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Sierra Leone launched the Free Health Care Initiative, which abolished health user fees for pregnant and breastfeeding women and children under five years of age, in 2010. Combining data from the Demographic and Health Survey and a geocoded dataset for the distribution of public health facilities, I design a difference-in-differences study involving birth timing and transportation cost to investigate its impact on infant mortality and desired fertility. I find that the program does not achieve its goal of reducing infant mortality, with the lack of vaccination being a major problem. Notwithstanding the lack of reduction in infant mortality, the program leads to a significant decline in desired fertility, implying that parents may overestimate the program's benefits and change their expectations of infant mortality accordingly. Heterogeneous effects by household wealth suggest that poor households are more adversely affected by the program than wealthy ones. [ABSTRACT FROM AUTHOR]

Postponement of first births is a key cause of declining fertility rates, especially in East Asia where recovery from delayed childbearing has been weak. This paper investigates achievement of ideal ages at marriage and first birth in Singapore using survey data on 657 married women aged 25–34. Almost 50 per cent marry within one year of their ideal age, but less than 30 per cent have their first child within six months of their ideal interval to first birth, with around 50 per cent waiting longer than ideal. The high proportion of women experiencing a longer-than-ideal first birth interval was observed across all age and educational groups. Regression results show that co-residence with a foreign domestic worker and paid leave entitlements are associated with higher probability of achieving their ideal first birth interval, whereas availability of parents/in-laws, husband's help and unpaid leave do not reduce time to childbearing. [ABSTRACT FROM AUTHOR]

This paper examines the long-term effects of birth cohort size on life outcomes. Using administrative data from Singapore, we study the outcomes of large birth cohorts created by the Chinese superstitious practice of zodiac birth timing, where parents prefer to give birth in the year of the Dragon. This practice is followed exclusively by the Chinese majority, with no similar patterns detected among non-Chinese minorities, allowing us to differentiate cohort size effects from confounding year-of-birth effects. Despite government efforts to increase public educational resources for these cohorts, Chinese Dragons earn lower incomes and are less likely to gain admission to national universities. There is also evidence of negative externalities on non-practising populations who happen to enter the labour market at the same time as Chinese Dragons. Our analysis suggests that the adverse life outcomes are not due to selection, but rather reflect the aggregate resource implications of birth cohort size. Supplementary material is available for this article at: [ABSTRACT FROM AUTHOR]

We analysed population data from the 2015–16 National Family Health Survey to disentangle the intricate underlying effects of reproductive behaviours and fertility preferences on child growth. We expected birth interval length to be more strongly associated with stunting than sibsize and these effects to be moderated by whether the child was wanted or unintended (mistimed/unwanted). Regression analyses showed strong and equal effects of short birth interval and sibsize on stunting, when adjusted for potential confounders and unobserved between-mother heterogeneity. There were no statistical associations between stunting and mistiming/unwantedness of index children, suggesting the absence of discrimination against such children. We conclude that while fertility preferences have no effect, reproductive behaviours exert significant influence on child growth. Sibsize has been falling for many years in India but birth interval lengths have remained largely unchanged. The results underscore the need for strengthening uptake of reversible contraceptives to enable longer birth intervals. [ABSTRACT FROM AUTHOR]

This study focused on the effects of the neighbourhood on the fertility outcomes among marriage immigrant wives in Taiwan. In particular, we investigated the effects of the proportion of marriage immigrants in the neighbourhood and ethnic composition of the neighbours on fertility behaviours of foreign wives. The study further explored whether and to what extent commercialised cross-border marriages moderate the relationships. Micro-data from the 2013 Living Demand of Foreign and Mainland Spouses and administrative data for 21 cities and counties were utilised in this study. We found that immigrant wives in an area with a higher proportion of marriage immigrants were likely to have higher fertility and shorter intervals between births. Immigrant wives who married through a broker were likely to have lower fertility if they were living in a neighbourhood with a higher proportion of marriage immigrants. The proportion of immigrants from Mainland China in the neighbourhood was negatively associated with fertility among immigrant wives from Mainland China. [ABSTRACT FROM AUTHOR]

We examine pathways between indicators of fertility tempo/quantum and depressive symptoms among parents aged 55+ with at least two children, using three waves of the English Longitudinal Study of Ageing. Using standard regression approaches and path analysis within the structural equation framework, we also investigate whether fertility trajectories mediated the association between childhood disadvantage and later-life depression. Results provide limited support for direct influences of fertility trajectories on depression, but indicate indirect linkages for both women and men. Associations are mediated by partnership history, social support, wealth, later-life smoking, and functional limitation. Associations between childhood disadvantage and later-life depression are partially mediated by fertility stressors. Results confirm the influence of life course experiences on depression at older ages and demonstrate the interlinked role of family and other life course pathways on later-life well-being. [ABSTRACT FROM AUTHOR]

The two fertility stalls that occurred in Bangladesh emerged as substantial barriers in controlling its burgeoning vast population. The first stall occurred during 1996–2000 in the mid-transition of fertility, while the second stall occurred during the recent period 2011–2014 in the late transition of fertility. This article explores the role of proximate determinants in those stalls by using the data of Bangladesh Demographic and Health Surveys. Data have been analyzed using proximate determinants model and a descriptive analysis technique. Findings show that contraceptive use and induced abortion are the main drivers of fertility transition in Bangladesh. Both stalls in Bangladesh are found to be associated with a stall in induced abortion. In addition, declining postpartum infecundability plays a vital role in setting first stall. At the end of this stall, composition of contraceptive use is also found less efficient. While, declining fertility-inhibiting effect of marriage and a marginal increase in contraceptive use are the additional factors that play key roles in setting second stall. The mixture of contraceptive use shows a shift to a more efficient composition in the recent years. Change in the timing of birth does not show any consistent link with any of the fertility stalls. [ABSTRACT FROM AUTHOR]

This paper describes a method to reconstruct birth histories for women in the 1900 and 1910 U. S. census IPUMS samples. The method is an extension of an earlier method developed by Luther and Cho (1988). The basic method relies on the number of children ever born, number of children surviving, number of children coresident in the household and age-specific fertility rates for the population to probabilistically assign an "age" to deceased and unmatched children. Modifications include the addition of an iterative Poisson regression model to fine-tune age-specific fertility inputs. The potential of birth histories for the study of the U.S. fertility transition is illustrated with a few examples. [ABSTRACT FROM AUTHOR]

There is still considerable uncertainty about how reproductive factors affect child mortality. This study, based on Demographic and Health Survey data from 28 countries in sub-Saharan Africa, shows that mortality is highest for firstborn children with very young mothers. Other children with young mothers, or of high birth order, also experience high mortality. Net of maternal age and birth order, a short preceding birth interval is associated with above average mortality. These patterns change, however, if time-invariant unobserved mother-level characteristics of importance for both mortality and fertility are controlled for in a multilevel-multiprocess model. Most importantly, there are smaller advantages associated with longer birth intervals and being older at first birth. The implications of alternative reproductive 'strategies' are discussed, taking into account that if the mother is older at birth, the child will also be born in a later calendar year, when mortality may be lower [ABSTRACT FROM AUTHOR]

Background: Recent steep declines in child mortality have been attributed in part to increased use of contraceptives and the resulting change in fertility behaviour, including an increase in the time between births. Previous observational studies have documented strong associations between short birth spacing and an increase in the risk of neonatal, infant, and under-five mortality, compared to births with longer preceding birth intervals. In this analysis, we compare two methods to estimate the association between short birth intervals and mortality risk to better inform modelling efforts linking family planning and mortality in children. Objectives: Our goal was to estimate the mortality risk for neonates, infants, and young children by preceding birth space using household survey data, controlling for mother-level factors and to compare the results to those from previous analyses with survey data. Design: We assessed the potential for confounding when estimating the relative mortality risk by preceding birth interval and estimated mortality risk by birth interval in four categories-less than 18 months, 18-23 months, 24-35 months, and 36 months or longer. We estimated the relative risks among women who were 35 and older at the time of the survey with two methods- in a Cox proportional hazards regression adjusting for potential confounders and also by stratifying Cox regression by mother, to control for all factors that remain constant over a woman's childbearing years. We estimated the overall effects for birth spacing in a meta-analysis with random survey effects. Results: We identified several factors known for their associations with neonatal, infant, and child mortality that are also associated with preceding birth interval. When estimating the effect of birth spacing on mortality, we found that regression adjustment for these factors does not substantially change the risk ratio for short birth intervals compared to an unadjusted mortality ratio. For birth intervals less than 18 months, standard regression adjustment for confounding factors estimated a risk ratio for neonatal mortality of 2.28 (95% confidence interval- 2.18-2.37). This same effect estimated within mother is 1.57 (95% confidence interval- 1.52-1.63), a decline of almost one-third in the effect on neonatal mortality. Conclusions: Neonatal, infant, and child mortality are strongly and significantly related to preceding birth interval, where births within a short interval of time after the previous birth have increased mortality. Previous analyses have demonstrated this relationship on average across all births; however, women who have short spaces between births are different from women with long spaces. Among women 35 years and older where a comparison of birth spaces within mother is possible, we find a much reduced although still significant effect of short birth spaces on child mortality. [ABSTRACT FROM AUTHOR]

Birth spacing is of considerable importance to study the tempo and quantum of fertility. Using data from the National Family Health Survey III, this study explored the birth interval dynamics in Odisha, an eastern state of India. The life table analysis of spacing between births clearly suggests that birth spacing in the recent past has increased and the proportion of women moving to the second, third, and fourth parity has declined, leading to the decline in fertility in Odisha. From the proportional hazards model, educational level of women, age of women at previous birth, sex and survival status of the previous child, and the period effect are found to be important determinants of birth spacing at higher parities. Socioeconomic differences do not show a large effect at lower order births. This highlights the fact that most women in Odisha, regardless of their background characteristics, tend to have second births. [ABSTRACT FROM AUTHOR]

Background: Although there are significant numbers of people displaced by war in Africa, very little is known about long-term changes in the fertility of refugees. Refugees of the Mozambican civil war (1977-1992) settled in many neighbouring countries, including South Africa. A large number of Mozambican refugees settled within the Agincourt sub-district, underpinned by a Health and Socio-demographic Surveillance Site (AHDSS), established in 1992, and have remained there. The AHDSS data provide a unique opportunity to study changes in fertility over time and the role that the fertility of self-settled refugee populations plays in the overall fertility level of the host community, a highly relevant factor in many areas of sub-Saharan Africa. Objectives: To examine the change in fertility of former Mozambican self-settled refugees over a period of 16 years and to compare the overall fertility and fertility patterns of Mozambicans to host South Africans. Methods: Prospective data from the AHDSS on births from 1993 to 2009 were used to compare fertility trends and patterns and to examine socio-economic factors that may be associated with fertility change. Results: There has been a sharp decline in fertility in the Mozambican population and convergence in fertility patterns of Mozambican and local South African women. The convergence of fertility patterns coincides with a convergence in other socio-economic factors. Conclusion: The fertility of Mozambicans has decreased significantly and Mozambicans are adopting the childbearing patterns of South African women. The decline in Mozambican fertility has occurred alongside socio-economic gains. There remains, however, high unemployment and endemic poverty in the area and fertility is not likely to decrease further without increased delivery of family planning to adolescents and increased education and job opportunities for women. [ABSTRACT FROM AUTHOR]

The probability distribution of parity-specific closed birth intervals in a heterogeneous population of women is obtained from Biswas' (1980) concept of gradually decreasing fecundabilities. The distribution of parity-specific last closed birth intervals and its moments of various orders are derived for a heterogeneous female population. Simulations are used to compare with models for a homogeneous female population with constant fecundability. The consideration of heterogeneity allows a better fit for empirical closed birth intervals. [ABSTRACT FROM AUTHOR]

High parity has been hypothesised to lead to a shorter and less healthy life. Using the 2007 Taft Ageing Health and Fertility Survey consisting of 696 women aged 50–79, this paper examines the extent to which women's health in middle and older ages is affected by their childbearing histories. The results show that high parity (>8) is associated with a reduction of GP-rated health by 0.094 points on a scale from 1 to 10. These health reductions are four times as large as those of an extra year of age, and are robust to controlling for birth interval, age, area of residence, education, marital status, work history, economic satisfaction and surviving daughters. There is a positive but curvilinear relationship between shorter birth intervals (<2 years) and GP-rated health accounting for socio-demographic factors. Our analysis suggests that parity and birth intervals, along with socio-demographic characteristics, affect women's well-being in later life. [ABSTRACT FROM AUTHOR]

It has often been argued that there are good theoretical and historical reasons to expect that deliberate birth spacing has played an important role in fertility patterns before the demographic transition. Yet, it has proved difficult to find hard empirical evidence. In this article, we propose a new model of the speed of parity progression that includes both fixed and random effects and that efficiently captures unobserved heterogeneity between couples in fecundability and postpartum amenorrhea. With this model, we demonstrate that pre-transition couples in the Netherlands indeed spaced their births during about the first ten years of marriage. In addition, we have found strong differentials in birth intervals by socio-economic position and religion. Finally, we also show how and why the model can be used with left-censored census data. ☆ An earlier version was presented at the XXV International Population Conference (IUSSP), Tours, France, July 2005. [ABSTRACT FROM AUTHOR]

Background: The Wenger Mennonites, a traditional horse-and-buggy group, are one of at least 30 embedded Anabaptist religious groups in the USA. Aim: This first study of Wenger fertility documents, explains, and compares Wenger fertility to three other Anabaptist groups: the Amish, the Hutterites, and the Old Colony Mennonites. Subjects and methods: The 1997 Wenger church directory provides household and fertility data for 14 530 individuals. This directory was transformed into an SPSS database so that age-specific birth rates could be analysed. Results: From 1966 to 1996, total fertility ranged from 10.68 to 8.31 for married women, and age-specific fertility rates for 20-24-year-old women never dropped below 0.500. For similar time periods, no higher rates were found in any of the comparison groups. Even so, fertility has dropped over 22% in the last 30 years, suggesting increasing regulation of fertility. Conclusion: Wenger fertility has been very high, at least since the 1960s, and continues to be higher than the comparison groups, even though there is some evidence of fertility decline, especially in older women. This high fertility is powered by high economic and social capital, and a farming community with a strong pro-natalist ideology. [ABSTRACT FROM AUTHOR]

Objectives: In Pakistan, the role of men has always been considered to dominate in the decision-making process pertaining to women's fertility and birth spacing. This study was done to explore men's knowledge, perceptions and behavior on various reproductive health issues.Methods: A cross-sectional survey was carried out among 180 married adult males in 12 rural districts of Pakistan in 2000. The study was qualitative, utilizing tools such as in-depth and key-informant interviews.Results: The findings pointed out gaps in knowledge and misconceptions among men on a range of reproductive health issues and stress the need for health education. The findings suggest that strategies such as couple counseling, door-to-door campaigns by village-based male family planning workers and small group meetings could be effective. This study indicates a pressing need for incorporating effective intervention strategies, both at the community and the clinic level, backed with efficient counseling, motivation, and provision of services with appropriate education of males in rural areas.Conclusion: The findings suggest that investment into promotion of healthy fertility control practices among men will be effective in the near future, as they are interested in acquiring new knowledge and are willing to become partners. [ABSTRACT FROM AUTHOR]

Seasonal patterns of five measures of reproduction in a population of married women are considered: marital fertility rate, pregnancy prevalence, mean open birth interval, mean closed birth interval-birth, and mean closed birth interval-woman. In a model the fertility rate is assumed to follow a known trigonometric curve; then the lag and relative variability of the other measures are considered in comparison with the fertility rate curve. The predictions from this theoretical work, when compared with observed patterns and trigonometric regression results for each measure in data from Bangladesh, are shown to be quite accurate. Implications for fertility analyses are discussed. [ABSTRACT FROM AUTHOR]