Determinants of fertility in Rwanda in the context of a fertility transition: a secondary analysis of the 2010 Demographic and Health Survey

Abstract

BackgroundMajor improvements to Rwanda’s health system, infrastructure, and social programs over the last decade have led to a rapid fertility transition unique from other African countries. The total fertility rate fell from 6.1 in 2005 to 4.6 in 2010, with a 3-fold increase in contraceptive usage. Despite this rapid national decline, many women still have large numbers of children. This study investigates predictors of fertility during this fertility transition to inform policies that improve individuals’ reproductive health and guide national development.MethodsWe used Poisson regression to separately model number of children born to ever married/cohabitated women (n = 8,309) and never married women (n = 1,220) age 15 to 49 based on 2010 Rwanda Demographic and Health Survey data. We used backward stepwise regression with a time offset to identify individual and household factors associated with woman’s fertility level, accounting for sampling weights, clustering, and stratification.ResultsIn ever married/cohabitating women, high fertility was significantly associated (p < 0.05) with the following variables: unmet need for contraception (IRR = 1.07), women’s desire for children (5+ versus 0–2 children: IRR = 1.22), woman’s number of siblings (8–20 versus 0–4: IRR = 1.03), and couples who desired different numbers of children (husband wants more: IRR = 1.04; husband wants fewer: IRR = 1.04). Low fertility in ever married/cohabitating women was associated with women’s education (higher versus no education: IRR = 0.66), household wealth (highest versus lowest quintile: IRR = 0.93), and delayed sexual debut (25+ versus 8–18 years: IRR = 0.49). In never married women, low fertility was associated with education (higher versus no education: IRR = 0.22), household wealth (highest versus lowest quintile: IRR = 0.58), delayed sexual debut (25–49 versus 8–18 years: IRR = 0.43), and having an unmet need for contraception (IRR = 0.69).ConclusionsAlthough the study design does not allow causal conclusions, these results suggest several strategies to further reduce Rwanda’s national fertility rate and support families to achieve their desired fertility. Strategies include policies and programs that promote delayed sexual debut via educational and economic opportunities for women, improved access to reproductive health information and services at schools and via health campaigns, and involvement of men in family planning decision making.

An Analysis of the Determinants of Fertility Differentials Amongst the Poorest Women Population in Kenya

“…Their study found an inverse relationship between wealth status and fertility, with significantly lower fertility among the richest women compared to high fertility among the poorest. Similar findings have been reported in [11,32] and [27]. Many other previous studies have focused on the sociocultural and economic determinants of fertility in various regions [11,13,14,18,23,24,27,29,32,34,35].…”

“…This study further explained education exposes women to information, empowers women, makes them more likely to be employed outside their home environment, and makes them more aware of their own health and the health of their children-all of which are negatively associated with the number of children a woman will have during her reproductive life. Similarly, educated women are more likely to postpone marriage, have smaller family size, and use contraception than are uneducated women [27]. The value of the odds ratio exp@β E B = 2.0524, for Age at first birth of the mothers that the odds of having TCEB greater than or equal to 5 children for women age 19 and below is 105.24% more than those women aged 25 years and above (OR=2.0524, CI=1.5872-2.6538) and 46.67% for women aged 20-24 years.…”

Applied statistical training to strengthen analysis and health research capacity in Rwanda

“…No teams submitted a manuscript within 4 months; the first manuscript was submitted within 6 months, two additional manuscripts were submitted within 12 months, a fourth manuscript was submitted at 18 months, and a fifth manuscript was submitted at 26 months to international peer-reviewed journals. At the time of this writing, three manuscripts were published [ 22 – 24 ], two were under revision to resubmit, and one remained under development.…”

Risk Factors for Pregnancies Among Females Age 15 to 19 in Rwanda: A Secondary Data Analysis of the 2014/2015 Rwanda Demographic and Health Survey (RDHS)

“…The latest Rwanda Demographic and Health Survey (RDHS 2014-15) found that teenage pregnancy rate had increased from 4.1% in 2005 to 7.3% in 2015, with the rate in some regions reaching as high as 15.8% (National Institute of Statistics of Rwanda (NISR), Ministry of Health (MOH) [Rwanda], 2015). While many studies have used DHS data to study risk factors related to antenatal care, postnatal care, fertility, and nutrition (Manzi et al, 2014;Mukabutera et al, 2016;Ndahindwa et al, 2014), none have studies those related to teenage pregnancies in Rwanda. Accordingly, this study utilized a secondary data analysis method to identify the risk factors contributing to teenage pregnancies in Rwanda.…”