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Fertility and contraceptive use

Modified on 2013/05/16 15:08 by Haoyi Chen Paths: Read in Order Categorized as Chapter 2 - Population, households and families
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 15-19 years old women; number of women 15-19 years old. 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 in the country? Number of births by age of mother; and number of women at reproductive age by age. As far as possible, these data should be disaggregated by: urban/rural areas, geographic areas, ethnicity and migration status of the mother, education of the mother, 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 and who are not using contraception and want to delay having a child in the next 2 years or want to stop childbearing. 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 of pregnancy and childbirth are the leading causes of death among 15-19 years old women (WHO, 2009). In addition, babies of very young mothers also 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, 2011c). Adolescent fertility remains high in countries with high levels of early marriage, limited access to reproductive health services, and few educational opportunities (United Nations, 2011a). Adolescents who are more likely to become pregnant are less educated and live in poor households in rural areas (WHO, 2009).

      Some countries in less developed regions still have considerably high fertility levels (United Nations, 2010a; 2011a; 2011f). In many developing countries, the rising age at marriage, increased education and access to contraceptive methods has contributed to the reduction of fertility (United Nations, 2011a). Still, the levels of fertility are spread over a broad range and in some of the countries with considerably high fertility rates the fertility decline has been slow or stagnating (United Nations, 2011f).

      While use of contraceptives has increased, many women who want to delay or stop their childbearing still do not use contraceptive methods (United Nations, 2011a). 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, overall, it has declined significantly (United Nations, 2011a). 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, 2011d). Women face several barriers in satisfying their unmet need for family planning, such as lack of services or difficulties accessing them, lack of awareness and information about family planning methods, or high cost of contraceptives (United Nations, 2009). In some countries, men may control women’s access to family planning services and/or decide on their own on the number of children (United Nations, 2000b). In general, younger, poorer, less educated and rural segments of the population tend to face greater barriers to access to family planning services (United Nations, 2011a).

      Fertility rates are below replacement level in most developed countries, raising concerns about negative population growth, demographic ageing and 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 bear most of the work for rearing children, experiencing difficulties in balancing work and family responsibilities, and decreasing their chances of achieving the desired fertility. Where the employment of mothers with young children is common, the availability and quality of childcare is a crucial issue (United Nations, 2010a). At the extreme, in some developed countries, more couples are choosing not to have any children at all (United Nations, 2011f).

      Childbearing outside of marriage varies widely across countries and is overall increasing (United Nations, 2011f). Many non-marital births occur in cohabiting unions, often by choice, and do not result in lone motherhood (United Nations, 2000a). However, many other non-marital births are a result of lack of use of contraceptive methods by young women without a current partner, resulting in lone parenthood and its often difficult consequences.

  • + Data needed
    • Number of births by age and marital status of mother; and number of women of reproductive age by age and marital status.

      When fertility data is 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 system, additional data on population by sex, age and other characteristics required need to be estimated based on population censuses and household surveys.

      Number of children ever born by age of mother.

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

      Contraceptive use by sex, age and method of contraception

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

      Additional breakdowns commonly used for contraceptive use statistics are number of own children, educational attainment, urban/rural areas, geographic 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 disaggregated by age and other characteristics.

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

      Household surveys such as demographic and health surveys and fertility and family surveys collect data on recent births, in the last 12 or 24 months, or retrospective birth histories during a longer time period. They also collect data on contraceptive use and information on desired number and spacing of children. Various characteristics of the mother as well as characteristics of the household are also collected.

  • + Conceptual and measurement issues
    • Number of births and number of children ever born may be underreported, due 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 based on supplementary information on births from population census and household surveys. In population censuses and household surveys, underreporting of children born is often due to 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 understand trends in non-marital fertility. Data are not available in countries relying solely on household surveys collecting data on fertility only for married women. In other countries where data on non-marital fertility are available, more detailed data on marital status of the mother is often needed to distinguish mothers living in various types of informal unions and mothers without a stable partner.

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

      Unmet need for family planning has often not been calculated using a comparable methodology over time (Bradley et al, 2012).

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