Background Multiple high-risk fertility behaviours (MHRFBs), including maternal age < 18 or > 34 years old, a birth order 4+, and birth spacing < 24 months, can directly or indirectly affect survival ...outcomes among under-five children. There is a dearth of available information and data about these two phenomena in Nigeria. Thus, this study evaluates the prevalence of MHRFBs and examines the association between MHRFBs and under-five mortality survival (U5M) outcomes among ever-married women of reproductive age in Nigeria. Methods This study used the recent secondary datasets from the Nigerian Demographic Health Surveys conducted in 2018, with a total sample size of 10,304 women of reproductive age. The outcome variable was MHRFBs. Multivariable logistic regression analysis was employed to examine the association between U5M and MHRFBs. Odds ratios with a p-value of less than 0.05 were considered significant. Results It was found that among women who had MHRFBs, U5M was prevalent, particularly in young maternal age (< 18 years) and within short birth intervals (< 24 months). The adjusted odds ratio of the association between MHRFBs and U5M shows the experience of MHRFBs, in addition to other factors such as household wealth index, type of marriage, and sex of child, to be significant predictors for U5M. The odds were higher for U5M to occur among women who had experienced MHRFBs compared to those who have not had an experience of MHRFBs aOR = 1.48; 95%CI: 1.02-2.17 . Similarly, the odds of U5M occurrence among women in polygamous marriages are higher compared to those in monogamous unions aOR = 1.35; 95% CI: 1.10-1.65. While under-five children born in the richest households (wealth quintiles) are less likely to die compared to those born in the poorest households aOR = 0.64; 95% CI: 0.41-1.01. Conclusion This study concludes that women in Nigeria who engaged in MHRFBs, particularly maternal ages < 18 years and short birth intervals (< 24 months), were more likely to experience U5M. Furthermore, children born to women who received post-natal care after delivery were more likely to survive U5M, as were children born to women with educated partners. We recommend strengthening educational opportunities and creating adaptive reproductive health education programs for ever-married women of reproductive age in Nigeria. Keywords: Under-five mortality, High-risk fertility behaviours, Ever-married women of reproductive age, Global health, DHS, Nigeria
Women's high-risk fertility behavior (HRFB), which is characterized by narrow birth intervals, high birth order, and younger maternal age at birth, have been scientifically reported to have ...detrimental effects on the mother and child's health. To date, there has been limited research into the underlying factors contributing to high-risk fertility behavior in Kenya. Thus, the aim of this study is to identify the factors associated with high-risk fertility behavior among women of reproductive age in Kenya.
The 2022 Kenyan Demography and Health Survey data was used for the current study. This study included 15,483 women of reproductive age. To account for the clustering effects of DHS data and the binary nature of the outcome variable, a multilevel binary logistic regression model was applied. An adjusted odds ratio with a 95% confidence interval was reported to declare the statistical significance. In addition, the model that had the lowest deviance was the one that best fit the data.
The overall prevalence of HRFB among Kenyan women were 70.86% (95%CI = 69.96, 71.40). Women with primary, secondary, and higher educational levels, Protestant and Muslim religion followers, women whose husbands/partners had secondary and higher educational levels, a high household wealth index, ever had a terminated pregnancy, and rural residence, all of these factors were found to be strongly associated with high-risk fertility behavior.
As per the findings of our study, in Kenya a significant proportion of women has experienced HRFB. This is a matter of concern as it poses a significant challenge to the healthcare system. The high prevalence of HRFB indicates that there is an urgent need to take appropriate measures in order to mitigate its impact. The situation calls for a comprehensive and coordinated approach involving all stakeholders to address this issue effectively. It would benefit policymakers to create programs that consider factors like education, wealth, and residence that make women more susceptible to HRFB. Targeting women living in high HRFB-prevalence areas could help address the root causes of the issue. This approach can alleviate negative impacts and ensure effective and sustainable solutions.
Many analyses demonstrate that rising unemployment rates generate a feeling of uncertainty that can influence fertility behaviour, inducing a short-term reduction in fertility. The authors wish to ...evaluate whether the recent changes in male and female unemployment are differently linked to fertility in different geographic areas of Italy. They used the following official aggregate data for the period 1995-2012: unemployment quarterly rates from the Labour Force Surveys conducted by the National Institute of Statistics (Istat) and quarterly general fertility rates. They applied a monitoring approach for the identification of structural breaks inside both of the time series and used a dynamic regression to identify specific temporal links between unemployment and fertility. Both male and female unemployment rates are negatively associated with fertility in the northern and central regions of Italy. Unemployment rates seem to be good predictors of fertility in these regions, although male unemployment appears to further reduce fertility beyond the reduction predicted by female unemployment.
Previous studies on the number of births and the health of the elderly have been highly focused on physical health and used samples from developed countries. Therefore, this study aimed to explore ...the effect of the lifetime number of births on depression in Chinese older adults. We used panel data for men and women aged 50 and over from the 2013-2018 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed through a short form of the Center for Epidemiologic Studies Depression Scale. We found that depression levels in women were significantly higher than in men, with a mean difference of 2.44 (
< 0.001). The model estimation results indicated that the number of births affected depression in older adults, and its increase could exacerbate depression in older adults. The number of births significantly impacted depression among the elderly aged 50-69. Furthermore, there was a negative relationship between the proportion of sons and older adults' depression, which was significant in older males; the number of abortions may exacerbate depression in older adults, especially in females.
One explanation offered for very low fertility has been the gap between improvements in women's socioeconomic status outside the home and gender inequality in the home. The related empirical evidence ...is lacking for East Asian countries, where women may face particular challenges combining career and family due to the unique regional context. This paper provides an up-to-date picture of Korean women's fertility intentions, fertility behaviour, and the division of domestic labour with husbands, parents, parents-in-law, and formal childcare services. It also examines how the informal and formal help women receive affects their fertility behaviour. Using data from the 2008, 2010, and 2012 waves of the Korean Longitudinal Survey of Women and Families, this study describes fertility intentions, fertility behaviour, and the division of labour. Focusing on women with one child, I use logit regressions to estimate how various sources of help relate to the intended and unintended births of second children. Fertility intentions were a good predictor of fertility behaviour. Both fertility intentions and behaviour displayed the greatest variability among women with one child. Husbands did not contribute much to domestic work, and gender inequality grew with parity. Husbands' support in the domestic sphere increased the likelihood of intended births. Formal help also had a positive impact when its costs were not high, but parental help had no significant impact. None of these sources of help was related to unintended births. Government policies that aim to address Korea's low fertility would be wise to target women with one child. Empirical evidence from Korea supports the recent theoretical literature on the association of low fertility with gender inequity. Various sources of support that relieve women's domestic labour burden and enhance their ability to reconcile work with family life may boost fertility rates in East Asia.
High-risk fertility behavior (HRFB) among women is the main factor in a wide range of detrimental effects on both the mother's and the child's health, which has an impact on both the mother's and the ...child's survival. Early childbearing is associated with a higher number of live births and may result in poorer maternal, baby, and child health outcomes. Infant and child mortality are also linked to short birth intervals and higher birth order. Thus, this study aims to examine the link between women's education, contraception use, and high-risk fertility behavior in Ethiopia.
Data was drawn from the 2019 Ethiopian Interim Demographic and Health Survey. The analysis covered a total of 5,846 women. The effect of predictor variables on HRFB was quantified using multivariable logistic regression analysis. At a 95% CI of the odds ratio excluding one, a significant association between the HRFB and predictor variables was observed.
About 72.8% (95% CI 71.6%-73.9%) of women experience high-risk fertility behaviors. Of these, 32% experience single high-risk fertility behavior, and 40.8% experience multiple high-risk fertility behaviors. Of those who experience high-risk fertility behaviors, 58.7% have birth orders of more than three, 22.4% have short birth intervals (less than 24 months); 35.1% are old (over 34 years old); and 1.6% are young (less than 18 years old). Women with no education (AOR = 4.31; 95% CI: 2.09, 8.89) and primary education only (2.71; AOR = 2.71; 95% CI: 1.63, 4.50) are more likely to engage in high-risk fertility behaviors than women with a higher level of education. Every additional year of schooling reduces the odds of high-risk fertility behavior by 6% (AOR = 0.94; 95% CI: 0.89, 0.98). The use of modern contraception (AOR = 0.74; 95% CI: 0.622, 0.879) and knowledge of modern contraception methods (AOR = 0.80; 95% CI: 0.66, 0.96) reduce the risk of HRFB.
Primary education and a lack of education significantly raise the risk of HRFB. However, in Ethiopia, the risk of experiencing HRFB is reduced through modern contraceptive methods, awareness of modern contraceptive methods, and years of education. All initiatives to decrease maternal and newborn mortalities by reducing the risk of HRFB should educate women and encourage them to use modern contraception.
Abstract
Background
High-risk fertility behavior is associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality. As far as our ...knowledge goes, there is not much study on determinants of high-risk fertility behavior in Ethiopia. Therefore, this study aimed to assess determinants of high-risk fertility behavior among reproductive-age women in Ethiopia.
Method
The study was based on secondary data analysis from the 2016 Ethiopia Demography and Health Survey. A total of 11,022 women who gave birth 5 years preceding the survey were included in this study. Kid’s Record (KR) dataset was used. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) was calculated for those variables included in the multilevel logistic regression model.
P
value ≤ 0.05 was employed to declare the statistically significant variables.
Results
More than three-fourths (76.9%) of (95% CI 76.11 to 77.69) reproductive-age women had at least one high-risk fertility behavior. Attended primary and secondary education adjusted odds ratio (AOR) (AOR = 0.71; 95% CI 0.63, 0.80 and AOR = 0.73; 95% CI 0.60, 0.89, respectively), never used contraceptive (AOR = 1.25, 95% CI 1.12, 1.40), unwanted pregnancies (AOR = 1.40, 95% CI 1.23, 1.59), had no ANC visit (AOR = 1.19, 95% CI 1.05, 1.35), rural-dwelling (AOR = 1.26, 95% CI 1.04, 1.51), regions of Ethiopia Somalia (AOR = 1.70; 95% CI 1.24, 2.32) and Amhara (AOR = 0.72; 95% CI 0.53, 0.96) were determinants of high-risk fertility behavior.
Conclusion
Education, rural residence, unwanted pregnancies, no antenatal care follow-up, and never used contraceptives were determinants of high-risk fertility behavior. Therefore, increased maternal health services, special intervention for hotspot areas, and giving special attention to rural dweller women were highly recommended.
The COVID-19 pandemic has affected various dimensions of the economies and societies. At this juncture, this paper examines the effects of pandemics-related uncertainty on fertility in the panel ...dataset of 126 countries from 1996 to 2019. For this purpose, the World Pandemics Uncertainty Indices are used to measure the pandemics-related uncertainty. The novel empirical evidence is that pandemics-related uncertainty decreases fertility rates. These results are robust to estimate different models and include various controls. We also try to explain why the rise in uncertainty during the COVID-19 pandemic has resulted in the fertility decline.
In low-and-middle-income, including Ethiopia, high-risk fertility behavior is a major public health concern. High-risk fertility behavior has an adverse influence on maternal and child health, ...which hampered efforts to reduce maternal and child morbidity and mortality in Ethiopia. Therefore, this study aimed to assess the spatial distribution and associated factors of high-risk fertility behavior among reproductive-age women in Ethiopia using recent nationally representative data.
Secondary data analysis was done with a total weighted sample of 5865 reproductive-aged women using the latest mini EDHS 2019. The spatial distribution of high-risk fertility behavior in Ethiopia was determined using spatial analysis. Multilevel multivariable regression analysis was used to identify predictors of high-risk fertility behavior in Ethiopia.
The prevalence of high-risk fertility behavior among reproductive-age women in Ethiopia was 73.50% (95% CI 72.36%, 74.62%). Women with primary education AOR = 0.44; 95%CI; 0.37, 0.52, women with secondary and above education AOR = 0.26; 95%CI; 0.20, 0.34, being Protestant religion followers AOR = 1.47; 95%CI; 1.15, 1.89, being Muslim religion follower AOR = 1.56; 95%CI; 1.20, 2.01, having television AOR = 2.06; 95%CI; 1.54, 2.76, having ANC visit AOR = 0.78; 95%CI; 0.61, 0.99, using contraception AOR = 0.77; 95%CI; 0.65, 0.90, living in rural areas AOR = 1.75; 95%CI; 1.22, 2.50 were significantly associated with high-risk fertility behavior. Significant hotspots of high-risk fertility behavior were detected in Somalia, SNNPR, Tigray region, and Afar regions of Ethiopia.
A significant proportion of women in Ethiopia engaged in high-risk fertility behavior. High-risk fertility behavior was distributed non-randomly across Ethiopian regions. Policymakers and stakeholders should design interventions that take into account the factors that predispose women to have high-risk fertility behaviors and women who reside in areas with a high proportion of high-risk fertility behaviors to reduce the consequences of high-risk fertility behaviors.
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