Decline In Total Fertility Rate Research Articles

Health District at Queenstown: Catalyst for translational research

Ageing societies dominating global demographics is not new. However, the pace of global population ageing is causing disquietude. In 2017, the global population over age 60 years exceeded those below 5 years for the first time in history, and only 3 years later, the population over age 65 surpassed those below 5.1,2 The US took 72 years to double its proportion of population over age 65 from 7% to 14% while Sweden took 85 years, but Asia has been projected to achieve this in about 23 years, with Singapore having taken 20 years.3 This unprecedented ageing acceleration in populations results from longer individual lifespans due to improvements in healthcare and population health, combined with a steady decline in total fertility rate—the latter being the mean number of children per woman in her lifetime. Unfortunately, the number of years in good health has not kept pace with lengthening lifespan; consequently, time spent in poor health is increasing.4 This demographic change, along with a widening healthspan and lifespan gaps will have dramatic impact on economic growth, workforce composition, healthcare, housing and transportation.

Educational field, economic uncertainty, and fertility decline in Finland in 2010–2019

Abstract Fertility declined sharply and unexpectedly in Finland in the 2010s across educational levels. Using Finnish register data, we calculated total fertility rates (TFRs) and the proportion of women expected to have a first birth in 2010–2019 for 153 educational groups—reflecting field and level—and estimated how the characteristics of a group predicted its decline. As the educational field predicts factors related to economic uncertainty, heterogeneity in fertility decline across fields could shed light on the role of economic uncertainty behind the recent fertility decline. In general, women with the highest initial fertility levels (health, welfare, and education) and women in agriculture experienced weaker fertility declines (around −20% or less), while women with the lowest initial levels (ICT, arts and humanities) experienced stronger declines (around −40% or more). The extent of the fertility decline increased with higher unemployment and lower income levels in the field and with a lower share employed in the public sector. These uncertainty measures together explained one-fourth of the decline in TFR and two-fifths of the decline in first births. The results imply that fertility declined across all groups, but those with stable job prospects escaped very strong declines. Objective economic uncertainty is one aspect that mattered for the recent fertility decline.

Fertility transition of Han and ethnic minorities in China: A tale of convergence and variation

China's large and diverse population exhibits interethnic variations in fertility, socioeconomic status, and culture. This study comprehensively analyzes data from multiple population censuses and qualitative interviews to identify fertility transition dynamics among ethnic groups in China. Taken together, the quantitative and qualitative results reveal a rapid decline in total fertility rates among both Han and ethnic minorities and a trend of convergence across different ethnic groups over the past few decades; in addition, the findings also show significant heterogeneity within ethnic minority populations. Our analysis sheds further light on the crucial role of social context and macro-level factors in shaping individuals’ reproductive behaviors. The results offer insights into how policies may address low fertility rates in China.

Trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014

BackgroundThe past few decades witnessed a considerable decline in total fertility rates globally. However in Ghana, there has been a slight increase in the fertility rate with little understanding of the reason for the increment. To understand this change, it is important to first examine the trend over a considerable period of time while taking into consideration some important inequality dimensions. This informed the need for this present study as we examined the trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014.MethodsData from the 1993–2014 Ghana Demographic and Health Surveys were used for the study, and we relied on the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software for the analysis. The analysis involved disaggregation of TFR by wealth index, education, place of residence and region. This was followed by the estimation of inequality by Difference, Population Attributable Risk, Ratio and Population Attributable Fraction. In the analysis, we set the statistical significance at a 95% confidence interval.ResultsFor all surveys, the total fertility rate was consistently highest among the poorest women (7.00, 6.28, 6.77, 6.61 and 6.29 in 1993, 1998, 2003, 2008 and 2014, respectively). The highest total fertility rate was recorded among women with no formal education in all the survey years. For instance, in the 2014 survey, the total fertility rate for women with no formal education was 5.98 and those with secondary/higher had a total fertility rate of 3.40. Women in rural areas had a higher total fertility rate compared to those in urban areas (4.90 vs. 3.40 in 2014). In terms of sub-national regions, the Northern region was the region where women consistently had the highest total fertility rate.ConclusionThere is a need for a collective effort to design interventions and policies to create awareness among the people of Ghana especially girls and women on the implications of high fertility.

Determinants of multidimensional poverty in Nigeria: a state level analysis

The determinants of multidimensional poverty at state level have received little attention in Nigeria. Hence, this study seeks to fill the gap. Data for the study covered 2016/2017 survey period and were analysed using analysis of variance (ANOVA) and ordinary least squares (OLS) techniques. The ANOVA results show significant variations in multidimensional poverty between the south-south, south-east, south-west, north-east, north-west and the north-central regions. The OLS results show that total fertility rate, underage pregnancy and region of residence have significant positive effects on multidimensional poverty while education and health have significant negative effects. The study concludes that decline in total fertility rate will reduce the population growth and burden of poor households and translate into decline in multidimensional poverty. The paper recommends that government should invest significantly in reproductive healthcare, education and sensitisation of individuals on the benefits of contraceptives.

Fertility, economic development, and suicides among women in India.

Indian states at greater levels of economic development report more suicides. This relation appears stronger among women relative to men. We test the hypothesis, suggested in the literature, that conflict between rapid economic growth and inadequate female autonomy (approximated using total fertility rate) varies positively with female suicides. We used state-level data on female suicides for all 35 Indian states and union territories, from 2001 to 2011, from the National Crime Records Bureau. We specified, as our outcome, age-adjusted female suicides per 100,000 population per state-year. We retrieved data on key covariates, namely, gross state domestic product (GSDP) per capita, total fertility rate (TFR), and other control variables from multiple national surveys and publicly available data sources. We examined whether and to what extent age-adjusted female suicides (per 100,000 population) correspond with total fertility rate (lower TFR indicates greater female autonomy and vice versa) within the context of greater economic development (GSDP per capita). Linear longitudinal mixed effect regressions controlled for state-specific random intercepts, son preference (male:female sex ratio at birth), literacy gap (percentage difference between literate males and females), access to health systems (institutional deliveries), female to male employment ratio, and linear time trends. At constant levels of GSDP per capita, a one unit decline in TFR corresponds with 0.27 fewer female suicides per 100,000 population (P value = 0.008). Sensitivity tests indicate that this relation does not hold for male age-adjusted suicides (per 100,000 population). Our findings, if replicated, indicate that at constant levels of economic development, lower TFR (indicating greater female autonomy) may reduce suicide risk among women.

MILITARY AND DEMOGRAPHIC INTER-LINKAGES IN THE CONTEXT OF THE LITHUANIAN SUSTAINABILITY

This paper aims at investigating military and demographic inter-linkages in the context of the Lithuanian sustainability. The investigation combines three important economic aspects such as demographic, military and sustainable development. The authors have revealed that demographic trends should be seen as a necessary conditions for ensuring the functioning of the military sector contributes to public security and sustainable development in general. Correlation and stepwise regression analysis, also Monte Carlo forecasting method have been applied for this purpose. Research results have revealed statistically significant interrelationship between military personnel as a share of total labour force and population growth rate, population median age, total fertility rate as well as birth rate. Moreover, Monte Carlo forecasting method allowed revealing for the next 10 years a steady slight increase in armed forces personnel, stable population growth rates, a rapid aging process and a slight decline of total fertility rate. Military and demographic estimations and future projections allow government to incorporate information into planning and sustainable development policy. The insights from this research may contribute to implementing the goals of sustainable development related to eradication of poverty, inequality, social exclusion, improvement in education, well-being and employment and tackling climate change.

Family Planning in Zambia: An Investment Pillar for Economic Development.

Family planning represents a 'best buy' in global efforts to achieve sustainable development and attain improvements in sexual and reproductive health. By meeting contraceptive needs of all women, significant public health impact and development gains accrue. At the same time, governments face the complex challenge of allocating finite resources to competing priorities, each of which presents known and unknown challenges and opportunities. Zambia has experienced a slow but steady increase in contraceptive prevalence, with slight decline in total fertility rate (TFR), over the past 20 years. Drawing from the Zambian context, including a review of current policy solutions, we present a case for making investments in voluntary family planning (FP), underpinned by a human rights framework, as a pillar for accelerating development and socio-economic advancement. Through multilevel interventions aimed at averting unintended pregnancies, Zambia - and other low- and middle-income countries - can reduce their age dependency ratios and harness economic growth opportunities awarded by the demographic dividend while improving the health and quality of life of the population.

Fertility transition in india: An application of Bongaarts model

Fertility in India has been steadily declining. It almost reached the replacement level in 2015 to 2016 and evidence shows that proximate determinants has a direct influence on fertility. The study aims at calculating the proximate determinants of fertility in India for the period from 2005 to 06 and 2015 to 16 as well as determine the most significant proximate determinant of fertility in India. It also examines the rural – urban fertility differentials for the year 2015 to 2016. The proximate determinants of fertility for few selected states in India has been calculated from 2015 to 2016. The study of the proximate determinants can help expanding clinical and community based contraceptive distribution, promoting breastfeeding, increasing age at marriage and reduce unintended pregnancies. The study is based on data obtained from National Family and Health Survey Round 3 and National Family and Health Survey Round 4. Bivariate analysis had been done to analyze the distribution of currently married women at age of 15 to 49 by biological and behavioral characteristics as well as decomposition analysis had been used to find the contribution of each indices. It is revealed from the study that an increase in use of contraception has led to decline in Total Fertility Rate (TFR) over the decade. The knowledge of contraception is almost universal in India. Even after a slight decline in proportion married, there had been a considerably high contribution of the proportion married towards increasing Total Fertility Rate (TFR). It is evident from the decomposition that only the increase in use of contraception has a positive impact on declining fertility.

Botswana’s Greatest Challenge beyond the Successful Decline in Total Fertility Rate

The paper gives a narration of the change of Botswana’s population age structure and a brief account of its economy. The part before the conclusion seeks to use figures or graphs to analyse the country’s prospects in capitalising on the window of opportunity in order to drive economic growth and development.

Toward an unwanted dividend? Fertility decline and the North–South divide in Italy, 1952–2018

Fertility, a key process shaping long-term population dynamics, has reflected demographic transitions and responds—more or less rapidly—to economic downturns. Assuming a non-neutral role of space on birth rates, the present study investigates the spatio-temporal evolution (1952–2018) of total fertility rate (TFR) at regional scale in Italy, a country with intense decline of births and enlarged socioeconomic divides between the wealthiest Northern regions and the most disadvantaged Southern regions. A progressive reduction of the traditional North–South fertility divide was observed in Italy since the 1980s with a rapid decline of TFR. Results of descriptive statistics and time series analysis indicate that regional fertility in Italy was increasingly associated with economic downturns. Considering the spatial response of birth rates to economic expansions and recessions, heterogeneous regional fertility trends underlie more individualistic behaviors that reflect a different propensity to childbearing in recent times. With both expansion and recession, fertility rates in Northern Italy—thanks to the contribution of internal and international migrations—were responding more rapidly to economic downturns than in Southern Italy—a disadvantaged region with a more stagnant population, emigration and aging, reverting the typical framework of the 1950s.

Family Planning in Zambia: An Investment Pillar for Economic Development

Family planning represents a 'best buy' in global efforts to achieve sustainable development and attain improvements in sexual and reproductive health. Ensuring access is amongst key transformative strategies that underpin health and sustainable development. It confers fertility choices on women and couples within a human rights framework. By meeting contraceptive needs of all women, significant public health impact and development gains accrue. At the same time, governments face the complex challenge of allocating finite resources to competing priorities, each of which presents known and unknown challenges and opportunities. As such, there is a need to carefully consider the estimated costs and benefits for each proposed investment in health, education, social welfare, and security. Zambia has experienced a slow but steady increase in contraceptive prevalence, with slight decline in total fertility rate (TFR), over the past 20 years. Increasing voluntary modern contraceptive use among women offers opportunities to reduce unintended pregnancy while effectively harnessing the demographic dividend in order to bolster socioeconomic outcomes for households and communities. Drawing from the Zambian context, we present a case for making investments in voluntary family planning (FP), underpinned by a human rights framework, as a pillar for accelerating development and socio-economic advancement. Through multilevel interventions aimed at averting unintended pregnancies, Zambia - and other low- and middle-income countries - can reduce their age dependency ratios and harness economic growth opportunities awarded by the demographic dividend while improving the health and quality of life of the population.

Association of maternal and child health related variables with decline in infant mortality rate in Punjab, India

Background: Infant mortality rate (IMR) is a sensitive indicator for monitoring child health and survival. Punjab state in North India is performing better than most of the other states in various health indicators. Punjab’s IMR has shown a rapid decline from 38/1000 live births in 2008 (Sample registration system (SRS) 2008) to 24/1000 live births in 2014 (SRS 2014). This study was planned to assess which of the maternal and child health services is associated with rapid decline in infant mortality rate. Methods: Association between various components of prenatal care, intranatal care and postnatal care, and child healthcare and socio demographic variables (taken from secondary data of District Level Household Surveys) and Infant Mortality Rate (taken from SRS) of Punjab was studied. Spearman correlation coefficient was calculated to measure the association between the variables. Results: Total fertility rate (TFR), women who had institutional deliveries, safe deliveries and mean children ever born are statistically significantly associated with decline in infant mortality rate. Conclusions: In Punjab, maternal and child health indicators are directly or indirectly associated with decline in infant mortality rate. Findings of the study demonstrate that the recent rapid decline in IMR of Punjab is strongly associated with increase in institutional deliveries and decline in TFR and the mean number of children ever born.

Fertility change in the American Indian and Alaska Native population, 1980–2010

Background: Since 1990, Vital Statistics reports show a dramatic decline in the total fertility rates (TFRs) of American Indian and Alaska Native (AI/AN) women in the United States. Objective: We study whether the decrease in TFRs is due to a real change in fertility for a stable population; a compositional change in who identifies as AI/AN; or a methodological issue stemming from differences in identifying race across the data systems used to calculate fertility rates. Methods: We use data from the decennial US Census to study change in AI/AN fertility from 1980–2010. Results: We find declining TFRs when fertility is calculated within a single data system. Additionally, although TFRs are relatively stable within the subgroups of married and unmarried AI/AN women, the proportion of AI/AN women who are married has declined across birth cohorts. Conclusions: The decrease in TFRs for AI/AN women is a real change in fertility patterns and is not due to differences in racial identification across data systems. Contribution: We update knowledge of AI/AN fertility to include the decline in TFRs between 1980 and 2010.

Fertility Desires and the Course of Fertility Decline in sub‐Saharan Africa

This research has two main goals: (i) to examine fertility desires (number of children) in sub-Saharan Africa: levels as compared to other major regions and recent trends; and (ii) to assess the extent to which fertility decline in sub-Saharan Africa is contingent on decline in fertility desires (singly and in combination with other reproductive changes).

REPRODUCTIVE AND CHILD HEALTH SERVICES AND DEMOGRAPHIC CHANGE IN THE DISTRICTS OF UTTAR PRADESH, 2002-13.

This study examined the effect of reproductive and child health (RCH) services on fertility and child mortality in the districts of Uttar Pradesh. It specifically measured the effect of antenatal care, medical assistance at birth, child immunization and use of modern methods of contraception on Total Fertility Rate (TFR), Infant Mortality Rate (IMR) and Under-five Morality Rate (U5MR) before and after the National Rural Health Mission (NRHM) period. Data from the 2002-04 District Level Household Survey (DLHS-2), 2012-13 Annual Health Survey (AHS) and the 2001 and 2011 Censuses of India were used. The TFR and U5MR were estimated from the Census of India with district as the unit of analysis. Descriptive statistics, composite indices, random- and fixed-effects models and difference-in-difference models were used to understand the effect of RCH services on the reduction in TFR, IMR and the U5MR. The results suggest large inter-district variations in the coverage of RCH services in the state. During the post-NRHM period, improvement was highest in safe delivery followed by immunization coverage and antenatal care and least for contraceptive use in most districts. The relative ranking of districts has not changed much over time. In 2002-04, the RCH Index was highest in Lucknow (0.442) followed by Ballia and least in Kaushambi (0.115). By 2012-13, it was highest in Jhansi (0.741) and lowest in Shrawasti (0.241). The districts of Kaushambi, Unnao, Mahoba, Banda and Hardoi performed better in the RCH Index over time, while Ballia, Gautam Buddha Nagar, Kanpur Nagar, Pratapgarh and Sonbhadra remained poor. The RCH service coverage and demographic outcomes were poor in seven districts, particularly those in eastern and western Uttar Pradesh. The regression analyses suggest that the RCH Index exerts greater influence on the reduction in IMR and U5MR, while female literacy exerts greater influence on the reduction in TFR. The results of the hybrid model suggest that a 10% change in RCH Index would lead to a 3 point decline in IMR, and a 10% increase in female literacy would lead to a 0.2 point decline in TFR. The study suggests continuing investment in female education and RCH services with a greater focus on poor-performing districts to realize demographic and health targets.

Timor‐Leste's demographic challenges for environment, peace and nation building

AbstractTimor‐Leste's nation‐building process faces significant demographic challenges because of its current and prospective population dynamics. Based on the 2010 census data this paper projects the demographic structure of Timor‐Leste by 2030 and discusses the impact of the same on peace, development and environmental sustainability. This paper projects that Timor‐Leste's population will increase from 1.06 million in 2010 to 1.82 million in 2030, and because of a slow decline in total fertility rates, its population characteristics will remain that of a very youthful country with an extraordinarily high dependency ratio. Timor‐Leste will have extremely high proportion of excess labour, high concentration of uneducated and jobless youth in small urban areas and an ever‐increasing demand on natural resources in the next two decades. In the context of poor performing domestic economy, very low formal sector employment and weak environmental governance, these challenges may well contribute to social conflict which is evident in the nation's recent past. This paper is an attempt to reflect upon the implications of Timor‐Leste's population dynamics by 2030 on urbanisation, economy (labour market) and the environment which tend to have a strong relationship with social stability.

Explaining fertility transition of a developing country: an analysis of quantum and tempo effect.

BackgroundThe Total Fertility Rate (TFR) is defined as the average number of births a woman would have if she were to live throughout the reproductive span and bear children at each age at the rates observed in a particular year or period. The current demographic explanation for decline in TFR is primarily attributed to an increase in postponement in pregnancy. Being cross-sectional, fertility measures can be confounded by changes in the timing of births across women’s lifetimes (tempo) and by changes in the numbers of children that they have by the time they end their childbearing (quantum). After a sharp fall in the last two decades, TFR of Bangladesh is now 2.3; whereas the TFR was greater than 3 in the last decade. However, mean age at childbearing showed decreasing trend in the last decade.MethodsThis is a secondary analysis of data from the three consecutive Bangladesh Demographic Health Surveys; BDHS-2004, 2007 and 2011. The method of Bongaarts and Feeney has been applied to estimate the tempo of fertility. Life Table analyses were applied on birth intervals to explain the tempo effect.ResultsThere was a sustained decline of the fertility quantum (the number of births per woman) as estimated by the conventional TFR; due to tempo effects during the last three BDHS surveys. Mean age at childbearing also showed decreasing trend in the last decade.ConclusionsThe current study shows the presence of a significant tempo effect with variability of timing in having first or higher order births. If this trend continues, Bangladesh will be able to achieve below replacement level of fertility soon.

Transição demográfica e transição do consumo urbano de água no Brasil

In this paper we discuss that, although the volume of the population is an important aspect to be considered in the relationship between population and environment, there are other factors that may be even more important. From a demographic perspective, for example, details such as composition and spatial distribution of the population are essential. In environmental terms, the style of development and level of consumption are crucial. Brazil is going through a time of important transitions. On the one hand, the demographic transition (decreased levels of mortality and birth rates), is characterized by the rapid decline in total fertility rate, from about 6 children per woman in the 1960s to fewer than 2 children per woman in the late 2000s. On the other hand, there is a consumption transition also incourse, discussed here in the relationship between improving the economic situation and increased water consumption, which is caused by the expansion of the supply system in urban areas and by the trend toward growing per capita consumption. Thus, while there has been a significant decrease in population growth rates, water consumption tends to increase as the result of changes in access patterns and consumption levels.

Probabilistic projections of the total fertility rate for all countries.

We describe a Bayesian projection model to produce country-specific projections of the total fertility rate (TFR) for all countries. The model decomposes the evolution of TFR into three phases: pre-transition high fertility, the fertility transition, and post-transition low fertility. The model for the fertility decline builds on the United Nations Population Division's current deterministic projection methodology, which assumes that fertility will eventually fall below replacement level. It models the decline in TFR as the sum of two logistic functions that depend on the current TFR level, and a random term. A Bayesian hierarchical model is used to project future TFR based on both the country's TFR history and the pattern of all countries. It is estimated from United Nations estimates of past TFR in all countries using a Markov chain Monte Carlo algorithm. The post-transition low fertility phase is modeled using an autoregressive model, in which long-term TFR projections converge toward and oscillate around replacement level. The method is evaluated using out-of-sample projections for the period since 1980 and the period since 1995, and is found to be well calibrated.