Evidence map›Paper›PMID 39269946›Full record

ArticlePLOS global public health2024

High-risk fertility behaviors and associated factors among married reproductive-age women in sub-Saharan Africa: A multilevel mixed-effect analysis of nationally representative data from 35 countries.

Kusse Urmale Mare, Setognal Birara Aychiluhm, Getahun Fentaw Mulaw, Kebede Gemeda Sabo, Mekuriyaw Gashaw Asmare, Betel Zelalem Wubshet, Tsion Mulat Tebeje, Beminate Lemma Seifu

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Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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3 · Its place in the literature

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4 citing papers in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Kusse Urmale MareDepartment of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.ORCID https://orcid.org/0000-0001-8522-1504
Setognal Birara AychiluhmDepartment of Epidemiology & Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia.ORCID https://orcid.org/0000-0001-7565-7515
Getahun Fentaw MulawSchool of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia.
Kebede Gemeda SaboDepartment of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Mekuriyaw Gashaw AsmareDepartment of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Betel Zelalem WubshetDepartment of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Tsion Mulat TebejeSchool of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.ORCID https://orcid.org/0000-0002-2911-2095
Beminate Lemma SeifuDepartment of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough high-risk fertility behaviors are linked with poor maternal and child health outcomes, their prevalence remains higher in resource-limited countries and varies significantly by context. Evidence on the recent estimates of these fertility risks at the sub-Saharan Africa level is limited. Therefore, this study aimed to examine the pooled prevalence of high-risk fertility behaviors and associated factors among married women in this region.

methodsData from DHS of 35 sub-Saharan African countries were used and a weighted sample of 243,657 married reproductive-age women were included in the analysis. A multilevel binary logistic regression models were fitted and the final model was selected based on the log-likelihood and deviance values. A p-value less than 0.05 and an adjusted odds ratio with a corresponding 95% confidence interval were used to identify the factors associated with high-risk fertility behaviors.

resultsThe pooled prevalence of high-risk fertility behaviors among women in sub-Saharan Africa was 77.7% [95% CI = 77.6%-77.9], where 43.1% [95% CI: 42.9%-43.3%], and 31.4% [95% CI = 31.2%-31.6%] had a single risk and combination of two or three fertility risks, respectively. The highest level of single-risk fertility pattern was observed in Burundi (53.4%) and Chad had the highest prevalence of both at least one (89.9%) and multiple (53.6%) fertility risks. Early and polygamous marriages, low maternal and husband education, poor wealth index, unmet need for contraception, couple's fertility discordance, rural residence, high community-level early marriage practice, and low community-level women empowerment were associated with risky fertility behaviors.

conclusionsMore than three-quarters of married women in SSA were engaged in high-risk fertility behaviors, with significant variations across the included countries. Therefore, addressing the modifiable risk factors like improving access to need-based contraceptive methods and empowering couples through education for a better understanding of their reproductive health with particular attention to rural settings are important in reducing these fertility risks. The results also suggest the need to strengthen the policies regulating the prohibition of early and polygamous marriages.

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PMID39269946
PMCPMC11398670

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