Alazbih Nega, Kaya Assefa Hailemariam, Mengistu Mezgebu, Gelaye Kassahun
Department of Population Studies, University of Gondar, Gondar, Ethiopia.
Population Studies, Addis Ababa University, Addis Ababa, Ethiopia.
Int J Womens Health. 2021 Dec 2;13:1197-1206. doi: 10.2147/IJWH.S334112. eCollection 2021.
Fertility decline in Ethiopia has been documented since the 1990s. Amhara National Regional State has recorded the most noticeable fertility decline. However, the specific factors that explain the incipient course of fertility decline in the study area and their relative contributions were not well investigated. Hence, the purpose of this study was to determine contributing factors of fertility decline and to assess variations in fertility that can be attributed to both changes in characteristics and reproductive behaviors of women aged 15-49 years between 2008 and 2014 in Dabat Demographic and Health Surveillance Site, Northwest Ethiopia.
Cross-sectional censuses were carried out in a Dabat Health and Demographic Surveillance System site in 2008 and 2014. Data for 4,775 and 10,807 women of reproductive age in 2008 and 2014 were used for the analysis. A Poisson regression model was employed to assess the trends of determinants of fertility, and multivariate decomposition analysis was applied to evaluate observed changes in fertility using data from two consecutive cross-sectional censuses of Dabat HDSS.
Findings indicated that there was a reduction of an average 640.69 births per 1,000 women of reproductive age during 2014 compared to 2008 in the surveillance site (95% CI=-669.5 to -582.4). This overall change in fertility was attributed to both the changing characteristics of women (76%) (95% CI=-524.74 to -453.13) and their reproductive behavior (24%) (95% CI=-224.36 to -79.14). Drivers of the recent fertility decline were increased age at first marriage, a decreased proportion of currently married women, shift in women's birth to later age, and a higher women's educational status.
This study indicated that the overall reduction in fertility was attributed to both changing characteristics of women and their reproductive behavior. Major contributors to the changes in fertility were postponing women's first marriage to a later age and changes in the proportion of currently married women over the study period. Encouraging women to complete at least secondary education is important to increase the age at first marriage and birth, which will in turn accelerate the current fertility transition.
自20世纪90年代以来，埃塞俄比亚的生育率下降情况已有记录。阿姆哈拉民族区域州的生育率下降最为明显。然而，解释该研究地区生育率下降初期过程的具体因素及其相对贡献尚未得到充分调查。因此，本研究的目的是确定生育率下降的影响因素，并评估2008年至2014年期间埃塞俄比亚西北部达巴特人口与健康监测点15至49岁女性的特征和生殖行为变化所导致的生育率差异。
2008年和2014年在达巴特健康与人口监测系统站点进行了横断面普查。分析使用了2008年和2014年4775名和10807名育龄妇女的数据。采用泊松回归模型评估生育率决定因素的趋势，并应用多变量分解分析，利用达巴特健康与人口监测系统连续两次横断面普查的数据评估观察到的生育率变化。
研究结果表明，与2008年相比，2014年监测点每1000名育龄妇女的平均出生数减少了640.69例（95%置信区间=-669.5至-582.4）。生育率的总体变化归因于女性特征的变化（76%）（95%置信区间=-524.74至-453.13）及其生殖行为的变化（24%）（95%置信区间=-224.36至-79.14）。近期生育率下降的驱动因素包括初婚年龄增加、当前已婚妇女比例下降、女性生育年龄推迟以及女性教育水平提高。
本研究表明，生育率的总体下降归因于女性特征的变化及其生殖行为的变化。生育率变化的主要因素是将女性初婚年龄推迟到更高年龄以及研究期间当前已婚妇女比例的变化。鼓励女性至少完成中等教育对于提高初婚和生育年龄很重要，这反过来将加速当前的生育率转变。
