Lower infant mortality, higher household size, and more access to contraception reduce fertility in low- and middle-income nations

• DOI: 10.1371/journal.pone.0280260
• Publication Date: 2023-02-22T18:26:46Z
• Authors: Corey J. A. Bradshaw; Claire Perry; Melinda A. Judge; Chitra M. Saraswati; Jane Heyworth; Peter N. Le Souëf
• Keywords: Proxy (statistics); Total fertility rate

Although average contraceptive use has increased globally in recent decades, an estimated 222 million (26%) of women child-bearing age worldwide face unmet need for family planning-defined as a discrepancy between fertility preferences and contraception practice, or failing to translate desires avoid pregnancy into preventative behaviours practices. While many studies have reported relationships availability/quality planning, infant mortality, fertility, these not been evaluated quantitatively across broad range low- middle-income countries. Using publicly available data from 64 countries, we collated test control variables six themes: (i) availability (ii) quality (iii) female education, (iv) religion, (v) (vi) socio-economic conditions. We predicted that higher nation-level family-planning services education reduce whereas greater household size (a proxy population density), religious adherence increase it. Given the sample size, first constructed general linear models each theme, which retained those with highest explanatory power within final model set determine partial correlation dominant variables. also applied boosted regression trees, generalised least-squares models, mixed-effects account non-linearity spatial autocorrelation. On among all found strongest associations access any form contraception. Higher mortality decreased fertility. Female home visitations by health workers, had weak, if any, power. Our suggest decreasing ensuring sufficient housing increasing will greatest effect on global thus provide new evidence progressing United Nation's Sustainable Development Goals reducing can be accelerated planning.