Once in a while Nick Kristof gets things right:
In rural parts of Congo Republic, the other Congo to the north, we found that even when people had heard of contraception, they often regarded it as unaffordable.
Most appalling, all the clinics and hospitals we visited in Congo Republic said that they would sell contraceptives only to women who brought their husbands in with them to prove that the husband accepted birth control.
Condoms are somewhat easier to obtain, but many men resist them. More broadly, many men seem to feel that more children are a proud sign of more virility.
So the pill, 50 years old this month in the United States, has yet to reach parts of Africa. And condoms and other forms of birth control and AIDS prevention are still far too difficult to obtain in some areas.
One of the most appalling facts about the limited use of contraception isn't used in Congo and other African countries is the role that American evangelism plays in strengthening old beliefs that women are breeders and not contraception isn't just bad, but evil. The point isn't here that the problem has been imported or is being created by American evangelists, thus making the issue one of identity or one of eternal victimization but rather that that imported fanaticism is making an already catastrophic situation worst by convincing well intentioned, but limited people that ignorance, poverty, and anti-intellectualism are not just bliss, but also close to Godliness.