Determinants of the desire to limit childbearing among married women in sub-Saharan African countries

Abstract

Most sub-Saharan African countries have experienced high total fertility rates, leading to rapid population growth and policy concerns. This study examined the determinants of the desire to limit childbearing among married women in four high-fertility sub-Saharan African countries using the most recent demographic and health survey data: Gabon (2019), Mali (2018), Tanzania (2022), and Zambia (2018). The analysis included married women desiring to limit childbearing, with sample sizes of 3,664 (Gabon), 6,782 (Mali), 6,946 (Tanzania), and 6,674 (Zambia). Multivariate binary logistic regression was performed, and the results were reported with 95% confidence intervals (CIs). Zambia recorded the highest proportion of married women desiring to limit childbearing (47%), whereas Mali had the lowest (23.9%). Older women (35 -49 years) were more likely to express this desire than younger women (15 -19 years) in Gabon (adjusted odds ratio [aOR] = 3.02; CI: 1.60 -5.70), Mali (aOR = 44.28; CI: 26.19 -74.89), Tanzania (aOR = 8.85; CI: 5.81 -13.49), and Zambia (aOR = 6.74; CI: 4.61 -9.86). Increasing parity was also a significant predictor. Women with one to two children had lower odds of wanting to limit childbearing compared to those with five or more children: (aOR = 0.05; CI: 0.03 -0.08) in Gabon, (aOR = 0.10, CI: 0.06 -0.15) in Mali, (aOR = 0.03; CI: 0.02 -0.04) in Tanzania, and (aOR = 0.04; CI: 0.03 -0.06) in Zambia. Across all countries, the age of a woman, parity, and decision-making were significant determinants of the desire to limit childbearing among married women. The study highlights the need to intensify reproductive health education and family planning services, particularly for younger women. In addition, empowering marginalized women can help them make informed reproductive choices, thus increasing their desire to limit childbearing.

Keywords

Women / Reproductive health / Fertility desire / Family planning / Sub-Saharan Africa

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