Determinants of fertility desire among reproductive age married/cohabiting women in Ethiopia; an analysis of PMA-ET 2021 data

Abstract

Abstract Background In Ethiopia, although many activities have been done to control the rapid population growth and reduce the average number of births per woman, in the last ten years it has not been feasible to achieve the desired level of change as was planned and intended in the national health sector transformation plan (HSTP) and reproductive health (RH) strategies. The annual growth of the population and fertility rates continue to be higher at 2.7 and 4.6, respectively. Fertility is one of the fundamental aspects affecting population dynamics, while fertility desire of women to have children is one of the key elements of fertility, which can be precursors to actual fertility performance, a useful tool for understanding aggregate fertility trends, and important for understanding future reproductive behavior. Women's fertility desire is the number of children they want to have in the next few years, based on their assessment of the costs and benefits of childbearing. Methods This analysis used cross-sectional data from Performance Monitoring for Action Ethiopia (PMA-ET) 2021. A total of 4138 married or cohabiting individual women between the ages of 15 and 49 who were not pregnant were include in this analysis. Sampling weighting factors and design based were applied in this analysis, chi-square test statistics were computed to see the overall association and used to check cell sample size adequacy. Multilevel binary logistic regression was used to identify important predictors of women’s fertility desire. Results were presented in the form of percentages and odds ratios with a 95% confidence interval (CI). Statistical significance was declared at a significance level of 0.05. Results The study revealed that about three-quarters 74.1% (95% CI; 71.5% − 76.6%), reproductive age married/cohabiting women in Ethiopia, desired to have a child. Women who reported forced pregnancy by their spouse, being of the Muslim religion, those aged 19 and above at first sex, and women who attained secondary or higher education were found to be positively and significantly associated with the likelihood of fertility desire to have a child. Whereas those women who reported 40 and above of age, 45 and above of her partner’s age, those who have three or more live births, a family size of five or more members, and those who had ever used FP were found to have a lower odds of fertility desire to have a child. Conclusion The prevalent high fertility desire to have a child in Ethiopia hinders the quick reduction of fertility rates and calls up on implementing multifaceted strategies that preserve this high fertility desire. Accordingly, socio-cultural and demographic variables were determined to influence the desire for children. Understanding these determinants is vital to developing successful fertility programs and policies specifically designed for different populations, prioritize and adopting interventions that increase everyone's access to and use of family planning options, and messaging that speak to a range of religious and cultural groups.