The demography of words: The global decline in non-numeric fertility preferences, 1993–2011

Frye, Margaret; Bachan, Lauren

doi:10.1080/00324728.2017.1304565

Cited by 22 publications

(17 citation statements)

References 60 publications

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“…Desired family size is an abstract concept and in high-fertility populations, as in our study sites, there may be an inability or unwillingness to provide a numerical answer for desired number of children if reproductive choice and agency are not yet fully accepted [ 28 ]. However, analysis of the DHS data from 32 countries showed that women’s provision of non-numeric responses to the desired family size question declined over a 19-year period (1993–2011) [ 28 ]; additionally, this study reported that as fertility rates declined, the proportion of women giving non-numeric responses also decreased. Knowledge about, and use of, contraception as well as level of education were inversely related to providing non-numeric responses where a numerical response is required [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy intention data completeness, quality and utility in population-based surveys: EN-INDEPTH study

Yargawa

Machiyama

Hardy

et al. 2021

Popul Health Metrics

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Background An estimated 40% of pregnancies globally are unintended. Measurement of pregnancy intention in low- and middle-income countries relies heavily on surveys, notably Demographic and Health Surveys (DHS), yet few studies have evaluated survey questions. We examined questions for measuring pregnancy intention, which are already in the DHS, and additional questions and investigated associations with maternity care utilisation and adverse pregnancy outcomes. Methods The EN-INDEPTH study surveyed 69,176 women of reproductive age in five Health and Demographic Surveillance System sites in Ghana, Guinea-Bissau, Ethiopia, Uganda and Bangladesh (2017–2018). We investigated responses to survey questions regarding pregnancy intention in two ways: (i) pregnancy-specific intention and (ii) desired-versus-actual family size. We assessed data completeness for each and level of agreement between the two questions, and with future fertility desire. We analysed associations between pregnancy intention and number and timing of antenatal care visits, place of delivery, and stillbirth, neonatal death and low birthweight. Results Missing data were <2% in all questions. Responses to pregnancy-specific questions were more consistent with future fertility desire than desired-versus-actual family size responses. Using the pregnancy-specific questions, 7.4% of women who reported their last pregnancy as unwanted reported wanting more children in the future, compared with 45.1% of women in the corresponding desired family size category. Women reporting unintended pregnancies were less likely to attend 4+ antenatal care visits (aOR 0.73, 95% CI 0.64–0.83), have their first visit during the first trimester (aOR 0.71, 95% CI 0.63–0.79), and report stillbirths (aOR 0.57, 95% CI 0.44–0.73) or neonatal deaths (aOR 0.79, 95% CI 0.64–0.96), compared with women reporting intended pregnancies. We found no associations for desired-versus-actual family size intention. Conclusions We found the pregnancy-specific intention questions to be a much more reliable assessment of pregnancy intention than the desired-versus-actual family size questions, despite a reluctance to report pregnancies as unwanted rather than mistimed. The additional questions were useful and may complement current DHS questions, although these are not the only possibilities. As women with unintended pregnancies were more likely to miss timely and frequent antenatal care, implementation research is required to improve coverage and quality of care for those women.

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Section: Discussionmentioning

confidence: 99%

Pregnancy intention data completeness, quality and utility in population-based surveys: EN-INDEPTH study

Yargawa

Machiyama

Hardy

et al. 2021

Popul Health Metrics

View full text Add to dashboard Cite

show abstract

“…Relatively small numbers of women report a desired family size that equals their actual family size. It may also be the case that the extent of such ex post rationalisations vary substantially depending on the cultural context as is the case with non-numeric responses [26].…”

Section: Discussionmentioning

confidence: 99%

“…Firstly, non-numeric responses (such as “up to God”) are problematic, though the make up less than 10% of the responses in the majority of surveys. Non-numeric responses have been found to be much more common amongst those with less education and a lower level of contraceptive knowledge, though such responses are increasingly rare [26]. We excluded non-numeric responses (in line with Casterline and Han) as they could not be incorporated into the AINC and such responses suggested that the very idea of a mismatch between fertility ideals and outcomes would make no sense to respondents who answered in this way [7].…”

Section: Methodsmentioning

confidence: 99%

Educational differentials in the realisation of fertility intentions: Is sub-Saharan Africa different?

Channon

Harper

2019

PLoS ONE

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Background The gap between fertility outcomes and fertility ideals is notably higher in sub-Saharan Africa (SSA) than elsewhere, relating to both under- and overachievement of fertility ideals. We consider the extent to which the relationship between fertility ideals and fertility outcomes is related to educational achievement. Further, we consider if these educational differentials are the same or different in SSA, and thereby consider the extent to which increasing levels of education in SSA may decrease fertility. Data and methods We use 227 Demographic and Health Surveys (DHSs) from 58 countries worldwide to look at population- level measures of the mismatch between fertility ideals and fertility outcomes. Population level measures are used to assess whether the correspondence between fertility intentions and achievements differ by level of education. We then look at the individual-level determinants of both under- and overachieving fertility intentions. Data from the most recent DHS in 54 of the original countries is used for the individual level analysis, with five countries excluded due to the most recent available survey being out of date. Results An average of 40% of women in SSA underachieve their stated fertility intentions compared to 26% in non-SSA countries. Furthermore, compared to other LMICs, higher levels of education are not related to better correspondence between fertility intentions and outcomes in SSA. In Middle/Western Africa countries, on average, 48% of women with secondary or higher education have fewer children than their ideal, compared to just 24% who have more children than their ideal. Conclusion We argue that the phenomenon of underachieving fertility ideals (or unrealized fertility) may be of particular importance for the ongoing fertility transition throughout SSA, especially as more highly educated groups do not appear to be following the patterns observed elsewhere.

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“…While concerns about data quality are valid, data availability (if not quality) has been improving, and statistical methods for treating preferences as dynamic processes have advanced considerably. Non‐numeric responses to questions about fertility desires such as “Don't know” and “Up to God” have declined (Frye and Bachan ), suggesting that the vast majority of women think numerically about the future with respect to their families.…”

Section: Uncertainty and Fertility In Africamentioning

confidence: 99%

The Flexibility of Fertility Preferences in a Context of Uncertainty

Trinitapoli¹,

Yeatman²

2017

Population & Development Rev

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The demography of words: The global decline in non-numeric fertility preferences, 1993–2011

Cited by 22 publications

References 60 publications

Pregnancy intention data completeness, quality and utility in population-based surveys: EN-INDEPTH study

Pregnancy intention data completeness, quality and utility in population-based surveys: EN-INDEPTH study

Educational differentials in the realisation of fertility intentions: Is sub-Saharan Africa different?

The Flexibility of Fertility Preferences in a Context of Uncertainty

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