Tumwizere Godfrey, Douglas Yiga Joseph, Kabagenyi Allen, Kwagala Betty
Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala, Uganda.
Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda.
PLOS Glob Public Health. 2025 Jun 25;5(6):e0004730. doi: 10.1371/journal.pgph.0004730. eCollection 2025.
Despite the extensive research on fertility desire among women worldwide, there is a dearth of literature on the desire for more children among high-parity women. This study aimed to identify the determinants of the desire for more children among high parity partnered women in Uganda.
This study was based on nationally representative data from the 2016 Uganda Demographic and Health Survey. The study sample comprised of a weighted sample of 4502 women aged 15-49 years with five and more children. A complimentary log-log model was fit to identify factors associated with the desire for more children among high-parity women in Uganda at the 5% level of significance.
The findings revealed that 21% of high parity partnered women desired more children. The odds of desire for more children were 26% higher among women without decision-making autonomy on the number of children (AOR = 1.262 95% CI 1.109-1.415) than women with decision-making autonomy, women with preference of more than 3 boys had 2 times odds of desire for more children compared to those who preferred less than three boys (AOR = 2.021, 95% CI = 1.726-2.367) while Catholic women had 80% higher odds of desire for more children (AOR = 1.896, 95% CI = 1.786-2.020) compared to Anglicans. On the other hand, the odds of having a desire for more children were 33% lower among Muslims (AOR = 0.676, 95% CI 0.559-0.817) and 21% lower among Pentecostals (AOR = 0.70895% CI = 0.598-0.837) compared to Anglicans. The odds of having a desire for more children were 75% lower among women with primary education (AOR = 0.252, 95% CI 0.062-0.441) than among those with no education. Compared to women using modern contraceptives the odds of desire for more children were 38% lower (AOR = 0.620, 95% CI 0.481- 0.865) than those with not using modern contraceptives. Women with at least five living children had 75% lower odds of desire for more children (AOR = 0.255, 95% CI 0.060-0.549) compared to those with two living children. Women with primary education had 75% reduced odds of desire for more children compared to no education (AOR = 0.252 95% CI 0.062-0.441) while women whose husbands attained at least a secondary level of education had 79% reduced odds of desire for more children (AOR = 0.210, 95% CI 0.190-0.411) compared to women whose husbands had no education.
This study recommends that Uganda's policymakers and Programme implementers emphasize the attainment of secondary or higher education, collaborate with religious leaders to promote health education sensitive to religious beliefs and practices and empower women to challenge social norms that restrict women's decision-making autonomy on fertility.
尽管全球对女性生育意愿进行了广泛研究，但关于多子女女性生育意愿的文献却很匮乏。本研究旨在确定乌干达多子女已婚女性生育意愿的决定因素。
本研究基于2016年乌干达人口与健康调查的全国代表性数据。研究样本包括4502名年龄在15 - 49岁、育有五个及以上子女的女性加权样本。采用互补对数-对数模型，在5%的显著性水平下确定与乌干达多子女女性生育意愿相关的因素。
研究结果显示，21%的多子女已婚女性希望生育更多子女。在子女数量上没有决策自主权的女性生育更多子女的几率比有决策自主权的女性高26%（调整后比值比[AOR]=1.262，95%置信区间[CI]为1.109 - 1.415）；与偏好男孩少于三个的女性相比，偏好三个及以上男孩的女性生育更多子女的几率高出两倍（AOR = 2.021，95% CI = 1.726 - 2.367）；与圣公会女性相比，天主教女性生育更多子女的几率高出80%（AOR = 1.896，95% CI = 1.786 - 2.020）。另一方面，与圣公会女性相比，穆斯林女性生育更多子女的几率低33%（AOR = 0.676，95% CI 0.559 - 0.817），五旬节派女性生育更多子女的几率低21%（AOR = 0.708，95% CI = 0.598 - 0.837）。与未受过教育的女性相比，受过小学教育的女性生育更多子女的几率低75%（AOR = 0.252，95% CI 0.062 - 0.441）。与使用现代避孕方法的女性相比，未使用现代避孕方法的女性生育更多子女的几率低38%（AOR = 0.620，95% CI 0.481 - 0.865）。与育有两个在世子女的女性相比，育有至少五个在世子女的女性生育更多子女的几率低75%（AOR = 0.255，95% CI 0.060 - 0.549）。与未受过教育的女性相比，受过小学教育的女性生育更多子女的几率降低了75%（AOR = 0.252，95% CI 0.062 - 0.441）；与丈夫未受过教育的女性相比，丈夫至少受过中等教育的女性生育更多子女的几率降低了79%（AOR = 0.210，95% CI 从(0.190 - 0.411)）。
本研究建议乌干达的政策制定者和项目实施者重视中等及以上教育的普及，与宗教领袖合作，推广对宗教信仰和习俗敏感的健康教育，并赋予女性权力，挑战限制女性生育决策自主权的社会规范。
