Ngalinda, Innocent: Age at First Birth, Fertility, and Contraception in Tanzania
Age at First Birth, Fertility, and Contraception in Tanzania
Dissertation

zur Erlangung des akademischen Grades
doctor philosophiae
(Dr. phil.)

eingereicht an
der Philosophischen Fakultät III
der Humboldt-Universität zu Berlin

von: Innocent Ngalinda ,
Masters of Arts in Population Studies geboren am 5.7. 1962 in Tansania

Präsident der Humboldt-Universität zu Berlin

Prof. Dr. Hans Meyer

Dekan der Philosophischen Fakultät III
Prof. Dr. Hartmut Häussermann

Gutachter:
Prof. Dr. Rainer Münz
Prof. Dr. Heinz Fassmann

Tag der mündlichen Prüfung: 8.12.98

ABSTRACT

AGE AT FIRST BIRTH, FERTILITY, AND CONTRACEPTION IN TANZANIA

by Innocent Ngalinda

The first visible outcome of the fertility process is the birth of the first child. The first birth marks a woman’s transition into motherhood. It plays a significant role in the future life of each individual woman and has a direct relationship with fertility. The age at which child bearing begins influences the number of children a woman bears throughout her reproductive period in the absence of any active fertility control. For countries in sub-Saharan Africa, where contraceptive use is relatively low, younger ages at first birth tend to boost the number of children a woman will have. However, even when family planning is widespread, the timing of first births can affect completed family size if contraception is used for spacing but not for limiting fertility.

The birth of a child is an event of great social and individual significance and its importance is recognised in all human societies. It signifies the transition of a couple into a new social status, i.e. parenthood with its related expectations and responsibilities. It marks the sexual and social maturity of the mother and the visible consummation of sexual intercourse .

The relationship between age at first birth and overall fertility in developing countries is generally an underdeveloped area as far as demographic research is concerned. Fertility analysts generally assume that child bearing only occurs within marriage. Then they treat age at first marriage to be a major proximate determinant of fertility. This assumption might have been true in most traditional societies, where births out of wedlock were not accepted and virginity was a prerequisite for marriage. This assumption, however, does not hold true in modern times, where a large number of children is born outside marriage. These facts have been the major motive of conducting the current research.

This study examines the reproductive behaviour of Tanzanian women. The study found the average age at first sexual intercourse to be 16 years; age at first marriage to be 17 years, while average age at first child bearing was estimated to be 18 years. By age 15, almost 10 percent of juvenile women have given birth. This study furthermore found that 41 percent of all first live births resulted from premarital conceptions. Out-of-wedlock births account for 24 percent of all first births in Tanzania according to the 1996 TDHS. The education of a woman, place of residence, and religion play the greatest roles in influencing age at first birth in Tanzania. The striking results were place of residence as it was found that rural residents have a higher mean age at first birth than women living in Dar es Salaam. Dar es Salaam women has the lowest mean age at first birth. Moslems have lower age at first birth than Catholics. There is also a strong relationship between age at first birth and age at first intercourse also with infant and child mortality. The results indicate that the younger the age of the mother at the birth of the first child, the higher the chances that the child dies.

The study of current levels and trends of fertility showed that, on the average, a Tanzanian woman bears 6 children. Between the 1960s and early 1980s, an average of 7 births per woman prevailed in Tanzania. The declining fertility in Tanzania was confirmed by the analysis of the decomposition of the change of the total fertility rate (TFR) between two TDHSs. It found that natural fertility control is being gradually replaced by contraceptive use although the percentage of women using contraception is still very low. The reduction in infant and child mortality, rising numbers of women attending schools, and a rise in age at first birth are among the factors responsible for the decline in fertility in Tanzania. Education on the other hand has played a major role in raising age at first birth. Education either delays first intercourse and subsequently birth as pregnant schoolgirls are prohibited to attend formal schools or it effects the acceptance of contraception to delay first conception. Specifically, this study establish that there is an inverse relationship between age at first birth and fertility. Marriage is a weak factor in explaining fertility in Tanzania. Women in polygamous unions had fewer number of children ever born than those in monogamous unions in Tanzania. Moslems have a lower fertility than Catholics. Women residing in urban areas have fewer children than those in the rural areas.

Women's education is the strongest predictor of the use of contraceptives in Tanzania. Catholic women are less likely to use contraceptives than Moslems. Tanzanian women residing in rural areas are less likely to use contraception than their counterparts residing in urban areas. Although age at first birth did not show any significance, age at first intercourse, age at first marriage and current age are highly related to contraceptive use.

Variation in age at first sexual intercourse; marriage; and birth, and the extent of practising contraception are found to depend mainly on religion, place of residence, and the age of a woman. It is important therefore to design separate programmes to raise age at first birth and to lower fertility according to the findings related to religion, place of residence, and target juvenile women separately.


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Inhaltsverzeichnis

TitelseiteAge at First Birth, Fertility, and Contraception in Tanzania
Abkürzungsverzeichnis List of Abbreviations
1 Introduction
1.1.Background Information
1.2.Research Problem
1.3. Rationale
1.4. Objectives
1.5. Organisation of the Thesis
2 Analytical Framework and Literature Review
2.1. Introduction
2.2. Conceptual Framework
2.3. Literature Review
2.3.1.Age at first motherhood
2.3.2.Fertility Changes in Sub-Saharan Africa
2.3.3.Proximate Determinants of Fertility
2.3.3.1.Proportion of Women engaged in Sexual Relations
2.3.3.2.Contraception
2.3.3.3.Post-partum Infecundability
2.3.3.4.Induced Abortion
2.3.3.5.Sterility
2.3.4.Determinants of Fertility
3 Data and Methodology
3.1. Introduction
3.2. Source of Data
3.3. Data Quality
3.4. Methodology
3.4.1.Bongaarts' Model for Estimating the Proximate Determinants of Fertility
3.4.2.Logistic Regression
3.4.3.Multiple Classification Analysis (MCA) Predictions
3.5. Background Characteristics of the Respondents for 1991/92 and 1996 TDHS
4 Age at First Birth
4.1.Introduction
4.2. Age at first birth in Tanzania
4.3. Proximate Determinants of Age at First Birth
4.3.1.Age at menarche
4.3.2.Age at First Sexual Intercourse<14>
4.3.3.Age at First Marriage
4.3.4.Primary Sterility
4.3.5.Contraceptive Use
4.3.6.Induced Abortion and Early Pregnancy Wastage
4.4.Interval between First Marriage and First Birth (Premarital first Births)
4.4.1.Covariates of Age at First Birth
4.4.2.Place of Residence
4.4.3.Religion
4.4.4.Education
4.5. Demographic Implications of Age at First Birth
4.5.1.Fertility
4.5.2.Infant and Child Mortality
4.5.3.Maternal Mortality and Morbidity
4.5.4.Natural Increase
4.6. Regression Analysis
4.7.Concluding remarks
5 Fertility
5.1. Introduction
5.2. Population Census Estimates
5.2.1.Crude Birth Rate
5.2.2.The Completed Family Size
5.2.3.Fertility Patterns
5.2.4.Level of Fertility
5.2.4.1.Parity Ratio Methods of Estimating Fertility
5.2.4.2.P/F Ratio Methods of Estimating Fertility
5.2.4.2.1.5.2.4.2.1. Brass P/F Ratio Method
5.2.4.2.2.Brass Relational Gompertz Model (BRGM)
5.2.4.2.3.Arriaga’s Approach
5.2.5.Summary of Census Fertility level Estimates
5.3. TDHS Estimates of Fertility
5.3.1.Fertility Patterns
5.3.2.Summary of TDHS Fertility level Estimates
5.4. Fertility Trends
5.5. Proximate Determinants of Fertility
5.6. Decomposition of Change in Fertility
5.7. Socio-Demographic Determinants of Fertility
5.8. Regression Analysis
5.9. Concluding Remark
6 Contraception in Tanzania
6.1. Introduction
6.2. Levels and Determinants of Contraceptive Knowledge and Use
6.2.1.5.2.5. Knowledge of Contraception
6.2.2.5.2.6. Current Use of Contraception
6.2.3.5.2.7. Contraceptive Method Mix
6.2.4.Multivariate Analysis of the Determinants of Current Contraceptive Use
6.2.4.1.Results for Currently Married Women
6.2.4.2.Results for never married women
6.3.Unmet need for Contraception
6.3.1.5.2.8. Estimates of Unmet Need and Demand for Contraception
6.3.2.Socio-demographic Differentials in Unmet Need for Family Planning
6.3.3.5.2.9. Multivariate Analysis of the Determinants of Unmet Need
6.3.4.5.2.10. Total Demand for Family Planning
6.4. Concluding Remarks
7 Early Motherhood, Contraceptive Awareness and Use among Adolescents
7.1. Introduction
7.2. Adolescents Child bearing
7.3. Socio-economic Factors Associated with Adolescents’ Age at first Motherhood
7.4. Adolescent Premarital Child bearing
7.5. Awareness and use of contraceptives
7.6. Unmet Need and Demand for Family Planning among Adolescents
7.7. Concluding remark
8 Summary and Conclusions
8.1. Summary of Findings
8.2. Policy Implications
8.3. Further Work
Bibliographie References
Anhang A Appendix
Selbständigkeitserklärung

Tabellenverzeichnis

Table 1: Percentage distribution of respondents and siblings by years of birth
Table 2: Percentage distribution of birth with reported year and month of birth by calendar years for surviving, dead and all children
Table 3: Mean number of children ever born by age group of women
Table 4: Percentage distribution of mothers by completeness of information on date of first birth by age group
Table 5: Percentage of women who had their first birth at ages 15-19 and 20-24 for selected years prior to the 1996 TDHS
Table 6: Percentage Distribution of respondents by background characteristics
Table 7: Percentage distribution of women by current marital status and current age
Table 8: Percentage distribution of adolescent women by current marital status
Table 9: Percentage distribution of women by age at first birth according to current age in Tanzania
Table 10: Percentage distribution of women, who ever gave birth, by age at first birth according to current age, 1991/92 TDHS
Table 11: Mean age at first birth by current age
Table 12: Proportions of women, who ever gave birth, by current age
Table 13: Logistic regression odds ratio predicting the relative risk that a woman had a live birth before age 15
Table 14: Mean age at first birth by current age in sub-Saharan Africa and selected developing countries
Table 15: Trends in age at first child bearing in sub-Saharan Africa and selected developing countries
Table 16: Percentage distribution of respondents’ age at first sexual intercourse by current age
Table 17: Mean age of respondents at first sexual intercourse by current age
Table 18: Odds ratio predicting that a woman had sexual intercourse before age 15
Table 19: Mean age at first sexual intercourse for sub-Saharan Africa including selected developing countries
Table 20: Percentage distribution of women age at first marriage by current age
Table 21: Mean age at first marriage by current age
Table 22: Logistic regression coefficients predicting the relative odds that a woman marries before exact age 15
Table 23: Mean age at first marriage for sub-Saharan countries and other selected countries
Table 24: Percentage of women, who remain childless by marriage duration and current age
Table 25: Percentage of childless currently married women in the first union
Table 26: Percentage distribution of non-pregnant unmarried sexually active women who use contraceptive to delay first birth by current age
Table 27: Percentage distribution of specific method used by current age
Table 28: Percentage of ever married women who had ever given birth by current age
Table 29: First marriage to first birth interval (in months) by current age
Table 30: Percentage of women who had ever given birth by current age
Table 31: Mean age at first birth by type of place of residence
Table 32: Mean age at first birth by type of place of residence
Table 33: Mean age at first birth by religion
Table 34: Mean age at first birth by level of education
Table 35: Mean number of children ever born by age at first birth
Table 36: Childhood mortality rates (first born) by mother’s age at birth; mortality rates (deaths per 1,000)
Table 37: Maternal mortality by age at death
Table 38: Regression results (unstandardised coefficients) of the relationship between age at first birth and selected variables
Table 39: Input and estimated crude birth rate by using formulae 5.3
Table 40: Mean number of children ever born
Table 41: Reported ASFR Tanzania
Table 42: Mean age of distribution of fertility
Table 43: Summary of fertility estimates by using various methods
Table 44: Summary of fertility estimates by using various methods
Table 45: Observed TFR in sub-Saharan African countries and other selected developing countries
Table 46: Data used to determine proximate determinants for the 1996 TDHS
Table 47: Summary measure of the proximate determinants of fertility for 1996 TDHS
Table 48: Data used to determine proximate determinants for the 1991/92 TDHS
Table 49: Summary measure of the proximate determinants of fertility for the 1991/92 TDHS
Table 50: Decomposition of the change in the TFR between 1991/92 and 1996
Table 51: Decomposition of the change in the CBR between 1991/92 and 1996
Table 52: Mean number of childrean ever born by selected socio-demographic characteristics and current age
Table 53: The variables used in the second regression analysis
Table 54: The OLS regression coefficients for the determinants of children ever born
Table 55: Regression results of the relationship between fertility and some selected variables
Table 56: Percentage distribution of women by knowledge of contraception by selected background characteristics
Table 57: Percentage distribution of women currently using contraceptive methods by selected background variables
Table 58: Contraceptive prevalence in sub-Saharan Africa (currently married women 15-49 who know and use any modern method in percentage) and other selected developing countries
Table 59: Percentage distribution of women currently using a contraceptive method according to the methods used and marital status
Table 60: Odds ratio associated with the determinants of current contraceptive use for currently married women
Table 61: Odds ratio associated with the retrospective determinants of current contraceptive use for never and currently married women
Table 62: Odds ratio associated with the determinants of current contraceptive use for never married women
Table 63: Percentage of currently married women with unmet need for family planning
Table 64: The coefficients of logistic regression models for the determinants of unmet need
Table 65: Multiple classification analysis for the estimated percentages having unmet need
Table 66: Percentage of currently married women according to demand for family planning and background characteristics
Table 67: Adolescents’ age at first sexual intercourse, marriage and birth
Table 68: Mean age at first birth by current age in sub-Saharan Africa and selected developing countries
Table 69: Socio-economic factors associated with adolescents’ age at first child bearing in Tanzania
Table 70: Regression results (unstandardised coefficients) of the relationship between adolescent’s age at first birth and some selected socio-economic variables
Table 71: Logistic regression odds ratio predicting the relative risk that a woman had a live birth before age 15
Table 72: Percentage distribution of adolescents by birth status
Table 73: Odds ratio predicting the relative risk that an ever-married woman had premarital sexual intercourse
Table 74: Odds ratio predicting the relative risk that a never married woman is sexually experienced
Table 75: Odds ratio predicting that a woman had her first child before first marriage

242

Table 76: Odds ratio predicting that an adolescent did not like the timing of her first pregnancy
Table 77: Percentage of adolescents in sub-Saharan Africa and selected developing countries by marital status at the birth of the first child
Table 78: Percentage distribution of first births by adolescent marital status at the time of the birth in sub-Saharan Africa and selected developing countries
Table 79: Percentage distribution of adolescents’ contraceptive awareness and use
Table 80: Adolescent modern contraceptive use in sub-Saharan Africa countries and selected developing countries
Table A-1: Summary of mean age at first sexual intercourse, marriage, and birth including TFR and contraceptive use in sub-Saharan Africa countries and selected developing countries
Table A-2: Contraceptive use method with current age of a user
Table A-3: Regression results of the relationship between fertility and selected variables
Table A-4: Unstandardised coefficients of regression analysis of the relationship between age at first birth and selected variables

Abbildungsverzeichnis

Figure 1: Map of the United Republic of Tanzania showing administrative regions
Figure 2: A Conceptual Framework to study Tanzania fertility
Figure 3: A simplified framework for the study of fertility in Tanzania
Figure 4: Percentage of currently married women (15-49 years) using a contraceptive method in Eastern and Southern African
Figure 5: Percentage distribution of women by current age in single years
Figure 6: Percentage distribution of women by five-year age groups
Figure 7: Distribution of births in calendar year
Figure 8: Distribution of mean number of children ever born by age
Figure 9: Mean age at first intercourse, first marriage, and first birth by current age
Figure 10: Percentage distribution of respondents by current age
Figure 11: Frequency distribution of age at first birth in single years
Figure 12: Trend in age at first birth in Tanzania 1991/92-1996
Figure 13: Age at first intercourse by single years
Figure 14: Age at first marriage in single years
Figure 15: Socio-economic variables associated with age at first marriage
Figure 16: Mean number of children ever born to ever-married women according to interval between age at birth and marriage
Figure 17: Completed family size in Tanzania
Figure 18: Patterns of fertility in Tanzania
Figure 19: Mean age at fertility schedule
Figure 20: Trends in age pattern of fertility for all censuses and TDHSs
Figure 21: Fertility trends in Tanzania 1967-1996
Figure 22: Percentage distribution of currently married women using contraception by current age
Figure 23: Estimates of unmet need for family planning
Figure 24: Adolescents’ age at first sexual intercourse, marriage and birth in single years
Figure 25: Estimates of Unmet Need for family planning

[Titelseite] [Abkürzungsverzeichnis] [1] [2] [3] [4] [5] [6] [7] [8] [Bibliographie] [Anhang] [Selbständigkeitserklärung]

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