Correlates of High Risk Fertility Behaviour in Ethiopia: A Multilevel Analysis of the 2011 Ethiopian Demographic and Health Survey Data

Abstract

High risk fertility is one of the main public health concerns in Ethiopia.  This study examines factors affecting high risk fertility (i.e. child birth at early (less than 18 years) and late (greater than 35 years), birth taking place within shorter birth interval (less than 24 months) and too many births (greater than four children)) based on last births taking place in the five years preceding the 2011 demographic and health survey data of Ethiopia collected among women in the age group 15–49 years. Percentage distribution was used to describe the data while a multilevel logistic regression model was fitted to identify the predictors of high risk fertility behaviour. The result shows that 58.7% of Ethiopian women were experiencing high risk fertility with considerable variation among the rural (62.1%) and urban (39.5%) residents. The likelihood of exposure to high risk fertility was significantly lower among educated women and those having high perception of HIV risk assessment but higher among that experiencing child loss and living in Somali region. The results generally indicate that high risk fertility behaviour in Ethiopia is partly explained by respondents’ educational attainment, survival status of children born to a woman, region of residence and neighbourhood factors that shape the perception of women about their exposure to risky situations. Awareness raising efforts should thus consider the socio-cultural contexts in which behavioural change occurs to tackle exposure to high risk fertility in addition to promoting the status of women to reduce their dependency on offspring at later ages.

Keywords: High risk, fertility, child loss, Ethiopia