Fertility - PDF document

1 Fertility | For more than 20 years
Fertility | For more than 20 years, Rwanda has been collecting sociodemographic data to evaluate the fertility levels and characteristics of its population. These efforts include the 1978 RGPH (General Population and Housing Ce | Fertility Underreporting of births, in particular, the omission of children living elsewhere and children who died very young (a few days or hours after birth), which can result in under-estimation of fertility levels. Misreporting of date of birth and/or age, in particular, the tendency to round off ages or year of birth, which can result in under- or overestimation of fertility at certain ages and/or Selective survival bias or selectivity effect: the women surveyed are those who have survived. Assuming that the fertility of women who died prior to the survey differs from the fertility of the survivors, the fertility levels obtained by the survey may be slightly biased. Finally, for the men’s survey, as for the women’s survey, information was gathered concerning total fertility by asking men a series of questions, including: the number of children they had, the gender of each child, the number of children living with them, the number living elsewhere, the number of children who had died, and the number still living. However, the men were not asked to provide a complete birth history. ERTILITY EVELS AND IFFERE

2 NTIALS Current fertility levels are meas
NTIALS Current fertility levels are measured in terms of age-specific fertility rates (ASFRs) and the total fertility rate (TFR). ASFRs are calculated by dividing the number of births in each age group into the total number of women for that age group. The TFR, a common measurement of current fertility, is the average of all of the ASFRs. It corresponds to the number of children the average woman would bear in her lifetime if fertility rates were to remain constant at the level prevailing during the period under three years preceding the survey. Table 4.1, illustrated by Figure 4.1, indicates that, at the national level, general fertility rates (GFRs) by age group follow the classic pattern of high fertility countries. In Rwanda, this pattern is characterized by relatively high early fertility (42 births per 1,000 for women age 15-19), followed by a rapid increase to very high levels for women age 20-24 (235 per 1,000), 25-29 (305 per 1,000), and 30-34 (273 per 1,000). This high fertility is sustained over a very long period (211 per 1,000 at age 35-39), before declining precipitously at the very end of the childbearing years (32 per 1,000 at age 45-49). These data show that the fertility of Rwandan women remains very high: at the end of her childbearing years, a Rwandan woman has an average of 6.1 children, nearly identical to the TFR of the

3 1992 RDHS-I (6.2), and even slightly hig
1992 RDHS-I (6.2), and even slightly higher than the TFR of the 2000 RDHS-II (5.8). However, the 1994 genocide seems to have had the effect of slowing the significant decline in fertility observed since the National Fertility Survey of 1983 (TFR of 8.5). The data in Table 4.1 show clear differentials in fertility by residence: women in urban areas have lower fertility than those in rural areas. The TFR, estimated at 6.1 children per woman for the country as a whole, ranges from 4.9 in urban areas to 6.3 in rural areas. This means that, if Table 4.1 Current fertility Age-specific and cumulative fertility rates, the general fertility rate, and the crude birth rate for the three years preceding the survey, by urban-rural residence, Rwanda 2005 Residence Urban Rural Total 15-19 35 43 42 20-24 172 249 235 25-29 269 313 305 30-34 228 283 273 35-39 170 218 211 40-44 90 121 117 45-49 17 34 32 TFR 4.9 6.3 6.1 GFR 152 198 190 CBR 39.8 43.8 43.2 Note: Rates for age group 45-49 may be slightly biased because of truncation. TFR: Total fertility rate for ages 15-49, expressed GFR: General fertility rate (births divided by the number of women age 15-44), expressed per 1,000 CBR: Crude birth rate, expressed per 1,000 popu- Fertility | current fertility levels were to remain constant, by the end of her

4 childbearing years a woman living in a
childbearing years a woman living in a rural area would have an average of 1.4 children more than a woman living in an urban area.This differential in fertility levels is seen at all ages (Figure 4.1). Childbearing begins very early for women in rural areas: 43 per 1,000 for women age 15 to 19, compared with 35 per 1,000 for this age group in urban areas. At ages 20 to 24, 1,000 women in rural areas give birth to an average of 249 children, compared with 172 for women in urban areas. However, women reach their peak fertility between the ages of 25 and 29 in both rural (313 births per 1,000) and urban (269 births per 1,000) areas. Table 4.1 shows the crude birth rate (CBR), or average number of live births annually in the total population, estimated at 43 per 1,000 for the country as a whole, and the general fertility rate (GFR), that is, the average number of live births per 1,000 women of reproductive age (15-44), estimated here at 190 per 1,000. Like the TFR, these two indicators vary significantly by residence. Rural areas have a GFR of 198 per 1,000, which means that 1,000 women in rural areas are giving birth to an average of 46 more children annually than their urban counterparts (GFR of 152 per 1,000). Similarly, the CBR for rural areas (44 per 1,000) is 4 points higher than the CBR for urban areas (40 per 1,000). Table 4.2 presents fe

5 rtility rates by background characterist
rtility rates by background characteristic. The TFR varies considerably by province, ranging from a high of 6.6 children per woman in the West province to a low of 4.3 children per woman in the City of Kigali. In other words, women in the West province have an average of 2.3 more children than women in the City of Kigali. The TFR is strongly correlated with level of educational attainment, varying from a low of 4.3 children for women with secondary educations or higher, to 6.9 for women with no education. This means that a woman with no education (6.9) has an average of 0.8 more children than a woman who has attended primary school (6.1), and an average of 2.6 more children than a woman who has attended secondary school or higher (4.3). Figure 4.1 Age-Specific Fertility Rates, by ResidenceRDHS 2005 1520253035404550 UrbanRuralTotal Fertility | The fertility results by background characteristic show cumulative fertility rates above the TFR for all categories except women with no education, indicating that fertility is declining for all women, regardless of residence or province. However, the difference between cumulative fertility (number of children ever born) and the TFR is greater in the City of Kigali (1.6 children) and in the wealthiest households (1.1 children) than anywhere else. Table 4.2 shows the percentage of women who reported

6 being pregnant at the time of the survey
being pregnant at the time of the survey. At the national level, 8 percent of women reported being pregnant. This is likely to be an underestimate because women in the early stages of pregnancy may be unaware or unsure of their pregnancy status.. Age, residence, culture, and/or beliefs may also affect a woman’s willingness to report her condition. In Rwanda, women generally declare their pregnancies only when their condition they becomes visible. For these reasons, the differentials in pregnancy rates shown here must be interpreted with a great deal of caution. It should be noted, however, that the findings are generally consistent with current fertility levels. In fact, the lowest pregnancy rates are observed for women living in the wealthiest households (6 percent), women with a secondary education or higher (6 percent), and women living in the City of Kigali (7 percent), which are the groups that also have the lowest fertility levels. ERTILITY RENDSTwo national demographic data collection efforts are conducted regularly in Rwanda: the General Population and Housing Census and the Demographic and Health Survey (DHS). The Censuses of 1978, 1991, and 2002 gathered information on natural population dynamics and were used to estimate fertility levels for those years by asking questions about births that occurred in the 12 months preceding the su

7 rvey. However, this method generally res
rvey. However, this method generally results in underestimates of fertility levels. The DHS surveys employ a more accurate method (women’s birth histories), which yield more reliable results. Yet the various RDHS surveys (1992, 2000, and 2005) and the Censuses of 1991 and 2002 have produced more or less similar results with respect to the TFR, which fluctuates around 6. This means that fertility has remained relatively stable in Rwanda since the RDHS-I. Table 4.3 shows age-specific fertility rates (ASFRs) for the three DHS surveys. Figure 4.3 examines past fertility trends based on the results of the 1992 RDHS-I, the 2000 RDHS-II, and the 2005 RDHS-III. The three ASFR curves follow a similar pattern: they increase rapidly with age and reach their peak between the ages of 25 and 29, then taper off steadily as they move toward the age group 45 to 49. It should be emphasized that the decline slows with this age group, demonstrating high levels of late fertility. However, the curve for the current survey (2005 RDHS-III) drops lower after age 40 than the other two curves, indicating a trend toward declining fertility in women of these Table 4.3 Trends in fertility Age-specific fertility rates (per 1,000 women) and total fertility rates, 1992 RDHS, 2000 RDHS, and 2005 RDHS Age group RDHS RDHS RDHS 15-19 60 52 42 20-24 227 240 235 25-29 294

8 272 305 30-34 270 257 273 35-39 214
272 305 30-34 270 257 273 35-39 214 190 211 40-44 135 123 117 45-49 46 33 32 TFR 6.2 5.8 6.1 Note: Age-specific fertility rates are per 1,000 women. Fertility | Age-Specific Fertility Rates for Five-Year Periods Preceding the Survey 1520253035404550 0-4 years5-9 years10-14 years15-19 years RDHS 2005 Women Age 15-34, Rwanda 1992, 2000, and 2005 798387889193949803Central year of estimates0123456Children per woman 1992 RDHS2000 RDHS2005 RDHS 2005 RDHS1992RDHS2000RDHS Fertility | Even at age 20-24, when more than half of women are still never-married (53 percent: see Marital Status in Chapter 6), there is still a wide gap between the proportion of married women who have had at least one child (85 percent) and the proportion of all women in this age group who have had at least one child (46 percent). Women who remain childless voluntarily are relatively rare in Rwanda, where the population is still very pro-natal (see Chapter 7, Fertility Preferences). For this reason, zero parity among married women age 35 to 49 would be an indicator of total or primary infertility. In Rwanda, only 1.2 percent of married women age 35 to 49 years (when the arrival of a first child is unlikely) have never had a child and can be considered infertile. This shows that the level of primary infertility has remained stable at low levels sinc

9 e 1983, when it was calculated at 1.5 pe
e 1983, when it was calculated at 1.5 percent. The percentage was as low as 0.7 percent in the RDHS-I, and was 1.2 percent in the RDHS-II. It should be noted that the level of primary infertility observed in Rwanda in 2005 is lower than the level found in some sub-Saharan countries such as Cameroon (3.6 percent in the 2004 EDSC), but is similar to that of other countries in this region such as Burkina Faso (1 percent in the 2003 EDSBF). The average number of children by age group for men is calculated on the basis of the total number of children ever born to men in their lifetime. Table 4.5.2 shows the number of children ever born for all men and for married men. Table 4.5.2 Children ever born and living : men Percent distribution of all men and currently married men by number of children ever bo children ever born and mean number of living children, according to age group, Rwanda 2005 Number of children ever born 0 1 2 3 4 5 6 7 8 9 10+ Total Number of men children ever bornchildren ALL MEN 15-19 99.8 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 1,102 0.00 0.00 20-24 83.5 9.9 4.8 1.4 0.3 0.0 0.0 0.1 0.0 0.0 0.0 100.0 946 0.26 0.23 25-29 39.9 17.8 17.9 16.0 5.2 2.0 0.8 0.4 0.1 0.0 0.0 100.0 632 1.40 1.22 30-34 15.7 11.2 15.5 19.5 18.7 12.1 3.2 2.7 0.7 0.7 0.0 100.0 509 2.86 2.38 35-39 8.2 6.1

10 9.1 14.6 16.8 14.6 13.3 9.4 3.5 3.0 1.5
9.1 14.6 16.8 14.6 13.3 9.4 3.5 3.0 1.5 100.0 442 4.26 3.50 40-44 2.9 2.3 4.7 8.5 11.8 13.1 13.6 16.8 11.1 7.6 7.5 100.0 404 5.90 4.72 45-49 1.7 1.1 3.7 5.7 3.8 8.0 15.4 13.1 12.4 10.8 24.4 100.0 378 7.43 5.79 50-54 1.3 0.8 1.6 2.1 1.6 5.9 7.6 12.0 15.8 13.0 38.4 100.0 260 8.63 6.50 55-59 0.8 1.2 0.7 0.0 3.8 3.8 3.3 14.0 13.3 15.8 43.3 100.0 147 9.28 6.59 Total 47.3 6.4 6.6 7.0 5.8 5.0 4.5 4.7 3.6 3.0 6.1 100.0 4,820 2.76 2.18 CURRENTLY MARRIED MEN 15-19 * * * * * * * * * * * * 2 * * 20-24 20.2 44.3 25.6 7.4 1.9 0.0 0.0 0.5 0.0 0.0 0.0 100.0 173 1.29 1.15 25-29 7.6 25.5 27.9 25.5 8.3 3.1 1.2 0.7 0.1 0.0 0.0 100.0 394 2.20 1.92 30-34 3.7 11.2 17.7 22.8 22.0 14.1 3.5 3.3 0.8 0.8 0.0 100.0 429 3.32 2.75 35-39 3.4 5.5 9.3 14.4 17.5 16.1 14.7 10.4 3.6 3.4 1.7 100.0 400 4.56 3.77 40-44 1.0 1.7 4.8 8.1 11.2 13.9 13.6 17.8 11.8 8.1 8.0 100.0 381 6.11 4.90 45-49 0.2 0.6 3.1 4.9 3.3 8.2 14.7 13.7 12.7 11.8 26.6 100.0 346 7.77 6.07 50-54 0.3 0.5 1.0 2.3 1.4 4.8 7.0 12.2 15.6 13.8 41.1 100.0 235 8.90 6.79 55-59 0.5 0.8 0.7 0.0 4.0 3.4 3.5 13.5 13.2 15.9 44.5 100.0 139 9.40 6.69 Total 4.0 10.4 12.0 12.9 10.5 9.4 8.1 8.9 6.5 5.7 11.5 Note : An asterisk indicates that a figure is based on fewer

11 than 25 unweighted cases and has been s
than 25 unweighted cases and has been suppressed Fertility | Table 4.6 Birth intervals Percent distribution of non-first births in the five years preceding the survey by number of months since preceding birth, according to background characteristics, Rwanda 2005 Months since preceding birth Background 7-17 18-23 24-35 36-47 48+ Number of non-first Median number of months since preceding Mother’s age 15-19 * * * * * * 7 * 20-29 12.2 20.1 43.4 14.6 9.7 100.0 2,578 27.7 30-39 6.2 13.7 41.0 21.3 17.7 100.0 3,243 32.5 40-49 4.2 8.6 34.1 24.2 29.0 100.0 1,245 37.1 Birth order 2-3 10.6 17.2 38.9 16.3 17.0 100.0 2,880 29.9 4-6 6.3 14.0 42.3 20.7 16.7 100.0 2,753 31.9 7+ 6.3 13.3 41.4 22.7 16.4 100.0 1,441 32.7 Sex of preceding birth Male 7.9 15.0 40.4 19.5 17.2 100.0 3,611 31.6 Female 8.2 15.4 41.0 19.2 16.2 100.0 3,463 30.9 Survival of preceding birth Living 5.4 14.2 42.7 20.5 17.1 100.0 5,834 32.1 Dead 20.4 19.5 31.1 14.1 15.0 100.0 1,240 26.4 Urban 11.5 16.4 36.3 15.7 20.1 100.0 968 29.9 Rural 7.5 15.0 41.4 19.9 16.2 100.0 6,106 31.4 Province Kigali city 12.7 16.3 32.6 16.6 21.9 100.0 486 30.1 South 6.9 14.9 39.1 21.1 18.0 100.0 1,708 32.6 West 7.9 16.6 41.7 19.2 14.6 100.

12 0 1,874 30.2 North 6.8 13.4 46.3
0 1,874 30.2 North 6.8 13.4 46.3 18.7 14.8 100.0 1,445 31.8 East 9.1 15.1 38.6 19.1 18.1 100.0 1,562 31.3 Education No education 7.3 15.0 37.1 21.1 19.5 100.0 2,128 32.7 Primary 8.3 14.9 43.0 18.9 15.0 100.0 4,368 30.8 Secondary or higher 9.4 17.6 37.1 15.7 20.2 100.0 578 30.1 Wealth quintile Lowest 6.2 13.0 40.4 20.9 19.6 100.0 1,513 32.8 Second 6.8 13.0 42.8 20.4 17.0 100.0 1,474 32.1 Middle 8.4 16.1 40.5 20.0 15.0 100.0 1,465 30.9 Fourth 8.4 14.7 41.9 19.4 15.7 100.0 1,395 31.0 Highest 11.1 19.9 37.3 15.4 16.3 100.0 1,226 28.8 Total 8.1 15.2 40.7 19.3 16.7 100.0 7,074 31.3 Note: First-order births are excluded. The interval for multiple births is the number of months since the preceding pregnancy tended in a live birth. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Regarding mother’s level of educational attainment, birth intervals for women with no education are longer (32.7 months) than birth intervals for women with a secondary education or higher (30.1). This is explained, among other things, by the fact that the median duration of breastfeeding is longer for women with no education than for women with some Household wealth data follow a similar pattern: 50 percent

13 of children in the poorest quintile are
of children in the poorest quintile are born 32.8 months after the birth of their immediately older sibling, or 4 months later than children in the richest quintile (28.8). Fertility | Table 4.8 Median age at first birth by background characteristics Median age at first birth among women age 25-49 years, by current age and background characteristics, Rwanda 2005 Current age Background 25-29 30-34 35-39 40-44 45-49 Women Urban 22.2 22.5 23.0 22.1 21.6 22.4 Rural 21.6 22.1 22.0 21.9 22.0 21.9 Province Kigali city 22.4 23.0 23.7 21.2 20.7 22.4 South 22.9 23.1 23.4 22.8 22.5 22.9 West 21.2 22.1 21.4 21.6 22.1 21.7 North 21.2 21.4 22.2 21.7 22.1 21.6 East 21.0 21.3 21.3 21.6 21.1 21.2 Education No education 20.8 21.3 21.2 21.3 21.8 21.4 Primary 21.6 22.2 22.3 22.1 22.1 22.0 Secondary or higher 23.9 23.6 24.5 24.0 22.9 23.9 Wealth quintile Lowest 21.4 21.9 22.2 21.5 21.8 21.8 Second 21.0 22.0 21.2 21.9 22.2 21.7 Middle 21.9 21.9 22.2 21.8 21.9 21.9 Fourth 21.7 22.1 21.9 22.1 21.9 21.9 Highest 22.3 22.9 23.2 22.6 21.9 22.7 Total 21.7 22.1 22.2 21.9 22.0 22.0 EENAGE ERTILITY Teenage fertility is an important demographic factor for many reasons. First

14 , children born to very young mothers ru
, children born to very young mothers run a greater risk of illness and death. Second, teenage mothers are more likely to suffer complications during pregnancy and less likely to treat them, exposing them to greater risk of complications during delivery and greater risk of dying for reasons related to childbearing. Third, early childbearing seriously affects a woman’s ability to pursue an education, thereby limiting her job opportunities. In Rwanda, teenagers make up 23 percent of all women of childbearing age, but only 3 percent have had at least one birth. Table 4.9 shows the proportion of teenagers who have already had one or more children, as well as those currently in their first pregnancy. Together these two subgroups make up the proportion of teenagers who have already begun childbearing: 4 percent of young women between the ages of 15 and 19 (3 percent are already mothers; 0.8 percent are pregnant for the first time). At age 15, 0.3 percent of women have begun childbearing, but the percentage increases steadily and rapidly with age: at age 17, 2 percent of women have already had at least one child or are pregnant for the first time. At age 19, this proportion reaches 13 percent, of which 10 percent are those who have already had at least one child. %FNPHSBQIJD
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