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Factors Behind Recent Fertility Plateauing in Jordan & Challenges to Maintaining Future Fertility Decline by Issa Almasarweh Professor – Jordan University.

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Presentation on theme: "Factors Behind Recent Fertility Plateauing in Jordan & Challenges to Maintaining Future Fertility Decline by Issa Almasarweh Professor – Jordan University."— Presentation transcript:

1 Factors Behind Recent Fertility Plateauing in Jordan & Challenges to Maintaining Future Fertility Decline by Issa Almasarweh Professor – Jordan University

2 Presentation Outlines  Jordan Fertility Trends  Jordan Fertility Goals  Factors Affecting Fertility Rates  Challenges to Sustained Decline in Jordan Fertility

3 Current TFR in the Region Source: 2011 PRB WPDS

4 Jordan Fertility Level is Plateauing DHS

5 Wanted Fertility Increased DHS

6 Early progression to first child 2009 DHS

7 Fertility – a key component in Jordan future PG 3 million born in the last 20 years 2.3 are expected in the next 10 years RECENT09 Constant

8 Reducing Fertility is a National Priority Goal for Jordan Births per couple RHAP2

9 Direct Factors Affecting Fertility Rate 1) % of women married 2) Contraceptive use 3) Postpartum insusceptibility 4) Induced abortion 5) Infertility Fertility

10 (1) Marriage - % of Women Ever-married DHS

11 % Ever-married below the age of 30 years 2002 & 2009 DHS

12 High Growth in Number of First Time Brides (4.3% annually)

13 Early Marriages <18= 14% of total 1 st time brides 15-19= 30% of total 1 st time brides

14 Age Specific Fertility Rates 2002 & 2009 DHS

15 Age Specific Fertility Rates - Urban 2002 & 2009 DHS

16 (2) Contraceptive use has leveled off DHS

17 Modern CPR by Sector -JCLS Based on JCLS

18 Infertility increased = % of women who are childless Based on JCLS

19 Contraceptive Prevalence Rate Total Fertility Rate 65 % 3.0 Contraceptive Use needs to increase ! Fertility Plateauing FamPlan: File RECENT09

20 Summary – Indexes of direct factors affecting fertility

21 Challenges to raise contraceptive use and reduce fertility  Shrinking FP Choices / Access  Missed / Lost Opportunities  Churning – Discontinuation  Others

22 1)Shrinking Choices / Access  Limited access to permanent & long-acting methods : Female Sterilization, Injectables, Implanon  Dominance of one and provider-based method (IUD)  Unmet preference for female providers (87%)  Disappearance of low-price OCs in the commercial sector  Uncertain role of major FP providers (JAFPP, RMS, Universities Hospitals)

23 2) Missed Opportunities  At premarital exam  At time of signing marriage contract  At delivery and postnatal period low postnatal return low postnatal counseling no immediate IUDs insertion after delivery (providers fear of expulsion or lack training)  At child health care visits  At Schools and Colleges  At youth centers, clubs, camps  At Mosques  At Workplace  At pharmacies

24 2) Missing Opportunities  Low demand on available services at SDPs  High downtime at SDPs due to lack of appointment system  Exclusion of FP in private health insurance  Exclusion of important groups: men, newly married, unmarried youth  Unfriendly breastfeeding environment at private hospitals

25 3) Churning – Discontinuation  High FP discontinuation and failure rates – Quality of services - informed choice (poor treatment of side effects; inadequate and poor FP counseling) – High use of traditional methods – Unsatisfied users (20% want another method) – Son Preference – Family pressure (63% DHS)

26 1 st Year Discontinuation Rate (%)

27 Reasons for Discontinuation 42 % Source: Contraceptive Dynamics Study

28 Unmet need for FP use Source : 2009 DHS

29 TFR and Unmet Need and Discontinuation HPC, 2011, Reducing Discontinuation of Contraceptive Use and Unmet Need for FP, policy Briefs

30 4) Other Challenges  Population Momentum – more than one million girl child exists now Number of women years will increase from 1.6 to 2.0 million by 2020 The impact of this is shown in the next slide

31 Projected Contraceptive Users (all methods) Current Users 19 % FamPlan: Files RECENT09 & RECENT09 Constant 42 %

32 4) Other Challenges  Divided civil society- politicalization of issues  Distortion of market forces through subsidies may delay the rationalization of childbearing decision by parents  Abuse of maternity leave by public sector servants


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