Alazbih Nega Mihret, Tewabe Getachew Nibret, Demissie Tariku Dejene
Department of Population Studies, University of Gondar, Gondar, Ethiopia.
Center for Population Studies, Addis Ababa University, Addis Ababa, Ethiopia.
Fertil Res Pract. 2017 Sep 5;3:12. doi: 10.1186/s40738-017-0039-8. eCollection 2017.
The overall decline of fertility in Amhara National Regional State between 2000 and 2011 was the highest in Ethiopia. The aim of the present study was to determine the most significant proximate determinant of fertility change during the last decade in the region using Bongaarts' model.
The sources of data were the 2000, 2005, and 2011 Ethiopia Demographic and Health Surveys. The model indices were calculated for each survey. Decomposition of fertility change into components of proximal determinants was also carried out. An index value close to 1 is a negligible inhibiting effect while a large inhibiting effect when the value very closes to 0.
The fertility-constraining effect of contraception increased from 0.93 in 2000 to 0.65 in 2011; however, it was lower than the effect of postpartum insusceptibility at all given times. The index of marriage remained unchanged in constraining fertility over the period (0.71 in 2000 and 0.70 in 2011) while the influence of postpartum insusceptibility slightly declined from 0.49 in 2000 to 0.54 in 2011 but was stronger than contraception and marriage. The contribution of contraception was most important in urban areas (0.46 in 2011 from 0.52 in 2005 and 0.64 in 2000); however, in rural areas, it became an important determinant over the period (0.95 in 2000 and 0.69 in 2011). The effect of postpartum insusceptibility in rural areas showed a decreasing trend (0.48 in 2000 and 0.53 in 2011). The index of marriage in rural areas was stable overtime (0.75 in 2000 and 0.73 in 2011) while in urban areas the effect declined from 0.42 in 2000 to 0.65 in 2011. Marriage was the most important proximate determinant of fertility among women with secondary and above education but the impact declined during the period (0.41 in 2000 and 0.61 in 2011). The importance of postpartum insusceptibility in limiting fertility among women with secondary and above education declined overtime (0.77 in 2000 and 0.87 in 2011) whereas the contribution of contraception became more important (0.44 in 2000 and 0.35 in 2011).
An increase in the level of contraceptive use and effectiveness overtime was the single most important contributing factor for the recent fertility decline in the region.
2000年至2011年期间，阿姆哈拉民族州的生育率总体下降幅度在埃塞俄比亚是最高的。本研究的目的是使用邦加茨模型确定该地区过去十年中生育率变化的最主要的直接决定因素。
数据来源为2000年、2005年和2011年的埃塞俄比亚人口与健康调查。为每次调查计算模型指标。还将生育率变化分解为近端决定因素的组成部分。指数值接近1表示抑制作用可忽略不计，而值非常接近0时则表示抑制作用很大。
避孕对生育率的抑制作用从2000年的0.93增加到2011年的0.65；然而，在所有给定时间，它都低于产后不易受孕的影响。在此期间，婚姻指数在抑制生育率方面保持不变（2000年为0.71，2011年为0.70），而产后不易受孕的影响从2000年的0.49略有下降至2011年的0.54，但比避孕和婚姻的影响更强。避孕的贡献在城市地区最为重要（2011年为0.46，2005年为0.52，2000年为0.64）；然而，在农村地区，它在此期间成为一个重要的决定因素（2000年为0.95，2011年为0.69）。农村地区产后不易受孕的影响呈下降趋势（2000年为0.48，2011年为0.53）。农村地区的婚姻指数随时间保持稳定（2000年为0.75，2011年为0.73），而在城市地区，其影响从2000年的0.42下降至2011年的0.65。婚姻是受过中等及以上教育女性生育率的最重要直接决定因素，但在此期间影响有所下降（2000年为0.41，2011年为0.61）。产后不易受孕在限制受过中等及以上教育女性生育率方面的重要性随时间下降（2000年为0.77，2011年为0.87），而避孕的贡献变得更加重要（2000年为0.44，2011年为0.35）。
随着时间推移，避孕使用水平和效果的提高是该地区近期生育率下降的唯一最重要因素。
