ArticlemedRxiv : the preprint server for health sciences2025
Beyond Education and Contraceptive Use: Do Caste, Ethnicity, and Religion Influence Fertility Behavior in Nepal? Evidence from Six Rounds of DHS.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Nepal has experienced a significant decline in fertility rates. However, notable variations persist, necessitating further analysis. This study systematically examines the determinants of fertility heterogeneity in Nepal, focusing on caste, ethnicity, religion, and related factors. Methods: The study analysed data from six rounds of the Nepal Demographic and Health Survey (1996-2022) to examine married women aged 15-49. A Poisson regression model was used to assess the relationship between various determinants and the Number of Children Ever Born (CEB). Results: Significant associations (p < 0.001) with CEB were identified. Women marrying at age ≥20 experienced a 25% reduction in expected CEB compared to those marrying at ≤19. Those with a met need for contraception had a 9.2% lower CEB, while urban women exhibited an 11.1% reduction compared to rural women. Muslim women had an 11.1% higher CEB, whereas Dalit and Janajati women showed lower CEB compared to Arya women. Additionally, women from poorer households had a 9.2% lower CEB, and educational attainment significantly influenced CEB, with post-secondary education linked to a 48.5% reduction in CEB. Conclusion: The study reveals some level of heterogeneity in fertility rates across caste, ethnicity, and religion. It emphasises the importance of female education, family planning, and women's empowerment in reducing fertility rates and suggests that targeted government investments can address these disparities.
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