Stanford University School of Medicine, 1070 Arastradero Road, Palo Alto, CA 94304, USA.
Stud Fam Plann. 2011 Sep;42(3):137-46. doi: 10.1111/j.1728-4465.2011.00274.x.
Iran experienced a dramatic decline in fertility from 1984 to 2001, which was most rapid in rural areas. Although many attribute the decline to the government's active participation in providing family planning services, most services were provided after the initial fertility decline that took place after 1984. We assess the extent to which timing of exposure to basic healthcare is related to fertility outcomes. We estimate the association between a woman's age of exposure to a health house (clinic) and number of children, using the 2001 Iranian Household Expenditure and Income Survey and the 2006 Iranian Census, and the location and dates of operation for each rural health house. We also look at the probability of a woman's giving birth one year after a clinic opened in her village. We use Poisson and logistic multivariate regressions and we control for individual, household, and village characteristics. Exposure to a health house in a woman's most fertile years (20-34) is associated with an 18 percent decrease in number of children ever born relative to those exposed after age 40. This negative association gets progressively stronger as length of exposure increases. Our findings suggest that early exposure to health services in rural areas contributed to Iran's fertility decline.
伊朗的生育率从 1984 年到 2001 年急剧下降，农村地区的下降速度最快。尽管许多人将下降归因于政府积极参与提供计划生育服务，但大多数服务是在 1984 年之后生育率最初下降之后提供的。我们评估了接触基本医疗保健的时间与生育结果之间的关系。我们使用 2001 年伊朗家庭支出和收入调查和 2006 年伊朗人口普查，以及每个农村医疗所的位置和运营日期，估计妇女接触卫生所（诊所）的年龄与子女数量之间的关联。我们还研究了妇女在其村庄的诊所开业一年后生育的概率。我们使用泊松和逻辑多元回归，并控制个人、家庭和村庄的特征。与 40 岁以后接触的人相比，妇女在最肥沃的 20 至 34 岁期间接触医疗所与生育子女数量减少 18%有关。随着接触时间的延长，这种负相关关系变得越来越强。我们的研究结果表明，农村地区早期接触卫生服务是伊朗生育率下降的原因之一。
