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Fertility and contraceptive use

Modified on 2015/05/22 15:02 by Sean Zheng Paths: Read in Order Categorized as Chapter 2 - Population, households and families
Table II.24

From gender issues to gender statistics on fertility and contraceptive use: illustrative examples


Policy-relevant questions Data needed Sources of data
What are the trends in adolescent fertility? Number of births among women aged 15 to 19 and number of women aged 15 to 19. Data for at least two points in time. Civil registration systems.
Household surveys.
Population censuses.
What are the population groups with the lowest and highest fertility levels in the country? Number of births by age of the mother and number of women of reproductive age by age. As far as possible, these data should be disaggregated by urban/rural areas, geographical areas, ethnicity, migration status, education and marital status of the mother, and wealth status of the household. Civil registration systems.
Population registers.
Household surveys.
Population censuses.
How prevalent is the unmet need for family planning among women who are married or in a union?

Number of reproductive-age women who are married or in a union, who are not using contraception and who want to delay having a child in the next two years or to stop childbearing altogether. Total number of reproductive-age women who are married or in a union. Household surveys.

  • + Gender issues
    • Early childbearing continues to be widespread in certain parts of the world. Very early childbearing brings with it heightened risks of complications or even death. In developing countries, complications relating to pregnancy and childbirth are the leading causes of death among 15- to 19-year-old women (WHO, 2009). In addition, babies of very young mothers have a higher risk of perinatal death than babies born to older mothers (WHO, 2009). Furthermore, many adolescent mothers cannot continue school, diminishing their chances of having skilled jobs in the formal labour market.

      Across the developing world, women are having fewer children. But even in some of the regions where overall fertility has declined, adolescent fertility remains relatively high (United Nations, 2011b). Adolescent fertility remains high in countries with high levels of early marriage, limited access to reproductive health services and few educational opportunities (United Nations, Economic and Social Council, 2011). Adolescents are more likely to become pregnant when they are less educated and live in poor households in rural areas (WHO, 2009).

      Some countries in the less developed regions still have considerably high fertility levels (United Nations, 2010a, 2011e; United Nations, Economic and Social Council, 2011). In many developing countries, the rising age at marriage, increased education and improved access to contraceptives has contributed to a reduction in fertility (United Nations, Economic and Social Council 2011). Still, fertility levels cover a broad range and, in some of the countries with considerably high fertility rates, the decline in fertility levels has been slow or is even stagnating (United Nations, 2011e).

      While the use of contraceptives has increased, many women who want to delay or even stop their childbearing still do not use them (United Nations, Economic and Social Council, 2011). The use of contraception, particularly modern methods, is the usual means by which couples and individuals exercise control over the number of children they have. Although the desired number of children remains high in several countries in the less developed regions, it has declined significantly overall (United Nations, Economic and Social Council, 2011). However, access to family planning services is lagging behind the population’s needs and significant proportions of women in developing countries have an unmet need for family planning (United Nations, 2011c). Women face several barriers in satisfying their unmet need for family planning, such as a lack of services or difficulties accessing services, a lack of awareness and information about family planning methods and the high cost of contraceptives (United Nations, Economic and Social Council, 2009). In some countries, men may control women’s access to family planning services and/or decide on their own the number of children that they will have (United Nations, 2000). In general, younger, poorer, less educated and rural segments of the population tend to face greater barriers in accessing to family planning services (United Nations, Economic and Social Council, 2011).

      Fertility rates are below replacement level in most developed countries, raising concerns about negative population growth, demographic ageing and the associated pressure on pension systems. Women tend to have fewer children in contexts of higher educational attainment and increased female labour force participation. Women’s increased participation in paid employment before, during and after child-rearing has been accompanied by a significant increase in men’s participation in domestic work in only a few countries (United Nations, 2010a). Consequently, women have continued to shoulder most of the burden of rearing children, making it difficult for them to balance work and family responsibilities and decreasing their chances of achieving their desired fertility. Where the employment of mothers of young children is common, the availability and quality of childcare is crucial (United Nations, 2010a). At the extreme, in some developed countries more couples are choosing not to have any children at all (United Nations, 2011e).

      Childbearing outside of marriage varies widely across countries and is increasing overall (United Nations, 2011e). Many non-marital births occur in cohabiting unions, often by choice, and do not result in lone motherhood (United Nations, Economic and Social Council, 1999). However, many other non-marital births are the result of a failure to use contraceptives by young women without a current partner, resulting in lone motherhood and its often difficult consequences.

  • + Data needed
    • Data on fertility commonly used are:

      (a) Number of births by age and marital status of the mother, and number of women of reproductive age by age and marital status. When fertility data are collected through population censuses and household surveys, both data on births and data on number of women by age are available from the same data collection instrument. However, when data on births are collected from civil registration systems, additional data on population by sex, age and such other characteristics as may be required need to be estimated on the basis of population censuses and household surveys;

      (b) Number of children ever born by age of the mother.

      Additional breakdowns commonly used for fertility statistics are educational attainment of the mother, urban/rural areas, geographical areas and ethnicity.

      Data on contraceptive use are:

      (a) Contraceptive use by sex, age and method of contraception;

      (b) In order to estimate the unmet need for family planning, information on several other characteristics is needed, namely, marital status (as a proxy for being sexually active), pregnancy status, wantedness of current pregnancy, post-partum amenorrhea status, infecundity and desire to delay or stop childbearing (Bradley and others, 2012).

      Additional breakdowns commonly used for contraceptive use statistics are number of own children, educational attainment, urban/rural areas, geographical areas and ethnicity.


  • + Sources of data
    • Civil registration systems can provide data on live births by age and other characteristics of the mother.

      Population registers can provide data on live births by age and other characteristics of the mother and data on female population by age and other characteristics.

      Population censuses are used to collect data on children ever born along with data on various characteristics of the mother. Some censuses are also used to collect data on recent births (births in the past 12 months) and age of the mother at birth of the first child. Data on various characteristics of the mother, as well as on characteristics of the household, are also collected.

      Household surveys, such as demographic and health surveys and fertility and family surveys, are used to collect data on recent births (births in the past 12 or 24 months) or on retrospective birth histories over a longer time period. They are also used to collect data on contraceptive use and on desired number and spacing of children. Data on various characteristics of the mother, as well as on characteristics of the household, are also collected. >

  • + Conceptual and measurement issues
    • Number of births and number of children ever born may be underreported, owing to premature death or omissions, especially in countries with less developed statistical systems. Data on births obtained from civil registration systems should be checked and adjusted for sex bias in reporting on the basis of supplementary information on births from population censuses and household surveys. In population censuses and household surveys, underreporting of children ever born is often due to a proxy response from male members of the household. Recall errors may be associated more often with older women than younger women. In general, a more complete and accurate reporting of children ever born is obtained when the information is collected separately for girls and boys.

      Data on non-marital fertility may not be available or detailed enough to provide an understanding of trends in non-marital fertility. Data on non-marital fertility are not available in countries that rely solely on household surveys that are used to collect fertility data only for married women. In countries where data on non-marital fertility are available, more detailed data on marital status of the mother are often needed in order to distinguish between mothers living in various types of informal union and mothers without a stable partner.

      Use of contraceptives may be underreported, especially where traditional methods or contraceptive sterilization are common.

      Often, unmet need for family planning has not been calculated using a comparable methodology over time (Bradley and others, 2012).

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