Abstract
Background: Despite aggressive measures to control the population in Nigeria, the population of Nigeria still remains worrisome. Increased birth rates have significantly contributed to Nigeria being referred to as the most populous country in Africa. This study analyses spatial patterns and contributory factors to fertility levels in different states in Nigeria.
 
 Method: The 2013 Nigerian Demographic Health Survey (NDHS) data were used to investigate the determinants of fertility levels in Nigeria using the geo-additive model. The fertility levels were considered as count data. Negative Binomial distribution was used to handle overdispersion of the dependent variable. Spatial effects were used to identify the hotspots for high fertility levels. Inference was a fully Bayesian approach. Results were presented within 95% credible Interval (CI).
 
 Results: Secondary or higher level of education of the mother, Yoruba ethnicity, Christianity, family planning use, higher wealth index, previous Caesarean birth were all factors associated with lower fertility levels in Nigeria. Age at first birth, staying in rural place of residence, the number of daughters in a household, being gainfully employed, married and living with a partner, community and household effects contribute to the high fertility patterns in Nigeria. The hotspots for high fertility in Nigeria are Kano, Yobe, Benue, Edo and Bayelsa states. 
 
 Conclusion: State-specific policies need to be developed to address fertility levels in Nigeria. 
 
 (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)
 
 S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1292693
Highlights
Fertility trends in most of the developed world in the late 1990s showed a substantial decline to two children or fewer from the traditional six children per woman.[1,2] Despite the declining fertility rate, the total fertility rate (TFR) is still high in sub-Saharan Africa
The 2013 Nigerian Demographic Health Survey (NDHS) was conducted by the National Population Commission (NPC) with funding support from the US Agency for International Development (USAID), the United Nations Population Fund (UNFPA), and the United Kingdom Department for International Development (DFID)
We modelled fertility patterns using the number of children ever born, where CEB comprises count data, to investigate the fertility patterns.[9]
Summary
Fertility trends in most of the developed world in the late 1990s showed a substantial decline to two children or fewer from the traditional six children per woman.[1,2] Despite the declining fertility rate, the total fertility rate (TFR) is still high in sub-Saharan Africa. In sub-Saharan Africa, the TFR is five children per woman on the average whereas countries like Chad, Mali, Niger and Nigeria record over six to seven children per woman.[3] Among sub-Saharan African countries, Nigeria is generally known as the most populous country in Africa with a population of over 174 million in 2013, which is approximately one-sixth of the total African population.[3] Nigeria is one of the sub-Saharan African countries with the fastest growing populations with a TFR of 6.8 in the early 1980s and 1990, 5.9 in 1991, 5.4 in 1994 and 5.2 in 1999.3 In 2003, the TFR was 5.7; this dropped to 5.5 in 2013, which depicts a decline in the fertility pattern This is relatively high compared with Latin America and Asia where fertility declined from 5.9 to 2.6 and less rapidly in North Africa and Western Asia from 6.6 to 3.5 births per woman.
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