of sub-Saharan African countries despite a grim regional backdrop of civil war, poverty, famine and the virtual collapse of nation-states in Zaire, Somalia and Liberia.

Countries such as Zimbabwe, Kenya, Botswana and Ghana, however, have all achieved varying degrees of population control. In the most promising places, like Zimbabwe, economic growth may soon outpace population growth. Ultimately, that may mean improved living conditions.

That promise contrasts sharply with Nigeria, which has 95 million people. With an annual growth rate of more than 3.1%--enough to double the population in about two decades--Nigeria is in the midst of a relentless baby boom that is exacerbating myriad social and political woes at a time when the economy has been battered by shrinking oil revenues.

As a result, the continent’s few family-planning success stories will be in the spotlight when world attention turns to Cairo this week for the landmark International Conference on Population and Development.

To be sure, Zimbabwe’s program is far from perfect. The average family now has 5.4 children, but that’s down from 6.7. And while the growth rate is believed to have fallen sharply, it averaged about 3% in the 1980s. More than half the population is under 18.

But Dr. Alex Zinanga, executive director of the Zimbabwe Family Planning Council, is optimistic. He said the most recent countrywide study, in 1988, showed that 43% of reproductive-age women used contraceptives.

“That’s far higher than for the rest of Africa,” he said. He expects a survey now under way to find even higher contraceptive use.

In some ways, Zimbabwe had a head start. It has a relatively high literacy rate, especially for women; good roads and communications, and a large, urbanized middle class. Religious opposition has not been a major factor.

But as elsewhere in Africa, Zimbabwe’s black leaders were highly suspicious of Western-style family-planning programs after they won independence in 1980 from the white-minority regime that ran the country, formerly known as Rhodesia.

“They looked at it as genocide, as a way of controlling the black population,” Zinanga said. “The government was very much against it at first.”

But President Robert Mugabe quickly realized he could not achieve his socialist aims if population growth was unchecked. Ironically, he since has dumped many of his discredited socialist policies but has kept the family-planning program. And the government support has been key.

The bicycle brigade of community workers, for example, is trained and paid by the government. And the government buys its own oral contraceptives rather than relying on foreign donors. The program also is listed as a line item in the national budget rather than being a stepchild of another department.

Official policy includes other inducements as well. Parents get tax deductions only for the first four children, for example. And women who work for the government are given time off to breast-feed only the first four children.

The AIDS crisis has added to the urgency. Zimbabwe has been hit hard by the epidemic, and the family-planning program now includes a “male motivation” campaign to persuade men to use condoms and husbands to limit their families.

“It’s recognized that reproductive decisions here are made by men,” said Roxana Rogers, family-planning administrator for the U.S. Agency for International Development in Harare, the capital. “So if you just target your campaign at women, which is the natural tendency, you’re missing the decision-makers.”

Religion has not affected the program. Only about 10% of the population is Roman Catholic, and far fewer are Muslim. Pope John Paul II visited in 1989, but Zinanga--who, like Mugabe, is Catholic--said his visit had no impact on the family-planning program.

“Religion is not something people are crazy about,” he said. “There’s a lot of Catholics, after church, they go and get their tubes tied or pick up their pills.”

Local Catholic leaders hope to change that. They issued a letter to clergy last week denouncing the Cairo conference as an “assault on the integrity of the family” and demanding that the government fight “corrosive foreign influences and ideologies.”

But Father Oskar Wermter, spokesman for the Zimbabwe Catholic Bishops’ Conference, concedes that he’s fighting a losing battle. Birth control “has been largely accepted by large parts of the population,” he said. “I must be honest. It is very controversial even here within the church.”

Indeed, out at the dusty village of Nyamadzawo, 30 miles east of Harare, government family-planning videos are shown at St. Mary’s, the local church. And one of the regular parishioners, Patricia Piroro, a 31-year-old mother of four, is also one of Dick’s regular family-planning clients.

On a warm and sunny afternoon last week, Piroro walked home, moving slowly and gracefully down the rutted road with a pail of water on her head and a child on her hip, to be greeted by Dick, who smiled and murmured a greeting.

As usual, the examination was inside the kitchen, a traditional round house with mud-brick walls and a thatched roof. A brilliant shaft of light pierced the tiny window, and black cooking pots perched atop a fire in the center of the floor. The two women sat side by side on maize bags spread on the ground.

After Dick had checked her patient’s blood pressure, they talked about whether Piroro should switch from oral contraceptives to Norplant implants or Depo Provera injections at a nearby clinic. Because her family income is less than $50 a month, she qualifies for free contraceptives; others pay a token sum of 15 cents.

Piroro said she still wasn’t sure. But clutching her youngest child, a toddler with a torn shirt and runny nose, she announced a far more basic decision. “I think four children is enough,” she said simply.