IF you have been married for more than one year, there will be one thing you will fear the most. The visit by “banafimbusa” (elderly female advisors).
Some people more harsh than me have unkindly called them, the “marriage Police”.
In Chewa, or is it  Ngoni, they all sound the same to me, I believe they are called “ Alangizi” literally translated those who show.
When this army of women invade the home of the newly weds, as they inevitably do, when there is no sign of babies in the very near future, the young couple will be ill at ease.
The young man will begin to shift in his chair, and very often, will quickly have a call requesting his presence at work for urgent office business.
Most often his young spouse will have no such convenient refuge.
She will have to face the group of women and answer the most basic of all questions.
“Where are the babies?”
The other day as I was driving along the Kafubu River bridge, I  tuned on to the local radio station. My ears were assailed by an affable tune , with a rather  harsh “ZAMROCK” beat to it.
It had a very danceable rhythm, and probably a very pertinent message. The rather subdued voice of a wary housewife requesting for the advice of the Alangizi.
I am not an Alangizi, but perhaps I thought I could rally to that cry, It is a subject so topical that I would be remiss not to write about it. It occurred to me that when I was growing up, the neighbours on both sides of our house had so many children, that they literally spilled over into our house
Our family, too, was so large that we literally spilled over into our neighbours’ yard. The common number of children in a family was somewhere between eight and nine children. My maternal aunt had 11 children for good measure, she had also had one miscarriage to top it off.
Nowadays the wall fences in the up market suburbs are so high this spillage, would never happen and besides the average family is somewhere between two and three children in size.
If this is a result of prudent family planning, then I need say no more, however, it appears that there has been a decline in the capacity of men and women to have children worldwide, particularly in Africa.
The Zambia Demographic Health Survey attests to this as well.
I can still hear the rendition of the song in my ears now, and the passionate plea, if I may broaden it, from the youth of Zambia, to the elders of Zambia, for some advice on the art of bearing children, In attempting to heed this cry, I will try to answer three questions;
•Is it more difficult for young people to have children now in Zambia than  it was in the past?
•Why is it more difficult to have children now?
•What are the health secrets that can help our young people to have children?

•Is it more difficult to have children in Zambia now?
The answer is a definite yes. This is based both on anecdotal and scientific evidence. When I was a young medical student just more than 25 years ago, we worked in the delivery wards in the hospitals.
In those years, in many of the hospitals where I worked, there were close to 20 to 50 new babies born every night.
These numbers have declined steeply over the years.
It may be said by some that this is evidence of the success of family planning methods and more local maternity services.
This may be true, however, this is not the only evidence.
Twenty years ago, the World Health Organisation recommended the minimum level of male sperm count ( the assessment of the power to have children in men) to be 40 million per millilitre of semen fluid volume.
In the latest WHO guidelines, this has been revised downwards to 20 million per millilitre.
The power of men to have children has declined  from the 1930s in quantity(numbers) by  75 per cent  and  in quality (healthiness) by 50 per cent.
This is scientifically proven and published information.
In Africa in particular, there is a belt of countries, commonly  called the infertility belt, this is the area covering central Africa below the Sahara Desert, this area has the lowest number of children born to each woman of child-bearing age.
There is a general theory proposed by Warren Thompson that as countries transition to wealth, the birth rates and  death rates will decline. In Africa, the paradox is that the decline in birth rates have not been mirrored by a similar decline in death rates.
In Zambia, in particular, the number of children per woman in urban areas has declined from 5.8 in 1992 to 4.3 in 2007.
Among young women of 20 to 35 years , the birth rate has declined from 350 per 1,000  in the 1980s to 250 per 1,000 in 2007.

Why is it more difficult to have children nowadays?
Someone said children are not as important  a mark of success, as they used to be in years gone by. In the traditional African villages, a man’s wealth was measured  by the number of animals and children he had.
Now the success of a man or woman is measured by the amount of education, money and property  they have. Even though this might be the case, there are other biological factors that appear to be threatening  the bearing of children.
These are the increase in diseases of lifestyle and sexually transmitted infections. Disease of lifestyle such as sugar disease (Diabetes) and high blood pressure (hypertension) reduce the sexual health of men and women. In a study done in Lusaka in 2011, it was shown that 38 per cent of men and 33 per cent of women had high blood pressure.
In another study on diabetes in Lusaka, it was observed that the rate of diabetes in Lusaka was at 2.6 per cent among men and 3 per cent among women. In addition, the number of people who are excessively over weight was about 11 per cent.
Sugar disease, high blood pressure and excessive weight adversely affect the sexual health of men. These diseases damage the blood vessels in particular as well as the nerves and also lower the male hormone testosterone.
The nerves, blood vessels and the male hormone provide the feeling and the energy that allows the bearing of children to take place. When these  are damaged  or reduced  the man is too weak to bear children.
Sexually transmitted diseases are one of the most common diseases in Zambia. Studies have shown that up to 8 per cent of  the of people aged between 15 to 49 years, who were surveyed in the demographic survey had the STI syphilis in the 2007 Zambian Demographic Health Survey. The first cases of Human Immuno-deficiency Virus(HIV) infection were first reported in Zambia around 1986.
Before 1980 HIV infection was unknown in Zambian.
The current HIV prevalence is reported as 14.3 per cent. The STI prevalence is reported to be as high as 34 per cent among HIV positive people.
The  body systems which are responsible for reproduction contains systems of tubes in both men and women.
These tubes carry the female eggs and the male sperms. When  STI germs enter these tubes, it causes infection in the tubes leading to scarring, narrowing and eventually completely blocking the tubes.
In addition, they damage the egg-producing  organs in females, the ovaries and in males the sperm-producing organs the testis.
On top of all this, there has been an increase in Tuberculosis(TB) cases in Zambia after the advent of HIV.  As many as 90 per cent of HIV positive patients also have TB.
TB affects like STIs, the testis, the ovaries as well as the reproductive tubes adding its damage to that caused by the STIs. All these diseases were either not there in the 1970s   or were very uncommon.
What are the secrets of bearing  children?
Several things can be said, however, to keep it brief and clear , the advice can be listed as follows;
•Prevention
• Promotion
•Planning
Among the prevention ideas, we must begin to live a life that increases our personal fertility.
This includes a lifestyle that will reduce our risks of developing  high blood pressure, sugar disease and excessive weight. We must also reduce our life time  risk of  developing HIV, STIs and TB.
These are the things that steal our babies. We must drink less alcohol, smoke less and stop adding as much salt as we do to all our food. We need to exercise more, we must do at least 20 minutes of vigorous exercise every day.
In promoting our personal health, we must change our lifestyle so that we eat better and live better. With food we must eat as much natural food as we can. We should avoid processed food.
The more the food is processed the more it loses the vital nutrients that make our reproductive systems healthy. Let us eat more white meat such as fish and chicken meat, as opposed to red meat. Zambia is blessed, we are always told, with 40 per cent of the water bodies in the SADC region.
I presume we have 40 per cent of the fish stocks too. Let’s eat that fish!!
Some fats are essential to the body, but choose the good fats. These good fats clean up our blood vessels and allow the blood to flow more freely in the body.
These good fats include plant-based fats, which are essential for making the reproductive cells healthy. Examples of these are, olive oil or coconut oils as well as oils produced from plant seeds, such as sunflower oil.
Zambia is lucky that it has large arable land where most of these are so easily grown. In promoting our reproductive health, we must live a healthy sexual life.
This includes delaying our first sexual encounter. Studies show that the longer we can delay our first sexual encounter the more healthy we will be.
If we are male, we should be circumcised before our first sexual encounter. We should reduce our total number of life-time sexual partners to as close to one as possible. These two actions will dramatically improve our chances of bearing children.
Plan well. You will be at your most fertile between 25 years and  35 years.
This would be the best time to think of having children. The fertility rates will tend to decrease after the age of 35 years. There is also increased risk of abnormal children and difficulties in delivery for women who have children after this age.
In Zambia, where young men and women are staying longer and longer in school, marriage and family building is being left to the 4th and 5th decade in life.
However, if it is possible, plan to start a family in your 3rd  and 4th decades of life.  It will also help you to support your children through school before you reach retirement.
I can still hear the song in my ear humming its gentle request for advice, but I feel the sense of relief of a grandfather who has dispensed his best advice to his favourite grandson.