Drivers of desire for more children among childbearing women in sub-Saharan Africa: implications for fertility control

Abstract

Background Despite the extensive research on fertility desires among women the world over, there is a relative dearth of literature on the desire for more children in sub-Saharan Africa (SSA). This study, therefore, examined the desire for more children and its predictors among childbearing women in SSA. Methods We pooled data from 32 sub-Saharan African countries’ Demographic and Health Surveys. A total of 232,784 married and cohabiting women with birth history, who had complete information on desire for more children made up the sample for the study. The outcome variable for the study was desire for more children. Multilevel logistic regression analysis was conducted. Results were presented using adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CI). Results The overall prevalence of the desire for more children was 64.95%, ranging from 34.9% in South Africa to 89.43% in Niger. Results of the individual level predictors showed that women aged 45–49 [AOR = 0.04, CI = 0.03–0.05], those with higher education [AOR = 0.80, CI = 0.74–0.87], those whose partners had higher education [AOR = 0.88; CI = 0.83–0.94], women with four or more births [AOR = 0.10, CI = 0.09–0.11], those who were using contraceptives [AOR = 0.68, CI = 0.66–0.70] and those who had four or more living children [AOR = 0.09 CI = 0.07–0.12] were less likely to desire for more children. On the other hand, the odds of desire for more children was high among women who considered six or more children as the ideal number of children [AOR = 16.74, CI = 16.06–17.45] and women who did not take decisions alone [AOR = 1.58, CI = 1.51–1.65]. With the contextual factors, the odds of desire for more children was high among women who lived in rural areas compared to urban areas [AOR = 1.07, CI = 1.04–1.13]. Conclusions This study found relatively high prevalence of women desiring more children. The factors associated with desire for more children are age, educational level, partners’ education, parity, current contraceptive use, ideal number of children, decision-making capacity, number of living children and place of residence. Specific public health interventions on fertility control and those aiming to design and/or strengthen existing fertility programs in SSA ought to critically consider these factors.

Which factors predict fertility intentions of married men and women? Results from the 2012 Niger Demographic and Health Survey

“…These authors argue that more educated men have higher average earnings, making it possible to afford a larger family. Contrary to the findings of previous studies [ 38 , 71 , 72 ], the current study found no statistically significant association between the level of education of women and desire for more children. However, we found the highest prevalence of desire for more children among women with secondary/higher education in Niger.…”

“…For example, Dyer et al [ 49 ] indicated that some women are divorced because they cannot have children. This finding is similar to previous studies by Ahinkorah et al [ 38 ], Hacettepe University Institute of Population Studies [ 45 ] and Ocalan et al [ 50 ], which showed that the desire for more children declined greatly with the increase in the number of children of a childbearing woman. Other studies that made similar observations include Adebowale et al [ 51 ], Babalola et al [ 52 ], Eklund [ 53 ], and De Silva [ 54 ] in Nigeria, China, and Sri Lanka.…”

“…Specifically, women who watched television at least once a week were less likely to desire more children compared to those who never watched television. This finding corroborates the findings of previous studies on the relationship between mass media and fertility by building a smaller family ideal [ 38 , 63 , 64 ]. The possible reason for the finding is that messages on social media such as television have the possibility of influencing the fertility behaviour of women through the use of family planning methods and limit the number of children they wish to have.…”

“…In terms of the national prevalence of desire for more children, the present study recorded 97.2% and 87.2% among men and women respectively. The observed prevalence of desire for more children in this population is higher than what has been reported in most studies [ 20 , 38 ]. They are much higher than the prevalence of 60% recorded in Ghana [ 17 ] and 63.1% recorded in Rakai, Uganda [ 20 ].…”

Consistency of the determinants of achieving fertility desires in Ghana: insights from 2003, 2008 and 2014 Ghana Demographic and Health Survey data sets

“…Studies have established that fertility preference is not stable and changes due to prevailing circumstances (Liefbroer, 2009;Trinitapoli & Yeatman, 2018). Furthermore, studies conducted in sub-Saharan Africa (SSA) including Ghana have identified a number of factors as predictors of high fertility preference (Ahinkorah et al, 2020;Kodzi et al, 2010;Odusina et al, 2020;Van Lith et al, 2013). Findings from these studies suggest positive relationship between fertility preference and actual fertility.…”