Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America.
Department of Biology, Stanford University, Stanford, California, United States of America.
PLoS One. 2018 Sep 18;13(9):e0203344. doi: 10.1371/journal.pone.0203344. eCollection 2018.
In this paper, we examine the inequality in the dynamics of the total fertility rate within 21 sub-Saharan African countries by wealth quintiles. We also examine the associated inequality within each country in the proximate determinants of fertility-marriage, contraception, and breastfeeding. Applying Bongaarts' proximate determinants of fertility framework, for 14/21 countries we analyze, we find that those in the richest wealth quintiles have had a more rapid decline in fertility rates than those in the poorest wealth quintiles. The rapid decline for those in the richest wealth quintiles is attributable to delayed marriage and modest increases in contraceptive use. Although the poorest lag in fertility decline, postpartum abstinence and breastfeeding are the most important factors for them for fertility regulation. Further encouraging maternal health programs that focus on natural methods of fertility regulation will work in favor of the poorest in sub-Saharan Africa in moving through the demographic transition.
本文考察了撒哈拉以南非洲 21 个国家按财富五分位数划分的总和生育率动态变化中的不平等现象。我们还考察了每个国家在生育的近期决定因素——婚姻、避孕和母乳喂养方面的相关不平等现象。应用邦加茨的生育近期决定因素框架，我们分析了 14/21 个国家的情况，发现最富有五分位数的生育率下降速度快于最贫穷五分位数。最富有五分位数的生育率快速下降归因于晚婚和适度增加避孕措施。尽管最贫穷的生育率下降滞后，但产后禁欲和母乳喂养是他们生育调节的最重要因素。进一步鼓励专注于自然生育调节方法的母婴健康计划将有利于撒哈拉以南非洲最贫穷的人顺利过渡到人口转型期。
