Determinants of fertility desire among married or cohabiting individuals in Rakai, Uganda: a cross-sectional study
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Reproductive health
Abstract
Recent trends in fertility rates indicate declines in total fertility rate (TFR) in some sub-Saharan African
countries. However, countries such as Uganda continue to have a persistently high TFR partly attributed to strong
preferences for large family sizes. We explored the factors that influence fertility desire among married or cohabiting
individuals in Rakai, a rural district in southwestern Uganda.
Methods: This cross-sectional study of fertility desire (desire to have another child) was nested in a clusterrandomized
demand-creation intervention trial for the promotion of couples’ HIV counseling and testing uptake
among married or cohabiting individuals that was conducted in Rakai district between March 1 and April 30,
2015. A total of 1490 married or cohabiting individuals, resident in three study regions with differing background
HIV prevalence, were enrolled into the study. Data were collected on socio-demographic, behavioral and fertilityrelated
characteristics. We used a modified Poisson regression model to generate prevalence ratio (PR) as a
measure of association for factors that were independently associated with fertility desire. We adjusted for
clustering at community level and used STATA version 14.0 for all analyses.
Results: Overall, fertility desire was high (63.1%, n = 940); higher in men (69.9%, n = 489) than women (57.1%,
n = 451). More than three-quarters (78.8%, n = 1174) had 3+ biological children while slightly more than twothirds
(68.5%, n = 1020) reported an ideal family size of 5+ children. Only 30% (n = 452) reported that they
had attained their desired family size. After adjusting for potential and suspected confounders, the factors that
were negatively associated with fertility desire were: age 30–39 (adjusted prevalence ratio [aPR] = 0.82, 95% CI: 0.78,
0.86) and 40+ years (aPR = 0.65, 95% CI: 0.60, 0.71); having six or more biological children (aPR = 0.88, 95% CI: 0.80, 0.97);
being HIV-positive (aPR = 0.86, 95% CI: 0.78, 0.95) and ever use of any family planning methods (aPR = 0.93, 95% CI: 0.87,
0.99). Being male (aPR = 1.19, 95% CI: 1.07, 1.33); having primary education (aPR = 1.21, 95% CI: 1.01, 1.44) and having
not yet attained the desired family size (aPR = 4.34, 95% CI: 3.50, 5.38) were positively associated with fertility desire
Description
Keywords
Fertility desire, Determinants, Married individuals, Rakai, Uganda
Citation
Matovu, J. K., Makumbi, F., Wanyenze, R. K., & Serwadda, D. (2017). Determinants of fertility desire among married or cohabiting individuals in Rakai, Uganda: a cross-sectional study. Reproductive health, 14(1), 1-11.10.1186/s12978-016-0272-3