Ahmed Shallo Seifadin
Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
Open Access J Contracept. 2020 Jun 3;11:33-41. doi: 10.2147/OAJC.S251693. eCollection 2020.
In Ethiopia, the fertility rate declined from 5.4 in 2005 to 4.6 by 2016. Many factors have been contributing to this decline. Understanding the factors contributing to the fertility decline and their level of fertility inhibiting effect has a paramount policy implication in any country. This study aimed to assess the contribution of the four proximate determinants of fertility, ie, contraception use, postpartum infecundity, marriage and abortion rate, to fertility decline in Ethiopia since 2005.
This study used publicly available data from the Ethiopia Demographic and Health Surveys (EDHS) of 2005, 2011 and 2016. The EDHS data were the representative data collected from the reproductive-age women through a cross-sectional study. The revised and fine-tuned Bongaarts model of proximate fertility determinants was used for data analysis. The components needed for the analysis were extracted from the full EDHS data using the STAT compiler. Finally, the analysis was done using Microsoft Excel.
Of the four proximate determinants of fertility, postpartum insusceptibility contributed the highest fertility inhibiting effect in all three EDHS, and its level was also more prominent among the poorest women. While post partum infecundity, marriage and abortion had a relatively constant effect on fertility over the last 15 years, the fertility inhibiting effect of contraceptive use significantly increased from 15% to 37%.
In conclusion, fertility variation in Ethiopia is largely due to the three intermediate determinants of fertility. Over the last one and half decades, contraceptive use was the single most important determinant responsible for fertility decline in Ethiopia. To achieve fertility at replacement level, the country needs a contraceptive prevalence rate of 69%, an increment of nearly 100% from its current contraceptive prevalence rate.
在埃塞俄比亚，生育率从2005年的5.4降至2016年的4.6。许多因素促成了这一下降。了解导致生育率下降的因素及其抑制生育的程度对任何国家都具有至关重要的政策意义。本研究旨在评估自2005年以来，生育的四个直接决定因素，即避孕措施的使用、产后不孕、婚姻和堕胎率对埃塞俄比亚生育率下降的贡献。
本研究使用了2005年、2011年和2016年埃塞俄比亚人口与健康调查（EDHS）的公开数据。EDHS数据是通过横断面研究从育龄妇女中收集的代表性数据。使用经过修订和微调的生育直接决定因素的邦加茨模型进行数据分析。分析所需的组件使用STAT编译器从完整的EDHS数据中提取。最后，使用Microsoft Excel进行分析。
在生育的四个直接决定因素中，产后不孕在所有三次EDHS中对生育的抑制作用最大，在最贫困妇女中其程度也更为突出。虽然产后不孕、婚姻和堕胎在过去15年对生育率的影响相对稳定，但避孕措施使用的生育抑制作用从15%显著增加到37%。
总之，埃塞俄比亚的生育率变化很大程度上归因于生育的三个中间决定因素。在过去十五年中，避孕措施的使用是埃塞俄比亚生育率下降的唯一最重要决定因素。为实现更替水平的生育率，该国需要避孕普及率达到69%，比目前的避孕普及率增加近100%。
