High Fertility Countries Research Articles

Linking high parity and maternal and child mortality: what is the impact of lower health services coverage among higher order births?

BackgroundA number of data sets show that high parity births are associated with higher child mortality than low parity births. The reasons for this relationship are not clear. In this paper we investigate whether high parity is associated with lower coverage of key health interventions that might lead to increased mortality.MethodsWe used DHS data from 10 high fertility countries to examine the relationship between parity and coverage for 8 child health intervention and 9 maternal health interventions. We also used the LiST model to estimate the effect on maternal and child mortality of the lower coverage associated with high parity births.ResultsOur results show a significant relationship between coverage of maternal and child health services and birth order, even when controlling for poverty. The association between coverage and parity for maternal health interventions was more consistently significant across countries all countries, while for child health interventions there were fewer overall significant relationships and more variation both between and within countries. The differences in coverage between children of parity 3 and those of parity 6 are large enough to account for a 12% difference in the under-five mortality rate and a 22% difference in maternal mortality ratio in the countries studied.ConclusionsThis study shows that coverage of key health interventions is lower for high parity children and the pattern is consistent across countries. This could be a partial explanation for the higher mortality rates associated with high parity. Actions to address this gap could help reduce the higher mortality experienced by high parity birth.

Understanding stalling demographic transition in high-fertility countries: a case study of Guatemala

The debate surrounding the use of period, cohort, and tempo-adjusted measures has framed most of the recent studies evaluating the utility of macro-level fertility indicators. Period measures are susceptible to distortions, due to birth timing changes, but there is currently no universally accepted adjustment technique. Recent comparative analyses have offered some insights but only as applied to the low-fertility developed world setting. The utility of different types of measures in the high fertility context is unclear. Furthermore, regional variation in the pace of fertility transition is characteristic of many less developed countries and is rarely incorporated into macro-level analyses. The purpose of this analysis is to evaluate macro-fertility indicators at the regional and national levels in a high-fertility country, Guatemala, using the four most recent survey data sets. The results support the use of macro-level period indicators and adjusted period indicators of fertility in developing country contexts.

Bayesian probabilistic population projections for all countries.

Projections of countries' future populations, broken down by age and sex, are widely used for planning and research. They are mostly done deterministically, but there is a widespread need for probabilistic projections. We propose a bayesian method for probabilistic population projections for all countries. The total fertility rate and female and male life expectancies at birth are projected probabilistically using bayesian hierarchical models estimated via Markov chain Monte Carlo using United Nations population data for all countries. These are then converted to age-specific rates and combined with a cohort component projection model. This yields probabilistic projections of any population quantity of interest. The method is illustrated for five countries of different demographic stages, continents and sizes. The method is validated by an out of sample experiment in which data from 1950-1990 are used for estimation, and applied to predict 1990-2010. The method appears reasonably accurate and well calibrated for this period. The results suggest that the current United Nations high and low variants greatly underestimate uncertainty about the number of oldest old from about 2050 and that they underestimate uncertainty for high fertility countries and overstate uncertainty for countries that have completed the demographic transition and whose fertility has started to recover towards replacement level, mostly in Europe. The results also indicate that the potential support ratio (persons aged 20-64 per person aged 65+) will almost certainly decline dramatically in most countries over the coming decades.

Immigration to the UK from High‐Fertility Countries: Intergenerational Adaptation and Fertility Convergence

The fertility of immigrants' children increasingly shapes the ethnic diversity of the population in Western Europe. However, few data are available on the fertility patterns of immigrants and their offspring. This article provides new fertility estimates of immigrants and immigrants' children by ethnic group in the United Kingdom that may provide better‐informed fertility assumptions for future population projection models. The impact of migration‐specific tempo effects on the period TFR of immigrants is analyzed. Among the results, intergenerational fertility transitions strongly contribute both to fertility convergence between ethnic groups and to fertility “assimilation” or “intergenerational adaptation” to the UK mainstream childbearing behavior. Ethnic fertility convergence, particularly marked for populations originating from high‐fertility countries, reflects in part decreasing fertility in sending countries and in part intergenerational adaptation to the UK mainstream. Higher educational enrollment of the daughters of immigrants may partly explain their relatively lower fertility.

Uncertain future, non-numeric preferences, andthe fertility transition: A case studyof rural Mozambique

In many high-fertility countries, and especially in sub-Saharan Africa, substantial proportions of women give non-numeric responses when asked about desired family size. Demographic transition theory has interpreted responses of "don't know" or "up to God" as evidence of fatalistic attitudes toward childbearing. Alternatively, these responses can be understood as meaningful reactions to uncertainty about the future. Following this latter approach, we use data from rural Mozambique to test the hypothesis that non-numeric responses are more common when uncertainty about the future is greater. We expand on previous research linking child mortality and non-numeric fertility preferences by testing the predictive power of economic conditions, marital instability, and adult mortality. Results show that uncertainty related to adult and child mortality and to economic conditions predicts non-numeric responses, while marital stability is less strongly related.

Special form of Gompertz model and its application

In this paper, we have proposed a special form of Gompertz model in which all parameters have direct demographic interpretation. The new model does not differ in structure from the classical Gompertz model. However, it has been shown to be more useful in various instances. For example, when quantifying fertility behaviour, this model adds a dimension called the effective fertility period , defined as the age interval within which the fertility level of a cohort rises from 5% to 95% of its saturation level or the Cohort Total Fertility Rate. Relative merits and demerits of the proposed model, in comparison to the other popular forms and the transformed versions of the Gompertz model, are discussed. The proposed model has been fitted to the cohort fertility schedules of high fertility countries like India and low fertility countries such as the USA, Austria, Slovakia, etc. In the context of India, the proposed model has been compared with other fertility models like Gamma model, Beta model, Hadwiger model, CT model, etc. It was found that the proposed model provides good fit to the cohort fertility schedules of high and low fertility countries. Samba S.R. PASUPULETI, Senior Research Fellow, Population Studies Unit, Indian Statistical Institute, 203 B.T. Road, Kolkata-700108, India. E-mail: srao113@gmail.com .. Prasanta PATHAK, Assistant Professor, Population Studies Unit, Indian Statistical Institute, 203 B.T. Road, Kolkata-700108, India. E-mail: prsnt@ isical.ac.in .

The Fertility Decline in India’s Kerala State: A Unique Example of Below Replacement Fertility in a High Fertility Country

This paper attempts to fill a gap in an updated study of the rapid fertility decline in Kerala, which has evoked world wide interest, using historical and recent data from direct and indirect sources. The three determinants of fertility decline – changes in age at marriage; the use of effective family planning methods as a result of the state’s aggressive family planning program; and the unique Kerala characteristics - have contributed to the fall in fertility. Additional insights are provided by comparing this with similar fertility decline in six countries of the region.

Population dynamics and climate change: what are the links?

Climate change has been described as the biggest global health threat of the 21(st) century. World population is projected to reach 9.1 billion by 2050, with most of this growth in developing countries. While the principal cause of climate change is high consumption in the developed countries, its impact will be greatest on people in the developing world. Climate change and population can be linked through adaptation (reducing vulnerability to the adverse effects of climate change) and, more controversially, through mitigation (reducing the greenhouse gases that cause climate change). The contribution of low-income, high-fertility countries to global carbon emissions has been negligible to date, but is increasing with the economic development that they need to reduce poverty. Rapid population growth endangers human development, provision of basic services and poverty eradication and weakens the capacity of poor communities to adapt to climate change. Significant mass migration is likely to occur in response to climate change and should be regarded as a legitimate response to the effects of climate change. Linking population dynamics with climate change is a sensitive issue, but family planning programmes that respect and protect human rights can bring a remarkable range of benefits. Population dynamics have not been integrated systematically into climate change science. The contribution of population growth, migration, urbanization, ageing and household composition to mitigation and adaptation programmes needs urgent investigation.

Discerning adaptation and disruption in the childbearing behaviour of immigrants in Greece: an analysis using micro-census data

This paper uses micro-data from the 2001 census of Greece to detect changes in the reproductive behaviour of recent immigrants. The analysis is based on descriptive methods and ordinal logistic regression models. Possible disruption and adaptation effects are investigated for different citizenships. The findings indicate that Albanians, who represent over half of the immigrants and originate from a high fertility country, show signs of reducing levels with increasing duration of residence consistent with the adaptation hypothesis. By contrast, for migrants from other Balkan and Eastern European countries there is some indication of a disruption in childbearing among recent arrivals.

Human population growth and the demographic transition

The world and most regions and countries are experiencing unprecedentedly rapid demographic change. The most obvious example of this change is the huge expansion of human numbers: four billion have been added since 1950. Projections for the next half century expect a highly divergent world, with stagnation or potential decline in parts of the developed world and continued rapid growth in the least developed regions. Other demographic processes are also undergoing extraordinary change: women's fertility has dropped rapidly and life expectancy has risen to new highs. Past trends in fertility and mortality have led to very young populations in high fertility countries in the developing world and to increasingly older populations in the developed world. Contemporary societies are now at very different stages of their demographic transitions. This paper summarizes key trends in population size, fertility and mortality, and age structures during these transitions. The focus is on the century from 1950 to 2050, which covers the period of most rapid global demographic transformation.

The Varying Value of Children

Using data from the Value of Children (VOC) replication study in 2002/3, the value of children for their parents is investigated cross-culturally for different age groups in 11 countries (South Korea, People's Republic of China, Indonesia, India, Palestine, Israel, Turkey, South Africa, Ghana, Germany and the Czech Republic). As a prerequisite, the cross-national equivalence of the VOC measurement is established in calculating the overall and the particular country-specific factorial structures. The analysis results in a three-dimensional structure of the VOC, namely comfort, social esteem and affect. This structure is replicated for every national group, and the resulting scales are of high internal consistency as revealed by the respective alpha coefficients. Additionally, the data are also tested for culture-specific response styles, for which the final VOC comparisons are controlled by means of a bias index. The findings indicate children's importance for comfort and esteem to be highest in high-fertility countries with lineage-based kinship systems and low affluence, while it is lowest in low-fertility countries with high affluence and a state-based insurance system. Affect is very high across all countries with only minor variations.

Spousal Communication, Power, and Contraceptive Use in Burkina Faso, West Africa

In most developing countries, despite increased knowledge and approval of family planning, contraceptive use is still low. Lack of spousal communication was identified as an important explanatory factor in the low level contraceptive use by spouses. This study describes the pathways of influence between spousal communication, power, and contraceptive use in Burkina Faso, West Africaa high fertility country with low prevalence of contraceptive use. The Burkina Faso society is patriarchal in which husbands have control over sexual and fertility matters and they extend authority over their wives on these issues and, therefore, the power dimension of the spousal communication model needs clarification. The data source for this paper was the 2003 Burkina Faso Demographic and Health Survey. From the individual recode file, married respondents were selected for inclusion in the sample (n = 9,537) and for analysis. The independent variables were spousal communication and relative power. The dependent variables were contraceptive use and the effects of age, education, number of living children, wealth, and marriage types were adjusted for. Results show that education, wealth, place of residence, and religion are some of the correlates of inter-spousal communication about contraceptive use. Additionally, the data have revealed that spousal communication and marital power were important and significant predictors of contraceptive use, with relative marital power being the Stronger predictor of the two.

Introducing Client‐centered Reproductive Health Services in a Pakistani Setting

Pakistan is a high-fertility country with elevated levels of maternal mortality and unmet need for family planning. Limited access to and poor quality of reproductive health services and gender-related problems comprise the major explanations for these poor indicators. The authors designed an intervention to address some of these issues and implemented it on a quasi-experimental basis in Bhalwal Tehsil of the Sargodha district of Punjab. The intervention introduced a client-centered approach to providing reproductive health services, including family planning and infant, child, and maternal health care. The intervention consisted of training health-care providers based in fixed-location clinics and in communities. It introduced the concept of SAHR (an acronym for salutation, assessment, help, and reassurance), to inculcate a client-centered approach to care that acknowledges explicitly and addresses a client's gender and power relations within her family and household. Results of the intervention indicate significant effects on providers' behavior related to SAHR elements. The changes provide demonstrable evidence that the public sector can shift toward client-centered services in reproductive health care in a challenging setting.

PARENTAL PERCEPTIONS OF COSTS AND BENEFITS OF CHILDREN AS CORRELATES OF FERTILITY IN KUWAIT

Kuwait is a high fertility country where the average number of desired children still exceeds 5. However, fertility behaviour is beginning to show a noticeable change and the current TFR is about 4.2 children. In order to understand the decline in fertility, the impact of perceived benefits and costs of children on Kuwaiti women's desired and achieved fertility is analysed. Data from a nationally representative survey of Kuwaiti households held in 1999 are used. Bivariate analyses show that the mean desired number of children is significantly higher among those who rank higher on the perceived value of children, and lower among those who are concerned about the cost of raising children. Achieved fertility (children ever born) shows a similar pattern. In the multivariate analysis, however, large family values emerge as the only significant predictor of (higher) desired as well as achieved fertility, net of the respondent's demographic and socioeconomic characteristics. The sociocultural, economic and political contexts that shape the mother's perceptions of the benefits and costs of children are analysed and it is concluded that the need for children as social and national capital is currently the most important driving force behind fertility desires and behaviour.

SCHWARTZ-KENNEY, Beth M., Michelle McCAULEY and Michelle A. EPSTEIN, eds., CHILD ABUSE: A Global View

SCHWARTZ-KENNEY, Beth M., Michelle McCAULEY and Michelle A. EPSTEIN, eds., CHILD ABUSE: A Global View. Westport, CT: Greenwood Press, 2000, 296 pp., $49.95 hardcover. Research on family processes around the world is quite immense. However, few of these studies examine the issue of child abuse, even though anecdotal evidence and existing data from governmental and non-governmental (NGOs) agencies indicate that child harassment and sexual exploitation and the use of child labor is widespread around the world. Indeed, in the case of the developing world where the problem may be more acute and hidden under the rubric of culture and poverty, scholarly research on the topic is quite limited. Moreover, in the developing world, what constitutes child abuse can vary from one society to another as well as in time and space. Indeed, demographic researchers have long suggested that in many high-fertility countries around the world, children are beneficial to parents from an early age, as they are a major source of cheap labor. The extent to which these normative practices impact or lead to abuse is as yet unclear. It is in light of the above observations that the scholarly community and child care advocates would welcome a book devoted entirely to the topic of child abuse in different cultural settings. This edited volume by Schwartz-Kenney, McCauley and Epstein provide insights into the prevalence of various types of child abuse as well as the available treatment strategies in sixteen countries from all over the world. For each country, the authors) provide comparable data on the history, dimension and prevalence of various types of child abuse (e.g., maltreatment, physical abuse, sexual abuse, and neglect). For example, in the case of Canada, the author indicates that the government has established child victim support programs to help prepare children for court cases. In England, the author points to the existence of two main ideological orientations that have influenced child abuse intervention programs: the belief that physical abuse arises from factors like stress, poverty and immaturity of parents, and the perception that child abuse is the result of male power and dominance. According to the chapter on India, the country's constitution has a provision that deals with issues affecting children. Unfortunately, these provisions are rarely enforced. According to the author on Ireland, treatment programs for sex offenders are scandalously underdeveloped. In the case of Israel, we are told that the belief that the Jewish family is pro-children has made it difficult for many people to accept the existence of the problem. Thus, the author calls for mandatory training about child maltreatment in professional studies such as medicine, social work and law. Japan does not have a cohesive, integrated system of child protection we are told. …

Pachyderms, primates, plants and population

In the past, growth in human population has often been associated with species loss. Current rates of population growth, both globally (1 million more births than deaths every 103 hours) and regionally, pose a threat of additional ecological damage. There is a well-documented unmet demand for family planning in nearly all high-fertility countries. Improved family planning and safe abortion services will improve the health of women and their families, accelerate fertility decline, and help preserve the environment. Many ecologically vulnerable areas are especially poorly served by family planning services. Examples are given here of improving family planning services through private health providers near the Kakamega Forest in western Kenya, and of adding family planning choices to a reforestation project run by the Jane Goodall Institute near the Gombe National Park, Tanzania. Wildlife biologists can play a critical role in identifying local professionals and institutions with the potential to improve family planning.

Comments on diane macunovich

Virginia Deane Abernethy comments on the paper that was written by Diane Macunovich on the consequences of immigration on US fertility. According to Macunovich immigration from any high-fertility Third World country into the US results in fewer total births for the planet. The departures induce a higher fertility rate among those left in the Third World country but this effect is offset based on Macunovichs calculations by much lower fertility induced among natives in the host country. In addition Abernethy observes that table IV of Macunovich s paper lacks other pertinent data that would show the addition of births removed from any high-fertility Third World country to US births and the births foregone by native-born and resident Americans. Finally Abernethy states that calls for soul-searching and ethical approaches to fast-developing demographic facts on the ground should have a foundation of truth.

Ethnic differences in contraceptive use in Kuwait: A clinic-based study

The Arab, Muslim, oil-rich nation of Kuwait has achieved unusually high levels of knowledge and use of contraception for a developing, high fertility country. Almost all women know of contraceptive pills without prompting, and 57–86% report having ever used a method (usually the oral pill or IUD) in recent studies. Based on a survey of six randomly selected clinics the present study compares the knowledge and use levels of two major ethnic groups—the Beduins and non-Beduins. It also analyses preference for various contraceptive methods and probable reasons for this. While Census or Survey data do not provide information about the size of ethnic groups analyzed in this paper, it is estimated that at least one-third of the population of Kuwait is Beduin. There is a significant difference between the levels of knowledge and use of contraception between the Beduin and non-Beduin women; current use being 42% and 65%, respectively. The differentials between the two groups are particularly marked among women of lower socioeconomic status, and tend to reduce notably once variables such as education and income are controlled. Within the subgroup of non-Beduins, socioeconomic differences in contraceptive use have virtually disappeared; the illiterate and relatively less affluent women are as likely to use a contraceptive method as the university educated, and richer women. However, among the Beduins, the usually expected differences by socioeconomic characteristics still persist. The oral pill is the best known and most commonly used method. Male sterilization is the least known and not practiced at all. Despite the high level of contraceptive use, the total fertility rate is still around 6 per woman. Some of the sociocultural reasons for the lack of a fertility impact are the use of contraceptive methods for spacing rather than limitation purposes, and the persistently large ideal family size which is 7.0 among Beduins and 5.7 among non-Beduins. The latter is consistent with the country's goal to increase the percentage of Kuwaiti nationals who presently comprise less than half of the total population.

Replacement-Level Fertility has Now Become the Rule In Most of Eastern Europe

Replacement level fertility in 7 eastern European countries from 2 studies are discussed in terms of the effects of policy on fertility completed cohort fertility mean age at childbearing cohort fertility by birth order and abortion and contraception. Several trends appear: 1) between about 1945-65 fertility declined throughout eastern Europe and 2) after 1965 fertility stabilized with variations in timing and magnitude. The fluctuations are attributed to pronatalist measures that restricted abortion and contraception after 1965 abortion laws were liberalized during the 1950s. Countries with the most radical changes in abortion law experienced the greatest declines in annual fertility i.e. Romanias total fertility rate (TFR) fell dramatically after abortion was legalized in 1956; however in Hungary fertility declines were from 2.6 to 2.0 births/women by 1960 after liberalization in 1956 but strong pronatalist measures preceded liberalization by 3 years. IN Bulgaria Poland and Yugoslavia fertility declined only slightly or sporadically and restrictions on abortions were either gradual or minimal. Czechoslovakia relaxed its abortion law in 1965 but introduced childbearing incentives; the result was a sudden increase in fertility and then a return to the prior level. Romania is considered the best example of the effects of government intervention on fertility. East Germany is also discussed. Demographic policy only marginally affected cohort fertility or completed fertility. The mean age at childbearing also decreased after World War II (WWII) i.e. between 1950-60 in Czechoslovakia the mean age dropped by 2 years. Liberalization around 1965 slowed or stopped the decline in mean age. East Germany and Bulgaria followed this pattern. Pronatalist measures contributed to a further decline in mean age at childbearing. Confounding factors were 1) laws that were contradictory cancelled each other out in longitudinal measures such as completed fertility and 2) laws were directed either at small or large families. Cohort fertility was examined by birth order; findings were that higher order fertility dropped in the 1935-50 cohorts and for later cohorts slowed or reversed itself. In countries where higher order births were lowest 2nd and 3rd births increased. The gap between high and low fertility countries has narrowed. The incidence of abortion was examined from national registry statistics and found to vary widely between countries and follow a non-western pattern. Since WWII abortion was the most frequently used method of preventing unwanted births in eastern Europe.

The Population Threat

Commentary is provided on the challenges faced by the new Clinton administration in formulating US key foreign policy initiatives. There is an urgent need to provide balanced and effective foreign aid for reducing high fertility rates in the developing world. There is also a need to effectively monitor the large migrations of populations. Over the past 10 years, the US has not been actively practicing world leadership on population issues. 3 changes in 1993 give impetus to redirect foreign policy: 1) the waning influence of fringe groups who controlled population issues; 2) the campaign promises to restore UN population stabilization programs; and 3) the evidence from the Persian Gulf and Yugoslavia that demographic issues require planning and assessment. Global population growth has been concentrated in the past 40 years, in part due to mortality declines and sustained high fertility. Of significance is the rapidness and momentum of growth. A high percentage are and will be children. Urban population is also growing rapidly in high fertility countries. Countries with high fertility and significant rural-to-urban migration also have large international migrations. The evolution of policy since the 1950s, which for the most part ignored population issues, is discussed. The American debates have been charged with emotionalism: about human sexuality, legitimacy of voluntary fertility control, the role and status of women and men, abortion, intergenerational transfer of obligations, ethnic solidarity and the sovereignty of national borders, and the proper roles of the state versus the marketplace. There have been over 200 years of ideological argument over population issues. The Malthusian argument was that large population size did not increase prosperity, and growth should be limited. The Marxist-Leninist position was that contraception was Malthusian, abortion was a woman's right, and population growth was neutral. By late 1970 the Chinese Maoists adopted the moral contraints urged by Malthus. US policies in the 1980s amounted to defunding of population programs and ideological suppression. Seven steps in US policy change are indicated. Centralization of responsibilities for population issues should be determined within government; the Department of State or the National Security Council are likely choices.