Alene Getu Degu, Worku Alemayehu
School of Public Health, Faculty of Medicine, Addis Ababa University, Ethiopia.
BMC Public Health. 2008 Dec 2;8:397. doi: 10.1186/1471-2458-8-397.
Ethiopia is one of the most densely populated countries in Africa with an estimated population of 77.1 million in mid-2007. Uncontrolled fertility has adversely influenced the socio-economic, demographic and environmental situations of the country. It is one of the largest and poorest countries that, even in the midst of crisis, has maintained high levels of fertility. This study was aimed at investigating the most important factors influencing fertility behavior in Northwest Ethiopia.
A comparative cross-sectional study which included 2424 women aged 25 years and above was undertaken in the Amhara region of Northwest Ethiopia. The study subjects were grouped into high fertile and low fertile categories. There were 1011 and 1413 women in the high and low fertile groups, respectively. A multi-stage cluster sampling stratified by place of residence was employed to select the required study subjects. Both bivariate and multivariate logistic regression techniques were used to analyze the data.
Among the 25 variables considered in this study, only 9 of them were found significantly and independently associated with the level of fertility. Women with at least secondary education were at a lower risk of high fertility with OR = 0.37 (95% CI: 0.21 to 0.64) compared to those with no formal education. However, women with primary education did not show any significant difference when compared with the same baseline group. Age at first marriage was inversely associated with the number of children ever born alive. Place of residence, household expenditure, number of children who have died, attitude towards using contraceptives, women's knowledge on the safe period, and current marital status were the other variables that showed significant associations with the level of fertility.
Female education beyond the primary level, reduced infant and child mortality, delayed marriage and correct knowledge on the safe period during the menstrual cycle were amongst the main factors that had a bearing on high fertility.
埃塞俄比亚是非洲人口最密集的国家之一，2007年年中估计人口为7710万。生育率不受控制对该国的社会经济、人口和环境状况产生了不利影响。它是最大且最贫穷的国家之一，即使在危机之中，生育率仍维持在较高水平。本研究旨在调查影响埃塞俄比亚西北部生育行为的最重要因素。
在埃塞俄比亚西北部的阿姆哈拉地区开展了一项比较性横断面研究，纳入了2424名25岁及以上的女性。研究对象被分为高生育率组和低生育率组。高生育率组和低生育率组分别有1011名和1413名女性。采用按居住地分层的多阶段整群抽样方法来选取所需的研究对象。使用双变量和多变量逻辑回归技术对数据进行分析。
在本研究考虑的25个变量中，只有9个被发现与生育水平显著且独立相关。与未接受正规教育的女性相比，至少接受过中等教育的女性高生育率风险较低，比值比（OR）为0.37（95%置信区间：0.21至0.64）。然而，与同一基线组相比，接受过小学教育的女性没有显示出任何显著差异。初婚年龄与存活子女数呈负相关。居住地、家庭支出、死亡子女数、对使用避孕药具的态度、女性对安全期的了解以及当前婚姻状况是其他与生育水平显示出显著关联的变量。
小学以上的女性教育、降低婴幼儿死亡率、推迟结婚以及对月经周期安全期的正确认识是影响高生育率的主要因素。
