The "Reproductive Transition": A Community-based Reproductive Health Surveillance Paradigm in Developing Countries

The major question at the center of this study is the model for reading maternal and neonatal health problems in developing countries. On the subject, the demographic, epidemiological and statistical literature has accustomed us to a reading model based on observation and analysis at the micro-individual scale. The unit of analysis is the individual. This classic model of analysis, based on sociodemographic variables, has some effectiveness / relevance, but is still limited. It appears partial and static. In contrast to this individualistic and fixed approach, we propose a dynamic and community-based observation scale that induces the concept of "reproductive transition". The reproductive transition is defined as the transition from a high-risk situation in a community to a lower-risk situation over a sustainable period in reproductive health. Indeed, the operational approach leads us to four types of expected results that are four possible trends of sociological evolution of this reproductive health. These expected results are: The transition started; the problems are decreasing. The stationary situation; there is neither growth nor decay. The transition is mixed; some problems are growing, others are decreasing. The alarming situation; all problems have an ascending pace. "Reproductive transition" thus appears as an innovative model for reading reproductive health problems. Its scale of observation is the community and not the individual. It thus constitutes a relevant health surveillance support for communities where maternal, neonatal and infant morbidity and mortality appear to be endemic.