Fertility In Uganda Research Articles

Factors influencing male fertility in Uganda

Male fertility is an important component of population research. Against this backdrop, this paper aims to examine the factors explaining male fertility changes in Uganda. The authors applied the own-children method, as described by Schoumaker, to understand the prevailing male total fertility rate trends and to select datasets for inclusion during the multivariate analysis, using the Uganda demographic health surveys conducted from 2006 to 2016. A multivariable Poisson decomposition regression model was used to examine factors associated with male fertility changes. This model analyzed data from the 2006 and 2016 surveys only and included a total sample size of 7839 male respondents. The outcome variable for the regression model was children ever born (CEB). The regression model showed that differences related to changes in the proportional composition of characteristics contributed 113% to the change in CEB, compared with the differences due to reproductive behavior, with other factors being kept constant. The most important proportional changes that led to meaningful variability in CEB were observed among the following characteristics: occupation, number of current wives, total number of lifetime partners, type of residence, education, and age at first childbirth. Thus, interventions to delay the formation of cohabitation and marriage unions and the onset of childbirth or fatherhood among adolescents and young men below the age of 25 should be prioritized as potent fertility regulation measures. In addition, the focus on eliminating the lack of education and primary education as the highest levels attained among boys and men should be prioritized to boost a rapid male fertility transition in Uganda.

Age at first marriage, age at first sex, family size preferences, contraception and change in fertility among women in Uganda: analysis of the 2006\u20132016 period

BackgroundUganda’s fertility was almost unchanging until the year 2006 when some reductions became visible. Compared to age at first marriage and contraceptive use, age at sexual debut and family size preferences are rarely examined in studies of fertility decline. In this study, we analyzed the contribution of age at first marriage, age at first sex, family size preferences and contraceptive use to change in fertility in Uganda between 2006 and 2016.MethodsUsing data from the 2006 and 2016 Uganda Demographic and Health Survey (UDHS), we applied a nonlinear multivariate decomposition technique to quantify the contribution of age at first marriage, age at first sex, family size preference and contraceptive use to the change in fertility observed during the 2006–2016 period.ResultsThe findings indicate that 37 and 63% of the change in fertility observed between 2006 and 2016 was respectively associated with changing characteristics and changing fertility behavior of the women. Changes in proportion of women by; age at first marriage, age at first sex, family size preferences and contraceptive use were respectively associated with 20.6, 10.5 and 8.4% and 8.2% of the change in fertility but only fertility behavior resulting from age at first sex was significantly related to the change in fertility with a contribution of 43.5%.ConclusionsThe study quantified the contribution of age at first marriage, age at first sex, family size preferences and contraceptive use to the change in fertility observed between 2006 and 2016. We highlight that of the four factors, only age at sexual debut made a significant contribution on the two components of the decomposition. There is need to address the low age at first sex, accessibility, demand for family planning services and youth-friendly family planning services to young unmarried women such that they can achieve their desired fertility. The contribution of other factors such as education attainment by women and place of residence and their relationship with changes in fertility calls for addressing if further reduction in fertility is to be realised.

Determinants of Change in Fertility among Women in Rural Areas of Uganda.

Fertility among rural women in Uganda continues to decline. Studies on fertility in Uganda have focused on the overall fertility in the country. In this study, we focus on determinants of change in fertility among rural women in Uganda using a multivariate Poisson decomposition technique to quantify the contribution of changes in the socioeconomic and demographic composition of women which we also refer to as the characteristic effects and changes in their fertility behavior (the coefficients' effects or risk of childbearing) to the overall reduction in fertility among women in rural areas during the 2006–2016 period. The “characteristics effects” are used to mean the effect of changing composition of women by the socioeconomic and demographic characteristics between 2006 and 2016. On the other hand, fertility behavior also presented as coefficients' effects mean changes in the risk or likelihood of giving birth to children by the rural women between the two survey years. Our findings indicate that the mean number of children ever born (MCEB) reduced from 4.5 to 3.9 in 2006 and this reduction was associated with both the changes in composition of women and fertility behavior. The composition of women contributed to 42% while the fertility behavior contributed to 58% of the observed reduction. The education level attained and the age at first sex showed significant contributions on both components of the decomposition. The observed decline in fertility is largely associated with the variation in the risk of childbearing among the rural women. The variation in the risk of childbearing by education and age at first sex of the rural women showed to be the biggest contribution to the observed change in fertility. Continued improvements in access, attendance, and completion of secondary schools by women in rural areas will be the key drivers to Uganda's overall transition to low fertility. Furthermore, with improved access to mass media in the rural areas, there can be changes in attitudes and large family size preferences which can create a conducive environment for the utilization of family planning services in the rural communities. Efforts should therefore focus on applying appropriate methods to deliver packaged family planning messages to these communities.

What is the association between IPV and Fertility in Uganda?

Abstract IPV, which emanates as a severe consequence of gender inequality in society, is the most pervasive form of IPV as most cases of abuse is perpetrated by intimate partners and has major health consequences for women. Women with a history of abuse are also at increased risk of reproductive health outcomes; such as high parity, inconsistent and lower levels of contraceptive use, unintended pregnancies, and adverse pregnancy outcomes. Despite concerted efforts by African governments, fertility levels in the region remain high. Africa is the region that has been least responsive to family planning programmes. This study investigates the associations between IPV and fertility in Uganda, using the Ugandan Demographic and Health Survey of 2011. Adult women of reproductive ages (15-49) that were included in the domestic violence module of the individual recode, were included in this study. Univariate, bivariate analysis, and unadjusted and adjusted Poisson Regression models were conducted for children ever born and the different forms of IPV (emotional, physical and sexual), as well as the socio-demographic and women’s empowerment variables. Both bivariate and multivariate analyses show a strong association between both these pervasive health problematics; and may therefore be one of the unexplained proximate determinants of persistently high fertility in countries such as Uganda. These results have important implications for understanding both the fertility transition in Uganda, but also for programmes and policies addressing unwanted pregnancies and unmet need for contraception that is driving fertility up, and IPV amongst women which we know from previous work has severe reproductive health outcomes but which we have now identified is a contributor to high fertility as well.

The influence of adolescent age at first union on physical IPV and fertility in Uganda: A path analysis

Background. Uganda has a high fertility rate, high levels of intimate partner violence (IPV) and also very young ages at first union. Experiencing IPV has previously been shown to increase fertility rates. Entering marriage at a later age has been shown to decrease fertility rates in some countries. Given that a large proportion of Ugandan women are married by the end of adolescence, marital age may be a key proximate determinant of fertility in Uganda. Objective. To examine the effect of age at first union on fertility, via the intermediate effect of physical IPV, among Ugandan women of reproductive age. Methods. Data from the 2011 Ugandan Demographic and Health Survey were used to create an integrated path model to investigate the effects of age at first union on fertility. Known factors that influence fertility were included in the model. The interaction with age at first union in increasing fertility differentials, via the intermediate effect of physical IPV, was assessed. Results. Results show that women who are preadolescent or adolescent at first union have a higher likelihood of experiencing IPV, indicated by both direct and indirect pathways that work via known intermediate and proximate factors. Furthermore, age at first union increases fertility, expressed as the number of children born to a woman, via a direct interaction. Conclusion. Most Ugandan women enter their first union during adolescence (<19 years), which exposes them to a higher risk of IPV and a longer period of childbearing, thereby increasing fertility rates.

Determinants of change in fertility pattern among women in Uganda during the period 2006\u20132011

BackgroundStudies on fertility in Uganda have attributed fertility reduction to a shift in the overall characteristics of women of reproductive age. It is not clear whether the reduction in fertility is due to changing socioeconomic and demographic characteristics over time or stems from the shifts in the reproductive behavior of women. In this paper we examine how fertility rates have changed between 2006 and 2011 and whether these changes have resulted from changing characteristics or from changing reproductive behavior of women.MethodsUsing the 2006 and 2011 Demographic and Health Survey data for Uganda, Multivariate Poisson Decomposition techniques were applied to evaluate observed changes in fertility.ResultsChanging characteristics of women aged 15–49 years significantly contributed to the overall change in fertility from 2006 to 2011. The change observed in older age at first marriage was the major contributor to the changes in fertility. The contribution that can be attributed to changes in reproductive behavior was not significant.ConclusionsThis study finds that the major contribution to the reduction in fertility between 2006 and 2011 was from increased education and delayed marriage among women. Continued improvement in secondary school completion, will lead to older age at first marriage and will continue to be an important factor in Uganda’s declining fertility rates.

Education and teenage childbirth in Uganda

PurposeThe role of increased schooling on teenage childbirth has been expansively studied especially in developed countries. However, caveats remain in the case of low-income countries especially Sub-Saharan Africa. The purpose of this paper is to ascertain the impact of increased schooling on the probability of first childbirth at 15 years or younger, 16-17, 18-19, and 20 years or older, in the important context of Uganda – a country with one of the highest adolescent fertility rates in Africa.Design/methodology/approachThe empirical analysis uses recent data from the nationally representative Demographic and Health Survey for Uganda conducted in 2011. The authors then adopt a fuzzy regression discontinuity design, estimated using instrumental variables techniques that exploit the exogenous change in schooling impelled by the universal primary education policy enacted in 1997 in Uganda. The empirical approach compares the fertility outcomes for women born in 1984-1992 (i.e. exposed to the policy) to those born in 1973-1981 (i.e. non-exposed).FindingsThe authors find that a one-year increase in schooling lowers the probability of first childbirth at age the age of 15 years or younger, 16-17, 18-19, and 20 years or older by nearly 8.2, 9.2, 9.4, and 9.5 percentage points, respectively. Also, pathways through which education impacts teenage motherhood included information access through the media, increased literacy, prenatal care utilization, marital status, and unhealthy sexual behavior.Originality/valueThe paper uses nationally representative survey data to scrutinize the causal influence of schooling on the probability of first childbirth using the 1997 universal primary education in Uganda as a natural experiment to identify the impact of schooling. The study recommends that expanding primary schooling opportunities for girls may be an effective strategy toward accelerated reductions in teenage fertility in Uganda.

Unfulfilled need for contraception among women with unmet need but with the intention to use contraception in Rakai, Uganda: a longitudinal study

BackgroundLongitudinal data from a rural Ugandan cohort was used to estimate rates of unfulfilled need for contraception, defined as having unmet need and intent to use contraception at baseline but having an unintended pregnancy or with persistent unmet need for contraception at follow up.MethodsBetween 2002 and 2009 (5 survey rounds), a total of 2610 sexually active non-pregnant women with unmet need for contraception at the start of an inter-survey period were asked whether they intended to use any method of contraception until they desired a child. Modified Poisson multivariate regression was used to estimate unadjusted and adjusted prevalence ratios (PR) and 95% CI of unfulfilled need for contraception.ResultsThe proportion of women with unmet need at the start of an interval who intended to use contraception significantly increased from 61 to 69.1% (p < 0.05). However the majority of women who said they intended to use contraception had unfulfilled need for contraception at the subsequent survey (64.8 to 56.8%). In the adjusted analysis, significant predictors of unfulfilled need for contraception included age 40–49 years (PR = 1.34; 95% CI 1.04–1.74) and those with unknown HIV status (PR = 1.16; 95% CI 1.06–1.26).ConclusionsThere is a significant discrepancy between women’s intent to use contraception (> 60%) and subsequent initiation of use (< 30%) with many having unintended pregnancies which might explain the persistent high fertility in Uganda. Future research needs to address unfulfilled need for contraception among women at risk of unintended pregnancies.

English

Little is known about how cropping systems influence soil quality and fertility in Uganda. Some cropping systems are more valued and as a result are given more nutrients and planted in certain soils, all of which leads to varying soil quality and fertility. This study compared soil quality (soil pH, cation exchange capacity (CEC), electric conductivity (EC), total N, and depth to restrictive layer (DRL)) and fertility (extractable P, K, Ca, Mg, and Na, and base saturation (BS) from five cropping systems (banana (Musa × paradisiaca L.)-dominant (B), coffee [Coffea robusta (L.) Linden]-dominant (C), banana-coffee (BC), annual with no crop rotation (ANR), and annual with crop rotation (AR); fertilized and unfertilized soils; and three soil types (black (Phaeozem), red (Ferralsol), and black-stony) in south-central Uganda. The analysis included farm assessments to establish management history of studied fields and soil sampling from 52 fields in Masaka District, Uganda. Main-effects ANOVA was employed to determine differences in means in soil under different cropping systems, soil types, and fertilizer use. Soil quality (pH at depths of 0 to 10 and 20 to 30 cm, CEC, and EC) and fertility (extractable Ca and Mg) varied by cropping system. The AR and B systems had higher soil quality and fertility compared to other cropping systems. Soil quality (pH at depths of 0 to 10 and 0 to 15 cm and DRL) and soil fertility (extractable P and K) varied by soil type. Black and black-stony soils had higher soil quality and fertility than red soils. Soil quality and fertility did not vary by fertilizer use. The results of this study indicate that both cropping system and soil type are associated with soil quality and fertility in south-central Uganda. Key words: Annual cropping, perennial cropping, soil management, soil types.

Fertility behaviour in Uganda: Does partner age difference matter?

High fertility in developing countries often strains socio-economic resources and impedes the achievements of national policies and individual goals. In this study, we investigated the effect of partner age difference on fertility in Uganda, a high fertility country in Sub-Sahara Africa. Data was drawn from the 2011 Uganda Demographic and Health Survey. Poisson regression model was used to isolate the effect partner age difference on fertility. Our findings from both unadjusted and adjusted regression models suggested that partner age difference had no effect on fertility in Uganda. However, the observed direction of flow was that; women with younger partners had slightly lower fertility (IRR:0.97 CI:0.8446–1.1159) while those with older partners by 1-5years had slightly higher fertility (IRR:1.05 CI:0.9532–1.1652) relative to women whose age was not different from their partners’.

Factors Associated with Adolescent Pregnancy and Fertility in Uganda: Analysis of the 2011 Demographic and Health Survey Data

Adolescent pregnancy and fertility are often discussed in literature as causes of health concern and as a social problem. Taking these accounts as a starting point, this paper uses the 2011 Uganda Demographic and Health Survey Data explore the factors related to adolescent fertility and pregnancy in Uganda. A total of 2,026 female adolescents are selected for this study. Logistic regression analyses adjusted for socioeconomic and demographic characteristics are estimated to predict the odds of an adolescent having borne a child in the 5 years preceding the survey, being currently pregnant and both having had a child in the 5 years preceding the survey or being currently pregnant at the time of the survey. Marital status is a strong predictor of the likelihood of both having a child in the 5 years preceding the survey and being currently pregnant at the time of the survey. Age equally appears to be an important predictor of the two outcomes, such that an increase in age was associated with increase in the odds of being pregnant and of having born a child. The discourse in this paper shows that adolescent pregnancy and childbearing is a serious policy intervention area that requires redress.

Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives

BackgroundHigh fertility among young people aged 15-24 years is a public health concern in Uganda. Unwanted pregnancy, unsafe induced abortions and associated high morbidity and mortality among young women may be attributed to low contraceptive use. This study aims at exploring reasons for low contraceptive use among young people.MethodsIn 16 focus group discussions, the views of young people about obstacles and enabling factors to contraceptive use in Mityana and Mubende districts, Uganda were explored. The groups were homogeneously composed by married and unmarried men and women, between the ages of 15-24. The data obtained was analyzed using qualitative content analysis.ResultsYoung men and women described multiple obstacles to contraceptive use. The obstacles were categorized as misconceptions and fears related to contraception, gender power relations, socio-cultural expectations and contradictions, short term planning, and health service barriers. Additionally, young people recounted several enabling factors that included female strategies to overcome obstacles, changing perceptions to contraceptive use, and changing attitude towards a small family size.ConclusionsOur findings suggest changing perceptions and behavior shift towards contraceptive use and a small family size although obstacles still exist. Personalized strategies to young women and men are needed to motivate and assist young people plan their future families, adopt and sustain use of contraceptives. Reducing obstacles and reinforcing enabling factors through education, culturally sensitive behavior change strategies have the potential to enhance contraceptives use. Alternative models of contraceptive service delivery to young people are proposed.

Fertility in Kenya and Uganda: A comparative study of trends and determinants

Between 1980 and 2000 total fertility in Kenya fell by about 40 per cent, from some eight births per woman to around five. During the same period, fertility in Uganda declined by less than 10 per cent. An analysis of the proximate determinants shows that the difference was due primarily to greater contraceptive use in Kenya, though in Uganda there was also a reduction in pathological sterility. The Demographic and Health Surveys show that women in Kenya wanted fewer children than those in Uganda, but that in Uganda there was also a greater unmet need for contraception. We suggest that these differences may be attributed, in part at least, first, to the divergent paths of economic development followed by the two countries after Independence; and, second, to the Kenya Government's active promotion of family planning through the health services, which the Uganda Government did not promote until 1995.

Family Planning in Rural Uganda: Knowledge and Use of Modern and Traditional Methods in Ankole

Ankole has recorded the highest fertility in Uganda over the past several decades. One of the main proximate determinants of fertility in the area is the low level of contraception. A study of knowledge and use of modern and traditional contraceptive methods is reported in this paper. It is shown that higher proportions of women known and practice traditional methods compared with modern ones. Several factors contributing to past low use of modern contraceptives in the area are examined and current contraceptive use is also examined.

THE BASIC FACTORS WHICH DETERMINE INHERENT SOIL FERTILITY IN UGANDA

SummarySoil samples collected from approximately 1700 fertilizer trials carried out around 62 centres in Uganda were analysed. Mean levels of total N. organic P and cation exchange capacity at the 60 centres which had non‐volcanic soils were very closely related to mean organic matter levels and largely explained the strong correlation of indices of available N, P and base status with organic matter. The indices of available P and base status were additionally related to pH and the indices of available N and P were further negatively correlated with sunshine hours.Soil organic matter itself was closely related to the content of clay, silt and free Fe. with which it is presumed it forms a stable complex, whilst soil pH decreased with rainfall in excess of evaporation. Thus soil texture, rainfall and hours of sunshine are the basic factors which largely determine inherent soil fertility in Uganda.