Determinants of fertility desire among married or cohabiting individuals in Rakai, Uganda: a cross-sectional study.
Determinants of fertility desire among married or cohabiting individuals in Rakai, Uganda: a cross-sectional study.
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在乌干达Rakai的已婚或同居个人中生育欲望的决定因素：一项横断面研究。
DOI：
10.1186/s12978-016-0272-3
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发表时间：
2017-01-10
影响因子：
3.4
通讯作者：
Serwadda D
中科院分区：
文献类型：
--
作者：
Matovu JK;Makumbi F;Wanyenze RK;Serwadda D
最近的生育率趋势表明，撒哈拉以南非洲一些国家的总生育率下降。然而，乌干达等国的总生育率仍然居高不下，部分原因是对大家庭的强烈偏好。我们探讨了影响乌干达西南部农村地区Rakai已婚或同居个体生育意愿的因素。这项关于生育意愿（希望再要一个孩子）的横断面研究嵌套在一项集群随机需求创造干预试验中，该试验旨在促进已婚或同居者对夫妇艾滋病毒咨询和检测的吸收，该试验于2015年3月1日至4月30日在Rakai区进行。共有1490名已婚或同居的个人，居住在三个研究地区，具有不同的背景艾滋病毒流行率，参加了这项研究。收集了社会人口学、行为和生育相关特征的数据。我们使用了一个改进的泊松回归模型，以产生患病率（PR）作为衡量与生育意愿独立相关的因素的关联性。我们调整了社区水平的聚类，并使用STATA 14.0版进行所有分析。总体而言，生育意愿较高（63.1%，n = 940）;男性（69.9%，n = 489）高于女性（57.1%，n = 451）。超过四分之三（78.8%，n = 1174）的人有3个以上的亲生子女，而略高于三分之二（68.5%，n = 1020）的人报告了5个以上子女的理想家庭规模。只有30%（n = 452）的人报告说，他们已经达到了理想的家庭规模。在调整了潜在的和可疑的混杂因素后，与生育意愿呈负相关的因素是：年龄30-39岁（调整后的患病率[aPR] = 0.82，95% CI：0.78，0.86）和40岁以上（aPR = 0.65，95% CI：0.60，0.71）;有6个或更多亲生子女（aPR = 0.88，95% CI：0.80，0.97）; HIV阳性（aPR = 0.86，95% CI：0.78，0.95）和曾使用任何计划生育方法（aPR = 0.93，95% CI：0.87，0.99）。男性（aPR = 1.19，95% CI：1.07，1.33）、小学教育程度（aPR = 1.21，95% CI：1.01，1.44）和尚未达到理想的家庭规模（aPR = 4.34，95% CI：3.50，5.38）与生育意愿呈正相关。尚未达到理想的家庭规模，是男性，并有小学教育与生育意愿在这一人群呈正相关。针对尚未达到理想家庭规模的个人、男子和受教育程度较低的个人采取生育调节干预措施，可能有助于降低这一人群的生育意愿。
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. This cross-sectional study of fertility desire (desire to have another child) was nested in a cluster-randomized 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 fertility-related 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. 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 two-thirds (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. Having not yet attained one’s desired family size, being male and having primary education were positively associated with fertility desire in this population. Targeting individuals who have not yet attained their desired family size, men and less educated individuals with fertility regulation interventions may help to reduce fertility desire in this population.