Thinking beyond the individual in reproductive health: evaluating the determinants of fertility through an analysis of the 2011 Uganda Demographic Health Survey

Mahmooda Khaliq, University of South Florida
Russell Kirby, University of South Florida

Fertility rates continue to increase and pose a serious threat to economic development. Uganda, the third fastest growing country in the world has a population of 29.6 million people, of which six million are women of reproductive age who on average will give birth to 6.7 children. Coupled with high fertility and 50% of the population under 15 years, Uganda faces numerous challenges in achieving a decline in fertility. Achieving a decline requires a better understanding of proximate and socioeconomic variables that directly or indirectly affect fertility. Using the Determinants of Fertility framework, this study aims to understand modern contraceptive use in Uganda with a particular focus on differentials due to individual, cultural and programmatic level factors. This study analyzed a nationally representative sample of 8,674 women of reproductive age (15-49 years) from the 2011 Uganda Demographic and Health Survey (UDHS). Manipulation of the UDHS using study inclusion and exclusion criteria, created a total sample of 6,401 women. Multivariable logistics regression with crude/adjusted odds ratios with 95% confidence intervals were obtained. Results reveal that factors such as age (OR=2.11, CI 95% 1.70, 2.62), education (OR=2.28, CI 95% 1.79, 2.92), wealth (OR=2.45 CI 95% 1.86, 3.21), number of children (OR=2.62, CI 95% 1.96, 3.52) and exposure to family planning programs (OR=1.50, CI 95% 1.28, 1.74) impact modern contraception use. These results showcase the need for interventions that are designed at the individual and household level and highlight the need for additional research on community contextual factors that impact contraceptive use.