Online Program

Socio-cultural determinants of fertility in small town Tanzania: A baseline cross-sectional study

Tuesday, November 3, 2015

Astha Ramaiya, MSc, Department of Community Health and Prevention, School of Public Health, Drexel University, Philadelphia, PA
Eveline Geubbels, PhD, Impact Evaluation, Ifakara Health Institute, Dar-Es-Salaam, Tanzania
Introduction: Fertility in sub-Saharan Africa remains high. We determined the independent association of any previous child death, religion, ethnicity and women’s empowerment status with above-average fertility (AAF), defined as 4 live births or more, in the small town of Ifakara, Tanzania.

Methods:  Logistic regression was used to analyze 2012/2013 survey data from 3,029 mothers aged 20 – 49 years. Door to door in-person interviews were conducted by field workers who assessed reproductive history, demographic and social status using structured questionnaires adapted from previous surveys. 

Results: Adjusted for age and other demographic factors, women who had experienced child death were 4.2 times more likely to have AAF (95% CI: 3.3 – 5.2). Catholics and other Christians were 1.3 (95% CI: 1.05 – 1.6) and 1.5 (95% CI: 1.03 – 2.2) more likely to have AAF in comparison to Muslims. Lower women’s empowerment status was weakly correlated with AAF. Ethnicity showed little role in explaining AAF.

Policy implications:  Having experienced child death and religion were associated with AAF in Ifakara town. Whereas the temporal sequence of the child death and increased fertility could not be established in our study, adoption of a religion or religious denomination is presumed to precede the start of childbearing and religion can therefore be interpreted as a determinant of AAF. When designing interventions to increase uptake of family planning and reproductive health services, an ecological perspective is needed to understand social norms that shape fertility preferences and the structural barriers to services access.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the relationship between socio-cultural determinants (previous child death, religion, ethnicity and women’s power status) and above-average fertility adjusted for other covariates.

Keyword(s): Reproductive Health, Community-Based Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a candidate for the DrPH in Community Health and Prevention at Drexel University. In the past I have been the project coordinator in implementing research within the field of HIV/AIDS, maternal child health, refugee health and reproductive health in developing countries, predominantly sub saharan Africa. I aided in designing the surveillance system for NCD and HIV/AIDS in Ifakara. This is the project i used to write up the abstract I am submitting.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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