Women's fertility desires and contraceptive behavior in three peri-urban communities in sub Saharan Africa

OlaOlorun, Funmilola; Seme, Assefa; Otupiri, Easmon; Ogunjuyigbe, Peter Olasupo; Tsui, Amy O.

doi:10.1186/s12978-016-0118-z

Cited by 33 publications

(26 citation statements)

References 13 publications

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“…Women who had consistent fertility desires were more likely to be consistent in their contraceptive use. Our findings reinforce the findings of other longitudinal and cross-sectional studies 7,10,11,14,27,32,33 . However, our study is distinct from the previous ones as our study has additionally included caste, religion, residential status and presence of son at home as confounding variables.…”

Section: Discussionsupporting

confidence: 91%

The role of change in fertility desire on change in family planning use: A longitudinal investigation in urban Uttar Pradesh, India

et al. 2019

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Background: Reproductive choice is one of the rights of any woman, but women are often ambivalent towards fertility desires and choice of contraception. Our study explores how the change in fertility desires influence the change in use of modern contraception over time in six cities of Uttar Pradesh, India. Methods: Data for this study comes from the Measurement, Learning and Evaluation (MLE) Project for Urban Health Initiative in six cities of Uttar Pradesh. Our study sample consists of 8735 women (weighted n=8655) who were fertile, non-sterilized and non-pregnant at the time of baseline survey. Potential bias due to lost to follow up was addressed using inverse probability weighing and then generalized estimating equations were applied to get odds for change in use of modern contraceptives. Results: Contraceptive use increased by different magnitudes from baseline to endline across all six cities. At baseline and endline, women who desired no more children reported a higher use of modern contraception than those who desired more children over time. Women from all cities who desired no more children at baseline had higher odds of modern contraceptive use than that of women who desired more children. The tempo of change in use of modern contraception over time among women with different fertility desires differed across the considered cities. Conclusion: Although there were city-wise differences observed, women’s fertility intentions have an impact on their use of modern contraceptives over the time period between baseline to endline. To obtain greater insight into city-level differences, mixed method studies will be more effective.

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Section: Discussionsupporting

confidence: 91%

The role of change in fertility desire on change in family planning use: A longitudinal investigation in urban Uttar Pradesh, India

et al. 2019

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“…Finally, our inability to collect data on current use of modern family planning methods was a key limitation, since these methods control fertility levels. However, given the low levels of modern contraceptive use in Uganda [27], and the fact that contraception tends to reduce with increased fertility desire [36], we can safely conclude that the fertility desire observed in our study population reflect a more realistic picture of the fertility levels in this rural population.…”

Section: Discussionmentioning

confidence: 68%

Determinants of fertility desire among married or cohabiting individuals in Rakai, Uganda: a cross-sectional study

et al. 2017

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BackgroundRecent trends in fertility rates indicate declines in total fertility rate (TFR) in some sub-Saharan African countries. However, countries such as Uganda continue to have a persistently high TFR partly attributed to strong preferences for large family sizes. We explored the factors that influence fertility desire among married or cohabiting individuals in Rakai, a rural district in southwestern Uganda.MethodsThis cross-sectional study of fertility desire (desire to have another child) was nested in a cluster-randomized demand-creation intervention trial for the promotion of couples’ HIV counseling and testing uptake among married or cohabiting individuals that was conducted in Rakai district between March 1 and April 30, 2015. A total of 1490 married or cohabiting individuals, resident in three study regions with differing background HIV prevalence, were enrolled into the study. Data were collected on socio-demographic, behavioral and fertility-related characteristics. We used a modified Poisson regression model to generate prevalence ratio (PR) as a measure of association for factors that were independently associated with fertility desire. We adjusted for clustering at community level and used STATA version 14.0 for all analyses.ResultsOverall, fertility desire was high (63.1%, n = 940); higher in men (69.9%, n = 489) than women (57.1%, n = 451). More than three-quarters (78.8%, n = 1174) had 3+ biological children while slightly more than two-thirds (68.5%, n = 1020) reported an ideal family size of 5+ children. Only 30% (n = 452) reported that they had attained their desired family size. After adjusting for potential and suspected confounders, the factors that were negatively associated with fertility desire were: age 30–39 (adjusted prevalence ratio [aPR] = 0.82, 95% CI: 0.78, 0.86) and 40+ years (aPR = 0.65, 95% CI: 0.60, 0.71); having six or more biological children (aPR = 0.88, 95% CI: 0.80, 0.97); being HIV-positive (aPR = 0.86, 95% CI: 0.78, 0.95) and ever use of any family planning methods (aPR = 0.93, 95% CI: 0.87, 0.99). Being male (aPR = 1.19, 95% CI: 1.07, 1.33); having primary education (aPR = 1.21, 95% CI: 1.01, 1.44) and having not yet attained the desired family size (aPR = 4.34, 95% CI: 3.50, 5.38) were positively associated with fertility desire.ConclusionHaving not yet attained one’s desired family size, being male and having primary education were positively associated with fertility desire in this population. Targeting individuals who have not yet attained their desired family size, men and less educated individuals with fertility regulation interventions may help to reduce fertility desire in this population.

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“…The correlated random effects analyses presented here take advantage of the longitudinal data to use an extension of fixed effects methods to control for the endogeneity of intentions and contraceptive use as predictors of birth outcomes. This has not been done in previous studies and so the results of previous research may be biased [10,17,18]. Using three time periods and controlling for this endogeneity we show that both fertility intentions and contraceptive use are related to subsequent pregnancy or birth experience.…”

Section: Discussionmentioning

confidence: 59%

Longitudinal examination of changing fertility intentions and behaviors over a four-year period in urban Senegal

et al. 2020

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Background: Fertility intentions and contraceptive use are often used to demonstrate gaps in programs and policies to meet the contraceptive needs of women and couples. Prior work demonstrated that fertility intentions are fluid and change over a woman's (or couple's) life course with changing marital status, childbearing, and education/employment opportunities. This study uses longitudinal data to better examine the fluidity of women's fertility intentions and disentangle the complex interrelationships between fertility and contraceptive use. Methods: Using survey data from three time points and three urban sites in Senegal, this study examines how women's fertility intentions and contraceptive use in an earlier period affect pregnancy experience and the intentionality of experienced pregnancies among a sample of 1050 women who were in union at all three time points. We apply correlated random effect longitudinal regression methods to predict a subsequent birth by fertility intentions and modern contraceptive use at an earlier period addressing endogeneity concerns of earlier analyses that only include two time periods. Results: Descriptive results demonstrate some change in fertility desires over time such that 6-8% of women who reported their pregnancy as intended (i.e., wanted to get pregnant at time of pregnancy) reported earlier that they did not want any(more) children. Multivariate analyses demonstrate that women who want to delay or avoid a pregnancy and are using modern contraception are the least likely to get pregnant. Among women who became pregnant, the only factor differentiating whether the pregnancy is reported as intended or unintended (mistimed or unwanted) was prior fertility intention. Women who wanted to delay a pregnancy previously were more likely to report the pregnancy as unintended compared to women who wanted to get pregnant soon. Conclusions: These results suggest some post-hoc rationalization among women who are getting pregnant. Women who say they do not want to get pregnant may be choosing not to use a contraceptive method in this urban Senegal context of high fertility. Programs seeking to reach these women need to consider their complex situations including their fertility intentions, family planning use, and the community norms within which they are reporting these intentions and behaviors.

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Women's fertility desires and contraceptive behavior in three peri-urban communities in sub Saharan Africa

Cited by 33 publications

References 13 publications

The role of change in fertility desire on change in family planning use: A longitudinal investigation in urban Uttar Pradesh, India

The role of change in fertility desire on change in family planning use: A longitudinal investigation in urban Uttar Pradesh, India

Determinants of fertility desire among married or cohabiting individuals in Rakai, Uganda: a cross-sectional study

Longitudinal examination of changing fertility intentions and behaviors over a four-year period in urban Senegal

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