High Fertility Rates Research Articles

Determinants of fertility experience among reproductive women age (15-49) in Ethiopia: Application of count regression models.

Fertility refers to the average number of children born to a woman over her reproductive years. Due to cultural norms, economic development, education, access to healthcare, and government policies, fertility rates vary significantly across different countries and regions of the world. Ethiopia is one of the developing countries in Sub-Sahara Africa and its fertility rate has consistently been one of the highest in the world. Hence the main goal of this study was to identify the leading factors for the total number of children born per mother in Ethiopia. This study used the most recent secondary data obtained from the 2019 Ethiopia Mini Demographic and Health Survey. A total weighted sample of 8885 women aged 15 to 49 was included in the study. The primary outcome variable in this study was the number of children born per mother, and different socio-demographic and economic factors that could influence fertility experience were included. The analysis was performed using STATA version 17 software. Negative Binomial regression model was used to assess the association between outcome and predictor variables. A p-value <0.05 was considered to be statistically significant. From a total of 8885 women, on average approximately 2.73 children were born per mother. Age of mothers (IRR = 1.08, 95% CI: (1.077, 1.082)), religion for Muslim (IRR = 1.13, 95% CI: (1.08, 1.18)) and others (IRR = 1.16, 95% CI: (1.11, 1.22)), level of education secondary and above (IRR = .61, 95% CI: (.58, .65)) and primary (IRR = .84, 95% CI: (.81, .87)), household member of six to nine (IRR = 1.24, 95% CI: (1.20, 1.28)) and household members more than nine people (IRR = 1.14, 95% CI: (1.07, 1.21)), wealth index for rich (IRR = .94, 95%, CI: (.91, .98)), marital status for not married (IRR = .49, 95%, CI: (.48, .51)), pregnant mothers (IRR = 1.08, 95%, CI: (1.02, 1.13)) and contraceptive users (IRR = 1.12, 95%, CI: (1.09, 1.16)) were the signficant variables for number of children ever born per mother. In Ethiopia, the average number of children born per mother was approximately 2.73. Poisson and Negative Binomial regression models were compared, and we found the Negative Binomial regression model to be better to identify the determinants of fertility experience in Ethiopia. Age of mothers, religion, current pregnancy, use of contraceptive methods, mothers' education level, household members, wealth index, number of children aged five and under, region (Somali, Gambela, and Addis Ababa), and marital status were the determinants responsible for fertility experience among mothers in Ethiopia. These findings are helpful for policymakers and healthcare professionals for developing targeted interventions and programs aimed at improving the high fertility rate experience in Ethiopia.

Growing Media pH and Nutrient Concentrations for Fostering the Propagation and Production of Lingonberry (Vaccinium vitis-idaea L.)

The lingonberry (Vaccinium vitis-idaea L.), recognized for its nutritional value and adaptability to cold climates, faces cultivation challenges, particularly in soil pH and fertility optimization. In a greenhouse study, lingonberry transplants were grown in media with pH levels of 6.5 (3:1:1 PRO-MIX BX/peat moss/perlite) and 5.2 (2:1 peat moss/perlite). Seven months post-exposure to different media pH, various fertility treatments (NPK) were tested, including a control (0–0–0), a balanced 5–5–5 kg ha−1 rate, a standard 36–24–48 kg ha−1 rate, and both higher (up to 54–36–72 kg ha−1) and lower (down to 9–6–12 kg ha−1) rates, applied every three weeks for fifteen weeks across six replications with a standard micronutrient rate. Results showed that media pH significantly affected plant height and volume, with plants at pH 6.5 growing 27% taller and larger than plants at pH 5.2. Fertility levels influenced plant volume, peaking at a moderate fertility rate (18–12–24 kg ha−1) before declining at higher rates. Interactions between pH and fertility significantly impacted shoot biomass, where higher fertility rates (above 36–24–48 kg ha−1) had a more pronounced negative effect on shoot biomass at pH 6.5 compared to pH 5.2. Root dry biomass was consistently 1.2–2.3 times greater than shoot dry biomass and less influenced by the treatments. Shoot death rates increased sharply at fertility rates above 18–12–24 kg ha−1, peaking at 21–35%. Nitrogen concentration in shoots and roots increased with higher fertilizer rates, peaking at 1.74% in the 45–30–60 kg ha−1 treatment. Fertility treatments raised growing media’s electrical conductivity (EC, 1:20 ratio), with a maximum of 1.41 dS m−1 in the 54–36–72 kg ha−1 treatment, though pH remained unchanged. Growing media nitrate levels increased with higher N rates, while ammonium levels were unaffected. Shoot death rates rose significantly with higher nitrate concentrations, particularly above 17.5 mg L−1, but showed no link to ammonium levels. Lingonberries can survive and thrive across a wide range of pH levels. These results indicate that lingonberries are resilient and low maintenance, requiring modest nutrient levels, and excessive fertilization hampers their growth.

Promoting Male Involvement in Family Planning: Insights From the No-Scalpel Vasectomy Program of Davao City, Philippines.

Despite global consensus on the importance of male involvement in family planning, disparities persist in low- and middle-income countries, where women continue to bear the responsibility for these initiatives. The Philippines, with a high fertility rate and unmet family planning needs, exemplifies this challenge. We present the experiences and lessons learned from implementing the no-scalpel vasectomy (NSV) program in Davao City, showcasing its potential for increasing male engagement in family planning decisions. Launched in 2008, the program aimed to address gender disparity by promoting NSV as a safe and effective contraceptive alternative to female-centric methods. Through the use of culturally sensitive information campaigns and couple-focused counseling, the program challenged traditional notions of masculinity and encouraged shared decision-making. Strong local government commitment and public-private partnerships played key roles in driving the program's success. Results showed an average annual increase of 80% in NSV clients over the past 3 years compared to before the COVID-19 pandemic, underscoring its effectiveness. The program presents a compelling intervention model for similar initiatives, highlighting how overcoming cultural barriers, infrastructure limitations, and budgetary constraints through policy advocacy, strategic partnerships, and tailored approaches can significantly boost male involvement in family planning and improve reproductive health outcomes within communities.

Factors associated with modern contraceptive utilization among reproductive age women in Cambodia; evidenced by the recent Cambodia demographic and health survey

IntroductionCambodia is a low-income country with limited access to family planning (FP) in terms of modern contraceptive utilization. Despite several FP programs designed to make contraceptives accessible, adoption of contraceptives has been difficult in Cambodia, which has high rates of fertility and maternal mortality. This gap in essential care can put women and adolescent girls at greater risk of adverse outcomes such as stillbirth, spontaneous abortion, unwanted pregnancy, or even maternal death. One of the goals set by the government to decrease both maternal and child mortality and morbidity was increasing the modern contraceptives utilization. So, the main objective of this study was to evaluate spatial variations in modern contraceptives utilization and its contributing factors among women.MethodsData from the Cambodia 2021–22 Demographic and Health Survey datasets were used for secondary data analysis. A total of 19,496 women of reproductive age participated in the study. A spatial and multilevel mixed effects analysis was done on the factors affecting modern contraceptives utilization among Cambodian women. Finally, the percentage, odd ratio, together with their 95% confidence intervals and the results of the spatial analysis were provided.ResultThe prevalence of modern contraceptive use was 31.2% in Cambodia. Living in an urban area [AOR = 1.224; 95% CI = (1.126.1.330); P = 0.0001]; being married [AOR = 34.131; 95% CI= (12.673, 91.921); P = 0.0001]; and having a history of terminated pregnancy [AOR = 1.137; 95% CI= (1.055, 1.225); P = 0.0001] were found to be positively associated with modern contraceptive utilization. In contrast to this, being between the age range of 46–49 [AOR = 0.421; 95% CI = (0.364, 0.487); P = 0.0001]; being a female-headed household [AOR = 0.784; 95% CI = (0.723, 0.850); P = 0.0001]; and current breast feeding [AOR = 0.84; 95% CI = (0.75, 0.93); P = 0.010] were found to be negatively associated with modern contraceptive utilization. Additionally, the spatial analysis of modern contraceptive utilization showed that a higher proportion was utilized in the southern and southwest regions of Cambodia.ConclusionIn this study, living in urban area, being married and having history of terminated pregnancy were found positively associated with modern contraceptive utilization. In contrast to this, being old age, being female headed household and being currently breast-feeding women were found negatively associated with modern contraceptive utilization. In addition to this, there were geographic (spatial) variations in modern contraceptive utilization among Cambodian’s women across the country.

Barriers to modern contraceptive utilization in Ethiopia.

Contraception is a critical service for women to control their reproductive health, allowing them to determine the number and spacing of their children prevent unintended pregnancies, reduce the risk of morbidity and mortality from associated with childbirth, and reduce the likelihood of abortions. Despite its benefits, the utilization of modern contraceptive methods remains low in certain regions of Ethiopia, Particularly in Afar and Somali, which are also experiencing high fertility rates. However, there is a substantial gap in understanding the sociocultural barriers that hinder the adoption of modern contraception in these regions. This study aims to explore these barriers to contraceptive use among women of reproductive age in Afar and Somali regions, providing qualitative insights that are essential for designing effective strategies to improve contraceptive service utilization. Asequential mixed method approach was employed, including scoping review and qualitative interviews. Scoping review focused on qualitative or mixed-methods studies conducted in Ethiopia and published between 2013 and 2023 in English, Selecting 14 articles Additionally, qualitative data were collected from Afar and Somali regions through In-depth interviews with women aged 15-49 who are married or in consensual union, and key informant interviews with health extension workers and contraception providers at health center. A total of 20 in-depth interviews and 07 key informants were conducted. Thematic analysis was used to analyze the data. The integrated findings from the scoping review and qualitative study reveal various barriers and determinants influencing contraceptive use among women in Ethiopia. Barriers includes religious or cultural beliefs, myths and misconceptions, fear of side effects, lack of knowledge and misinformation, negative attitude towards contraceptives, partner opposition, socio-cultural factors, fear of being judged by family and friends, and lack of communication between husband and wife, husband altitude, distance from health facility, availability of service and different contraceptive choice, separate room for family planning services, and cost of contraceptive method and transportation. The scoping review corroborates these findings, emphasizing on the role of socio-demographic, economic, cultural, religious, health service, and knowledge-related factors. Higher education, urban residence, higher income, mass media exposure, spousal communication, family size, and access to quality health services were associated with increased utilization, while lack of awareness, misconceptions, myths, side effects, fear of infertility, partner opposition, social stigma, and cultural norms decreased utilization. The study recommended promoting contraceptive use, challenging socio-cultural norms through Social Behavioural Communication and Counselling (SBCC), engaging partners and community members, and improving the quality of care.

The epidemiological declining in the human fertility rate in the arab world for 10 years period 2011–2021

Recently, there has been worldwide growing interest on profiling the human fertility of populations because there has been a noticeable global decline in fertility rate, leading to increased attention toward reproductive health and fertility.The decline in fertility of population of the Arab World was investigated for the 10 years period between 2011–2021. The Arab World was classified into three regional blocks; Block-1 Arabian Peninsula countries: Bahrain, Kuwait, Saudi Arabia, Oman, Qatar, United Arab Emirates (UAE), Yemen. Block-2 Fertile Crescent Arab countries: Iraq, Jordan, Lebanon, Syria, West Bank and Gaza. Block-3 African Arab countries: Algeria, Comoros, Djibouti, Egypt, Libya, Mauritania, Morocco, Somalia, Sudan, Tunisia. Data on fertility rates for the 10 years period between 2011–2021 were collected from the World Bank for Arab countries. Statistical analysis along with decline in the fertility rates were determined. Results: Fertility rates varied across Arab countries in 2011 and 2021, with notable decline ranging from 24.3% to 3.8%, except for Algeria, with zero decline. Countries that exhibited significant decline were Jordan (24.3%) followed by Iraq (22.2%) then Yemen (19.1%); Whereas, countries that exhibited slight fertility decline were Libya (3.8%), followed by Tunisia (4.5%), Lebanon (4.5%) and Kuwait (4.5%). On another note, lowest fertility rate was observed in UAE as maintained between 1.7% and 1.5% and the highest fertility rate was observed in Somalia as maintained between 7.3% and 6.3% for 2011 and 2021 respectively. Conclusion: The present study reveals the declining-trend in fertility rate across Arab countries, influenced by variable factors. Therefore, we recommend to the Council of the Health Ministries in the Arab-League to focus on investigating the fertility decline as an important parameter for public health in the Arab world to maintain natural balanced fertility rate.As some non-biological factors surrounding the Arabian region, such as instability, war, migration, the present study did not aim to include the influence of war and migration on fertility because both war and migration are non-biological external factors and both are not among the WHO criteria for fertility determination which based of the population growth rate of population under normal living conditions.

Projecting future excess deaths associated with extreme precipitation events in China under changing climate: an integrated modelling study

Climate-change-induced extreme precipitation events have attracted global attention; however, the associated excess deaths burden has been insufficiently explored and remains unclear. We first defined an extreme precipitation event for each county when the daily total precipitation exceeded the county-specific 99·5th percentile of the daily precipitation from 1986 to 2005; then we estimated the associations between extreme precipitation events and cause-specific deaths in 280 Chinese counties using a two-stage time-series model. Second, we projected the excess deaths related to extreme precipitation events by combining the bias-corrected multi-model precipitation predictions derived under different combined emission-population scenarios of three representative concentration pathways (RCPs; RCP2·6, RCP4·5, and RCP8·5) and three shared socioeconomic pathways (SSP2, a business-as-usual scenario) populations (S1, low fertility rate; S2, medium fertility rate; and S3, high fertility rate). We quantified the climate and population contributions to the changes of future excess deaths nationwide and by climatic zones. Compared with the non-extreme precipitation days, the percentage increase of deaths associated with exposure to extreme precipitation days is 13·0% (95% CI 7·0-19·3) for accidental cause, 4·3% (2·0-6·6) for circulatory disease, and 6·8% (2·8-10·9) for respiratory disease. The number of annual average excess deaths related to extreme precipitation events during 1986-2005 was 2644 (95% CI 1496-3730) for accidental cause, 69 (33-105) for circulatory disease, and 181 (79-279) for respiratory disease. In the 2030s, the total number of excess deaths of these three causes will increase by 1244 (43%), 1756 (61%), and 2008 (69%) under RCP2·6, RCP4·5, and RCP8·5 scenarios combined with a medium-fertility-rate population (SSP2-S2), respectively, but will decrease by 3% under RCP2·6-SSP2-S2 and increase by 25% under RCP8·5-SSP2-S2 in the 2090s. Humid and water-limited regions in subtropical, middle-temperate, and plateau climate zones will face highly increased risks. Climate and population factors contributed disproportionally among the five climate zones. This study is the largest integrated projection exploring the disease burden associated with extreme precipitation events. The excess deaths will be amplified by climate and population changes. Improving mitigation and adaptation capacities is crucial when responding to precipitation extremes. National Natural Science Foundation of China and Wellcome Trust.

Disorder by design: chaos in urban transformation within ultra-orthodox neighbourhoods

This paper employs a critical theoretical framework to examine the emergence and perpetuation of chaos and disorder in urban spaces. Specifically, we examine the dynamics of chaos during urban transformations, focusing on how it manifests itself in the redevelopment of religious enclaves and its implications for the daily lives of urban residents in two Haredi neighbourhoods in Jerusalem. We have coined the term ‘constant urban chaos’ to characterize this space as both the source and the desired outcome. These spaces of chaos reveal how neighbourhoods are shaped by individual and collective initiatives to preserve the communal ways of life through spatial patterns. Our findings suggest that chaos serves a specific purpose in urban development, providing desirable patterns that sustain city intricacies and delicate networks. Using this mutually beneficial arrangement, the municipality and communities meet the housing needs of specific demographic groups characterized by high fertility rates and non-conventional housing needs while minimizing socio-spatial conflicts. In examining the intricate interplay between urban chaos, community dynamics, and municipal involvement, this study challenges conventional notions of disorder and highlights the strategic utilization of chaos for urban development.

Fertility, economic development, and remittances in post-communist times

ABSTRACT This study investigates fertility responses to remittances across developed and developing countries in post-communist times. We first collected fertility, remittances, and income statistics over the 1995–2020 period and created a new vulnerability index that identifies less economically developed states with high fertility rates and dependent on remittances. We then examined the global fertility effects of remittances between 1995 and 2015 via Ordinary Least Squares, Fixed Effects, and Instrumental Variable estimation methods. The baseline regression results suggest that the relationship between remittances and fertility rates of remittances-receiving countries is generally inverse. We also found that the fertility-reducing power of remittances is heterogeneous worldwide. To illustrate the findings, we constructed two heat maps for 196 countries. The first one depicts the distribution of the vulnerability index, and the second one is dedicated to variations in the fertility effects of remittances across countries based on the vulnerability index.

Health facility and workforce factors influencing utilization of reproductive health services in selected South Sudan public health facilities

Background: Despite representing only one-tenth of the global population and 20% of worldwide births, nearly half of all maternal deaths occur in Africa. RH issues account for up to 18% of the global disease burden and 32% for women of reproductive age. Access to essential RH interventions, including family planning, is limited in Sub-Saharan Africa, characterized by low contraceptive use (13%) and a high total fertility rate (5.5 children per woman). Methods: This study used a mixed-method research design, integrating both quantitative and qualitative approaches to provide a comprehensive understanding of the factors influencing RH service utilization in South Sudan. This design allowed for in-depth exploration and quantitative analysis of data patterns and trends. Results: The study identified significant barriers to RHS utilization among women in South Sudan. Although many women were aware of the nearest RH clinic, 42.3% were not. Accessibility was a major issue, with 45.8% of women living more than 2 km from the nearest clinic, and the average distance being 2.2 km. Statistically significant relationships were found between health facility characteristics and RHS use. Interviews indicated that higher education levels among healthcare providers improved their skills, critical thinking, and ability to deliver comprehensive RH care, positively influencing service utilization. Conclusions: Key determinants of RHS utilization included awareness of services, proximity to facilities, and availability of contraceptives. The health workforce’s education, staffing levels, workload management, and fair compensation were also critical. To improve RHS utilization, the study recommends community outreach to raise awareness, expand facilities in remote areas, and offer diverse contraceptive options. Future research should address limitations like sampling biases and regional focus, explore broader geographical areas, longitudinal trends, and the impact of specific interventions, and consider technology’s role in enhancing access.

The Effects of Rearing Systems on Incubation, Egg Production and Quality Traits in Pharaoh Quails

This study was conducted to determine the effect of rearing quails in different rearing systems on egg production, egg quality characteristics, and incubation results. The 360 quails were distributed equally to 3 different rearing groups (cage, enriched cage, and floor) in a male:female mixed at the age of 3 weeks. The eggs were individually weighed and recorded one by one daily (5487 eggs) for 3 months. To determine egg quality and incubation characteristics, 750 eggs were broken, and 3284 eggs were incubated, respectively. The results showed that female quail in the floor group have lower body weight at 6 weeks old (177.19 g), and they reached sexual maturity (age of first egg laying) later (65.36 day, P&lt;0.01), The lowest egg production (61.14%) occurred in the floor group during the 3-month egg production period (P&lt;0.05). The lowest average egg weight (9.07 g) was determined in the floor group (P&lt;0.05). It was determined that the eggs of quails raised in the enriched group had a rounder shape index because they have larger widths (P&lt;0.01). While the highest average yolk height (11.24 mm) was determined in the enriched cage group (P&lt;0.01), the highest averages of albumen length (72.41 mm) and lowest averages of yolk index (48.43%) were determined in the cage group (P&lt;0.01). The lowest average values (113.17) in Haugh unit were detected in the floor group (P&lt;0.05). The highest fertility rate (98.44%) was in Floor♂:Cage♀, the highest hatchability of fertile egg rate (94.67%) was obtained from Enriched♂:Cage♀, and the highest hatchability (89.10%) was obtained from Floor♂:Cage♀ pairing (P&lt;0.05). The lowest fertility rate (88.00%) was obtained from the Enriched♂:Floor♀, the lowest hatchability of fertile egg rate (86.01%) was obtained from the Enriched♂:Enriched♀, and the lowest hatchability (75.62%) was obtained from the Enriched♂: Enriched♀ groups. As a result, it has been revealed that the effect of various rearing systems is different on egg production, egg quality traits, and hatching results in quails. Thus, it has been shown that different programs at the rearing period to be applied to the male and female quails can achieve better incubation results and reproductive success.

The Effects of Nitrogen Application and Varietal Variation on the Product Quality and In Vitro Bioaccessibility of Bioactive Compounds of Baby Spinach Varieties Grown in a Soilless Growth Medium.

Baby spinach is becoming increasingly popular as a salad ingredient and needs high fertiliser rates to grow well and attain higher-quality leaves (dark green leaves). Chemical fertilisers, especially nitrogen (N), boost yields. There are many risks associated with nitrogen fertilisation. Additionally, spinach contains phenolic compounds and carotenoids. Nitrogen fertilisation affects growth, development, yield and metabolites. This study examined the impact of lower concentrations of N (0, 30, 60, 90, 120, 150 mg/L) on yield and colour properties [light intensity (L*) colour coordinates, unique for green colour (a*) and yellow colour (b*)], as well as the impact of varying N concentrations on the total phenolic content and p-coumaric acid, quercetin, ferulic acid, kaempferol, lutein, zeaxanthin, β-carotene and antioxidant activities in the baby spinach varieties 'Acadia', 'Crosstrek' and 'Traverse', and it was established that N fertilisation improves phytochemical bioaccessibility and antioxidant activity. In a split strip plot design, three baby spinach varieties were treated with different N concentrations, including 0, 30, 60, 90, 120 and 150 mg/L. For 40 days, three baby spinach varieties were grown on soilless Mikskaar Professional substrate 300. During both seasons, 'Crosstrek' had the highest fresh mass (921.4 g/m2, 856.3 g/m2) at 120 mg/L N, while 'Traverse' had the highest fresh mass at 554.8 g/m2 and at 564.3 g/m2 at 90 mg/L N and did not differ significantly from 90 to 150 mg/L N during either season. During both seasons, 'Acadia' at 90 mg/L N increased fresh mass to 599 g/m2 and 557.9 g/m2. The variety × N supply interaction significantly affected the leaf colour; chlorophyll content across seasons; the levels of bioactive compounds, p-coumaric acid, quercetin, ferulic acid, kaempferol, lutein, zeaxanthin and β-carotene in spinach varieties; the in vitro bioaccessibility; and the antioxidant activity. Varietal differences influenced the bioaccessibility of phenolic compounds and carotenoid components. The appropriate N levels can be used during plant cultivation to optimise the bioaccessibility of this spinach variety. Thus, fertilising 'Traverse' with 90 mg/N mL increased the in vitro bioaccessibility of β-carotene (35.2%), p-coumaric acid (7.13%), quercetin (8.29%) and ferulic acid (1.92%) without compromising the yield.

A Retrospective Analysis of Breast Cancer Mortality among Jewish and Muslim Arab Women in Israel: The Role of Sociodemographic Factors.

Breast cancer mortality rates vary across ethnic groups in Israel, where protective factors such as high fertility and breastfeeding rates may be moderated by socioeconomic factors and mammography rates. We aim to investigate disparities in breast cancer mortality between Jewish and Muslim Arab women in Israel and examine how sociodemographic variables and number of children are associated with mortality. Our retrospective follow-up study uses data from the Israeli Central Bureau of Statistics and multivariable Cox regression models, adjusting for age, number of children, country of origin, locality size, and socioeconomic status. Compared to Jewish women, Muslim Arab women exhibited lower breast cancer mortality rates. However, after adjusting for multiple sociodemographic variables, no significant differences persisted between Jewish and Muslim Arab women. Having more than three children was associated with lower mortality among Muslim Arab women but not among Jewish women. European/American origin, larger localities, and medium socioeconomic status were associated with higher mortality. Sociodemographic factors may therefore explain the disparities in breast cancer mortality between Jewish and Muslim Arab women in Israel. Targeted intervention programs that consider the unique characteristics and risk factors of different ethnic groups are needed to reduce disparities and improve outcomes.

Estimating the cost of young stock mortality in livestock systems-An application to sheep farming in Ethiopia.

In sub-Saharan Africa, pre-weaning young stock mortality (YSM) is in the order of 20 to 30% across most livestock species and production systems. High YSM has significant economic implications for livestock keepers, but few studies provide estimates of the "cost of YSM." This study explores a bio-economic herd modeling approach to estimate the "cost of YSM" at farming/livestock system level. The static zero-growth version of DYNMOD was used to calculate the annual physical and monetary output of a sheep flock consisting of 100 breeding females at different levels of lamb mortality. Production parameter values and prices were taken from recently published research. Calculations were carried out for values of lamb mortality decreasing from 30% to 0% in 5% intervals, with 20% representing the "baseline" YSM. Calculations were repeated for a "high" fertility scenario (100% vs. 59% parturition rate) to gauge the sensitivity of the cost of YSM to another parameter determining flock productivity. The relation of revenue per head and YSM is close to linear over the range of analyzed YSM with 1% decrease in YSM resulting in an increase in revenue per animal of approximately 1%. At the higher fertility rate, the absolute cost of YSM to sheep farmers is higher while the relative increase in revenue per animal resulting from YSM reduction is lower. The estimated difference in revenue of the 100-ewe flock between the 20% and 0% lamb mortality scenarios (at baseline fertility) amounts to approximately USD 90 per additionally surviving lamb, which is far above its market value. Reduced lamb mortality ultimately impacts flock revenue through increased sales of "mature" animals, which embody the value of a lamb plus the revenue/profit from raising it to marketable age/weight. The modeling results suggest that foregone profit is an important component of the systemic "cost of YSM." Consequently, expected profit per animal, in addition to its current market value, is essential for estimating the absolute cost of YSM at farming system level.

ROLE OF GOVERNANCE IN TRANSITION FROM MIDDLE-INCOME TRAP

This study examines the role of governance in transitioning from middle-to high-income status in 20 countries. All the growth models indicate that the rule of law plays a significant role. Significant interactions among government effectiveness were observed in the post-transition period. A significant effect of political stability and corruption control and a significant interaction effect of government effectiveness were also observed in the transition to high income, using extended Cox regression. The probit regression revealed that the interaction of low government effectiveness, low insurance, heavy reliance on agriculture, high fertility rates, high inflation, limited foreign investment and excessive public debt posed obstacles to achieving high-income status. The weak rule of law, corruption control and regulatory quality also affected the failure of the 42 upper-middle-income countries to reach a high-income level.

Understanding maternal Ethnomedical Folklore in Central Uganda: a cross-sectional study of herbal remedies for managing Postpartum hemorrhage, inducing uterine contractions and abortion in Najjembe sub-county, Buikwe district

Pregnant women in rural Uganda largely rely on medicinal plants for inducing labor, treating postpartum hemorrhage (PPH), and inducing abortion. 90% of the women in both rural and urban Uganda use plants to manage pregnancy symptoms like constipation, heartburn, morning sickness, body aches, nausea, and vomiting. After delivery women continue using plants to manage postpartum complications and for infant care especially herbal baths. This study documented how ethnomedical folklore has been used to aid childbirth, manage postpartum hemorrhage, and induce abortion.MethodsA cross-sectional ethnobotanical survey was conducted from May – December 2023 in Najjemebe sub-county, Buikwe district. 206 respondents from 12 villages were selected using snowball sampling. Key informants included Traditional Birth Attendants (TBAs) and herbalists. Data was collected using semi-structured questionnaires and focus group discussions. Voucher specimens of the plants were identified and authenticated at Makerere University Herbarium. Data were analyzed using descriptive statistics, Informant Consensus factor (ICF), Use Reports (URs), paired comparisons, and GraphPad Prism® version 9.0.0 software.ResultsAll respondents (N = 206, 100%), used plants to induce labour, treat PPH, and induce abortion. One hundred four plant species were documented: most cited or preferred were: Hoslundia opposita (N = 109, 53%), Phytolacca dodecandra (N = 72, 35%), and Commelina erecta (N = 47, 23%). The plants belonged to 49 families, Lamiaceae (16.3%) and Fabaceae (14.3%) having the majority of the species. Herbs were 42 (40%) and trees 23 (22%). Oral administration 95(72%) was the commonest, then topical 19 (14.4%) and vaginal 14(10.6%).ConclusionHealth surveys revealed that about 27% of deliveries in Uganda take place outside a health facility. Due to the oxytocic effects of plant species reported in this study, they play a triple role of being uterotonics, abortifacients, and treating postpartum haemmorhage. The dilemma lies in the unknown dosages and toxicity levels that could endanger both the mother’s and the unborn child’s lives. Due to Uganda’s high rates of population growth, overall fertility, maternal mortality, and morbidity, policies, and programmes on gendered health provision need to be reevaluated. Integrating herbal medicine into health care systems appears to be a feasible solution.

Neonatal mortality rate and determinants among births of mothers at extreme ages of reproductive life in low and middle income countries

Neonatal mortality, which refers to the death of neonates during the first 28 completed days of life, is a critical global public health concern. The neonatal period is widely recognized as one of the most precarious phases in human life. Research has indicated that maternal extreme ages during reproductive years significantly impact neonatal survival, particularly in low- and middle-income countries. Consequently, this study aims to evaluate the neonatal mortality rate and determinants among neonates born to mothers at extreme reproductive ages within these countries. A secondary analysis of demographic and health surveys conducted between 2015 and 2022 in 43 low- and middle-income countries was performed. The study included a total sample of 151,685 live births. Researchers utilized a multilevel mixed-effects model to identify determinants of neonatal mortality. The measures of association were evaluated using the adjusted odds ratio within a 95% confidence interval. The neonatal mortality rate among neonates born to mothers at extreme ages of reproductive life in low- and middle-income countries was 28.96 neonatal deaths per 1000 live births (95% CI 28.13–29.82). Factors associated with higher rates of neonatal mortality include male gender, low and high birth weight, maternal education (no or low), home deliveries, multiple births, short preceding birth intervals, lack of postnatal checkups, and countries with high fertility and low literacy rates. This study sheds light on the neonatal mortality rates among neonates born to mothers at extreme ages of reproductive life in low- and middle-income countries. Notably, we found that neonatal mortality was significantly higher in this group compared to neonatal mortality rates reported regardless of maternal ages. Male babies, low and high birth-weighted babies, those born to mothers with no or low education, delivered at home, singletons, babies born with a small preceding birth interval, and those without postnatal checkups faced elevated risks of neonatal mortality. Additionally, neonates born in countries with high fertility and low literacy rates were also vulnerable. These findings underscore the urgent need for targeted interventions tailored to mothers at extreme ages. Policymakers and healthcare providers should prioritize strategies that address specific risk factors prevalent in these vulnerable populations. By doing so, we can improve neonatal outcomes and ensure the survival of these newborns during the critical neonatal period.

Parents’ age and total fertility rate in selected high-income countries from Europe and North America, 1990–2020

ObjectiveTo provide a comprehensive picture of trends in parents’ age and total fertility rate in selected most populous high-income countries from Europe and North America. Study designData were retrieved from official statistics published by the United Nations, the World Bank, the European Union (EU), and by national health statistics offices. ResultsMean maternal age at birth showed increasing trends in all considered countries; in 2020, the highest mean age was observed in Italy (32.2) and Spain (32.3), and the lowest one in the USA (28.8). Mean maternal age at first birth also showed upward trends. In the 1990s, mean age at first birth ranged from 25.5 to 26.9 years, except for the USA where it was below 25 years. The countries with the highest average maternal age at first birth were Italy and Spain, reaching 31 years over the most recent years. Data on mean paternal age at birth were scant. In Germany (2019) it was 34.6 and in the USA (2014) 27.9 years. In Italy, mean paternal age increased from 34.2 in 2000 to 35.5 in 2018, in the UK from 30.7 in 1990 to 33.4 in 2017, and in Canada, a decrease was observed from 29.1 in 2006 to 28.3 in 2011. Finally, Sweden and the USA had the highest fertility rates, around two children in some years, while Italy and Spain had the lowest ones, with less than 1.5 children over the whole period. ConclusionsMonitoring of trends in reproductive factors is crucial to gain insight into society from a cultural and sociological point of view and to analyze the impact of these changes on reproductive health and related conditions.

Spatio-temporal Trends and Patterns of Synthetic Fertility Index Across African Countries: A Comprehensive Analysis from 1950 to 2023

This paper examines the spatiotemporal trends and patterns of the Synthetic Fertility Index (SFI) in African countries from 1950 to 2023. The study used data from the Demographic and Health Surveys (DHS) program and Atlasocio.com to analyse the evolution of fertility rates in Africa. The findings reveal a significant decline in fertility rates over the past decades, with many countries experiencing a shift from high SFI exceeding 6 children per woman in the mid-20th century to levels below 3 children per woman by 2023. However, regional disparities persist, with North African countries and South Africa consistently demonstrating lower SFIs compared to their counterparts in West Africa, Central Africa, and East Africa. The study emphasizes the importance of addressing persistent regional disparities in fertility rates through targeted policies and interventions aimed at improving access to education and healthcare, promoting gender equality, and addressing cultural norms and practices that perpetuate high fertility rates. Overall, the study provides valuable insights into the demographic transition taking place in Africa and highlights the need for continued research and policy action to promote socio-economic development in the continent

Multilevel analysis on prevalence and associated factors of modern contraceptive uptake in Somaliland: based on The Somaliland Health and Demographic Survey 2020

IntroductionContraception is the deliberate prevention of unwanted pregnancy through various contraceptive methods. Its uptake is low in Sub-Saharan African countries, particularly in east Africa. This might be linked to the high prevalence of unwanted pregnancies and the high fertility rate in the area. Although studies reporting the prevalence and associated factors of modern contraceptive uptake are available in other African countries, no study has been conducted in Somaliland. Therefore, the current study aimed to assess its prevalence and associated factors in Somaliland using Somaliland Health and Demographic Survey (SLHDS) data.Methods and materialsThe study used Somaliland Demographic Health Survey (SLDHS) 2020 data. The survey was a national-level survey using a cross-sectional study design. A total of 3656 reproductive-age women were included in the current study. To determine independent predictors of modern contraceptive uptake, a multi-level multivariable logistic regression analysis was done. Random effect analysis, standard error (SE) and intra-cluster correlation (ICC) were computed.ResultsThe proportion of modern contraceptive uptake among reproductive age groups in Somaliland is 1%. Modern contraceptive uptake is significantly associated with the residence, educational level and wealth index of participants. Women from nomadic communities had lower odds (AOR: 0.25; 95% CI: 0.10, 0.66) of modern contraceptive uptake compared to those from urban areas. Being in the highest wealth quintiles (AOR: 17.22; 95% CI: 1.99, 155.92) and having a tertiary educational level (AOR: 2.11; 95% CI: 1.29, 9.11) had higher odds of using the modern contractive method compared to those with the lowest wealth quintiles and non-formal education, respectively.ConclusionThe prevalence of modern contraceptive uptake in Somaliland was very low. It is associated with the level of education, wealth index and residence of the women.