Determinants of Fertility Behaviour among Adolescent Reproductive Women in Bangladesh

Rashed Alam Correspondence: Md. Rashed Alam, Assistant Professor, Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi-6205, Bangladesh Email:mrasps_29us@yahoo.com

Abstract Adolescent's reproductive health and fertility behaviour in Bangladesh is in the worst condition. Fertility behaviour among adolescent reproductive women in Bangladesh, using national representative data from the Bangladesh Demographic and Health Survey (BDHS), 2003-2004, allowing for the existence of observed characteristics that affect both adolescent reproductive women and fertility was studied. The study pertains to 1,703 ever married adolescent women in the reproductive age group (10-19). The challenges and risks the young people face during this period impact directly on their physical and emotional mental wellbeing. The reduction of fertility is one of the major problems of developing countries in the world and Bangladesh is one of them. The purpose of this study is to identify the effects of various socio-economic and demographic variables on fertility in six divisions of Bangladesh. Multivariate analysis, such as multiple classification analysis, has been used to identify the important determinants of children ever born. The study result shows that various socio-economic and demographic variables affect on adolescents fertility. These are adolescent's education, place of residence, religion, working status, breast feeding etc. An inverse relation is found between age at marriage, and fertility. Results show that fertility is highest in rural areas than that of urban areas. Divisional difference reveals that fertility is highest in Chittagong division and lowest in Khulna division among the adolescent mothers. This also indicated that the total fertility rate decreased about 10% from 1999/00 to 2003/04 respectively. Keywords: Fertility behaviour, Adolescent reproductive women, Multiple Classification Analysis and Bangladesh.

INTRODUCTION
Young people do not live in isolation. Much of what they do is determined by what others do including the leading adults in their families, in their communities and in health and education programs in the workplace and in policy and lawmaking positions Nurul M. I. (1995). One third of the world's population is between the age of 10 to 24 and four out of five of these young people live in the developing countries. They form a great pool of resources for humanity with their energy, idealism and fresh views. But at the same time, they can be quite vulnerable to the fast changes taking place around them. The tremendous flow of population towards the cities, the spread of telecommunications across cultural and geographic boundaries, increased traveling, a generally earlier beginning of puberty and a later age at marriage, a decrease in the influence and strength of the family as an institution, the advent of AIDS, increase in violence and easier access to potentially harmful tobacco, alcohol and other drugs, have significant impacts on the behaviour and health of young people. The International Conference on Population and Development (ICPD) held in Cairo in 1994 also emphasized the special needs of adolescents and youth. Since, then government and non-government organizations carried out some activities that are related to certain aspects of adolescents' health. The aim of this study is to isolate which factors under consideration contribute of the selected factors influencing fertility of adolescent reproductive women.

Fertility Phenomena in Bangladesh
Fertility refers to an actual reproductive performance of a woman or group of women. Fertility in Bangladesh is high even by the standards of developing nations. Although teenage fertility rates were declining throughout the late 1960s and early 1970s, their reproductive behavior emerged as a major social and health concern. Teenage mothers are more likely to suffer from severe complications during delivery, which result in higher morbidity and mortality for both themselves and their children. In addition, young mothers may not be sufficiently emotionally mature to bear the burden of childbearing and rearing. Early entry into reproduction denies them the opportunity to pursue academic goals. This is detrimental to their prospects for good careers, which often lowers their status in society. Bangladesh has been passing through a critical phase of fertility transition. The level of fertility started to decline since the mid-seventies. The decline occurred at a rapid pace during the period 1975 to 1993/94. The total fertility rate was 6.3 in 1975 and decreased to 3.4 in 1993/94. However, since 1993/94, the level of total fertility appears to be unchanged at a level of 3.3, as observed from the BDHS 1996/97 and 1999/2000 results. However, during the period 1993/94 and 1999/2000, the contraceptive prevalence rate has increased substantially from 44.6 per cent to 53.8 per cent. Bangladesh demography and health survey (BDHS, 2004) shows that, one-third of adolescents age 15-19 in Bangladesh has begun childbearing. Twenty-eight percent of these teenagers in Bangladesh have given birth, and another 5 percent are pregnant with their first child. As expected, the proportion of women age 15-19 who have begun childbearing rises rapidly with age. Early childbearing among teenagers is more prominent in rural areas, compared with urban areas in Rajshahi and Khulna divisions, compared with other divisions. Childbearing begins later in Sylhet, compared with the rest of the other divisions, mainly because of relatively late marriage in Sylhet. Delayed childbearing is strongly related to education among women age 15-19. Only 16 percent of the teenagers who had completed secondary education had begun childbearing, compared with almost half of those with primary incomplete or no education. Childbearing begins earlier among adolescents in the poorest 40 percent of the households; in these households, four out of ten adolescents have begun childbearing. In contrast, three out of ten of the adolescents in the richest 20 percent of the households either have had births or are pregnant with their first child. Some researchers strongly believe that family planning programs played the main role in the rapid fertility decline that occurred in less developed countries in the 1980s and 1990s.


Table 1: Trends in Total Fertility Rate (TFR) by Divisions, and Percent Change for the Period 1993/94-2003/2004, Bangladesh

During late 1980's to early 1990's all the divisions in Bangladesh experienced a more or less uniform decline in fertility. Even in Chittagong division, having the highest fertility in the mid-1980s, which is still continuing, the rate of decline was almost identical in magnitude as compared to that of the other divisions. However, since 1993/94 the decline in fertility is not uniform across the regions. During the period 1993/94 -1996/97, Chittagong division shows increase in fertility level by about 3 per cent, while all other divisions show some decline in fertility.

Click here for Figure 1: Trends in Total Fertility Rate (TFR) by Divisions for the Period 1993/94-2003/2004, Bangladesh

The magnitude of decline was higher in Khulna (17.4%) followed by Rajshahi (8.3%), Dhaka (7.8%) and Barisal (4.6%) during the period 1993/94 to 1996/97. On the other hand, during the period 1996/97 to 1999/00 fertility has increased in low fertility regions Khulna and Rajshahi and also in Dhaka, but declined in Barisal and Sylhet. During the period 1999/00 to 2003/04 total fertility rate declined in Rajshahi (13.9) and Barisal (11.04) divisions and increased in a low rate in Khulna(3.7) and Sylhet (2.94) divisions. Between 1999-2000 BDHS and the 2004 BDHS, the proportion of adolescents age 15-19 who had begun childbearing declined slightly, from 35 to 33 percent. The total fertility rate in Bangladesh declined from 5.12 in 1989 to 3.44 in 1993/94 and remained constant thereafter. The total marital fertility rate showed a steady decline from 5.54 in 1989 to 3.81 in 1996/97. However, the rate appears to have increased to 3.94 in 1999/2000.

Data Sources and Methodology
The data for the present study have been taken from Bangladesh Demographic and Health Survey (BDHS), 2003-2004 which is a nationally representative survey of 11,440 women aged 10-49 and 4297 men aged 15-54 from 10,500 households covering 361 sample points (clusters) throughout Bangladesh; 122 in urban areas and 239 in rural areas. This survey is the fourth in a series of national-level population and health surveys conducted as part of the global Demographic and Health Surveys (DHS) program. It was selected from the master sample maintained by the Bangladesh Bureau of Statistics (BBS) for the implementation of the surveys before the next census (2001). It is designed to provide data to monitor the population and health situation in Bangladesh as a follow-up to the 1993-94, 1996-97 and 1999-2000 BDHS surveys. Previous surveys included only ever-married women and currently married men; this is the first DHS survey in Bangladesh to also include never-married men; i,e., the sample for the survey was ever-married women age 10-49 and all men age 15-54.

Methodology: There are a variety of socio-economic and cultural factors that may influence fertility among the adolescent's reproductive women. To examine the differential patterns of mean number of children ever born among adolescents, the well known Multiple Classification Analysis (MCA) is employed. Multiple Classification Analysis (MCA) requires one dependent variable and two or more independent variables. The dependent variable can be either a continuous or a categorical variable but all the independent variables must be categorical variables. MCA can equally handle the nominal and ordinal variables and can also deal with linear and non-linear relationships of predictor variables with dependent variables (Andrew F.M., James N.M., John S. and Laurak K., 1973).

Mathematically, the model can be expressed by the following equation:



where,

is the value or score of an individual who falls in the i th category of the of factor A, j th category of the factor B and k th category of the factor.

y is the grand mean of Y.

is the effect due to the i th category of the factor A, which is equal to the difference between y and the mean of its category of factor A.

is the effect due to j th category of the factor B, which is equal to the difference between y and the mean of its category of the factor B.

is the effect due to the k th category of the factor C, which is equal to the difference between y and the of its category of factor C.

is the error related with Yijk score of the individuals.

In order to assess the intensity of working status of women on their age at marriage and children ever born per ever-married women, multiple classification analysis (MCA) is adopted. The co-efficient h2 and b2 obtained from MCA respectively provide the unadjusted and adjusted coefficients. While h2 shows how well a single predictor explains variation in age at marriage and b2 shows the proportion of variation explained by a predictor taking into account the proportion explained by the other predictors. In this study the multiple classification analysis is undertaken first to evaluate the contribution of socio-economic and demographic variables such as respondent's education, husband's occupation, place of residence, religion, ownership of electricity, respondents working status, access to mass media, region, partner's working status and age at marriage on children ever born. In this case children ever born are taken to be the dependent variable and socio-economic and demographic variables as explanatory variables. All the socio-economic and demographic variables are the categorical variables. They are included in MCA in the fashion of the following table.


Table 2: Variables and Categories Used in the Multiple Classification Analysis

Results and Discussions
The result indicates that the proportions of variance explained by MCA are not very high for women (Multiple R2). The low value of R2 may be due to some interrelations among the predictor variables considered here or there may be some other factors, which may affect the mean number of children ever born.


Table 3: Results of Multiple Classification Analysis of Children Ever Born per Ever-Married Adolescents by Some Selected Socio-economic and Demographic Characteristics, 2004 BDHS Data

Table 3 shows the mean number of children ever born both unadjusted and adjusted by different socio-economic and demographic characteristics with the values of h2 and b2 produced from multiple classification analysis with data of 2004 Bangladesh Demographic and Health Survey (BDHS). Here divisions, respondent's education, husband's education, husband's working status, place of residence, ownership of electricity, mass-media communication, religion, age at marriage, husband's occupation and work status of respondents are considered as the determinants of children ever born.

Among the selected factors respondent's education is one of the most effective. It is important to note that highly educated adolescents have been found to have lower fertility. Findings indicate that educational attainment has strong association (h2=0.161) with mean number of children ever born. But the effects of educational level remain low even after adjusting for the effect of all other predictors in the model (b2=0.065). The mean number of children ever born was 0.74 for adolescent women who were illiterate and 0.55 for highly educated adolescent women. It may be that educated adolescents marry later and had lower fertility within marriage.

Husband's education seems to be a less effective factor than adolescent women's education in explaining the variation in mean number of children ever born among adolescent women (h2 =0.160, b2 =0.065). The adolescent women of higher educated husbands had the mean number of children ever born as 0.64 while it was 0.72 for illiterate husbands. Another socioeconomic variable that emerges from the literature as an important influence on fertility behavior is place of residence. Respondents with an urban residence have lower fertility than their rural counterparts. We find that place of residence has a low effect on mean number of children ever born (h2 =0.013). The mean number of children ever born (adjusted) in rural and urban areas, were 0.66 and 0.64 respectively. This may be due to the fact that adolescents in urban areas had later marriage, higher level of real income, better health services, educational facilities, and employment opportunities in the modern sector.

It is observed that Khulna division had the lowest number of children ever born (0.58) and Chittagong division the highest (0.77). Sylhet (0.71), Dhaka (0.64), Rajshahi (0.63) and Barisal (0.59), was the next to the level of Chittagong. Region becomes less important (h2 =0.078 and b2 =0.094) for adolescents when other socio-economic factors were controlled.

Muslim community has higher fertility than their non-Muslims counterparts. It may be due to the religious value systems, which influence individuals. Mean children ever born were 0.65 and 0.63 respectively for Muslim and non-Muslims community. Religion becomes less important (h2 =0.012 and b2 =0.009) for adolescents when other socio-economic factors were controlled.

The work status of adolescents also shows a substantial effect on childbearing. Children ever born on the average was higher for non-working adolescents than working adolescents. Though the difference was not remarkable, still working adolescent women have produced a smaller number of children than the non-working group. Results show that mean number of children ever born was .63 those who did work and .65 those who did not work. For adolescent women work status also had a low effect on children ever born (h2 =0.014 and b2 =0.009).

Ownership of electricity shows least effect on children ever born. It is observed that mean (adjusted) children ever born were 0.69 and 0.62 respectively for "without electricity in the household" and "having electricity in the household". For adolescent women ownership of electricity also had a low effect on children ever born (h2 =0.044 and b2 =0.047).

The average number of children ever born decreases with the increased access to mass media. It is observed that mean (adjusted) children ever born per ever married adolescent women were 0.66 and 0.61 respectively for no access to media and access to media. It has less importance on children ever born (h2 =0.086 and b2 =0.032).

It has been observed from the Table 4.16, where the mean number of children ever born varies very high between husband's working status. Also Table 4.16 shows mean number of children born per ever married adolescents 0.38 for working and 0.66 for non-working occupations in their husbands. It has less importance on children ever born (h2 =0.076 and b2 =0.060).

Age at marriage has a direct affect on fertility and it is the most influential variable than all other variables. There exists an inverse relation between age at marriage and fertility which is the higher age at marriage, the lower number of children ever born. Adolescent women who were married at fewer than 14 years had on average .81 children; women who were married 15 to 19 years had on average 0.44 children. The effect of place of residence remains strong (h2 =0.280 and b2 =0.264) when other socio-economic variables are controlled.

Conclusion
The result deserves considerations from the viewpoint of policy implication. It has been found that the total effect of marital status has direct negative influence on fertility in almost all divisions. Thus rising age at marriage by implementing a minimum-age law may lower fertility, and breast-feeding may also indicate lower fertility since at that time adolescent women are risk free from reproduction. Adolescent's education and age at first marriage are one of the most important correlates which effect and are the strongest for explaining the variability in children ever born. Although the average level of education is very low, education still has a strong negative relationship with children ever born. The husband's education is also important but not as strong as adolescent women's education. Mass media and working status of adolescent women is also important, affecting the children ever born. Other variables also have some importance on reducing fertility such as religion, region and electricity facility etc.

From the above analysis we have observed that, total effect of female education on fertility is found to be negative. Education may provide better employment opportunities outside home and age at marriage can be raised through providing education. Based on the results it may be suggested that attention should be focused on the need for providing educational facilities, particularly in rural areas in order to depress the level of fertility in Bangladesh.

REFERENCES
Andrew F.M., James N.M., John S. and Laurak K. (1973) "Multiple Classification Analysis (2nd Ed.)", Ann Arbor Institute for Social Research, University of Michigan.
Ahmed. (1982). " Differential Fertility in Bangladesh: A Path Analysis", Social Biology, Vol. 28, No. 1-2, Pp. 102-110.
Amin R. and R. Faruqee (1980) "Fertility and its Regulation in Bangladesh", Washington D.C.
Balakrishanan, G.E Ebanks and C.F. Grinstaff (1979). "Patterns of Fertility in Canada". 1971 Census Analytical Study, Ottawa: Statistics of Canada. BDHS (1999-2000). Bangladesh Demographic and Health Survey 1999-2000, Institute of Population Research and Training (NIPORT), Dhaka, Bangladesh.
Dixon, R (1971). "Explaining Cross-Cultural Variation in Age at Marriage and Proportion Never Marriage". Population Studies, Vol. 25 No. 2.
MacDonald P. (2000). "Gender Equity in Theories of Fertility Transition". Paper Presented at Meeting of the Population Association of America, Los Angeles.
M.N. Islam and I.U. Ahmed, (1998). Age at First Marriage and its Determination in Bangladesh. Asia Pacific Population Journal Vol. 13, No. 2, June 1998.
Mitra, S. N., Ali, M. N., Islam, S., Cross, A. R. & Saha, T. (1994) "Bangladesh Demographic and Health Survey 1993-94". Mitra and Associates, Dhaka.
Mitra, S.N., Ahmed, A. S., Anne, R. C. & Kanta J. (1997) "Bangladesh Demographic and Health
Survey, 1996-97". (Calverton, Maryland, Macro International Inc.; Dhaka, National Institute of
Population Research and Training and Mitra and Associates).
Mitra, S. N., Ahmed, A. Saha, T. & Kumar, S. (2001) "Bangladesh Demographic and Health Survey, 1999-2000". NIPORT, Dhaka, Bangladesh, Mitra Associates, Dhaka, Bangladesh.
Nurul M. I. (1995) "Fertility and Reproductive Health Status of Married. Adolescents in Rural Bangladesh", IMED-PDEU.
United Nations (1985). "Women Employment and Fertility: Comparative Analysis of World Fertility Survey Results for 38 Developing Countries". Population Studies Series No. 96, New York.
UNFPA (1994) "International Conference on Population and Development", Cairo 1994.