Role of women's empowerment in determining fertility and reproductive health in Bangladesh: a systematic literature review

INTRODUCTION

Research on fertility and reproductive health has expanded rapidly. However, questions regarding the association between women empowerment and fertility in terms of the reproductive health status in Bangladesh remain unanswered. This study aimed to address these questions through a systematic literature review.

METHODS

In this review study, the PubMed, Scopus, Banglajol, and Google Scholar databases were searched systematically and screened in terms of the inclusion and exclusion criteria. Data from 15 articles included in this review were extracted for further assessment.

RESULTS

Fifteen studies with a total of 212,271 participants from Bangladesh met our selection criteria. Most of the articles were conducted on ever-married women aged 15 to 49 years using nationally representative Bangladesh Demographic and Health Survey data. The major religions were Islam (86.8%-90.2%) and Hinduism (10%-13%). The age of women at first marriage varied from 14 to 20 years, and the age at first birth ranged from 16 to 22 years. The fertility rate in Bangladesh has reduced remarkably over the period from 1975 to 2022. After controlling for other social and health factors, the study found that empowerment factors such as women's education, working status, involvement in household decision-making, participation in economic decision-making, and freedom in movement influenced the fertility and reproductive health status in Bangladesh.

CONCLUSION

As an initial step, this study found a negative relationship between women's empowerment and the control of fertility and reproductive health. Greater policy focus should be directed toward women empowerment factors to improve the fertility situation and reproductive health status in Bangladesh and other countries with similar sociodemographic profiles.

Socio-economic status of women and fertility outcome in Benue State, North-Central, Nigeria

Nigeria still records high fertility despite launching programs to reduce fertility rate. We therefore surveyed the influence of socio-economic status of women on their fertility outcome in Benue State, North-Central, Nigeria. Data from 1049 childbearing women were collected using questionnaires. The data were analyzed using logistic regression and chi-square statistics. Significant relationship exists between education, income, occupation, age, marital status and fertility outcome at p < .05. To achieve global health development and be amongst the best performers in global quality of life measures, women's empowerment programs are encouraged to enhance their autonomy in decision making with reference to reproduction.

Roles of Proximate Determinants of Fertility in Recent Fertility Decline in Ethiopia: Application of the Revised Bongaarts Model

INTRODUCTION

In Ethiopia, the fertility rate declined from 5.4 in 2005 to 4.6 by 2016. Many factors have been contributing to this decline. Understanding the factors contributing to the fertility decline and their level of fertility inhibiting effect has a paramount policy implication in any country. This study aimed to assess the contribution of the four proximate determinants of fertility, ie, contraception use, postpartum infecundity, marriage and abortion rate, to fertility decline in Ethiopia since 2005.

METHODS

This study used publicly available data from the Ethiopia Demographic and Health Surveys (EDHS) of 2005, 2011 and 2016. The EDHS data were the representative data collected from the reproductive-age women through a cross-sectional study. The revised and fine-tuned Bongaarts model of proximate fertility determinants was used for data analysis. The components needed for the analysis were extracted from the full EDHS data using the STAT compiler. Finally, the analysis was done using Microsoft Excel.

RESULTS

Of the four proximate determinants of fertility, postpartum insusceptibility contributed the highest fertility inhibiting effect in all three EDHS, and its level was also more prominent among the poorest women. While post partum infecundity, marriage and abortion had a relatively constant effect on fertility over the last 15 years, the fertility inhibiting effect of contraceptive use significantly increased from 15% to 37%.

CONCLUSION

In conclusion, fertility variation in Ethiopia is largely due to the three intermediate determinants of fertility. Over the last one and half decades, contraceptive use was the single most important determinant responsible for fertility decline in Ethiopia. To achieve fertility at replacement level, the country needs a contraceptive prevalence rate of 69%, an increment of nearly 100% from its current contraceptive prevalence rate.